Megan Gilliver

Leisure noise exposure: Participation trends, symptoms of hearing damage, and perception of risk

Abstract Objective: Leisure activities that emit high noise levels have the potential to expose participants to excessive noise exposure, which can result in hearing damage. This study investigated young peoples participation in high-noise leisure activities and the relationship between their leisure noise exposure, symptoms of hearing damage, and perception of risk. Design: Participants completed an online survey relating to participation in selected high-noise leisure activities, symptoms of hearing damage, and beliefs about the risk posed by these activities. Study sample: One thousand 18- to 35-year-old Australian adults completed the survey. Results: Annual noise exposure from the five leisure activities ranged from 0–6.77 times the acceptable noise exposure, with nightclubs posing the greatest risk. Those who attended one noisy activity were more likely to attend others, in particular nightclubs, pubs, and live music events. Noise exposure was correlated with early warning signs of hearing damage and perceived risk of damage. Conclusions: Active young adults who engage in noisy activities are showing early signs of hearing damage. Furthermore, they perceive the risk associated with their activities. The challenge for researchers and hearing health practitioners is to convert self-perceived risk into positive hearing health behaviours for long-term hearing health.

Estimating young Australian adults’ risk of hearing damage from selected leisure activities

Objective: Several previous studies have attempted to estimate the risk of noise-induced hearing loss from loud leisure noise. Some of these studies may have overestimated the risk because they used noise estimates taken from the higher end of reported levels. The aim of the present study was to provide a realistic estimate of the number of young Australian adults who may be at risk of hearing damage and eventual hearing loss from leisure-noise exposure. Design: Average noise levels at five high-noise leisure activities, (1) nightclubs; (2) pubs, bars, and registered clubs; (3) fitness classes; (4) live sporting events; (5) concerts and live music venues, were calculated using 108 measurements taken from a large database of leisure noise measurements. In addition, an online survey was administered to a convenience sample of 1000 young adults aged 18 to 35 years, who reported the time spent at these leisure activities and the frequency with which they undertook the activities. They also answered questions about tinnitus and their perceived risk of hearing damage. Although the survey data cannot be considered representative of the population of young Australian adults, it was weighted to this population in respect of age, gender, education, and location. The survey data and the average noise levels were used to estimate each individual’s annual noise exposure, and in turn, estimate those at risk of hearing damage from leisure-noise exposure. Results: For the majority of participants (n = 868), the accumulated leisure noise level was within the acceptable workplace limit. However, 132 participants or 14.1% (population weighted) were exposed to an annual noise dose greater than the acceptable workplace noise limit. By far, the main source of high-risk leisure noise was from nightclubs. Those with more leisure-noise exposure experienced more tinnitus and perceived themselves to be more at risk than those with lower noise exposures. Conclusions: It is recommended that nightclub operators reduce noise levels, display warnings, and provide earplugs for patrons and employees. Health promoters should focus their attention on those young adults who are most at risk and provide them with targeted practical advice about reducing their leisure-noise exposure and avoiding hearing loss.

Evaluation of the NAL-NL1 and the DSL v.4.1 prescriptions for children: Paired-comparison intelligibility judgments and functional performance ratings

Abstract This paper reports intelligibility judgments and real-life functional performance of 48 children in a double-blind, cross-over trial comparing the NAL-NL1 and the DSL v.4.1 prescriptions. Intelligibility judgments were obtained by using a paired-comparisons procedure with audiovisual stimuli. Functional performance of children during two eight-week periods, each with hearing aids adjusted to one prescription, was assessed by parents and teachers (PEACH and TEACH) and by childrens self reports (SELF). Consistently across reports, performance was significantly better in quiet than in noise. On average, better performance in noise (a higher Noise subscale score) was associated with NAL-NL1 than with DSL v.4.1, both for the PEACH and the SELF. This difference was significant for the SELF in Australia. Intelligibility judgments revealed preferences that were equally split between prescriptions in both countries, on average. In the Australian sample, intelligibility judgments agreed with the questionnaire ratings and with parents’ ratings. An increase in preference for NAL was significantly associated with lesser hearing loss. The effect was not significant in the Canadian sample. Sumario Este trabajo reporta juicios de inteligibilidad y rendimiento funcional en la vida real de 48 niños, en un estudio doble ciego cruzado para comparar las prescripciones NAL-NL1 y DSL v.4.1. Los juicios de inteligibilidad se obtuvieron usando comparaciones por pares con estímulos audio-visu-ales. El rendimiento funcional de los niños durante dos perío-dos de ocho semanas, con auxiliares auditivos ajustados a una de las prescripciones, fue evaluado por padres (PEACH) y maestros (TEACH) y por auto-reportes de los niños (SELF). Consistentemente en los reportes, el rendimiento fue signifi-cativamente mejor en silencio que en ruido. En promedio, el mejor rendimiento en ruido (puntuación de una mayor subes-cala de ruido) se asoció con NAL-NL 1 en comparación con DSL v.4.1, ambos con PEACH y SELF. Esta diferencia fue significativa para SELF en Australia. Los juicios de inteligi-bilidad revelaron preferencias que se dividieron igualmente en promedio, entre las prescripciones en ambos países. En la muestra de Australia, los juicios de inteligibilidad estuvieron de acuerdo con las puntuaciones de cuestionarios y con las de los padres. Un aumento en la preferencia por el NAL se aso-ció significativamente con menor pérdida auditiva. El efecto no fue significativo en la muestra de Canadá.

Medical practitioners’ attitudes to hearing rehabilitation for older adults

Abstract Objective: Medical practitioners have the potential to play a significant role in older adults’ help seeking behaviour in relation to hearing rehabilitation. The current study aimed to look at attitudinal factors that influence practitioners’ decisions to discuss hearing difficulties with older patients and refer them for hearing rehabilitation. Design: A questionnaire based on constructs from the Health Belief Model was used to examine factors that may influence practitioners’ referral decisions. Study Sample: One hundred and ten practitioners’ attitudes to hearing rehabilitation were examined. Results: The results indicated that practitioners have a high level of awareness about their older patients’ susceptibility to hearing loss, and a good understanding of the severity of the associated impacts on older adults’ lives. Although practitioners acknowledged the theoretical benefits of hearing rehabilitation, many appear less certain about the potential for actual benefit for their older adults. Barriers to referral include negative perceptions about how older patients prioritise hearing, and patients’ ability to afford and adapt to the use of hearing aids. Conclusions: Additional research and education targeted at these area may be beneficial for medical practitioners to increase referral behaviour and improve discussions about hearing rehabilitation with their older patients. Sumario Objetivo: Los médicos tienen el potencial para jugar un papel significativo en la conducta de las personas mayores en cuanto a la búsqueda de rehabilitación auditiva. Este estudio tiene como objetivo observar los factores que influyen en la actitud de los médicos para decidirse a discutir con los pacientes de edad mayor, sus dificultades auditivas y referirlos a rehabilitación auditiva. Diseño: Se utilizó un cuestionario basado en los constructos del Modelo de Creencias en Salud para examinar los factores que pueden influir en las decisiones para referir pacientes. Muestra: Se examinaron las actitudes hacia la rehabilitación auditiva en cien pacientes y diez médicos. Resultados: Los resultados indican que los médicos tienen un alto nivel de conciencia sobre la susceptibilidad de los pacientes mayores a presentar hipoacusia y comprenden la severidad del impacto que esto tiene en sus vidas. Aunque los médicos reconocen los beneficios teóricos de la rehabilitación auditiva, muchos de ellos parecen estar menos convencidos del potencial benéfico real en los adultos mayores. Las barreras para referir a los pacientes incluyen las percepciones negativas sobre la forma en la que los pacientes mayores dan prioridad a la audición y la habilidad de los pacientes para costear y adaptarse al uso de un auxiliar auditivo. Conclusiones: Investigaciones adicionales y educación específica en estas áreas pueden ser beneficiar a los médicos para aumentar la conducta de referencia y la discusión con sus pacientes mayores sobre la rehabilitación auditiva.

A Qualitative Study of Earplug Use as a Health Behavior: The Role of Noise Injury Symptoms, Self-efficacy and an Affinity for Music

The use of earplugs in loud music venues is confined to a small minority who wish to avoid hearing damage from excessive noise exposure. Using the framework of the health belief model (HBM), structured interviews were held with 20 earplug-wearing clubbers. Qualitative analysis revealed the HBM constructs relevant to understanding this group’s motivation to protect their hearing. Personal experience of noise injury symptoms was the most common cue triggering earplug use. Awareness of the benefits of earplugs and appreciation of the long-term implications of hearing damage, affinity for music and high self-efficacy were also key variables underlying this health behaviour.

The NOISE (Non-Occupational Incidents, Situations and Events) Database: A new research tool

Abstract This paper describes the development of the NOISE (Non-Occupational Incidents, Situations and Events) Database. The NOISE database currently contains 536 separate leisure activities and events, including noise level measurements, (LAeq and LCpeak), and detailed information about the circumstances of each event. The data are organized into seven categories, in which high-noise events and activities can be identified. Thirty-five percent of events in the database were over 85 dB (the level at which noise is considered a risk according to workplace standards) and 3% were over 100 dB. Fourteen percent of events exceeded the acceptable workplace noise exposure limit of 1.01 Pa2h. The noise exposure levels recorded in the database can be used to identify high-risk leisure activities and to estimate individuals’ leisure noise exposures and make comparisons between leisure and workplace noise exposures.

WHEN EXPECTATION MEETS EXPERIENCE: PARENTS’ RECOLLECTIONS OF AND EXPERIENCES WITH A CHILD DIAGNOSED WITH HEARING LOSS SOON AFTER BIRTH

Abstract Objective: To examine parents’ recollections of and their experiences with bringing up a child diagnosed with hearing loss at a very young age. Design: Based on the analysis of informal parent discussion groups, four open-ended questions were formulated to solicit information about parents’ expectations following diagnosis, as well as experiences and challenges when raising a child with a hearing loss. Study sample: Forty parents of children, aged between three to five years, who were diagnosed with hearing loss before the age of three years. Results: Parents’ responses revealed strong support for early intervention, high expectations for their childs development, and desire for information tailored to individual needs. Parents also reported anxiety relating to their perceptions of the significance of consistent device usage on their childs development. Further concerns arose from their observations of the difficulties experienced by their child in real-world environments despite consistent device usage, and their perception of their childs language delay despite early intervention. Conclusions: The findings point to a need to support parents to form realistic expectations based on current knowledge. Implications for clinicians to provide improved management of children with hearing loss are discussed.

Noise with attitude: influences on young people's decisions to protect their hearing.

Abstract Abstract Objective: To investigate young peoples experiences and attitudes towards hearing health and their participation in noise reduction behaviours, to better understand how education and prevention messages may be better targeted. Design: An online survey was used to investigate participants’ own hearing health, their engagement with noise reduction behaviour, and their beliefs about hearing health and the risk posed by leisure activities. Study sample: Results are presented for 1000 Australian young adults (18–35 years). Results: Most participants reported current good hearing health, although over a fifth showed possible early warning signs of damage. Approximately half of participants took steps to reduce their noise exposure. However, preventative action was not related to hearing loss symptomology, or perceived personal risk of noise-related damage. Participants’ engagement with hearing health was related to beliefs about the risk posed by leisure noise, hearing health awareness, and the importance of hearing. Conclusions: There is a need to further educate young people about the risks posed to hearing by leisure activity participation and factors that may assist improve hearing health. It is important that hearing health messages move past the traditional emphasis on knowledge, and move towards the use of more personalized motivators of noise reduction behaviour.

The objective-subjective assessment of noise: young adults can estimate loudness of events and lifestyle noise.

Objective: The aim of the study was to establish whether individuals can subjectively estimate: (1) the loudness of events with respect to the objectively measured noise level; and (2) the overall loudness of their daily noise exposure level. Design: Participants wore personal noise exposure meters for up to five days. During this time, participants kept diaries of daily events and estimated the loudness of these events and their overall noise exposure using 1-to-10 rating scales. Study sample: A group of 45 volunteers aged between 18 and 35 years participated in the study. Results: 86% of participants’ subjective estimates were significantly correlated with the objective noise measurements. Multiple regression showed that age, overall lifestyle noise, and diary quality were predictors of the strength of correlation observed. In addition participants’ subjective estimates of their overall noise exposure were significantly correlated with their actual average daily noise exposure. Conclusions: Results suggest that individuals can make a reasonable estimate of the loudness of events they experience and the overall level of noise they experience. These results may have significant influence for those interested in producing effective hearing health awareness programs in that individuals may be capable of assessing their own degree of hazard exposure.

Changing beliefs about leisure noise: using health promotion models to investigate young people's engagement with, and attitudes towards, hearing health.

Abstract Objective: To investigate factors influencing young peoples motivation to reduce their leisure noise exposure, and protect their hearing health. Design: Questionnaires were conducted online to investigate young peoples hearing health attitudes and behaviour. Items were developed using an integrated health promotion approach. The stage of change model was used to group participants in relation to their engagement with noise reduction behaviour. The health belief model was used to compare each groups perceptions of susceptibility and severity of hearing loss, as well as the benefits and barriers to noise reduction. Study sample: Results are presented for 1196 young Australians aged between 18 and 35 years. Results: Participants’ engagement with noise reduction behaviour was used to assign them to stage of change groupings: Maintenance (11%), Action (28%), Contemplation (14%), or Pre-contemplation (43%). Each groups responses to health belief model items highlighted key differences across the different stages of engagement. Conclusions: Future hearing health promotion may benefit from tailoring intervention activities to best suit the stage of change of individuals. Different information may be useful at each stage to best support and motivate young people to look after their hearing health.