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Otolaryngology--head and Neck Surgery :... Jun 2024Operating room (OR) sounds may surpass noise exposure thresholds and induce hearing loss. Noise intensity emitted by various surgical instruments during common pediatric...
OBJECTIVE
Operating room (OR) sounds may surpass noise exposure thresholds and induce hearing loss. Noise intensity emitted by various surgical instruments during common pediatric otolaryngologic procedures were compared at the ear-level of the surgeon and patient to evaluate the need for quality improvement measures.
STUDY DESIGN
Cross-sectional study.
SETTING
Single tertiary care center.
METHODS
Noise levels were measured using the RISEPRO Sound Level Meter and SoundMeter X 10.0.4 at the ear level of surgeon and patient every 5 minutes. Operative procedure and instrument type were recorded. Measured noise levels were compared against ambient noise levels and the Apple Watch Noise application.
RESULTS
Two hundred forty-two total occasions of noise were recorded across 62 surgical cases. Cochlear implantation surgery produces the loudest case at the ear-level of the patient (91.8 Lq Peak dB; P < .001). The otologic drill was the loudest instrument for the patient (92.1 Lq Peak dB; P < .001), while the powered microdebrider was the loudest instrument for the surgeon (90.7 Lq Peak dB; P = .036). Noise measurements between surgeon and patient were similar (P < .05). Overall agreement between the Noise application and Sound Level Meter was excellent (intraclass correlation coefficient of 0.8, with a 95% confidence interval ranging from 0.32 to 0.92).
CONCLUSION
Otolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise-related hearing loss. Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long-term hearing conservation.
DISCUSSION
Otolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise-related hearing loss. The duration, frequency of exposure, and volume levels of noise should be studied further.
IMPLICATIONS FOR PRACTICE
Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long-term hearing conservation.
PubMed: 38881393
DOI: 10.1002/ohn.857 -
Redox Biology Aug 2024The ABCC1 gene belongs to the ATP-binding cassette membrane transporter superfamily, which plays a crucial role in the efflux of various endogenous and exogenous...
The ABCC1 gene belongs to the ATP-binding cassette membrane transporter superfamily, which plays a crucial role in the efflux of various endogenous and exogenous substances. Mutations in ABCC1 can result in autosomal dominant hearing loss. However, the specific roles of ABCC1 in auditory function are not fully understood. Through immunofluorescence, we found that ABCC1 was expressed in microvascular endothelial cells (ECs) of the stria vascularis (StV) in the murine cochlea. Then, an Abcc1 knockout mouse model was established by using CRISPR/Cas9 technology to elucidate the role of ABCC1 in the inner ear. The ABR threshold did not significantly differ between WT and Abcc1 mice at any age studied. After noise exposure, the ABR thresholds of the WT and Abcc1 mice were significantly elevated. Interestingly, after 14 days of noise exposure, ABR thresholds largely returned to pre-exposure levels in WT mice but not in Abcc1 mice. Our subsequent experiments showed that microvascular integrity in the StV was compromised and that the number of outer hair cells and the number of ribbons were significantly decreased in the cochleae of Abcc1 mice post-exposure. Besides, the production of ROS and the accumulation of 4-HNE significantly increased. Furthermore, StV microvascular ECs were cultured to elucidate the role of ABCC1 in these cells under glucose oxidase challenge. Notably, 30 U/L glucose oxidase (GO) induced severe oxidative stress damage in Abcc1 cells. Compared with WT cells, the ROS and 4-HNE levels and the apoptotic rate were significantly elevated in Abcc1 cells. In addition, the reduced GSH/GSSG ratio was significantly decreased in Abcc1 cells after GO treatment. Taken together, Abcc1 mice are more susceptible to noise-induced hearing loss, possibly because ABCC1 knockdown compromises the GSH antioxidant system of StV ECs. The exogenous antioxidant N-acetylcysteine (NAC) may protect against oxidative damage in Abcc1 murine cochleae and ECs.
Topics: Animals; Mice; Multidrug Resistance-Associated Proteins; Cochlea; Hearing Loss, Noise-Induced; Mice, Knockout; Antioxidants; Oxidative Stress; Disease Models, Animal; Reactive Oxygen Species; Endothelial Cells
PubMed: 38870779
DOI: 10.1016/j.redox.2024.103218 -
Cureus May 2024Aerosol mitigation equipment implemented due to COVID-19 has increased noise levels in the operating room (OR) during otolaryngological procedures. Intraoperative sound...
INTRODUCTION
Aerosol mitigation equipment implemented due to COVID-19 has increased noise levels in the operating room (OR) during otolaryngological procedures. Intraoperative sound levels may potentially place personnel at risk for occupational hearing loss. This study hypothesized that cumulative intraoperative noise exposures with aerosol mitigation equipment exceed recommended occupational noise exposure levels.
METHODS
Sound levels generated by the surgical smoke evacuator (SSE) during adenotonsillectomy were measured using a sound level meter and compared to surgery without SSE.
RESULTS
Thirteen adenotonsillectomy surgeries were recorded. Mean sound levels with the SSE were greater than the control (72 ± 3 A-weighted decibels (dBA) vs. 68 ± 2 dBA; p=0.015). Maximum noise levels during surgery with SSE reached 82 ± 3 dBA.
CONCLUSION
Surgeons performing adenotonsillectomy with aerosol mitigation equipment are exposed to significant noise levels. Intraoperative sound levels exceeded international standards for work requiring concentration. Innovation is needed to reduce cumulative OR noise exposures.
PubMed: 38868294
DOI: 10.7759/cureus.60214 -
Journal of Environmental Management Jul 2024As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current... (Review)
Review
As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector.
Topics: Hearing Loss, Noise-Induced; Humans; Aviation; Noise, Occupational; Occupational Exposure; Aircraft
PubMed: 38850921
DOI: 10.1016/j.jenvman.2024.121413 -
Work (Reading, Mass.) Jun 2024Varied noise environments, such as impulse noise and steady-state noise, may induce distinct patterns of hearing impairment among personnel exposed to prolonged noise....
BACKGROUND
Varied noise environments, such as impulse noise and steady-state noise, may induce distinct patterns of hearing impairment among personnel exposed to prolonged noise. However, comparative studies on these effects remain limited.
OBJECTIVE
This study aims to delineate the different characteristics of hearing loss in workers exposed to steady-state noise and impulse noise.
METHODS
As of December 2020, 96 workers exposed to steady-state noise and 177 workers exposed to impulse noise were assessed. Hearing loss across various frequencies was measured using pure tone audiometry and distortion product otoacoustic emission (DPOAE) audiometry.
RESULTS
Both groups of workers exposed to steady-state noise and impulse noise exhibited high frequencies hearing loss. The steady-state noise group displayed significantly greater hearing loss at lower frequencies in the early stages, spanning 1- 5 years of work (P < 0.05). Among individuals exposed to impulse noise for extended periods (over 10 years), the observed hearing loss surpassed that of the steady-state noise group, displaying a statistically significant difference (P < 0.05).
CONCLUSION
Hearing loss resulting from both steady-state noise and impulse noise predominantly occurs at high frequencies. Early exposure to steady-state noise induces more pronounced hearing loss at speech frequencies compared to impulse noise.
PubMed: 38848149
DOI: 10.3233/WOR-230066 -
BioRxiv : the Preprint Server For... May 2024Hearing loss is one of the most common types of disability; however, there is only one FDA-approved drug to prevent any type of hearing loss. Treatment with the highly...
Hearing loss is one of the most common types of disability; however, there is only one FDA-approved drug to prevent any type of hearing loss. Treatment with the highly effective chemotherapy agent, cisplatin, and exposure to high decibel noises are two of the most common causes of hearing loss. The mitogen activated protein kinase (MAPK) pathway, a phosphorylation cascade consisting of RAF, MEK1/2, and ERK1/2, has been implicated in both types of hearing loss. Pharmacologically inhibiting BRAF or ERK1/2 is protective from noise and cisplatin-induced hearing loss in multiple mouse models. Trametinib, a MEK1/2 inhibitor, protects from cisplatin induced outer hair cell death in mouse cochlear explants; however, to the best of our knowledge, inhibiting MEK1/2 has not yet been shown to be protective from hearing loss . In this study, we demonstrate that trametinib protects from cisplatin-induced hearing loss in a translationally relevant mouse model and does not interfere with cisplatin's tumor killing efficacy in cancer cell lines. Higher doses of trametinib were toxic to mice when combined with cisplatin but lower doses of the drug were protective from hearing loss without any known toxicity. Trametinib also protected mice from noise-induced hearing loss and synaptic damage. This study shows that MEK1/2 inhibition protects from both insults of hearing loss and that targeting all three kinases in the MAPK pathway protect from cisplatin and noise-induced hearing loss in mice.
PubMed: 38826449
DOI: 10.1101/2024.05.20.595056 -
The Cochrane Database of Systematic... May 2024Infants in the neonatal intensive care unit (NICU) are subjected to different types of stress, including sounds of high intensity. The sound levels in NICUs often exceed... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Infants in the neonatal intensive care unit (NICU) are subjected to different types of stress, including sounds of high intensity. The sound levels in NICUs often exceed the maximum acceptable level recommended by the American Academy of Pediatrics, which is 45 decibels (dB). Hearing impairment is diagnosed in 2% to 10% of preterm infants compared to only 0.1% of the general paediatric population. Bringing sound levels under 45 dB can be achieved by lowering the sound levels in an entire unit; by treating the infant in a section of a NICU, in a 'private' room, or in incubators in which the sound levels are controlled; or by reducing sound levels at the individual level using earmuffs or earplugs. By lowering sound levels, the resulting stress can be diminished, thereby promoting growth and reducing adverse neonatal outcomes. This review is an update of one originally published in 2015 and first updated in 2020.
OBJECTIVES
To determine the benefits and harms of sound reduction on the growth and long-term neurodevelopmental outcomes of neonates.
SEARCH METHODS
We used standard, extensive Cochrane search methods. On 21 and 22 August 2023, a Cochrane Information Specialist searched CENTRAL, PubMed, Embase, two other databases, two trials registers, and grey literature via Google Scholar and conference abstracts from Pediatric Academic Societies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) or quasi-RCTs in preterm infants (less than 32 weeks' postmenstrual age (PMA) or less than 1500 g birth weight) cared for in the resuscitation area, during transport, or once admitted to a NICU or stepdown unit. We specified three types of intervention: 1) intervention at the unit level (i.e. the entire neonatal department), 2) at the section or room level, or 3) at the individual level (e.g. hearing protection).
DATA COLLECTION AND ANALYSIS
We used the standardised review methods of Cochrane Neonatal to assess the risk of bias in the studies. We used the risk ratio (RR) and risk difference (RD), with their 95% confidence intervals (CIs), for dichotomous data. We used the mean difference (MD) for continuous data. Our primary outcome was major neurodevelopmental disability. We used GRADE to assess the certainty of the evidence.
MAIN RESULTS
We included one RCT, which enroled 34 newborn infants randomised to the use of silicone earplugs versus no earplugs for hearing protection. It was a single-centre study conducted at the University of Texas Medical School in Houston, Texas, USA. Earplugs were positioned at the time of randomisation and worn continuously until the infants were 35 weeks' postmenstrual age (PMA) or discharged (whichever came first). Newborns in the control group received standard care. The evidence is very uncertain about the effects of silicone earplugs on the following outcomes. • Cerebral palsy (RR 3.00, 95% CI 0.15 to 61.74)and Mental Developmental Index (MDI) (Bayley II) at 18 to 22 months' corrected age (MD 14.00, 95% CI 3.13 to 24.87); no other indicators of major neurodevelopmental disability were reported. • Normal auditory functioning at discharge (RR 1.65, 95% CI 0.93 to 2.94) • All-cause mortality during hospital stay (RR 2.07, 95% CI 0.64 to 6.70; RD 0.20, 95% CI -0.09 to 0.50) • Weight (kg) at 18 to 22 months' corrected age (MD 0.31, 95% CI -1.53 to 2.16) • Height (cm) at 18 to 22 months' corrected age (MD 2.70, 95% CI -3.13 to 8.53) • Days of assisted ventilation (MD -1.44, 95% CI -23.29 to 20.41) • Days of initial hospitalisation (MD 1.36, 95% CI -31.03 to 33.75) For all outcomes, we judged the certainty of evidence as very low. We identified one ongoing RCT that will compare the effects of reduced noise levels and cycled light on visual and neural development in preterm infants.
AUTHORS' CONCLUSIONS
No studies evaluated interventions to reduce sound levels below 45 dB across the whole neonatal unit or in a room within it. We found only one study that evaluated the benefits of sound reduction in the neonatal intensive care unit for hearing protection in preterm infants. The study compared the use of silicone earplugs versus no earplugs in newborns of very low birth weight (less than 1500 g). Considering the very small sample size, imprecise results, and high risk of attrition bias, the evidence based on this research is very uncertain and no conclusions can be drawn. As there is a lack of evidence to inform healthcare or policy decisions, large, well designed, well conducted, and fully reported RCTs that analyse different aspects of noise reduction in NICUs are needed. They should report both short- and long-term outcomes.
Topics: Humans; Infant, Newborn; Intensive Care Units, Neonatal; Infant, Premature; Noise; Infant, Very Low Birth Weight; Randomized Controlled Trials as Topic; Sound; Ear Protective Devices; Bias; Hearing Loss, Noise-Induced
PubMed: 38813836
DOI: 10.1002/14651858.CD010333.pub4 -
HNO May 2024
[When does the risk of noise-induced hearing loss become relevant? : The new exposure tables for occupational noise-induced hearing loss (BK-Nr. 2301 traffic light scheme)].
PubMed: 38806639
DOI: 10.1007/s00106-024-01483-2 -
The Laryngoscope May 2024This article aims to analyze the scientific literature on hearing loss (HL) in the field of Otorhinolaryngology published from the past to the present.
OBJECTIVES
This article aims to analyze the scientific literature on hearing loss (HL) in the field of Otorhinolaryngology published from the past to the present.
METHODS
A comprehensive dataset comprising 8013 articles on HL, spanning from 1980 to 2023, was retrieved from the Web of Science database and analyzed using various statistical and bibliometric methods.
RESULTS
The leading countries in productivity were the United States, Japan, and Germany. The top productive journals included the International Journal of Pediatric Otorhinolaryngology (n = 652), Otology & Neurotology (579), and Acta Oto-Laryngologica (512). The journals with the highest h-index on hearing loss were Hearing Research (h = 65), Ear and Hearing (60), and Laryngoscope (55). Factor analysis revealed that the HL literature consisted of four constructs: main topics, speech/sound, genetics, and pharmaceutical therapies. Sudden sensorineural HL, sensorineural HL, cochlear implant, unilateral, noise-induced and conductive HL, pediatric and age-related HL, tinnitus, auditory brainstem response, audiometry, and prognoses for hearing health were the most researched topics from past to present. In recent years, the trending topics are genomic analysis, gene mutations, whole-exome sequencing, genetic sequencing technique, the use of machine learning in HL, and the effect of COVID-19 on hearing health.
CONCLUSION
The bibliometric analysis results clearly indicate significant progress in the field of hearing loss over the past 40 years. The 8013 articles published between 1980 and 2023 encompass a wide range of research in this area. These analyses can assist in identifying priority areas and focal points for future research.
LEVEL OF EVIDENCE
N/A Laryngoscope, 2024.
PubMed: 38804613
DOI: 10.1002/lary.31533 -
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing... May 2024To analyze the characteristics of high-frequency average hearing loss in both ears of noise exposed workers in Tianjin in 2020, and quantitatively analyze the...
To analyze the characteristics of high-frequency average hearing loss in both ears of noise exposed workers in Tianjin in 2020, and quantitatively analyze the influencing factors of high-frequency hearing loss in both ears of workers. In March 2023, Collect and organize basic information about noise-hazardous enterprises and personal information of workers exposed to noise. Data from the Tianjin Occupational Disease and Health Hazard Factors Information Monitoring System from January 2020 to December 2020, and analyze the impact of basic information of employees, enterprise size, regional distribution, industry category, and economic type on the high-frequency average hearing loss of workers during work. Apply logistic regression to quantitatively analyze the influencing factors of abnormal high-frequency average hearing threshold of noise exposed workers. The size, economic type, industry category, and regional distribution of enterprises, as well as the gender, age, length of service of workers, have an impact on the abnormal high-frequency average hearing threshold of noise exposed workers (χ(2)=733.56、3 497、27、1352.84、1197.62、2570.59、22.30、506.60, <0.001) . Quantitative analysis using a logistic regression model showed that in the basic information of workers, noise exposed workers were male (=2.500, <0.001) and aged 30-39, 40-49, and 50-59 years (=1.33, <0.001; =1.68, <0.001; =1.52, < 0.001) , with a length of service of 4 to<10 years and≥10 years (=1.08, <0.001; =1.615, <0.001) being the influencing factors for high-frequency hearing loss in both ears of noise exposed workers; In terms of enterprise characteristics, medium-sized, small and micro enterprises (=1.12, <0.001; =1.75, <0.001; =2.09, <0.001) , enterprises located in the fourth district around the city (=1.268, <0.001) , and enterprises with economic types of collective economy, other economy, private economy, Hong Kong, Macao and Taiwan investment, shareholding system, and other industry economies ( are all >1, <0.001) are all factors affecting high-frequency hearing loss in noise exposed personnel. Noise is a common occupational hazard factor in Tianjin's enterprises, especially for workers in micro enterprises who face a high risk of hearing abnormalities. Therefore, enterprises need to strengthen the management and intervention of noise operations to prevent the occurrence of hearing loss in workers.
Topics: Humans; Noise, Occupational; Male; Female; Hearing Loss, Noise-Induced; China; Occupational Exposure; Adult; Logistic Models; Risk Factors; Middle Aged; Occupational Diseases
PubMed: 38802307
DOI: 10.3760/cma.j.cn121094-20230517-00177