Brainstem auditory evoked potentials in children with lead exposure

AbstractIntroductionEarlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated.ObjectiveTo investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test.MethodsContemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months±3 years, 2 months).ResultsThe mean time-integrated cumulative blood lead index was 12μg/dL (SD±5.7, range: 2.433). All participants had hearing thresholds equal to or below 20dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I–III, III–V, and I–V, and the cumulative lead values.ConclusionNo evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area

Saúde auditiva, o vírus da imunodeficiência humana e a síndrome da imunodeficiência adquirida: uma revisão Hearing health, the human immunodeficiency virus and the acquired immunodeficiency syndrome: a review

TEMA: a Síndrome da Imunodeficiência Adquirida (SIDA/AIDS) é causada pelo Vírus da Imunodeficiência Humana (VIH/HIV), e resulta numa imunidade reduzida, o que torna o indivíduo mais susceptível a doenças e infecções oportunistas. Com o avanço da doença as estruturas do sistema auditivo central podem ser comprometidas pela ação direta do vírus ou decorrente de infecções secundárias e neoplasias. O portador do HIV/AIDS pode também se tornar mais vulnerável a outras patologias do ouvido. OBJETIVO: o objetivo desta revisão foi exploratório, visando identificar os possíveis pontos de interseção entre distúrbios auditivos e a Síndrome da Imunodeficiência Adquirida. Realizou-se uma revisão da literatura sobre a saúde auditiva dos portadores de HIV/AIDS e foi discutido o impacto potencial de patologias auditivas na qualidade de vida. CONCLUSÃO: a literatura sugere que várias possiveis associações existam entre os distúrbios auditivos e a Síndrome da Imunodeficiência Adquirida e o Vírus da Imunodeficiência Humana. Profissionais de saúde, inclusive aqueles dos serviços públicos no Brasil, deveriam examinar a necessidade de iniciativas de saúde auditiva dirigida aos portadores de HIV/AIDS para prevenir patologias auditivas ou reduzir seu impacto na qualidade de vida.<br>BACKGROUND: Acquired Immunodeficiency Syndrome (or Acquired immune deficiency syndrome or AIDS) is caused by the Human Immunodeficiency Virus (HIV) and results in reduced immunity, leaving affected individuals more susceptible to illness and opportunistic infections. As the disease progresses, structures within the central auditory system can be affected either by the direct action of the virus or as a consequence of secondary infections. Other areas of the auditory system may also be more vulnerable to pathology in people living with HIV or AIDS. PURPOSE: the goal of this review was exploratory, to identify possible points of intersection between auditory disorders and Acquired Immune Deficiency Syndrome. This paper reports the results of a literature review on auditory disorders associated with HIV and AIDS and discusses the potential impact of ear pathologies among HIV/AIDSinfected populations. CONCLUSION: literature suggests several possible types of association between auditory disorders and the Acquired Immune Deficiency Syndrome and the Human Immunodeficiency Virus, and that people with HIV/AIDS may require hearing care interventions. Health professionals, including those from the Brazilian public health system, should examine the need for hearing-related services among HIV/AIDS patients in order to reduce the impact of the disease on daily life activities and prevent insofar, further auditory deterioration

Youth Attitude to Noise Scale (YANS) questionnaire adaptation into Brazilian Portuguese Adaptação para o português brasileiro do questionário: Youth Attitude to Noise Scale (YANS)

The growing exposure of teenagers to environmental noise and music has generated interest in studies about the impact of such exposure, as well as the measures taken in these situations. Therefore, it is fundamental to use a valid and reliable instrument. AIM: to validate a Brazilian Portuguese version of the Youth Attitude to Noise Scale questionnaire. STUDY DESIGN: cross-sectional, repeated measures. MATERIALS AND METHODS: Translation from English into Portuguese, pre-test, linguistic adaptation, review of grammar and idiomatic equivalence, and translation from Portuguese back to English. Instrument application. Retesting within 30 to 90 days. Measurement of the questions used following Likert's scale. Through factorial analysis, explanation for the connections among a set of variables. RESULTS: there was a match between translation and counter-translation. The questions were satisfactorily understood. The factorial analysis was well defined with the use of four factors. The instrument's reproducibility was proven by the 0.75 Cronback Alpha general index. CONCLUSIONS: Significant correlations, indicating the construction and content validity for its use, serving as a tool to assess the attitudes of the youth facing exposure to environmental noise or music.A crescente exposição da população adolescente ao ruído ambiental e à música tem gerado interesse de estudos sobre o impacto desta exposição, bem como das atitudes tomadas frente a estas situações. Portanto, é fundamental que seja utilizado um instrumento confiável e válido. OBJETIVO: Validar para a língua portuguesa, versão do questionário Youth Attitude to Noise Scale. FORMA DE ESTUDO: Transversal, medidas repetidas. MATERIAL E MÉTODO: Tradução do idioma inglês para o português, pré-teste, adaptação linguística, revisão da equivalência gramatical e idiomática, processo inverso de tradução do português para o inglês. Aplicação do instrumento. Realização do reteste, num prazo de 30 a 90 dias. Medição das questões utilizadas seguindo a escala de Likert. Através da análise fatorial, explicação para a ligação entre um conjunto de variáveis. RESULTADOS: Houve correspondência nas traduções e contratraduções. O entendimento das questões foi satisfatório. A análise fatorial ficou bem definida com a adoção de quatro fatores. A reprodutibilidade do instrumento foi demonstrada pelo índice geral do Alfa de Cronbach de 0,75. CONCLUSÕES: Correlações significativas, indicando a validade de construção e conteúdo para seu uso, servindo como instrumento na avaliação das atitudes dos jovens diante da exposição ao ruído ambiental ou à música

Versão e adaptação para o português brasileiro do questionário: crenças e atitudes sobre prevenção de perda auditiva Translation and adaptation of the questionnaire "beliefs and attitudes on hearing loss prevention" into Brazilian Portuguese

OBJETIVO: validar a versão para língua portuguesa do questionário "Crenças e Atitudes sobre a Prevenção de Perdas Auditivas", desenvolvido pelo National Institute for Occupational Safety and Health in 1996. MÉTODO: a validação do questionário seguiu as seguintes etapas: tradução do idioma inglês para o português, pré-teste com um subgrupo de 10 trabalhadores, adaptação lingüística, revisão da equivalência gramatical e idiomática e processo inverso de tradução do português para o inglês, para verificar se houve descaracterização do questionário. Participaram do estudo 31 trabalhadores de uma indústria frigorífica, 17 do sexo masculino e 14 do sexo feminino, com idade média de 29 anos e 7 meses. As questões utilizadas foram medidas seguindo a escala de Likert com cinco graus, onde 1 - corresponde a "concordo totalmente" e 5 - "discordo totalmente". A análise fatorial objetivou explicar a ligação entre um conjunto de variáveis correlacionadas. Os trabalhadores responderam ao primeiro questionário (Versão A) e num prazo de 15 dias responderam ao segundo questionário (Versão B). RESULTADOS: a reprodutibilidade do instrumento foi demonstrada pelo índice geral de Alfa de Cronbach de 0, 8146 para o formulário A e 0, 8569 para o formulário B. As correlações foram significantes indicando a validade de construto e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora. CONCLUSÕES: o questionário foi traduzido e adaptado para ser aplicado na população brasileira, denominado Crenças e Atitudes sobre a Prevenção de Perdas Auditivas, e servirá como instrumento na avaliação das atitudes e comportamento dos trabalhadores frente ao ruído e prevenção de perdas auditivas.PURPOSE: to evaluate the Brazilian Portuguese version of the instrument "Beliefs and Attitudes on Hearing Loss Prevention", developed by the National Institute for Occupational Safety and Health in 1996. METHOD: the development of the Portuguese scale followed the following steps: translation from English into Brazilian Portuguese, pre-test with a group of 10 workers compared to the target population, linguistic adaptation, review of grammatical and idiomatic equivalence, and reverse translation into English in order to check that the instrument remained true to its original version. Following this elements, the Portuguese instrument was validated with the group of 31 workers. The participating workers came from a meat-packing company. Seventeen were males and 14 were females, and their mean age was 29 years and 7 months. The questions were constructed using a 5-point Likert scale where 1 meant "disagree completely" and 5 meant "agree completely." A factorial analysis was conducted in order to check construct validity of correlated questionnaire items. The participants responded to the first questionnaire (version A) and 15 days later responded to the second questionnaire (Version B). RESULTS: the validity of the entire instrument was demonstrated by a Cronbach's Alpha of 0.8146 for the version A of the instrument and 0.8569 for the Version B. The significant correlations among related questionnaire items indicate the validity of its format and content for the intended usage with a Brazilian Portuguese version with a population of workers. CONCLUSIONS: the questionnaire was translated and adapted to Brazilian Portuguese and will facilitate the evaluation of attitudes and beliefs of Brazilian-Portuguese speaking workers towards noise and hearing loss prevention

Cochrane method for systematic review and meta-analysis of interventions to prevent occupational noise-induced hearing loss - abridged

PURPOSE: Assess the effect of non-pharmaceutical interventions at work on noise exposure or occupational hearing loss compared to no or alternative interventions. RESEARCH STRATEGIES: Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. SELECTION CRITERIA: Randomized Controlled Trials (RCT), Controlled Before-After studies (CBA) and Interrupted Time-Series studies (ITS) evaluating engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance were included. Case studies of engineering controls were collected. DATA ANALYSIS: Cochrane methods for systematic reviews, including meta-analysis, were followed. RESULTS: 29 studies were included. Stricter legislation can reduce noise levels by 4.5 dB(A) (very low-quality evidence). Engineering controls can immediately reduce noise (107 cases). Eleven RCTs and CBA studies (3725 participants) were evaluated through Hearing Protection Devices (HPDs). Training of earplug insertion reduces noise exposure at short term follow-up (moderate quality evidence). Earmuffs might perform better than earplugs in high noise levels but worse in low noise levels (very low-quality evidence). HPDs might reduce hearing loss at very long-term follow-up (very low-quality evidence). Seventeen studies (84028 participants) evaluated hearing loss prevention programs. Better use of HPDs might reduce hearing loss but other components not (very low-quality evidence). CONCLUSION: Hearing loss prevention and interventions modestly reduce noise exposure and hearing loss. Better quality studies and better implementation of noise control measures and HPDs is needed

Avaliação do conforto do protetor auditivo individual numa intervenção para prevenção de perdas auditivas The evaluation of comfort of the personal hearing protection devices as an intervention for hearing loss prevention

OBJETIVO: analisar o conforto do protetor auditivo individual como parte de uma intervenção para prevenção de perdas auditivas em trabalhadores expostos a elevados níveis de ruído, por meio da utilização de um questionário de avaliação de conforto. MÉTODO: realizou-se análise dos documentos da empresa, investigação do ruído e uso de protetor auditivo individual anterior, seleção do protetor auditivo individual, atividades educativas, aplicação de questionário e realização audiometrias. A população foi composta de 20 trabalhadores expostos a ruído acima de 80 dB(A). Os trabalhadores utilizaram protetores tipo inserção e concha, cada um durante 15 dias e responderam ao questionário de avaliação do conforto em duas ocasiões. RESULTADOS: dentre os participantes 85% eram homens e 15% mulheres, idade média 35 anos. O Índice de Conforto do protetor tipo inserção foi 4,6 e concha 6,1, com tempo médio de utilização de 6 horas 40 minutos. Dentre as razões negativas ao uso do equipamento destacaram-se: interferência com a comunicação (20%), diminuição da audição (10%) e não sentir necessidadede usar (10%). CONCLUSÃO: os protetores auriculares estudados tiveram seus escores cotados em níveis aceitáveis, sendo considerados ambos confortáveis. Contudo, existiu uma diferença significante no Índice de Conforto entre protetores de diferentes tipos (inserção e concha). Com isso, pôde-se concluir que, o protetor auditivo individual tipo concha foi considerado o mais confortável e melhor aceito pela população estudada.<br>PURPOSE: to analyze the comfort of the individual hearing protectors as part of an intervention for prevention of hearing loss in workers exposed to high noise levels, using a questionnaire of comfort assessment. METHOD: company safety and health records were reviewed, noise measurements were performed, new HPDs were selected, the comfort of the devices was evaluated and audiometric tests were conducted. The study population was 20 workers exposed to noise levels above 80 dB(A). The workers used two types of HPD (earplugs and earmuffs), each for 15 days, followed by an application of the questionnaire after each trial period. RESULTS: 85% of the participants were males and 15% females and their average age was 35 years old. The comfort index for the studied earplug was 4.6, and for the studied earmuff was 6.1. The participants wore the HPDs during their full work shift which lasted 6 hours and 40 minutes. Other barriers were indentified to the use of hearing protection: interference with communication (20%), decreased hearing (10%) and lack of clarity on the need to use it (10%). CONCLUSION: the HPDs analyzed in this study had their scores acceptable and were considered both comfortable. However, there was a significant difference in the comfort Index between protectors of different types (earplug and earmuff). The conclusion was that the earmuff is considered the most comfortable and more accepted HPDs by this population