Adriana Bender Moreira de Lacerda

Efeitos ototóxicos da exposição ao monóxido de carbono: uma revisão

BACKGROUND Ototoxic effects of carbon monoxide exposure: a review. AIM To analyze the literature on hearing and Carbon Monoxide (CO). METHODS To describe the physical properties, the absorption, distribution and metabolism of CO, as well as its origin, production, sources and the international standards for occupational exposure. Several studies about the effects of CO exposure to the auditory system of humans and experimental animals were discussed. The main economic sectors where the combined exposure to noise and CO takes place were identified. A description of the basic CO toxic mechanisms that are able to raise occupational noise-induced hearing loss was given. CONCLUSION The review of the literature indicated the following: 1. Examples of CO exposure sources include air pollution, smoking and second-hand smoking, and occupational exposures. 2. COs main toxic mechanism can lead to hypoxia due to the conversion of oxyhemoglobin to carboxyhemoglobin. 3. Rats have been the most used experimental animals in CO auditory effects studies, this group of studies has demonstrated the combined effects of acute exposure to CO and noise. 4. Studies about the negative effects of CO exposure over the human auditory system were mainly carried out after acute exposures to CO. These studies did not control or report exposure to noise as a contributor to the observed hearing deficits. Currently the available evidence indicates the need for further research on the effects of CO exposure to the auditory system, alone or in combination with noise.

Características do zumbido em trabalhadores expostos a ruído

Tinnitus is a common auditory complaint among individuals exposed to noise. AIM: this paper aims to study the characteristics of tinnitus in workers exposed to noise. STUDY DESIGN: this is a descriptive prospective study. MATERIALS AND METHOD: Fifty-two individuals averaging 29 years of age were enrolled in a hearing loss prevention program at a meat processing plant. The participants were interviewed and had their hearing tested in 2005 and 2006. RESULTS: seventy-one percent of the participants were found to have normal hearing. Tinnitus was present in 16% of the males and in 9% of the females. Mean noise exposure length was 7 years and noise levels ranged from 86 to 91 dBA (48%). Bilateral tinnitus (46%) of the hissing type (40%) and moderate intensity (49%) was the most prevalent. Symptoms began to be observed within one to five years after initial exposure to noise (67%) and manifested themselves in weekly episodes (41%) that bothered the patients mostly at night (34%). A significant correlation was observed between the frequency of tinnitus episodes and the noise levels to which workers were exposed. CONCLUSION: tinnitus should be included in hearing loss prevention programs in order to more comprehensively promote occupational hearing health.

Ambiente urbano e percepção da poluição sonora

A presente pesquisa avaliou a percepcao da populacao de uma grande cidade em relacao a poluicao sonora (ruido urbano). Buscou-se identificar quais fontes sonoras sao percebidas com maior frequencia pela populacao e quais reacoes psico-sociais relacionadas ao ruido urbano sao identificados por ela. Foi utilizado um questionario composto de questoes fechadas, abrangendo aspectos demograficos e aspectos psico-sociais referentes ao ruido ambiental. Oitocentos e noventa e dois (892) individuos participaram da pesquisa. As principais fontes de ruido citadas pelos moradores como causadoras de incomodo foram: 1) o trafego de veiculos (67 %), 2) os vizinhos (33%), 3) o barulho de sirenes (23%), 4) o barulho de animais (21%) e 5) o barulho gerado pela construcao civil (21 %). As principais reacoes psico-sociais foram: 1) irritabilidade (55%), 2) baixa concentracao (28%), 3) insonia (20%) e 4) dor de cabeca (19%). Os resultados obtidos coincidem com dados obtidos em pesquisas desenvolvidas na Europa, EUA e no Brasil, de que a poluicao sonora ambiental influencia a qualidade de vida da populacao, gerando reacoes psico-sociais importantes, como: 1) irritabilidade e 2) insonia. Estes podem estar na base de outras doencas (disfuncoes cardiovasculares), podendo interferir na saude e no bem estar dos individuos em particular e de uma populacao urbana como um todo, gerando um problema de saude publica.The present study investigated the psychosocial complaints related to urban noise among the population of Curitiba. We used a questionnaire of closed-set questions to collect data on demographics and psychosocial reactions to environmental noise when subjects are at home. Eight hundred and ninety-two individuals (892) participated of the study. The main noise sources associated with discomfort or annoyance were traffic noise (67%), neighbors (33%), sirens (23%), animals (21%), and construction (21%). The main psychosocial complaints were annoyance (55%), disrupted concentration (28%), sleep disorders (20%) and headaches (19%). The data confirm that noise pollution has an influence on the quality of life of the population as manifested by several psychosocial complaints that could have a negative impact on the health and well being of populations.

The characteristics of tinnitus in workers exposed to noise

UNLABELLED Tinnitus is a common auditory complaint among individuals exposed to noise. AIM this paper aims to study the characteristics of tinnitus in workers exposed to noise. STUDY DESIGN this is a descriptive prospective study. MATERIALS AND METHOD Fifty-two individuals averaging 29 years of age were enrolled in a hearing loss prevention program at a meat processing plant. The participants were interviewed and had their hearing tested in 2005 and 2006. RESULTS seventy-one percent of the participants were found to have normal hearing. Tinnitus was present in 16% of the males and in 9% of the females. Mean noise exposure length was 7 years and noise levels ranged from 86 to 91 dBA (48%). Bilateral tinnitus (46%) of the hissing type (40%) and moderate intensity (49%) was the most prevalent. Symptoms began to be observed within one to five years after initial exposure to noise (67%) and manifested themselves in weekly episodes (41%) that bothered the patients mostly at night (34%). A significant correlation was observed between the frequency of tinnitus episodes and the noise levels to which workers were exposed. CONCLUSION tinnitus should be included in hearing loss prevention programs in order to more comprehensively promote occupational hearing health.

The combined effect of noise and carbon monoxide on hearing thresholds of exposed workers

Animal models have been used to demonstrate the potentiation of noise‐induced hearing loss (NIHL) by carbon monoxide. It has been shown that the addition of carbon monoxide to otherwise safe noise exposure levels produces significant NIHL in rats. However, the effects of chronic exposure to low level of carbon monoxide in a noisy work environment are still unknown. The aim of this study was to compare the hearing thresholds of a group of workers exposed to noise and carbon monoxide (Group 1) to another group of workers where carbon monoxide exposure is absent or negligible (Group 2). The analysis was based on 9396 audiograms collected by the Quebec National Public Health Institute between 1983 and 1996. The results show significantly poorer hearing thresholds at high frequencies (3, 4, and 6 kHz) for the carbon monoxide exposed group (p<0.001). The potentiation effect also varied according to years of exposure in work place; a larger effect is observed for workers with between 15 to 20 years of exposure (p<0.001). This study provides the first demonstration of a potentiation effect of NIHL by carbon monoxide in humans.

Hábitos auditivos e comportamento de adolescentes diante das atividades de lazer ruidosas

RESUMO Objetivo: identificar atitudes e habitos auditivos de adolescentes frente ao ruido (ambiental e lazer). Metodo: amostra: 125 adolescentes, ambos os generos, media de idade de 16,7 anos, estudantes do ensino fundamental e medio de escolas de diversos municipios paranaenses. Utilizou-se a versao brasileira do questionario Youth Attitude to Noise Scale (YANS) para explorar atitudes dos adoles-centes diante do ruido e questoes relacionadas aos habitos auditivos e dados demograficos dos adolescentes. Analise por estatistica descritiva, testes de Fisher e Qui-quadrado. Resultados: atitu-des: 40,2% dos adolescentes concordam que barulhos e sons altos sao aspectos naturais da nossa sociedade, 32% sentem-se preparados para tornar o ambiente escolar mais silencioso e 41,6% con-sideram importante tornar o som ambiental mais confortavel; 38,4% dos adolescentes apresentam zumbido e consideram-se sensiveis ao ruido. A maioria (85,6%) dos entrevistados relatou nao se pre-ocupar antes de ir a shows e discotecas, mesmo com experiencias precedentes de zumbido; 75,2%, nao fazem uso de protetor auditivo. Habitos auditivos: 46,4% referiram que ouvem musica com fones de ouvido diariamente e 34,4% ouvem musica com equipamento de som em casa. Diferencas signi-ficantes entre os generos, foram observadas na pratica de atividades esportivas e nauticas e grupo musical. Conclusoes: os integrantes desse estudo apresentam atitudes positivas para o ruido e os habitos mais comuns foram ouvir musica com fone de ouvido ou equipamento de som (casa ou carro).DESCRITORES: Perda Auditiva Provocada por Ruido; Adolescentes; Habitos; Atividades de Lazer

Limiares auditivos em músicos militares: convencionais e altas frequências

PURPOSE: To analyze and characterize tonal auditory thresholds between 500 Hz and 16,000 Hz of professional musicians, specifically members of a military band. METHODS: A historic cohort study was carried out comparing one group of 50 professional musicians (military band) with another group (44 subjects) without history of professional exposure to intense sound; the groups were homogenous (p<0.05%) in relation to gender (male) and age (about 35 years old). Tone threshold audiometry for conventional (from 500 to 8,000 Hz) and high frequencies was applied (from 9,000 to 16,000 Hz). RESULTS: Exposure to music triggered permanent hearing impairment. As to conventional auditory thresholds, the exposed and non-exposed groups presented sensorineural hearing loss of 32 and 2.27%, respectively. The subjects exposed to music had 14.54 times more risks of acquiring sensorineural hearing loss than the non-exposed group. After 20 years of exposure to music, significant worsening was observed in auditory thresholds, especially at extended high frequencies, and differences occurred between the groups from the age of 30 on. CONCLUSION: Exposure to music caused permanent hearing impairment, showing differences in relation to the non-exposed group, registered in conventional audiometry and at high-frequency audiometry.

Oficinas educativas como estratégia de promoção da saúde auditiva do adolescente: estudo exploratório

Purpose: Develop and evaluate educational workshop on hearing health and noise exposure adolescents, students of public school. Methods: Intervention study involving 91 adolescents. Educational activity was conduce based on the problem-posing education and as a methodological resource group work in the form of workshops in which young people were invited to reflect on the hearing health and noise exposure in cultural activities (leisure),and environmental education. Was used differents strategies playful and dialogical as: theater, music, conversation wheel, making mural. For evaluation of the workshop were applied two questionnaires, one questionnaire before and another after the workshop aimed at identifying and understandingc an change attitudes of young people against the noise, and the other on the development of the workshop. Results: After the workshops, was observed changes in the understanding of young people, considering the noise as something bad and harmfulto health, however significant differences were observed, the necessary care with hearing related to cultural activities. The students’ perceptions related to the dynamics used in the workshops was very good or goodby more than 80% of the evaluations. Conclusion: The educational workshops showed to be appropriate for health education of hearing students. Changes were observed in the understanding of teenagers, especially the effect of noise on cultural activities. The playful and dialogical strategies proposed in the workshop were accepted and appreciated by adolescents.

Percepção e o impacto da música na audição de integrantes de banda militar

PURPOSE: To evaluate the exposition to loud music, the perception of its intensity and its impact in the hearing of integrants of a military band. METHODS: Sound pressure levels (SPL) at the place where the band rehearsed were measured, a questionnaire was applied, and an audiological assessment was carried out (acoustic immittance measures and pure-tone audiometry). The participants were 50 musicians of the military band of the Parana (Brazil) army, all male, with mean age of 34.9 years and mean exposure duration of 14.2 years. RESULTS: Forty two percent of the participants considered that the sound pressure levels at rehearsals are very high; 76% reported to have experienced tinnitus and 54% had had hearing difficulties; 58% consider that intense music might harm hearing abilities; 32% had hearing loss. The sound pressure levels during rehearsals varied between 90.1 and 110.3 dB(A). CONCLUSION: The studied musicians were exposed daily to high sound pressure levels, which might cause health problems, such as tinnitus and hearing loss. Although the subjects considered the intensity of music as loud, they did not take prevention measures during rehearsals.

Newborn physiological responses to noise in the neonatal unit.

INTRODUCTION The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. OBJECTIVE To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. METHODS Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Students t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. RESULTS Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. CONCLUSION Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.