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   Table of Contents - Current issue
July-September 2023
Volume 25 | Issue 118
Page Nos. 121-201

Online since Thursday, September 28, 2023

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Noise in Preschools and its Psychological and Cardiovascular Effect on Preschool Teachers p. 121
Sonja Brachtl, Michael Trimmel
Purpose: Noise exposure in preschools is cited as one of the main stresses by preschool teachers in surveys worldwide. Hearing-related symptoms as well as physiological stress reactions are often mentioned in this context. Therefore, the aim of the study was to investigate whether the noise has an impact on the cardiovascular activity of the preschool teachers. Methods: The study took place in nine private preschools in Vienna. In the classrooms of 23 preschool teachers stationary noise recordings were conducted and the participants were equipped with 24-hour electrocardiograms (ECGs). Questionnaires on noise-related stress, well-being, stress perception, burnout risk, noise annoyance, and noise sensitivity were provided. Data were described descriptively and correlations and one-way analyses of variance (ANOVAs) with repeated measures were performed. Results: The average sound pressure level in the classrooms during the first four hours was LAeq 74.7 dB(A) (standard deviation [SD] = 1.74). A significant correlation between heart rate and sound pressure level (LAeq,4 h) was found, r = 0.40, P = 0.04 (one-tailed). Noise sensitivity and noise annoyance showed no effect. With increasing sound level classes [≤65 dB(A), 66–75 dB(A), 76–85 dB(A)], the heart rate increased significantly, and the heart rate variability decreased significantly. It was also found that tolerating noise becomes more difficult with increasing length of employment and increasing age. Conclusion: The noise level in classrooms showed an impact on the cardiovascular activity of preschool teachers, which can be considered as an indicator of stress. Measures to reduce noise in preschools are recommended.
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Association between Occupational Noise Exposure and Insomnia among Night-Shift Production Workers: A 4-Year Follow-up Study p. 135
Seunghyeon Cho, Dae-Young Lim, Suwhan Kim, Hyeonjun Kim, WonYang Kang, Won-Ju Park
Objectives: This study aimed to investigate whether occupational noise exposure is a risk factor for insomnia among male night-shift production workers. Methods: This study followed 623 male night-shift production workers at a tire manufacturing factory without insomnia for 4 years. Insomnia was evaluated based on the insomnia severity index at baseline and at 4-year follow-up. A score of ≥15 was defined as insomnia. The higher occupational noise exposure group was defined as those individuals exposed to 8-hour time-weighted-average noise above 80 dB (A). Results: Participants’ mean age was 46.3 ± 5.6 years. Of the 623 participants, 362 (58.1%) were in the higher occupational noise exposure group. At 4-year follow-up, insomnia occurred in 3.2% (n = 20) of the participants. In a multiple logistic regression analysis, the odds ratio of insomnia was 3.36 (95% confidence interval 1.083–10.405, P = 0.036) in the higher occupational noise exposure group when compared with the lower noise exposure group after adjusting for confounders. Conclusion: Our findings suggested that occupational noise exposure affected insomnia in male night-shift production workers. To prevent insomnia, efforts are required to reduce workplace noise exposure levels. Alternatively, moving to a less noisy work environment should be considered for workers with severe insomnia.
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Effects of Genes, Lifestyles, and Noise Kurtosis on Noise-Induced Hearing Loss p. 143
Xiaoyu Yin, Zheng Li, Tianyu Zhao, Lei Yang
Objective: To explore the association of lifestyles, caspase gene (CASP), and noise kurtosis with noise-induced hearing loss (NIHL). Design: Three hundred seven NIHL individuals and 307 matched controls from factories in Chinese factories participated in this case–control study. Age, sex, noise exposure, exfoliated oral mucosa cells, and lifestyles of participants were gathered by the authors. The single nucleotide polymorphisms (SNPs) were genotyped using the Kompetitive Allele Specific polymerase chain reaction (KASP) method. Results: The risk of NIHL was higher for people who worked in the complex noise environment than for people exposed to steady noise environment (adjusted: OR = 1.806, P = 0.002). Smoking and regular earphone use increased the risk of NIHL (adjusted: OR = 1.486, P = 0.038). The GG genotype of the recessive model and G allele in rs1049216, together with the TT genotype of the recessive model in rs6948 decreased the NIHL risk (adjusted: OR = 0.659, P = 0.017). Oppositely, the AA genotype of additive model in rs12415607 had a higher NIHL risk (adjusted: OR = 1.804, P = 0.024). In the additive models, there was a positive interaction between noise kurtosis and CASP3 polymorphisms (RERI = 1.294, P = 0.013; RERI = 1.198, P = 0.031). Conclusions: Noise kurtosis, three SNPs (rs1049216, rs6948, and rs12415607), smoking and earphone use were found to be related to NIHL, and there was a positive interaction between noise kurtosis and CASP3. Results from this study can be used to prevent and detect NIHL and for genetic testing.
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An Exploratory Study of Cervical Vestibular-Evoked Myogenic Potential in Users of Personal Listening Devices p. 158
Teja Deepak Dessai, Rashmi J Bhat, Kaushlendra Kumar
Context: The use of personal listening devices (PLDs) is becoming increasingly popular, particularly among young people. Numerous studies have demonstrated that being exposed to PLDs can have adverse effects on the auditory system. Owing to the similarities between the auditory and vestibular systems, it is possible that the negative effects of PLD use may extend to the vestibular system, an area that has not been extensively studied. Aim: The study aimed to investigate the impact of exposure to PLDs on the vestibular system, specifically the sacculo-collic reflex assessed by the cervical vestibular-evoked myogenic potential. Settings and Design: The current study used a cross-sectional study design. Materials and Methods: A total of 80 participants were divided into four groups based on the history of PLD exposure. Each group consisted of 20 participants who underwent cervical vestibular-evoked myogenic potential (cVEMP) testing using alternating polarity 500 Hz tone bursts. Statistical Analysis Used: Analysis of variance (ANOVA) and Bonferroni post hoc test were used to obtain the statistically significant difference among the group. Results: The results showed that the amplitude of p1-n1 of cVEMP was significantly reduced in individuals with longer PLD exposure duration. Conclusion: The study suggests that listening to music through a PLD at high levels of volume controls could be deleterious to the vestibular well-being of an individual. The study highlights the importance of being aware of the adverse effects of using PLDs to prevent potential damage to the vestibular systems.
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The Effect of Auditory Stimulation on the Nonlinear Dynamics of Heart Rate: The Impact of Emotional Valence and Arousal p. 165
Dmitri Dimitriev, Olga Indeykina, Aleksey Dimitriev
Background: Although it is known that sound exposure evokes changes in autonomic activity, the effects of noise and music on the nonlinear behavior of heart rate fluctuations remain poorly understood and controversial. This study aims to assess the influence of sound subjective emotional valence and arousal on the nonlinear characteristics of the autonomic nervous system during passive listening. Methods: In this study, 42 subjects listened to four sounds: (1) white noise, (2) road traffic noise, (3) excitatory music, and (4) a lullaby. The experiment consisted of two consecutive sessions: 5 minutes of rest, followed by 5 minutes of listening. RR intervals were recorded during both sessions. The following linear and nonlinear heart rate variability (HRV) indices were computed: Standard deviation of NN (SDNN), The root mean square of successive differences between normal heartbeats (RMSSD), F, high frequency (HF), approximate entropy (ApEn) and sample entropy (SampEn), correlation dimension (D2), Poincaré plot indices (SD1, SD2), fractal scaling exponents (alpha1, alpha2), and recurrence plot indices (mean line length [Lmean], maximum line length [Lmax], determinism [DET], laminarity [LAM], maximal vertical length [Vmax], trapping time [TT], Shannon entropy of line length distribution [ShanEn]). Results: Excitatory music was associated with a significant decrease in SDNN (from 47.3 ± 3.59 to 38.31 ± 3.16, P < 0.01), RMSSD (from 51.07 ± 4.75 to 42.53 ± 3.9, P < 0.05), HF (from 1516.26 ± 245.74 to 884.07 ± 183.44, P < 0.001), and low frequency (LF; from 973.33 ± 176.09 to 760.28 ± 150.35, P < 0.05). Excitatory music exposure induced significant increases in DET (P < 0.01), SD1 (P < 0.05), and SD2 (P < 0.05), but changes in detrended fluctuation analysis (DFA), SampEn, and D2 were nonsignificant. Traffic noise, white noise, and the lullaby did not cause significant changes in the measures of HRV. Conclusion: Presentation of excitatory music that evokes strong negative emotions elicits a prominent decrease in respiratory sinus arrhythmia. Poincaré plot and recurrence plot measures possess high sensitivity to excitatory music. Contrary to previous studies, we did not find the effects of relaxing music on HRV.
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Personal Listening Device Use and Attitude to Noise in Relation to Depression and Anxiety among Medical Students p. 176

Background: High levels of environmental noise may lead to psychological symptoms. The present study has hypothesized that personal listening device (PLD) use and a negative attitude to noise are significantly related to anxiety and/or depression. Methods: This is a cross-sectional study conducted on 431 six-grade students (35% male) at the Faculty of Medicine, University of Belgrade. All students completed the questionnaires related to socio-demographic data, noise/music exposure habits, behaviors related to PLD use, tinnitus, headaches, consumption of alcohol, coffee, energy drinks and cigarettes, YANS (Youth Attitude to Noise Scale), CES-D (The Center for Epidemiologic Studies Depression), and GAD–7 (Generalised Anxiety Disorder Assessment − 7 item scale) questionnaires. Results: There were 396 (91.9%) of investigated students who used PLD, with more frequent use among girls compared to boys (95.0% and 86.8%, respectively; p = 0.002). We found no significant relationship between the frequency of PLD use and depression and anxiety. However, continuous daily PLD use longer than 1 hour was significantly and positively related to depression (p = 0.006). Students with depression had a lower total YANS score compared to those without depression, indicating a more negative attitude toward noise (p = 0.042). Students with no difficulties to concentrate in noise and with a positive attitude to daily noises had about 37% lower chance to suffer from depression and anxiety, respectively. Conclusions: PLD use is common among medical students and may be associated with their mental health. Longer than 1 hour of continuous daily use of PLD may be positively related to depression. We also found a significant relationship between difficulties concentrating in noisy environments and depression, and between negative attitudes to daily noises and anxiety.
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Characterization and Prediction of Speech Intelligibility at the Output of Hearing Aids in a Noisy Working Environment p. 183

Objective: Hearing aids are more and more technically advanced, but do not necessarily guarantee the reproduction of useful signals in all working environments. This is particularly the case for speech intelligibility. This study focuses on the prediction of hearing aid performance in the case of a moderate deafness setting, in service and industrial work environments. To improve intelligibility, hearing aids propose signal processing options such as noise reduction and compression. These processes can transform hearing aids into nonlinear systems. The aim of this study is to develop a nonlinear method for the characterization of hearing aids. Materials and Methods: The method is based on the synchronized swept sine (SSS) signal method.[16] The SSS method is applied for determining hearing aid frequency responses fitted according to the present methodology and several processing options. The characterization of hearing aid’s program containing the noise reduction function is specifically analyzed. Indeed, to be fully active and efficient, the hearing aid, with the noise reduction feature activated, needs to be immersed in a noisy environment which does not allow nonlinear characterization. A linear approach is taken to study this feature. Three hearing aids commonly sold by hearing care professionals are studied here; all of them have three different programs. The characterization for each program is discussed. Results: The statistical study showed that the intelligibility, assessed using the speech transmission index in these sound environments, is well estimated for every program, although certain differences are observed when the compression effect is too high in the service work sector. Conclusion: The characterizations of hearing aids using the programs studied did not highlight the presence of frequency nonlinearities. The characterization method could not take into account amplitude nonlinearities when there is too much gain compression in the hearing process. Globally, all the hearing aid programs provided a very significant improvement in intelligibility in service and industrial work contexts.
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Correlation between the Degree of Hearing Loss and the Levels of Anxiety and Depression in Patients with Tinnitus p. 195

Objectives: This study aimed to explore the correlation between the degree of hearing loss (HL) and the degrees of anxiety and depression in patients with tinnitus. Materials and Methods: This retrospective study involved the use of basic clinical data from 600 enrolled patients with tinnitus who visited the otolaryngology clinic in Affiliated Jinhua Hospital, Zhejiang University School of Medicine from April 2020 to June 2022. The tinnitus handicap inventory (THI) scale was used to assess the tinnitus status among the participants. The pure tone audiometry (PTA) test was used to conduct audiological assessments for all patients to determine their hearing condition. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the levels of anxiety and depression among the participants, respectively. The correlation between the HL and anxiety/depression scores from the questionnaires was tested through Pearson correlation analysis. Results: Among the 600 enrolled patients with tinnitus, most patients had mild-to-moderate degree of tinnitus, accounting for 248 cases (41.3%) and 179 cases (29.8%), respectively. PTA results showed that a large proportion of patients with tinnitus were accompanied with HL (467 cases, 77.8%). Among them, patients with mild HL accounted for the largest proportion with a total of 241 cases (40.2%). Based on the results of SAS and SDS test, almost half of the patients had symptoms of anxiety and depression, accounting for 52.3% (314 cases) and 48.8% (293 cases), respectively. Similarly, patients with mild anxiety and depression occupy the largest proportion, accounting for 35.8% (215 cases) and 23% (138 cases), respectively. Pearson correlation analysis showed that the degree of HL was closely related to THI/SAS/SDS scores (P < 0.001). Conclusion: These findings indicate a strong positive correlation between the degree of HL and anxiety/depression scores in patients with tinnitus.
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