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      Noise-Induced Hearing Loss Still a Problem in Shipbuilders: A Cross-Sectional Study in Goa, India

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          Abstract

          Background:

          Workplace safety regulations seek to mitigate noise-induced hearing loss (NIHL), conventionally associated with the shipbuilding industry. Despite this, are workers still predisposed to NIHL?

          Aims:

          To study the prevalence of NIHL among noise-exposed subjects in the shipbuilding industry in Goa and to compare it with that among the non-exposed population working in the same industry in relation to certain relevant factors.

          Subjects and Methods:

          This is a cross-sectional study in the shipbuilding industry, Goa This study examined 552 workers: 276 shipbuilders and 276 office staff, of similar age, duration of employment and socio-economic status working at a shipbuilding enterprise. An interviewer-administered questionnaire was followed by audiometry. Values were presented as percentages, Mean (SD) and odds ratio (OR) and its 95% confidence interval (CI) (Woolfe's method). Fisher's exact test and binary logistic regression were used. P value of < 0.05 was taken as significant. SPSS version 16 was used.

          Results:

          NIHL was found in 17 (6%) shipbuilders, while no office staff was detected to have this condition (OR = 37.29, 95% CI 22.42-62.18). The shipbuilders with NIHL were 52.5 years of age and had been employed for 30.4 years, on an average. None of the 17 cases of NIHL were found to be using earplugs consistently; 11 reported using them “sometimes” and six “never” used them.

          Conclusions:

          NIHL continues to affect shipbuilders, owing their non-compliance to workplace regulation. Health education is the need of the hour.

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          Most cited references27

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          Validation of self-reported hearing loss. The Blue Mountains Hearing Study.

          Large-scale epidemiological studies have often used self-report to estimate prevalence of age-related hearing loss. However, few large population-based studies have validated self-report against measured hearing loss. Our study aimed to assess the performance of a single question and a brief hearing handicap questionnaire in identifying individuals with hearing loss, against the gold standard of pure-tone audiometry. We examined 2015 residents, aged 55-99 years, living in the west of Sydney, Australia, who participated in the Blue Mountains Hearing Study during 1997-1999. Audiologists administered a comprehensive questionnaire, including the question: 'Do you feel you have a hearing loss?' The Shortened Hearing Handicap Inventory for Elderly (HHIE-S) was also administered during the hearing examination, which included pure-tone audiometry. The single question and HHIE-S were compared with measured losses at levels >25, >40 and >60 decibels hearing level (dBHL) to indicate mild, moderate and marked hearing impairment, for pure-tone averages (PTA) of responses to 500, 1000, 2000 and 4000 Hz. The single question yielded reasonable sensitivity and specificity for hearing impairment, and was minimally affected by age and gender. HHIE-S scores >8 had lower sensitivity but higher specificity and positive predictive value. The HHIE-S performed slightly better in younger than older subjects and performed better for moderate hearing impairment. In this older population with a high prevalence of hearing loss (39.4%), both a question about hearing and the HHIE-S appeared sufficiently sensitive and specific to provide reasonable estimates of hearing loss prevalence. Both could be recommended for use in epidemiological studies that aim to assess the magnitude of the burden caused by age-related sensory impairment but cannot measure hearing loss by audiometry.
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            Occupational exposure to noise and the attributable burden of hearing difficulties in Great Britain.

            To determine the prevalence of self reported hearing difficulties and tinnitus in working aged people from the general population, and to estimate the risks from occupational exposure to noise and the number of attributable cases nationally. A questionnaire was mailed to 22 194 adults of working age selected at random from the age-sex registers of 34 British general practices (21 201 subjects) and from the central pay records of the British armed services (993 subjects). Information was collected on years of employment in a noisy job; and whether the respondent wore a hearing aid, had difficulty in hearing conversation, or had experienced persistent tinnitus over the past year. Associations of hearing difficulty and tinnitus with noise exposure were examined by logistic regression, with adjustment for age, sex, smoking habits, and frequent complaints of headaches, tiredness, or stress. The findings were expressed as prevalence ratios (PRs) with associated 95% confidence intervals (CIs). Attributable numbers were calculated from the relevant PRs and an estimate of the prevalence of occupational exposure to noise nationally. Some 2% of subjects reported severe hearing difficulties (wearing a hearing aid or having great difficulty in both ears in hearing conversation in a quiet room). In men, the prevalence of this outcome rose steeply with age, from below 1% in those aged 16-24 years to 8% in those aged 55-64. The pattern was similar in women, but severe hearing loss was only about half as prevalent in the oldest age band. Tinnitus was far more common in subjects with hearing difficulties. In both sexes, after adjustment for age, the risk of severe hearing difficulty and persistent tinnitus rose with years spent in a noisy job. In men older than 35 years with 10 or more years of exposure, the PR for severe hearing difficulty was 3.8 (95% CI 2.4 to 6.2) and that for persistent tinnitus 2.6 (95% CI 2.0 to 3.4) in comparison with those who had never had a noisy job. Nationally, some 153 000 men and 26 000 women aged 35-64 years were estimated to have severe hearing difficulties attributable to noise at work. For persistent tinnitus the corresponding numbers were 266 000 and 84 000. Significant hearing difficulties and tinnitus are quite common in men from the older working age range. Both are strongly associated with years spent in a noisy occupation--a predominantly male exposure. The national burden of hearing difficulties attributable to noise at work is substantial.
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              Joint effects of smoking, noise exposure and age on hearing loss.

              Smoking has been shown to have adverse effects on hearing, but it's unclear whether smoking interacts with known causes of hearing loss such as noise exposure and ageing. To examine the hypothesis that smoking, noise and age jointly affect hearing acuity. This cross-sectional study was carried out in 535 male adult workers of a metal processing factory. Pure-tone audiometric tests were utilized to assess hearing loss. Noise exposure assessment was based on a job exposure matrix constructed with industrial hygienist scoring and job titles. Each participant answered questionnaires about socio-demographic, life-style, occupational and health-related data. Analysis of the possible underlying biological model was undertaken assessing departures from additivity using measures of the size of the interaction present. Age and occupational noise exposures were, separately, positively associated with hearing loss. For all the factors combined the estimated effect on hearing loss was higher than the sum of the effects from each isolated variable, especially for smoking and noise among those 20-40 years of age, and for smoking and age among those non-exposed to occupational noise. The synergistic effect of smoking, noise exposure and age on hearing loss, found in this study, is consistent with the biological interaction. Furthermore, it is possible that distinct ototoxic substances in the chemical composition of mainstream smoke may synergistically affect hearing when in combination with noise exposure, which needs to be examined in future studies.
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                Author and article information

                Journal
                Ann Med Health Sci Res
                Ann Med Health Sci Res
                AMHSR
                Annals of Medical and Health Sciences Research
                Medknow Publications & Media Pvt Ltd (India )
                2141-9248
                2277-9205
                Jan-Mar 2013
                : 3
                : 1
                : 1-6
                Affiliations
                [1] Department of Community Medicine, Pondicherry Institute of Medical Sciences, Ganapathychettikulam, Kalapet, Puducherry, India
                [1 ] Department of Health and Safety, Goa Shipyard Limited, Vasco, Goa, India
                [2 ] Department of Preventive and Social Medicine, Goa Medical College, Bambolim, Goa, India
                Author notes
                Address for correspondence: Dr. Nateshan Bhumika, Department of Community Medicine, Pondicherry Institute of Medical Sciences, Ganapathychettikulam, Kalapet, Puducherry, India. E-mail: thedoctortoday@ 123456gmail.com
                Article
                AMHSR-3-1
                10.4103/2141-9248.109453
                3634202
                23634321
                cd4aa815-2809-4384-8f00-2e30986c33e9
                Copyright: © Annals of Medical and Health Sciences Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Medicine
                asia,audiometry,earplugs,hearing loss,noise,occupational health,smoking,welding
                Medicine
                asia, audiometry, earplugs, hearing loss, noise, occupational health, smoking, welding

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