scholarly journals Cochrane method for systematic review and meta-analysis of interventions to prevent occupational noise-induced hearing loss – abridged

CoDAS ◽  
2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Christina Tikka ◽  
Jos Verbeek ◽  
Erik Kateman ◽  
Thais Catalani Morata ◽  
Wouter Dreschler ◽  
...  

ABSTRACT Purpose Assess the effect of non-pharmaceutical interventions at work on noise exposure or occupational hearing loss compared to no or alternative interventions. Research strategies Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. Selection criteria Randomized Controlled Trials (RCT), Controlled Before-After studies (CBA) and Interrupted Time-Series studies (ITS) evaluating engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance were included. Case studies of engineering controls were collected. Data analysis Cochrane methods for systematic reviews, including meta-analysis, were followed. Results 29 studies were included. Stricter legislation can reduce noise levels by 4.5 dB(A) (very low-quality evidence). Engineering controls can immediately reduce noise (107 cases). Eleven RCTs and CBA studies (3725 participants) were evaluated through Hearing Protection Devices (HPDs). Training of earplug insertion reduces noise exposure at short term follow-up (moderate quality evidence). Earmuffs might perform better than earplugs in high noise levels but worse in low noise levels (very low-quality evidence). HPDs might reduce hearing loss at very long-term follow-up (very low-quality evidence). Seventeen studies (84028 participants) evaluated hearing loss prevention programs. Better use of HPDs might reduce hearing loss but other components not (very low-quality evidence). Conclusion Hearing loss prevention and interventions modestly reduce noise exposure and hearing loss. Better quality studies and better implementation of noise control measures and HPDs is needed.

Author(s):  
David C. Byrne ◽  
Thais C. Morata

Exposure to industrial noise and the resulting effect of occupational hearing loss is a common problem in nearly all industries. This chapter describes industrial noise exposure, its assessment, and hearing disorders that result from overexposure to noise. Beginning with the properties of sound, noise-induced hearing loss and other effects of noise exposure are discussed. The impact of hearing disorders and the influence of other factors on hearing loss are described. Typically, noise-induced hearing loss develops slowly, and usually goes unnoticed until a significant impairment has occurred. Fortunately, occupational hearing loss is nearly always preventable. Therefore, this chapter gives particular attention to recommendations for measures to prevent occupational hearing loss such as engineering noise controls and hearing protection devices.


Author(s):  
Chanbeom Kwak ◽  
Woojae Han

To prevent intensive noise exposure in advance and be safely controlled during such exposure, hearing protection devices (HPDs) have been widely used by workers. The present study evaluates the effectiveness of these HPDs, partitioned into three different outcomes, such as sound attenuation, sound localization, and speech perception. Seven electronic journal databases were used to search for published articles from 2000 to 2021. Based on inclusion criteria, 20 articles were chosen and then analyzed. For a systematic review and meta-analysis, standardized mean differences (SMDs) and effect size were calculated using a random-effect model. The funnel plot and Egger’s regression analysis were conducted to assess the risk of bias. From the overall results of the included 20 articles, we found that the HPD function performed significantly well for their users (SMDs: 0.457, 95% confidence interval (CI): 0.034–0.881, p < 0.05). Specifically, a subgroup analysis showed a meaningful difference in sound attenuation (SMDs: 1.080, 95% CI: 0.167–1.993, p < 0.05) when to wear and not to wear HPDs, but indicated no significance between the groups for sound localization (SMDs: 0.177, 95% CI: 0.540–0.894, p = 0.628) and speech perception (SMDs: 0.366, 95% CI: −0.100–1.086, p = 0.103). The HPDs work well for their originally designated purposes without interfering to find the location of the sound sources and for talking between the workers. Taking into account various factors, such as the characteristics of the users, selection of appropriate types, and fitting methods for wearing in different circumstances, seems to be necessary for a reliable systematic analysis in terms of offering the most useful information to the workers.


2021 ◽  
Vol 104 (3) ◽  
pp. 349-358

Objective: To investigate hearing protection devices (HPDs) use and its relationship with hearing loss among steel industry workers in Thailand. Materials and Methods: The present cross-sectional study included 93 eligible participants who are working in the designated high-noise-level zones, which is 85 or more A-weighted decibels [dB(A)] for eight hours time-weighted average, of the two factories. Self-report forms were used to obtain HPDs use by industry workers and noise exposure level was measured with Spark® (Model 706) noise dosimeter. Audiometric screening for hearing loss was performed at a regional hospital by the qualified technician. The hearing loss in each ear was defined if the average threshold level was found to have exceeded 25 dB(A) at high frequencies of 4 and 6 kHz. Results: The findings showed that 45.2% of workers used earplug, 16.1% used earmuff, and 38.7% used both, and most workers (55.8%) wear HDPs regularly, for six of seven days per week. Fifty seven percent of workers wear HDPs for more than 60% time of an 8-hour work shift. Most workers (75.2%) have hearing loss. Conclusion: The authors’ result revealed that almost half of workers used hearing protection devices and most workers use HPDs during the 8-hour work time. Abnormal hearing ability were found among workers. The education program such as the hazards of noise on potential auditory loss, a noise education training program and full use of HPDs are encouraged to prevent effect of noise on workers. Keywords: Hearing protection devices, Noise induced hearing loss, Steel industry


2021 ◽  
Author(s):  
Chanbeom Kwak ◽  
Woojae Han

Abstract Background: To prevent intensive noise exposure in advance and be safely controlled during such exposure, hearing protection devices (HPDs) have widely been used for workers. The present study evaluates the effectiveness of these HPDs, partitioned into three different outcomes, such as sound attenuation, sound localization, and speech perception. Methods: For thus systematic review and meta-analysis, standardized mean differences (SMDs) and effect size were calculated using a random-effect model. Seven electronic journal databases were used to search published articles from 2000 to 2020. Based on inclusion criteria, 20 articles were chosen and then analyzed. Results: Overall, the HPD function performed significantly well for their users (SMDs: 0.457, 95% confidence interval [CI]: 0.034-0.881, p< 0.05). Specifically, a subgroup analysis showed a meaningful difference in sound attenuation (SMDs: 1.080, 95% CI: 0.167-1.993, p< 0.05) when to wear and not to wear HPDs, but indicated no significance between the groups for sound localization (SMDs: 0.177, 95% CI: 0.540-0.894, p = 0.628) and speech perception (SMDs: 0.366, 95% CI: -0.100 -1.086, p = 0.103). Conclusions: The HPDs work well for their originally designated purposes without interfering to find the location of the sound sources and for talking between workers. In a further study, various factors, such as characteristics of the users, selection of appropriate types, and fitting methods for wearing in different circumstances should be differenciated in terms of offering the most useful infomation to the workers.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A C Campagnolo Goncalves Toledo ◽  
N Soares De Almeida ◽  
A Pierucci ◽  
A Straioto Salomao ◽  
I Ribeiro Lemes ◽  
...  

Abstract Introduction Smartphone applications for health (M-Health) seem to overcome barriers to access Cardiovascular Rehabilitation Programs (CRP), because of their high degree of acceptance and also their potential to influence the frequency of physical exercise in weight loss. Objective To analyze the effectiveness of the combination of M-Health and CRP compared to CRP alone on functional capacity, adherence to CRP, management of cardiovascular risk factors in cardiac patients. Design Systematic Review and Meta-Analysis. Methods The following databases were used Medline via Ovid, EMBASE, Central, PEDro and SPORTDiscus via EBSCOhost from their inception until July/2020. We included randomized controlled trials investigating the effects of M-Health in combination with CRP compared to CRP alone in adults with heart disease, and the interventions with M-Health consisted of text messages, e-mails, and applications. The primary outcome of this review was functional capacity, measured by VO2peak, or self-reported physical activity (METs.min/week). PEDro scale was used to assess the methodological quality of the studies and the GRADE approach to assess the overall quality of evidence. Pooled estimates were calculated using a random effect model to obtain mean difference (MD) or standardized mean differences (SMD) and their respectives 95% confidence intervals (CI). Results Nineteen RCTs were eligible, the median risk of bias was 7 out of 10 points. The primary endpoint was analyzed by subgroups, time of intervention and kind of type CRP, eigthteen of these studies assessed functional capacity. CRP in combination with a m-health intervention was more effective than CRP alone in improving VO2peak, ml/min/kg, (MD: 0.84, CI: 0.30 to 1.38; I2=0%, high quality evidence, 12 trials, n=1889) at short-term follow-up, but at medium-term follow-up (MD: 0.84, CI: −0.26 to 1.41; I2=0%, high quality evidence, 8 trials, n=927,). Similarly, CRP associated with m-health was superior to CRP alone in increasing self-reported at short-term, METs.min/week, (MD:1.31, CI: −0.24 to 2.37; I2 = not aplicable, very low quality evidence, 1 trial, n=18), and at medium-term follow-up (MD: 0.18, CI: −0.01 to 0.36; I2=56%, moderate quality evidence, 4 trials, n=1107). Conclusion High quality of evidence shows that M-Health improves cardiorespiratory fitness at short-term follow-up. In addition, supervised program showed to be more effective than non-supervised. Funding Acknowledgement Type of funding sources: None.


2021 ◽  
pp. 1-13
Author(s):  
Leigh Ann Reel ◽  
Candace Bourland Hicks ◽  
Courtney Arnold

Purpose: Noise-induced hearing loss (NIHL) has been found in rural children, potentially due to occupational and recreational noise exposure without consistent use of hearing protection devices (HPDs). However, questions remain regarding the specifics of rural adolescents' noise exposure and use of hearing protection around different types of noise. As such, the purpose of the current study was to provide preliminary results on rural adolescents' noise exposure and use of hearing protection for gunfire, heavy machinery, power tools, all-terrain vehicles (ATVs), and music. Method: A questionnaire was administered to 197 students (seventh to 12th grade) from rural schools in West Texas. Questions were related to noise exposure and use of HPDs for specific categories of noise. Testing was performed at the schools, with an investigator recording each student's responses. Results: Approximately 18%–44% of adolescents reported exposure 12 or more times a year to gunfire, heavy machinery, power tools, and ATVs. Only 1%–18% of the adolescents reported never being exposed to such noise sources. Almost half of rural adolescents never used hearing protection around gunfire, and 77%–91% reported never wearing hearing protection when exposed to heavy machinery, power tools, and ATVs. Conclusions: The current study revealed that rural adolescents are exposed to noise sources that could damage their hearing. However, the majority of rural adolescents do not consistently wear hearing protection. Additional research is now needed to extend these findings by assessing rural adolescents' duration of exposure to different noise sources, in addition to investigating prevention of NIHL in this population. Supplemental Material https://doi.org/10.23641/asha.17139335


2021 ◽  
pp. oemed-2020-106838
Author(s):  
Elon D Ullman ◽  
Lauren M Smith ◽  
Marjorie C McCullagh ◽  
Richard L Neitzel

ObjectiveThis study investigated risk factors for poor earplug fit, with a focus on the association between hearing loss and personal attenuation ratings (PARs).MethodsEarplug fit was assessed by obtaining PARs using a real ear at attenuation threshold (REAT) system. Hearing loss was assessed using the unoccluded hearing thresholds measured during the REAT testing and the results of a speech-in-noise test. Potential predictors of PARs were modelled using both simple and multiple linear regression. Hearing loss was the primary predictor of interest.ResultsData were collected from 200 workers at ten above-ground mining sites in the Midwestern USA. Workers reported wearing their hearing protection on average 73.9% of the time in a high noise environment (mean 8-hour time-weighted average noise exposure 85.5 dBA, range 65–103 dBA). One-quarter (26.7%) of workers were found to have a hearing loss (hearing threshold ≥25 dB across 1–4 kHz), and 42% reported symptoms of tinnitus. Workers with a hearing loss had a significantly lower PAR than those without a hearing loss (β=−5.1, SE=1.7).ConclusionsThe results of the adjusted regression models suggest that workers with hearing loss achieved significantly lower PARs than those without hearing loss. This association between hearing loss and hearing protection devices (HPD) fit brings into focus the potential benefit of fit checks to be included in hearing conservation programmes. Workers found to have hearing loss should be prioritised for fit testing, as their hearing impairment may be associated with poor HPD fit.


2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A5.3-A6
Author(s):  
Zara Ann Stokholm ◽  
Inge Brosbøl Iversen ◽  
Henrik Kolstad

Current legislation and threshold limits for occupational noise exposure may not sufficiently account for higher vulnerability of the foetus. We conducted a systematic literature review and identified 20 relevant studies of prenatal noise exposure levels and health. Maternal tissues attenuate industrial noise by about 30 dB. The foetus responds the earliest to noise exposure from the 19th week of gestational age. There is some evidence of an increased risk of hearing loss at prenatal noise levels≥85 dBA (8 hour average) and little evidence at lower levels. Increased risks for preterm birth, small-for-gestational-age and congenital malformations are seen as single study findings at levels≥90 dBA. There is little evidence for how noise exposure may increase the risk of extra-auditive effects in the foetus. Methodological shortcomings and the scarce number of studies limit the conclusions that can be drawn. Still, we recommend pregnant women avoid working at noise levels≥85 dBA.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Johanes Nugroho ◽  
Ardyan Wardhana ◽  
Cornelia Ghea

Purpose. A previous meta-analysis has conducted nonrandomized trials for mechanochemical ablation (MOCA). Since medium-term follow-up data from randomized clinical trials (RCTs) are becoming available, we chose to perform a meta-analysis of RCTs to assess the efficacy and safety of MOCA for saphenous vein insufficiency. Methods. A systematic search of all RCTs comparing the anatomical success of MOCA for saphenous vein insufficiency to thermal ablation was performed using the PubMed and Cochrane Library databases. We employed the Mantel-Haenszel random-effects meta-analysis of outcomes using RevMan 5.3. Results. Four studies (615 patients) were included in this meta-analysis. The MOCA group had 93.4% and 84.5%, whereas the thermal ablation group had 95.8% and 94.8% of anatomical success rate at 1 month (short-term) and a period of more than 6 months but less than 1-year follow-up (mid-term), respectively. According to intention-to-treat analysis, there were similar anatomical successes in MOCA and thermal ablation groups at the short-term follow-up (low-quality evidence; relative risk RR=0.98 (95% CI, 0.94–1.03); P=0.44; I2=53%). The estimated effect of MOCA on anatomical success showed a statistically significant reduction at the mid-term follow-up (moderate-quality evidence; RR=0.89 (95% CI, 0.84–0.95); P=0.0002; I2=0%). MOCA had fewer incidence of nerve injury, deep vein thrombosis, and skin burns compared to the thermal ablation procedure (low-quality evidence; RR=0.33 (95% CI, 0.09–1.28); P=0.11; I2=0%). Conclusion. MOCA offered fewer major complications but lesser anatomical success at the period of more than 6 months but less than 1-year follow-up than thermal ablation. Trial Registration. This trial is registered with UMIN Clinical Trial Registry (UMIN ID 000036727).


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