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PURPOSE: The purpose of this article was to assess the effectiveness of the Dangerous Decibels (DD) program in students in the short- and medium-term follow-ups (up to 6 months), including an online game. METHOD: A randomized trial was conducted between two interventions (DD and placebo). The research included 58 participants who were divided into two groups: the study group (SG) and the control group. The following phases were developed: intervention (DD or placebo), post-3-month assessment and availability of the online game, and post-6-month assessment. A questionnaire was administered to assess their performance. Overall total scores and category scores were obtained. RESULTS: Improved overall scores were found in the SG in the immediate post-intervention (p = .004), post-3-month (p = .022), and post-6-month (p = .002) questionnaires, as well as the knowledge and behavior categories. CONCLUSIONS: The DD program effectively improved the knowledge and behavior of 10- to 12-year-old children regarding noise in the short- and medium-term follow-ups. However, no significant changes were achieved in terms of barriers only by using the program and the online game. Adding a second intervention (the online game) to the program seems to be a good option to maintain the changes achieved with the interactive class.

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PURPOSE: This study evaluates the exposure of call center operators (CCOs) to occupational noise, its association with auditory and nonauditory symptoms, and the feasibility of monaural and binaural headsets. METHOD: We measured the noise exposure sound pressure levels (SPLs) with the microphone-in-real-ear technique and administered a questionnaire on auditory/nonauditory symptoms and headset preference. RESULTS: We assessed 79 CCOs with normal hearing. Overall, 98.7% of the participants reported at least one auditory symptom, and 88.6% reported at least one nonauditory symptom after using the headset. We found significant associations between the headset volume setting and the number of auditory and nonauditory symptoms and between sharp increases in sound level and tinnitus. The microphone-in-real-ear diffuse-field-related SPLs with monaural headsets (85.5 dBA) were significantly higher than those with binaural headsets (83.1 dBA). Binaural headsets were the preference of 84.8% of the subjects. The SPLs of the binaural headsets were significantly lower than those of the monaural headsets in the subjects who preferred the binaural headsets. CONCLUSIONS: CCOs with normal hearing reported auditory and nonauditory symptoms, highlighting the need for attention and further investigation. The binaural headsets were preferable, as they were associated with a lower SPL and a higher call quality. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.18361463.

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PURPOSE: To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. RESEARCH STRATEGY: Searches were carried out in PubMed, Web of Science and Scopus databases. SELECTION CRITERIA: The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. DATA ANALYSIS: For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. RESULTS: 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. CONCLUSÃO: Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

OBJETIVO: realizar uma revisão sistemática sobre a efetividade de intervenções para prevenção da perda auditiva induzida por ruído ocupacional, atualizando os achados da mais recente versão da revisão sistemática Cochrane do mesmo tema. ESTRATÉGIA DE PESQUISA: As buscas ocorreram nas bases PubMed, Web of Science e Scopus. CRITÉRIOS DE SELEÇÃO: Como intervenções, foram considerados: controles de engenharia/administrativos; dispositivos de proteção auditiva (DPA); vigilância auditiva e monitoramento audiológico. ANÁLISE DOS DADOS: Para a análise de risco de viés, cada estudo foi avaliado de acordo com a adoção de randomização, alocação, cegamento, desfecho, outras fontes de viés. RESULTADOS: Foram obtidas 475 referências no total. Destas, 17 estudos cumpriram os critérios de inclusão: um randomizado, um de série temporal interrompida e 15 de antes e depois. A maioria dos estudos foi realizada em indústrias; três em ambiente militar e/ou de treinamento de tiro; um em orquestra e outro em construção civil. A maioria dos estudos mostrou alto risco de viés. Seis estudos verificaram redução da exposição ao ruído a curto prazo por meio de controles de engenharia/administrativos; um verificou impacto positivo decorrente de mudança na legislação; cinco verificaram efeitos positivos dos DPA na diminuição da exposição ao ruído e dos treinamentos educacionais no uso do DPA; e dois encontraram redução dos níveis de ruído e aumento no uso do DPA decorrentes da implementação de programas de conservação auditiva. CONCLUSÃO: Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

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OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

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INTRODUCTION: Noise in the school environment has been a major concern in many countries around the world. Students need a favorable signal-to-noise ratio in the classroom to ensure adequate speech intelligibility, which is directly dependent on the acoustics of the classroom and favorable noise levels in these environments. OBJECTIVE: To evaluate the effectiveness of physical, organizational, and educational interventions to achieve noise reduction in a school. METHODS: Presentations on the effects of noise were made to school administrators, teachers, and students (educational activities), and also to the students' families. Then, thermoacoustic treatment, changes in break times, equipment maintenance, and scheduling of students' departure were applied. Sound pressure levels were measured before and after interventions for the unoccupied and occupied classroom conditions (n = 11 classrooms) and of the school's outside areas (n = 4). Self-administered printed pre- and postintervention multiple-choice questionnaires were completed by the students in the classroom. Measures of the signal-to-noise ratio of the teachers' voice before and after the interventions were also conducted (n = 3 classrooms). The interventions included installation of an acoustic ceiling, installation of air-conditioning, and replacement of the existing furniture with wood furniture. RESULTS: Comparing the pre- and postintervention questionnaires, the Annoyance Index was reduced from 0.78 to 0.59. The tinnitus reported by the individuals increased significantly in the postintervention questionnaire (p < 0.001). Significant reductions in noise levels in both unoccupied and occupied classrooms were observed. There was also an improvement in the mean signal-to-noise ratio in the evaluated classrooms (n = 3) from +7.5 to +8.4 dB. CONCLUSION: Subjective measures and objective assessments demonstrated that both physical and educational interventions had a positive effect on short-term changes in habits and noise reduction in the school environment.

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Resumo Objetivo realizar uma revisão sistemática sobre a efetividade de intervenções para prevenção da perda auditiva induzida por ruído ocupacional, atualizando os achados da mais recente versão da revisão sistemática Cochrane do mesmo tema. Estratégia de pesquisa As buscas ocorreram nas bases PubMed, Web of Science e Scopus. Critérios de seleção Como intervenções, foram considerados: controles de engenharia/administrativos; dispositivos de proteção auditiva (DPA); vigilância auditiva e monitoramento audiológico. Análise dos dados Para a análise de risco de viés, cada estudo foi avaliado de acordo com a adoção de randomização, alocação, cegamento, desfecho, outras fontes de viés. Resultados Foram obtidas 475 referências no total. Destas, 17 estudos cumpriram os critérios de inclusão: um randomizado, um de série temporal interrompida e 15 de antes e depois. A maioria dos estudos foi realizada em indústrias; três em ambiente militar e/ou de treinamento de tiro; um em orquestra e outro em construção civil. A maioria dos estudos mostrou alto risco de viés. Seis estudos verificaram redução da exposição ao ruído a curto prazo por meio de controles de engenharia/administrativos; um verificou impacto positivo decorrente de mudança na legislação; cinco verificaram efeitos positivos dos DPA na diminuição da exposição ao ruído e dos treinamentos educacionais no uso do DPA; e dois encontraram redução dos níveis de ruído e aumento no uso do DPA decorrentes da implementação de programas de conservação auditiva. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

Abstract Purpose To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. Research strategy Searches were carried out in PubMed, Web of Science and Scopus databases. Selection criteria The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. Data analysis For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. Results 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

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OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

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OBJECTIVE: The present study evaluates a training program for fitting different hearing protection devices (HPDs) based on personal attenuation rating (PAR) before, immediately after, and six months after training. METHODS: A total of 67 workers from a public university in the city of São Paulo, Brazil, were invited to participate in the measurement of PARs for foam and silicone protectors through the 3M™ E-A-Rfit Validation System. Two evaluations were performed for each protector at each sampling date: one after reading printed material (the package instructions) and another after being trained by an audiologist. The same procedures were repeated after six months. The final sample consisted of 30 individuals. ANOVA was used for statistical analysis. RESULTS: Larger PAR values ​​were observed after training by the audiologist, and smaller values ​​were observed after six months. Then, after re-training, the values increased again. There were no statistically significant differences in PAR among the HPDs tested. Even after the two training sessions, 23 to 27% of the subjects did not obtain adequate PAR values. CONCLUSION: These findings emphasize the need for continual worker training in the correct fit of earplug HPDs and the importance of longitudinal PAR monitoring. In addition, some workers, despite the training provided, did not adapt to the HPDs used. Therefore, it is essential that other protection methods and/or other HPD types are made available to these individuals.

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PURPOSE: To determine the field efficacy of an earmuff used by the employees of a private company. METHODS: Measurements were performed using a double-channel noise dosimeter. Noise levels collected in one-third-octave bands were corrected with the frequency response for diffuse sound field and attenuation was compared with values provided by the manufacturer of the hearing protection device (HPD). RESULTS: Comparisons between the corrected noise reduction and the attenuation provided by the manufacturer of the HPD show no statistically significant differences in attenuation for most frequency bands, with higher mean values for the observed corrected noise reduction. However, despite the fact that the field attenuation values are above those obtained in the laboratory, when individual attenuation values were compared with expected attenuation values it was found that the employees have below-expected noise attenuation in all frequency bands. CONCLUSIONS: The fact that over 60% of the employees had frequency band attenuations below that expected for most frequency bands underscores the need for individual assessment of attenuation provided by the HPD in the workplace, to assess whether the HPD is functional and what provisions should be implemented in a specific workplace.

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