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      Jet fuel exposure and auditory outcomes in Australian air force personnel

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          Abstract

          Background

          Animal data suggest that jet fuels such as JP-8 are associated with hearing deficits when combined with noise and that the effect is more pronounced than with noise exposure alone. Some studies suggest peripheral dysfunction while others suggest central auditory dysfunction. Human data are limited in this regard. The aim of this study was to investigate the possible chronic adverse effects of JP-8 combined with noise exposure on the peripheral and central auditory systems in humans.

          Methods

          Fifty-seven participants who were current personnel from the Royal Australian Air Force were selected. Based on their levels of exposure to jet fuels, participants were divided into three exposure groups (low, moderate, high). Groups were also categorised based on their noise exposure levels (low, moderate, high). All participants were evaluated by tympanometry, pure-tone audiometry (1–12 kHz), distortion product otoacoustic emissions (DPOAEs), auditory brainstem response (ABR), words-in-noise, compressed speech, dichotic digit test, pitch pattern sequence test, duration pattern sequence test and adaptive test of temporal resolution. All auditory tests were carried out after the participants were away from the Air Force base for a minimum of two weeks, thus two weeks without jet fuel and noise exposure.

          Results

          Jet fuel exposure was significantly associated with hearing thresholds at 4 and 8 kHz; average hearing thresholds across frequencies in the better ear; DPOAEs at 2.8, 4 and 6 kHz; ABR wave V latency in the right ear; compressed speech and words-in-noise. Further analyses revealed that participants with low exposure level to jet fuels showed significantly better results for the aforementioned procedures than participants with moderate and high exposure levels. All results were controlled for the covariates of age and noise exposure levels.

          Conclusions

          The results suggest that jet fuel exposure, when combined with noise exposure, has an adverse effect on audibility in humans. Taking all the test results into consideration, jet fuel exposure combined with noise exposure specifically seems to affect the peripheral hearing system in humans.

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          Most cited references24

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          Clinical experience with impedance audiometry.

          J. Jerger (1970)
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            Development of a speech-in-multitalker-babble paradigm to assess word-recognition performance.

            A simple word-recognition task in multitalker babble for clinic use was developed in the course of four experiments involving listeners with normal hearing and listeners with hearing loss. In Experiments 1 and 2, psychometric functions for the individual NU No. 6 words from Lists 2, 3, and 4 were obtained with each word in a unique segment of multitalker babble. The test paradigm that emerged involved ten words at each of seven signal-to-babble ratios (S/B) from 0 to 24 dB. Experiment 3 examined the effect that babble presentation level (70, 80, and 90 dB SPL) had on recognition performance in babble, whereas Experiment 4 studied the effect that monaural and binaural listening had on recognition performance. For listeners with normal hearing, the 90th percentile was 6 dB S/B. In comparison to the listeners with normal hearing, the 50% correct points on the functions for listeners with hearing loss were at 5 to 15 dB higher signal-to-babble ratios.
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              Biological and health effects of exposure to kerosene-based jet fuels and performance additives.

              Over 2 million military and civilian personnel per year (over 1 million in the United States) are occupationally exposed, respectively, to jet propulsion fuel-8 (JP-8), JP-8 +100 or JP-5, or to the civil aviation equivalents Jet A or Jet A-1. Approximately 60 billion gallon of these kerosene-based jet fuels are annually consumed worldwide (26 billion gallon in the United States), including over 5 billion gallon of JP-8 by the militaries of the United States and other NATO countries. JP-8, for example, represents the largest single chemical exposure in the U.S. military (2.53 billion gallon in 2000), while Jet A and A-1 are among the most common sources of nonmilitary occupational chemical exposure. Although more recent figures were not available, approximately 4.06 billion gallon of kerosene per se were consumed in the United States in 1990 (IARC, 1992). These exposures may occur repeatedly to raw fuel, vapor phase, aerosol phase, or fuel combustion exhaust by dermal absorption, pulmonary inhalation, or oral ingestion routes. Additionally, the public may be repeatedly exposed to lower levels of jet fuel vapor/aerosol or to fuel combustion products through atmospheric contamination, or to raw fuel constituents by contact with contaminated groundwater or soil. Kerosene-based hydrocarbon fuels are complex mixtures of up to 260+ aliphatic and aromatic hydrocarbon compounds (C(6) -C(17+); possibly 2000+ isomeric forms), including varying concentrations of potential toxicants such as benzene, n-hexane, toluene, xylenes, trimethylpentane, methoxyethanol, naphthalenes (including polycyclic aromatic hydrocarbons [PAHs], and certain other C(9)-C(12) fractions (i.e., n-propylbenzene, trimethylbenzene isomers). While hydrocarbon fuel exposures occur typically at concentrations below current permissible exposure limits (PELs) for the parent fuel or its constituent chemicals, it is unknown whether additive or synergistic interactions among hydrocarbon constituents, up to six performance additives, and other environmental exposure factors may result in unpredicted toxicity. While there is little epidemiological evidence for fuel-induced death, cancer, or other serious organic disease in fuel-exposed workers, large numbers of self-reported health complaints in this cohort appear to justify study of more subtle health consequences. A number of recently published studies reported acute or persisting biological or health effects from acute, subchronic, or chronic exposure of humans or animals to kerosene-based hydrocarbon fuels, to constituent chemicals of these fuels, or to fuel combustion products. This review provides an in-depth summary of human, animal, and in vitro studies of biological or health effects from exposure to JP-8, JP-8 +100, JP-5, Jet A, Jet A-1, or kerosene.
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                Author and article information

                Contributors
                adrian.fuente@umontreal.ca
                l.hickson@uq.edu.au
                tmorata@cdc.gov
                warwickhwilliams@gmail.com
                a.khan2@uq.edu.au
                eduardo.fuentes@uc.cl
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                31 May 2019
                31 May 2019
                2019
                : 19
                : 675
                Affiliations
                [1 ]ISNI 0000 0000 9320 7537, GRID grid.1003.2, School of Health and Rehabilitation Sciences, The University of Queensland, ; Brisbane, Australia
                [2 ]GRID grid.294071.9, Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montreal, ; Quebec, Canada
                [3 ]ISNI 0000 0004 0423 0663, GRID grid.416809.2, National Institute for Occupational Safety and Health, ; Cincinnati, OH USA
                [4 ]ISNI 0000 0004 0643 6737, GRID grid.419097.2, National Acoustic Laboratories, ; Sydney, NSW Australia
                [5 ]ISNI 0000 0001 2157 0406, GRID grid.7870.8, Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, , Pontificia Universidad Católica de Chile, ; Santiago, Chile
                Article
                7038
                10.1186/s12889-019-7038-0
                6544957
                6544f70f-c4df-44e5-8ef0-ebccc030fbd9
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 January 2019
                : 23 May 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: APP1027549
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                exposure,hearing loss,jet fuels,military personnel,noise
                Public health
                exposure, hearing loss, jet fuels, military personnel, noise

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