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PubMedDate not supplied

The effect of water exposure after tympanostomy tube insertion.

INTRODUCTION: Unprotected water exposure as a cause of otorrhea in patients with tympanostomy tubes remains controversial. Although most otolaryngologists continue to recommend either the avoidance of swimming or the use of water precautions during swimming, evidence indicates that the infection rate may not be affected by this practice. This study prospectively evaluates the possible role of unprotected water exposure in the occurrence of post-tympanostomy-tube otorrhea. MATERIALS AND METHODS: Two hundred twelve consecutive patients undergoing tympanostomy tube placement were randomized into swimming and nonswimming groups. No special precautions (eg, ear plugs, canal occlusion, antibiotic drugs) were used in either group. This incidence of otorrhea was then compared between these groups. RESULTS: One-year follow-up was obtained in 107 patients. There was no significant difference in the incidence of otorrhea or the number of otorrhea episodes between the two groups. CONCLUSIONS: Swimming is not contraindicated in patients with tympanostomy tubes, and water precautions do not decrease the incidence of otorrhea.

Anti-Bacterial Agents↗
PubMed2006

Staging workers' use of hearing protection devices: application of the transtheoretical model.

The threat of noise-induced hearing loss is a serious concern for many workers. This study explores use of the transtheoretical model as a framework for defining stages of workers' acceptance of hearing protection devices. A secondary analysis was performed using a cross-section of data from a randomized, controlled clinical trial of an intervention to increase use of hearing protection. Use of hearing protection devices was well distributed across the theorized stages of change. Chi-square analysis and analysis of variance revealed significant differences between stages for the variables studied. Discrete stages of hearing protection device use can be identified, laying the foundation for further work investigating use of the transtheoretical model for promoting hearing protection device use. The model can provide a framework for tailoring interventions and evaluating their effects. With further development of the transtheoretical model, nurses may be able to easily identify workers' readiness to use hearing protection devices and tailor training toward that goal.

Adult↗
PubMed2006

Water precautions and ear surgery: evidence and practice in the UK.

BACKGROUND: Patients are traditionally advised to refrain from exposing their ears to water after most otological procedures. However, recent evidence suggests that water does not adversely affect the outcome for children with tympanostomy tubes. The evidence behind the potential harmful effects of water on the outcome of other otological procedures is scarce. OBJECTIVE: The study was done to determine the current practice of otolaryngology consultants in the UK on the advice given to patients regarding swimming, diving and bathing in soapy water after myringotomy and tympanostomy tube insertion, mastoidectomy and myringoplasty. METHOD: Questionnaire based survey mailed to 382 members (consultants only) of the British Association of Otolaryngologists--Head & Neck Surgeons in the UK. RESULTS: A total of 195 responses were received (reply rate 51 per cent). In all, 95.6 per cent of the respondents allowed their patients to swim after insertion of tympanostomy tubes, with 32.9 per cent insisting on the use of earplugs until extrusion of the tympanostomy tubes. However, 61.6 per cent of the respondents restricted diving in these patients. In comparison, the respondents were more conservative with water precautions following myringoplasty and mastoidectomy. More than half the respondents recommended earplugs for bathing after all three operations. CONCLUSION: This study reveals current national practice among UK otolaryngologists. There is no general consensus in post-operative advice following otolaryngological procedures, indicating a need for national guidelines.

Baths↗
PubMed1983

Hearing protectors: a review of recent observations.

Hearing protectors are the most widely used means of protecting hearing from the harmful effects of noise. Economic considerations make it unlikely that noise can be reduced at the source to acceptable levels in the immediate future and isolation of workers in sound-attenuating enclosures or reduction of an individual's exposure time is not always practical. Personal hearing protective devices are affordable and readily available. Despite many years of use, a number of theoretical and practical questions remain about their utility.

Ear Protective Devices↗
PubMed1990

Attenuation performance of four hearing protectors under dynamic movement and different user fitting conditions.

An experiment was conducted to determine the effects of movement activities and alternative fitting procedures on protection levels afforded by four hearing protection devices (HPDs). Psychophysical attenuation measurements at nine one-third-octave bands from 125 to 8000 Hz were obtained prior to, during, and following a 2-hr wearing stint that included periods of either highly kinematic but controlled work activity or vigorous temporomandibular movement. The 40 subjects, who were nonusers of HPDs, initially fit the protectors according to either the instructions on the package (i.e., subject fit) or after receiving interactive training on proper fit (i.e., trained fit). Thereafter no further protector adjustments were allowed during the wearing period. The subject-fit condition resulted in significantly lower protection levels, from 4 to 14 dB, at 1000 Hz and below for a premolded polymer earplug, a user-molded foam earplug, and a double protector consisting of a muff over the foam plug. The muff alone was significantly more resilient to fitting effects on attenuation than were the plugs. Movement activity caused up to a 6-dB significant reduction in frequency-specific attenuation over time for the premolded plug, muff, and muff-plug combination. The compliant foam earplug was largely resistant to either type of movement effect but did benefit more than the other devices from use of the trained-fit procedure. Implications of the results for hearing protector testing protocol, device selection, and user training are discussed.

Adult↗
PubMed1997

Noise exposures. Effects on hearing and prevention of noise induced hearing loss.

1. Over 30 million workers are exposed to hazardous noise on the worksite. Continual exposure to high noise levels damages and destroys hearing cells within the ear, making noise induced hearing loss an irreversible impairment. 2. Hearing conservation programs are required by law for workers in industrial settings where noise exposures equal or exceed 85 dB(A). Many workers, such as those in construction and agricultural industries, are not covered by these programs. 3. Reducing noise through engineering or administrative controls is the first line of defense. When this is not sufficient, two types of personal hearing protection devices are available: passive hearing protection devices such as ear muffs, canal caps, and ear plugs, which reduce noise mechanically; and active noise reduction devices, which electronically cancel sound waves at the ear. 4. The most effective hearing protection devices are those with which the worker is most comfortable will use 100% of the time. The occupational health nurse has a major role in promoting increased use of hearing protection devices through continued contact with workers, administrators, and safety personnel.

Ear Protective Devices↗
PubMed1993

Detection of warble tones in wideband noise with and without hearing protection devices.

Noise attenuation by linear hearing protection devices (HPDs) is considered to be independent of the environmental noise level. Linearity of HPDs is one of the basic assumptions underlying the Real Ear Attenuation at the Threshold (REAT) method of HPD testing, which utilizes quiet conditions. However, non-linear growth of masking at high intensity levels may result in the effects of HPDs on detection of speech and warning signals being different from those at high noise levels. The purpose of this study was to determine if the non-linear growth of masking can affect detection of warble signals by persons using HPDs in wideband noise presented at the 100 dB(A) level. Audiometric thresholds of hearing of 10 listeners were measured under four experimental conditions: (1) noise off, HPDs off (condition C1); (2) noise off, HPDs on (condition C2); (3) noise on, HPDs on (condition C3); and (4) noise on, HPDs off (condition C4). The results of this study indicate that detection of signals by persons using HPDs in noise < 100 dB(A) can be well predicted from noise attenuation characteristics of HPDs measured in quiet without the need for a correction factor accommodating non-linear growth of masking. This finding has implications for predicting the audibility of warning signals in noise by persons wearing HPDs.

Adult↗
PubMed2007

Noise exposure and hearing conservation in U.S. coal mines--a surveillance report.

This study examines the patterns and trends in noise exposure documented in data collected by Mine Safety and Health Administration inspectors at U.S. coal mines from 1987 through 2004. During this period, MSHA issued a new regulation on occupational noise exposure that changed the regulatory requirements and enforcement policies. The data were examined to identify potential impacts from these changes. The overall annual median noise dose declined 67% for surface coal mining and 24% for underground coal mining, and the reduction in each group accelerated after promulgation of the new noise rule. However, not all mining occupations experienced a decrease. The exposure reduction was accompanied by an increase of shift length as represented by dosimeter sample duration. For coal miners exposed above the permissible exposure level, use of hearing protection devices increased from 61% to 89% during this period. Participation of miners exposed at or above the action level in hearing conservation programs rapidly reached 86% following the effective date of the noise rule. Based on inspection data, the occupational noise regulation appears to be having a strong positive impact on hearing conservation by reducing exposures and increasing the use of hearing protection devices and medical surveillance. However, the increase in shift duration and resulting reduction in recovery time may mitigate the gains somewhat.

Coal Mining↗
PubMed1993

The noise exposed factory workers: the prevalence of sensori-neural hearing loss and their use of personal hearing protection devices.

A total of 524 industrial workers were studied. They consisted of 442 noise exposed and 82 non-noise exposed workers. The purpose was to compare the prevalence of sensori-neural hearing loss among the noise exposed and the non-noise exposed workers, to study their knowledge on the hazard of noise to hearing and the workers' attitude towards the hearing protection devices. The prevalence of sensori-neural hearing loss was significantly higher among the noise exposed workers, i.e., 83% versus 31.7% (p < 0.01). However, the prevalence of hearing impairment was much lower for both groups, being 30.1% for the noise exposed and 3.7% for the non-noise exposed group. Although hearing protection devices were provided to 80.5% of the workers, only 5.1% were wearing them regularly. The possibility of developing hearing loss due to exposure to excessive noise was only known by 35.5% of the noise exposed workers. This awareness was found to have a positive correlation with the workers' compliance to the hearing protection devices. Our findings highlight the need for workers to be educated on the hazards of excessive noise exposure to hearing.

Auditory Threshold↗
PubMed1988

Gender differences in real-world hearing protector attenuation.

This research investigated the possibility of differences in real-world attenuation attributable to gender. A total of 160 subjects, 80 males and 80 females, under the age of 45 years, and with normal hearing, were tested. Subjects were assigned to four hearing protector categories with the restriction that there were 20 males and 20 females in each group. The devices chosen for study were the E-A-R expandable foam plug, the Willson Sound Silencer premolded vinyl plug with double flange, the Bilsom Soft polyethylene encapsulated glass fiber plug, and the MSA Ear Defender (V-51R) premolded vinyl plug with single flange. Binaural headphone detection thresholds were measured in quiet with the open ear, and subsequently with protectors fitted binaurally for one-third octave noise bands centered at 250, 500, 1000, 3150 and 6300 Hz. The results indicated that attenuation scores achieved by females were less than those observed for males when the device was sold in only one size. Apart from the question of adequate sizing, for two of the insert protectors studied, mean achieved attenuation fell short of the manufacturer's specifications by as much as 18 dB, for particular frequencies tested. The relatively wide variation in scores observed for all four protectors in spite of experimenter-fit could not be accounted for by differences in either hearing threshold across subjects or by size of plug fit, for those devices available in several sizes.

Adolescent↗
PubMedDate not supplied

Factors influencing use of hearing protection among farmers: a test of the pender health promotion model.

BACKGROUND: Most farmers are exposed to potentially hazardous noise levels through many of their work activities, such as operating tractors, grain dryers, and chain saws. Rates of noise-induced hearing loss in this group are high. Although this condition is preventable through the use of hearing protection, rates of protective device use are low. Understanding factors influencing the use of hearing protection devices will provide direction for programs to increase their use and decrease risk of noise-induced hearing loss. OBJECTIVES: A study was designed using the Pender Health Promotion Model to identify factors affecting farmers' use of hearing protection devices. METHOD: Model testing was conducted with a convenience sample of 139 farmers. Prior to model testing, existing instruments designed to measure concepts from the Health Promotion Model were modified for use with farmers through interviews, validity testing with an expert panel, and reliability testing with first a small (n = 36) then a second larger (n = 139) convenience sample of farmers. Instruments measuring cognitive and affective factors related to hearing protection device use were administered to farmers at a regional farm show in the Midwest. RESULTS: A logistic regression analysis identified interpersonal support, barriers, and situational influences as statistically significant predictors of this health behavior, correctly predicting 78% of the cases. Results of model testing were consistent with results of previous studies of Health Promotion Model variables with other worker groups' use of hearing protection. CONCLUSIONS: Information from this study can be used to design and evaluate interventions to promote hearing protection device use among farmers and reduce the level of noise-induced hearing loss in this high-risk and underserved worker group.

Agricultural Workers' Diseases↗
PubMed2003

Communication in noise with acoustic and electronic hearing protection devices.

The purpose of the present study was to evaluate communication ability in noise at two signal presentation levels when using acoustic and electronic hearing protection devices (HPDs). Fourteen normal hearing subjects were fitted binaurally with custom acoustic HPDs (ER-15) and custom electronic HPDs (Starkey SA T9). Probe microphone measurements were obtained on 28 ears for three experimental conditions (open ear, acoustic HPD, electronic HPD) at four input signal levels (60, 70, 80, 90 dB SPL). Also, communication in noise was evaluated for three conditions (open ear, acoustic HPD, electronic HPD) at two input signal levels (75 and 90 dB SPL) using the Hearing In Noise Test. Results indicated significantly greater attenuation as well as significantly better communication in noise for the acoustic HPD. Results also indicated that the electronic HPD failed to attenuate any input signal utilized. Although results of behavioral testing indicated that communication ability in noise was not significantly impacted by varying the signal presentation level when utilizing either HPD, a more salient finding may be that utilization of the electronic HPD may place listeners at risk for temporary or permanent sensorineural hearing loss.

Adult↗
PubMed1993

Auditory perception with level-dependent hearing protectors. The effects of age and hearing loss.

Auditory perception with hearing protectors was assessed in three groups of subjects, two with normal hearing, but differing in age, and one with moderate bilateral sensorineural hearing loss. Individuals were tested with the ears unoccluded, and fitted with each of two level-dependent ear muffs and their conventional level-independent counterparts. One of the former devices provided limited amplification. In each of these five ear conditions, the threshold of audibility for one-third octave noise bands centered at 500, 1,000, 2,000 and 4,000 Hz, consonant discrimination, and word recognition were measured in quiet and in a continuous impulse noise background. The results showed that the attenuation of sounds (i.e. the difference between protected and unoccluded thresholds) in quiet did not vary as a function of age or hearing loss for any of the four protectors. In noise, the difference between protected and unoccluded listening was close to zero, as long as hearing was normal. With hearing loss as a factor, there was a significant increment in the protected threshold, the amount determined by the device. Word recognition in quiet was adversely affected in normal-hearing listeners by the three attenuating devices but improved in noise relative to unoccluded listening. Amplification had a deleterious effect for both consonant discrimination and word recognition in noise. In hearing-impaired listeners, speech perception was impeded by all four muffs but less so in quiet with limited amplification.

Adult↗
PubMedDate not supplied

Effects of booster interventions on factory workers' use of hearing protection.

BACKGROUND: The provision of reinforcements or boosters to interventions is seen as a logical approach to enhancing or maintaining desired behavior. Empirical studies, however, have not confirmed the effectiveness of boosters nor assessed the optimum number of boosters or the timing for their delivery. OBJECTIVES: This randomized controlled trial contrasted the effect of four booster conditions (a). 30 days; (b). 90 days; (c). 30 and at 90 days; and (d). no boosters of the intervention to increase the use of hearing protection devices (HPDs). METHODS: A total of 1325 factory workers completed a computerized questionnaire and were randomly assigned to one of three computer-based (tailored, nontailored predictor-based, or control) multimedia interventions designed to increase the use of hearing protection devices. After the intervention, colorful boosters specific to the type of training received were mailed to workers' homes. Posttest measures of use were administered at the time of their next annual audiogram 6 to 18 months after the intervention. RESULTS Repeated measures of analysis of variance (ANOVA) showed a significant main effect for the booster (after 30 days) in the group that received tailored training (F[3442] = 2.722; p =.04). However, in the assessment of the interaction between time (pretest and posttest) and boosters (four groups), the ANOVA did not find significant differences in hearing protection device use for any of the training groups. To assess for significant differences between groups, post hoc comparisons were conducted at the pretest and posttest for the total sample and for the subsample of workers who reported using hearing protection devices less than 100% of the time needed. Sheffé contrasts by intervention group, gender, ethnicity, and hearing ability found no significant changes in the mean use of hearing protection devices for the booster groups. CONCLUSIONS: Although the provision of boosters represented a considerable commitment of resources, their use was not effective in this study. However, it would be premature to eliminate boosters of interventions. Further study is needed to explore the effects of different booster types for increasing the use of hearing protection devices, and to assess carefully the effects of boosters on other health behaviors in studies with controlled designs.

Adult↗
PubMed2000

Hyperacusis: case studies and evaluation of electronic loudness suppression devices as a treatment approach.

Hyperacusis, as defined here, is a relatively rare condition in which the patient, with or without hearing loss, experiences severe loudness discomfort to everyday environmental sound levels. The case studies of 14 patients with severe hyperacusis are described; all wore passive attenuators (earplugs and/or earmuffs) in an attempt to alleviate their discomfort, frequently producing communication difficulties. These subjects were fitted binaurally with experimental electronic loudness suppression devices housed in in-the-ear casings. The devices supplied low-level amplification followed by an extreme form of amplitude compression for moderate or high-level inputs in an attempt to reduce loudness discomfort without reducing audibility. Many of the subjects were found to function with a wider dynamic range with the active devices compared with passive attenuators or the unoccluded ear, and most reported that they benefited from the devices in at least some listening situations.

Adult↗
PubMed1989

Noise exposure and permanent hearing loss of textile workers in Thailand.

Hearing loss induced by noise exposure in a large scale textile mill (number of workers = 1,611) in Thailand was investigated on the basis of interviews, noise measurements, and audiometric tests. The frequency of subjective symptoms relating to noise exposure was higher in the weavers than among other mill workers and office workers. The average noise levels in the weaving sections and other sections were 101.3 +/- 2.7 dBA and 89.8 +/- 5.3 dBA, respectively. The results of the audiometric tests revealed the significantly higher noise-induced hearing loss among workers in the weaving section compared to other mill workers and office workers (P less than 0.01). Among weavers, hearing levels decreased with the longer years of work. Concerning personal noise protective devices, 38.6% of the weavers never used them. It was concluded that hearing loss status in the workers of the mill was serious. Improvements by means of integrated work organization activities were recommended.

Adult↗
PubMed2006

[Analysis of hearing threshold shift measured by otoacoustic emissions in soldiers after shooting with use hearing protectors].

BACKGROUND: The aim of the study was to assess the influence of short-term impulse noise on the size of temporary threshold shift in soldiers using hearing protectors during exposure. MATERIAL AND METHODS: The study covered 80 subjects with normal tympanic membrane and thresholds measured by pure tone audiometry lower than 20 dB. There were two groups: I--composed of 40 soldiers protected during shooting and II--comprised 40 young males which did not shoot (controls). Transient evoked otoacoustic emissions were performed by an ILO 292 Echoport Otodynamics device 3-5 min before shooting and 2 min, 1, 2 and 3 h after shooting. RESULTS: The results showed that post-exposure changes in soldiers who used ear-muffs were not significant. CONCLUSION: The use of hearing protectors is strongly recommended because most of them seem to sufficiently attenuate impulse noise from firearms.

Adult↗