The importance and place of medical audiology in occupational health

Opisuju se osnovni zadaci audiološke službe u medicini rada s obzirom na sve veći broj izvora buke u modernoj industriji. Ističe se da takve zadatke moraju obavljati dobro uvježbani audiološki timovi pripravni za otkrivanje štetnih učinaka na sluh i to već u samom početku, ali i za utvrđivanje mogućih simulacija, agravacija ili disimulacija. Spomenuti timovi sastavljeni od audiologa i audiometrista moraju biti i prikladno opremljeni suvremenim aparatima i kvalitetnom tihom komorom. Upozorava se da takvih timova u nas ima jako malo pa se često događa da audiometrijske analize izdaju i nedovoljno kvalificirane osobe. To, međutim, može u radnika s previđenim početnim oštećenjem sluha i vestibularnog aparata, a koji rade na visinama, imati teških posljedica pa se upozorava na moguće nesreće na poslu i posljedičnu odgovornost.Medical audiology is concerned with the state of hearing and its damages and lesions as well as with the pathology of vestibular disorders. It is particularly important in various forensic procedures and also for health insurance institutions. The audiological examination consists of two parts: the first is performed by an otorhinolaryngologist-audiologist and the second by an audiometrist (nurse or technician). The important anamnestic procedure is performed by a medical audiologist in the first stage of the examination and then follows the ear, nose and throat examination. Diagnosis and conclusions come at the end of the treatment. The role of the audiometrist is also important. He must have a sound practical and theoretical training in all audiometrical procedures since the audiogram for which he is responsible may serve as an important document for various institutions. The actual interpretation of the audiogram is equally essential, particularly in the case of a causal relationship of the present state of hearing and the incriminated injury. Previously, it was maintained that only noise causes impairments of hearing but now it is known that vibrations are equally harmful. Therefore it is important that all workers working under noise and vibrations undergo a detailed audiological examination

Simulation and aggravation in audiometry

Na temelju literaturnih podataka i vlastitih iskustava prikazuje autor problem simulacije i agravacije u audiologiji. Simulacija se dokazuje na tri načina: klasičnim otološkim metodama i pokusima, posebnim metodama audiometriranja i metodama više audiometrije i objektivnom audiometrijom. Klasične otološke metode su nesigurne i nepouzdane, pa se na taj način rijetko može dokazati simulacija. Audiološke metode su katkad uspješne. U najvećem se broju slučajeva egzaktno dokazivanje simulacije može provesti tek metodama više audiometrije i objektivnom audiometrijom. Pri dokazivanju agravacije treba u većini slučajeva primijeniti specijalne metode audiometriranja supraliminarnim testovima ili objektivnu audiometriju, jer rutinske metode audiometrijske pretrage rijetko dovode do rezultata.In view of the data from the literature and his own experience the authot discusses the problem of simulation and aggravation in audiology. There are three methods of verifying simulation: (a) classical otological methods, (b) special audiometry, .and (c) methods of advanced audiometry and objective audiometry. Classical otological methods are not considered reliable and satisfactory; audiologic analysis may sometimes give good results; in most cases, however, the exact verification can only be obtained by using the methods of advanced audiometry and objective audiometry. In verifying aggravation special methods of supraliminal audiometry and objective audiometry should be used, because the routine audiometric tests have rarely proved successful

Audiologic expertising for invalid revenue

Svrha audiološke rentne ekspertize je određivanje procenta gubitka sluha na temelju Fowler-Sabineove metode. Procenat gubitka sluha služi audiologu kao osnova za izračunavanje procentualne težine invaliditeta. Taj postupak još uvijek nije unificiran, iako je vrlo važan. Autor raspravlja o glavnim principima tog postupka, uzimajući u obzir i vlastita iskustva. U audiologiji su naročito važne forenzičke ekspertize kao i ekspertize u okviru osiguranja od nezgoda, pa su izneseni glavni elementi i principi toga rada.The audiologic expertising for invalid revenue is based on the estimation of the loss of hearing by the Fowler-Sabine method. The percentage of invalidity is estimated by the degree of deterioration in hearing. The procedure, although very important, has not been unified so far. The author discusses the main principles of the procedure taking into account his own experience. The importance of audiologic expertising both for the forensic medicine and prevention of accidents is pointed out, and the elements of this work are described

Laboratory evaluation of insecticidal effectiveness of a natural zeolite formulation against Sitophilus oryzae (L.), Rhyzopertha dominica (F.) and Tribolium castaneum (Herbst) in treated wheat

Inert dusts are increasingly becoming an integral part of programs for protection of cereal grains from stored-product insects. The intention in this study was therefore to conduct preliminary tests of insecticidal potentials of the natural zeolite formulation Minazel SP (66% SiO2, particle size ≤ 50 μm) originating from Serbia in controlling S. oryzae, R. dominica and T. castaneum. Dust effectiveness was tested in the laboratory (24±1ºC and 50-55% r.h. for parents and 24±1ºC and 60±5% r.h. for F1 progeny) by exposing insects to wheat treated with 0.50, 0.75 and 1.00 g/kg of Minazel SP. Mortality was determined after 7, 14 and 21 days of insect contact with threated wheat, and total mortality after an additional 7 days of recovery on untreated broken wheat. Progeny production in F1 generation was also determined for each insect species after 8-12 weeks. After seven days of exposure and 7 days of recovery of all tested species, the highest efficacy of 62% was observed after the highest application rate of 1.00 g/kg against S. oryzae. The highest efficacy after 14 and 21 days was achieved with the same application rate against T. castaneum (100%), S. oryzae (96-98%) and R. dominica (70-82%). Progeny reduction (IR – inhibition rate) of all tested species depended on the duration of parents exposure to treated wheat. After 7 days of exposure progeny reduction rates were 49-67% for S. oryzae, 42-68% for R. dominica and 47-78% for T. castaneum. After 14 days of exposure, inhibition rates were 55-78% for S. oryzae, 72-81% for R. dominica and 53-90% for T. castaneum, while progeny reductions of S. oryzae were 51-85%, R. dominica 80-96% and T. castaneum 87-99% after 21 days of exposure. Keywords: Wheat grain, Sitophilus oryzae, Rhyzopertha dominica, Tribolium castaneum, Natural zeolit

Susceptibility of red flour beetle Tribolium castaneum (Herbst) populations from Serbia to contact insecticides

Contact insecticides remain the principal option for controlling stored-product insects. Unsatisfactory results of insecticide applications are caused by several factors, one of the most important being resistance of stored-product insects. The objective of this study was to examine the susceptibility in several populations of red flour beetle Tribolium castaneum (Herbst) from Serbia to different contact insecticides. Toxicity of the insecticides dichlorvos, malathion, chlorpyrifos-methyl, pirimiphos-methyl, deltamethrin and bifenthrin to adults of a laboratory population of T. castaneum was investigated in the laboratory by topical application. At the LD50, deltamethrin was the most toxic and malathion the least toxic of the insecticides. Discriminating dose data for the laboratory population were used to test the susceptibility of 10 other populations originating from different storage facilities (silos, warehouses and flour mills) in Serbia. The discriminating dose of malathion caused mortality of up to 85% in seven populations, indicating malathion resistance in those populations. For two populations of T. castaneum from Nikinci and Jakovo LD values, ld-p lines and levels of susceptibility/resistance (RRs) were determined. The most toxic insecticide for adults from Nikinci and Jakovo was deltamethrin, while malathion was least toxic. The resistance ratios (RRs) for malathion at the LD50 were 17.6 for beetles from Nikinci, and 26.0 for beetles from Jakovo. Keywords: Tribolium castaneum adults; Different populations; Insecticide toxicity; Susceptibility resistanc

Audiological analysis of workers in the shipyard »3th may« in Rijeka

Izvršena je audiološka analiza kod 439 brodogradilišnih radnika, koji su radili na 13 raznih bukom ugroženih radnih mjesta. Analiza se vršila u tri pravca: vršena su mjerenja intenziteta i kvaliteta buke na pojedinim mjestima. Buka je zatim snimana na magnetofonske vrpce i kasnije spektroskopski analizirana. Svima radnicima je audiometrijski ispitan sluh, pa je ustanovljeno, da kod polovice pregledanih postoje teža i teška oštećenja sluha. Samo kod 3 slučaja ustanovljene su svježe akustične traume, a u četiri slučaja potpuna refrakternost na štetno djelovanje buke. Analiza komponiranih audiograma pokazuje veliku fluktuaciju težine oštećenja sluha prema pojedinim radnim mjestima, što opet ovisi o intenzitetu buke, u kojoj pojedine grupe radnika rade. Komparativna analiza audiometrijskih nalaza i spektroskopskih analiza buke pokazala je usku povezanost oblika i težine oštećenja sluha radnika sa pojedinih radnih mjesta s frekventnim i intenzitetskim karakteristikama buke odnosnih radnih mjesta. Analiza je dokumentirana sa 31 audiogramom, sa 16 fotospektrograma buke, sa 9 komponiranih audiograma i sa 27 tablica. Iznijeti su glavni principi medikolegalne problematike profesionalnih traumatskih oštećenja sluha bukom i kratke smjernice za definitivnu kodifikaciju. Kod preventivnih i profilaktičkih mjera medicinskog karaktera iznijet je prijedlog osnivanja audioloških kartona za sve radnike po fabrikama, gdje se radi uz jaču buku, a osim toga obvezatan pregled svih novih radnika. Izloženi su principi individualne zaštite od buke pomoću antifona, te ukazano na potrebu uključivanja gluhih ljudi na rad u tvornicama, gdje vlada jaka buka.Audiological analysis of 439 workers in the shipyard was performed. The workers worked in 13 different noisy places. The analysis was done in three ways: The intensity and quality of noise in different places was measured. Afterwards the noise was recorded on a tape recorder and then spetroscopically analysed. All workers were audiometrically examined and it was stated that 50 per cent had severe reduction of hearing. A fresh acoustic trauma was found in only 3 cases and complete unsusceptibility to noise in 4 cases. The analysis of composed audiograms shows great fluctuation of the severity of the damage of hearing depending on noise in working places. The comparative analysis of audiometric curves and spectroscopic pictures reveals a close connection between the severity of the loss of hearing and the frequencies and intensity of noise in different places of work. The main medicolegal principles are pointed out with a brief indication concerning codification. The establishment of audiological cards for all factory workers is· proposed, as well as the use o antiphons for individual protection. The authors suggest that deaf people should be employed in all the factories with extremely noisy working places. The advantages of such a policy are strongly emphasized

Testing of susceptibility to industrial noise

Autori su izradili svoj prema ranijim testovima potpuno originalni test, u kojem su za opterećenje upotrebili namjesto čistih tonova i bijelog šuma, kao što je to bilo kod prijašnjih testova, standardnu industrijsku buku jačine 100-116 decibela kroz 5 minuta. Rezultat opterećenja promatrali su prema ponašanju Carhartova testa odumiranja tona na pragu (treshold tone decay test). Na nizu normalnih slučajeva i različnih grupa oštećenog sluha provedeno je ispitivanje po tom testu, pa su autori konačno zaključili, da ni njihov test nema indikativnu vrijednost, ali su unatoč tome došli do idućih važnih činjenica: Pogrešno je misliti, kako se to dosad radilo, da kratka zvučna opterećenja, koja su upotrebljavana u indikativnim testovima, moraju imati direktne kauzalne veze s nastajanjem oštećenja sluha i da pitanje uzročnog nastajanja profesionalnih oštećenja sluha treba tražiti i u nekim drugim elementima, a ne samo u onima, koji su dosad uzimani u obzir. Baš zbog toga nisu ni sva dosadašnja nastojanja za pronalaženje pouzdanih indikativnih testova bila uspješna, pa će trebati najprije podvrći reviziji patofiziološki studij nastajanja profesionalnih industrijskih oštećenja sluha, a tek onda treba na potpuno novim osnovama prići pronalaženju pouzdanog indikativnog testa.With the increase of occupational damages of hearing it has proved desirable to find a test indicative of the susceptibility of workers to the damaging effect of industrial noise. In 1940. Payser introduced a test which did not prove reliable. Wilson, Kilm and Theilgaard tried to modify Payser\u27s test, but without satisfactory results. The authors have developed their original test in which instead of pure tones and white noise they use standardized industrial noise at the level of 100-116 decibels during 5 minutes, and assess the results obtained in relation to the results of Carhart\u27s threshold tone decay test. Experience has shown that this test is not fully indicative either. The authors point out that further studies of the pathophysiology of the damaging effect of industrial noise are to be carried out, before a reliable test of the susceptibility to industrial noise can be developed

Audiological analysis in a textile factory

Audiološki je obrađena jedna tekstilna tvornica, koja upošljava oko 800 radnika. Elektroakustička mjerenja su dala razinu buke od 102-105 din-fona. Spektroskopska frekventna analiza pokazala je ascendentnu krivulju, koja se u području od 1.600-2.000 Hz penje do 93 din-fona. U dvoranama se nalazi maksimalno mogući broj tkalačkih strojeva, pa je uz jaku buku prisutna i snažna vibracija. Pregledano je ukupno 609 radnika i radnica. Samo kod 51 radnika je. pronađen uredan sluh, tj. kod 8°/o, dok je kod 53 radnika pronađena prevelika osjetljivost na buku. Kod ovih radnika je uz kratki radni staž registrirano jače oštećenje sluha. Audiološka slika je veoma šarolika, pa su uz tipične akustičke traume registrirane atipične, unilateralne i nesimetrične. Kod 27 radnika s kr-o n ič n im supurativnim otitidama nisu registrirana nikakva oštećenja sluha unatoč dugom radnom stažu, pa se čini da je proces u srednjem uhu djelovao u protektivnom smislu na razvijanje akustičke traume. Razmotreno je i pitanje prevencije i profilakse, pa je prikazan plan sistematskih audioloških pregleda svega radništva, a napose novih radnika prije stupanja na posao.Audiological analysis in a textile factory with 800 workers was carried out. Electroaccoustical measurement showed the values of 102-105 din-phons. Spectroscopical analysis gave an ascendent curve with the top 93 din-phons in the area of 1 600-4 000 Hz. 609 workers were audiometrically examined. Only 51 workers, i. e. 8%, were found to have normal hearing and in 53 workers excessive susceptibility to noise with severe lesions of hearing, in spite of a very short stay in the factory was found. The analysis has shown many different types of lesions of hearing (assimetric, unilateral and atypic). In a special group there were workers with active or adhesive otitis media but normal hearing, in spite of the long period of time spent in the factory, so that it semed that otitis had played a protecting role in the appearance of accoustic trauma. As regards preventive and prophylactic measures, a system of audiological examination is set forth

Forensic problems related to occupational damage of hearing caused by noise

Raspravlja se o ulozi otorinolaringologa-audiologa u sudbenom rješavanju sporova između radnika s oštećenjem sluha i poduzeća u kojemu je radnik radio i gdje je možda došlo do ove profesionalne ozljede. Ističe se važnost utvrđivanja stanja sluha prije stupanja na posao u kojemu je radnik izvrgnut štetnom djelovanju buke. Iznose se i primjeri iz sudske prakse.From the point of view of forensic expertise the determination of the severity of hearing lesions present many problems and difficulties to an otorhinolaryngologist-audiologist. In the first place he must establish whether there is a relationship between the present state of damaged hearing and the incriminated accident. Unfortunately in many cases this is not easy because many etiological factors having no connection with the incriminated injury may interfere. On the other side the audiologist cannot know the objective value of the audiogram as he cannot be sure that there are no aggravating factors present. For this reason he must often insist that the audiogram be repeated to get accurate and highly objective values. This is very important because in every forensic case the financial aspect is also involved. Therefore, the otorhinolaryngologist-audiologist as a forensic expert must examine each case with the highest possible objectivity

Audiologic expertising for invalid revenue

Svrha audiološke rentne ekspertize je određivanje procenta gubitka sluha na temelju Fowler-Sabineove metode. Procenat gubitka sluha služi audiologu kao osnova za izračunavanje procentualne težine invaliditeta. Taj postupak još uvijek nije unificiran, iako je vrlo važan. Autor raspravlja o glavnim principima tog postupka, uzimajući u obzir i vlastita iskustva. U audiologiji su naročito važne forenzičke ekspertize kao i ekspertize u okviru osiguranja od nezgoda, pa su izneseni glavni elementi i principi toga rada.The audiologic expertising for invalid revenue is based on the estimation of the loss of hearing by the Fowler-Sabine method. The percentage of invalidity is estimated by the degree of deterioration in hearing. The procedure, although very important, has not been unified so far. The author discusses the main principles of the procedure taking into account his own experience. The importance of audiologic expertising both for the forensic medicine and prevention of accidents is pointed out, and the elements of this work are described