A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus

Current notions of “hearing impairment,” as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as “Auditory Processing Disorder” (APD) or “Central Auditory Processing Disorder” is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus

Occupational Noise, Smoking, and a High Body Mass Index are Risk Factors for Age-related Hearing Impairment and Moderate Alcohol Consumption is Protective: A European Population-based Multicenter Study

A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment

Hearing loss in workers exposed to different type of noise

It's well documented that noise damages peripheral part of the auditory tract (cochlea). Only few investigations were performed to assess central hearing disturbances caused by noise on animal. The aim of the study was to evaluate the site of hearing damage in 2 groups of individuals exposed to different types of noise. First group consisted of 62 dockyard workers exposed to impulsive noise with co-exposure to hand-arm vibration while second group included 76 bottle glass factory workers exposed to continuous steady-state noise. Results were referred to 86 control subjects exposed neither to noise nor vibrations. Pure-tone audiometry, immitance audiometry, Auditory Brainstem Response (ABR) and cognitive-event relate auditory evoked potentials (wave P-300) were performed in all subjects. Audiometric results revealed the poorest hearing level in dockyard workers among all groups. The bottle factory workers had also significant hearing impairment at high frequencies as compared to controls. Although the wave V at the ABR was prolonged in the dockyard workers this change could reflect sensorineural hearing thresholds shift and retrocochlear damage. The latency of P-300 wave was prolonged in dockyard workers exclusively suggesting a cortical effect of exposure to impulsive noise. Conclusions. Exposure to high level impulsive noise in combination with hand-arm vibration may cause hearing deficit greater than expected. Abnormalities involve peripheral and central auditory system. More observations are necessary to confirm these findings

Can otoacoustic emission help in the differencial diagnosis of occupational noise-induced hearing loss?

Translated from Polish (Med. Pr. 1997 v. 48(6) p. 613-620)SIGLEAvailable from British Library Document Supply Centre-DSC:9022.381(HSE-Trans--15985)T / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Kombinirano djelovanje ototoksičnih otapala i buke na sluh radnika u tvornici automobila u Iranu

Exposure of workers to mixtures of organic solvents and to occupational noise is frequent in a number of industries. Recent studies suggest that exposure to both can cause a more severe hearing loss than exposure to noise alone. Our cross-sectional study included 411 workers of a large automobile plant divided in three groups. The fi rst group included assembly workers exposed to noise alone; the second included workers in a new paint shop, who were exposed to a mixture of organic solvents at a permissible level; and the third group included paint shop workers exposed to both noise and higher than permissible levels of organic solvents in an old paint shop. These groups were compared in terms of low-frequency hearing loss (model 1; average hearing threshold >25 dB at 0.5 kHz, 1 kHz, and 2 kHz) and high-frequency hearing loss (model 2; average hearing threshold >25 dB at 3 kHz, 4 kHz, 6 kHz, and 8 kHz). High-frequency hearing loss was more common in workers exposed to a combination of noise and mixed organic solvents even at permissible levels than in workers exposed to noise alone even after correction for confounding variables. This study shows that combined exposure to mixed organic solvents and occupational noise can exacerbate hearing loss in workers. Therefore, an appropriate hearing protection programme is recommended, that would include short-interval audiometric examinations and effi cient hearing protectors.Profesionalna izloženost radnika mješavinama organskih otapala i buci česta je u mnogim industrijskim granama. Nedavna su istraživanja pokazala da izloženost i jednom i drugomu može dovesti do većih oštećenja sluha negoli samo izloženost buci. Ovo je presječno ispitivanje obuhvatilo 411 radnika velike tvornice automobila u Iranu, koji su podijeljeni u tri skupine. Prva je skupina obuhvatila radnike na sklapanju dijelova izložene samo buci, druga radnike u novoj autolakirnici, koji su uz buku bili izloženi mješavini organskih otapala u dopuštenim razinama, a treća je skupina obuhvatila radnike u staroj autolakirnici, koji su uz buku bili izloženi prekomjernim razinama mješavine organskih otapala. Te smo skupine usporedili s obzirom na gubitak sluha za niže frekvencije (0,5 kHz, 1 kHz i 2 kHz; prosječni prag >25 dB) odnosno više frekvencije (3 kHz, 4 kHz, 6 kHz i 8 kHz; prosječni prag >25 dB). Gubitak sluha za više frekvencije bio je učestaliji u radnika izloženih kombinaciji buke i mješavini organskih otapala nego u radnika izloženih samo buci, čak i kada su razine otapala bile unutar dopuštene granice te kad su se uklonile ometajuće varijable. Ovo je ispitivanje potvrdilo da istodobna profesionalna izloženost mješavini organskih otapala i buci može pogoršati gubitak sluha. Stoga je nužno osmisliti odgovarajući program zaštite sluha koji bi obuhvatio učestalo testiranje sluha i djelotvornu zaštitnu opremu