Many recreational activities are accompanied by loud concurrent sounds and decisions regarding the hearing hazards associated with these activities depend on accurate sound measurements. Sound level meters (SLMs) are designed for this purpose, but these are technical instruments that are not typically available in recreational settings and require training to use properly. Mobile technology has made such sound level measurements more feasible for even inexperienced users. Here, we assessed the accuracy of sound level measurements made using five mobile phone applications or "apps" on an Apple iPhone 4S, one of the most widely used mobile phones. Accuracy was assessed by comparing application-based measurements to measurements made using a calibrated SLM. Whereas most apps erred by reporting higher sound levels, one application measured levels within 5 dB of a calibrated SLM across all frequencies tested.

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The workplace contributes significantly to the total dose of daily noise to which a person is subjected. Therefore, millions of people around the world are exposed to potentially dangerous noise levels and consequently, there is an urgent, global need for legislation to adequately protect the auditory health of workers. Occupational noise legislation has been adopted in many of the countries with different degrees of comprehensiveness and varying levels of sophistication. This paper presents a global view of current legislation on occupational noise in the 22 countries that make up the Americas, that is, Latin America, Canada, and the United States. Upon analysis of the legislation, there are notable differences among countries in the defined values for permissible exposure limit (PEL) and exchange rate. Of the countries that have regulations, the majority (81%) use a PEL of 85 dBA. A PEL of 85 dBA and the 3-dB exchange rate are currently used by 32% of the nations in the Americas. Most nations limit impulsive noise exposure to a peak unweighted sound pressure level of 140 dB (or dBC), while a few use slightly lower limits. However, 27% of the countries in the region still have not established regulations with respect to permissible noise levels and exchange rates. This fact is leaving millions of workers in the Americas unprotected against occupational noise. Provide an overview and analysis of the current legislation on occupational noise in the 22 countries that make up the Americas. The information on legislation, regulations, and standards discussed in this paper were obtained directly from official government sources in each country, the International Labour Organization database, or through various colleagues in each country. (1) There are notable differences among countries in the defined values for PEL and exchange rate. (2) Of the countries that have regulations, the majority (81%) use a PEL of 85 dBA. A PEL of 85 dBA and the 3-dB exchange rate are currently used by 32% of the nations in the Americas. (3) Most nations limit impulsive noise exposure to a peak unweighted sound pressure level of 140 dB (or dBC), while a few use slightly lower limits. (4) 27% of the countries in the region still have not established regulations with respect to permissible noise levels and exchange rates. (5) Millions of workers in the Americas are unprotected against occupational noise.

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Adolescent exposure to loud music has become a social and health problem whose study demands a holistic approach. The aims of the current study are: (1) To detect early noise-induced hearing loss among adolescents and establish its relationship with their participation in musical recreational activities and (2) to determine sound immission levels in nightclubs and personal music players (PMPs). The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs) were classified as: normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3). The musical general exposure (MGE), from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01), in Group 3 compared with Group 2 (P < 0.05) only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01). Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05) and in Group 3 compared with Group 1 (P < 0.05). A significant difference (P < 0.05) was found in Group 1's HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2) dBA and PMPs (82.9-104.6) dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

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The objective of this study was to assess the effects on heart rate variability (HRV) of exposure to different styles of "relaxing" music. Autonomic responses to musical stimuli were correlated with subjective preferences regarding the relaxing properties of each music style. Linear and nonlinear HRV analysis was conducted in 25 healthy subjects exposed to silence or to classical, new age or romantic melodies in a random fashion. At the end of the study, subjects were asked to choose the melody that they would use to relax. The low-to-high-frequency ratio was significantly higher when subjects were exposed to "new age" music when compared with silence (3.4 ± 0.3 vs. 2.6 ± 0.3, respectively, P < 0.02), while no differences were found with "classical" or "romantic" melodies (2.1 ± 0.4 and 2.2 ± 0.3). These results were related to a reduction in the high frequency component with "new age" compared to silence (17.4 ± 1.9 vs. 23.1 ± 1.1, respectively P < 0.004). Significant differences across melodies were also found for nonlinear HRV indexes. Subjects' preferences did not correlate with autonomic responses to melodies. The results suggest that "new age" music induced a shift in HRV from higher to lower frequencies, independently on the music preference of the listener.

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Young people expose themselves to potentially damaging loud sounds while leisure activities and noise induced hearing loss is diagnosed in increasing number of adolescents. Hearing and music exposure in a group of adolescents of a technical high school was assessed at the ages of: 14-15 (test) and 17-18 (retest). The aims of the current study were: (1) To compare the auditory function between test and retest; (2) to compare the musical exposure levels during recreational activities in test and retest; (3) to compare the auditory function with the musical exposure along time in a subgroup of adolescents. The participants in the test were 172 male; in the retest, this number was reduced to 59. At the test and retest the conventional and extended high frequency audiometry, transient evoked otoacoustic emissions (TEOAEs) and recreational habits questionnaire were performed. In the test, hearing threshold levels (HTLs) were classified as: Normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3); the Musical General Exposure (MGE), categorized in: Low, moderate, high, and very high exposure. The results revealed a significant difference (P < 0.0001) between test and retest in the HTL and global amplitude of TEOAEs in Group 1, showing an increase of the HTL and a decrease TEOAEs amplitude. A subgroup of adolescents, with normal hearing and low exposure to music in the test, showed an increase of the HTL according with the categories of MGE in the retest. To implement educational programs for assessing hearing function, ear vulnerability and to promote hearing health, would be advisable.

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A potential consequence of exposure to noise is a temporary reduction in auditory sensitivity known as temporary threshold shift (TTS), which mainly depends on the intensity and duration of exposure to the noise. Recovery time is related to the amount of initial hearing loss, and the most recovery takes place during the first 15 min following exposure. This study evaluated the efficacy in otoprotection against noise-induced hearing loss of an orally administrated food supplement containing coenzyme Q ₁₀ -Ter. This water-soluble formulation of coenzyme Q ₁₀ shows better bioavailability than the native form and has been found to have a protective effect on outer hair cells after exposure to noise in animal models. Thirty volunteers were enrolled, and the right ear of each subject was exposed to a narrow-band noise centered at 3 kHz for 10 min at the intensity of 90 dB HL. In the 30 subjects enrolled, TTS was evaluated after 2, 15, and 30 min and the recovery time was recorded in each subject. The longest recovery time was 45 min. Among the 18 subjects who underwent a second test after treatment with Q-Ter, the mean recovery time was 31.43 min. The results of the present study show that 30 days' treatment with Q-Ter can aid faster recovery after exposure to noise (P < 0.0001). The reduction in the recovery time following treatment can be explained by Q-Ter-mediated improvement of the outer hair cells' response to oxidative stress.

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This study was conducted to evaluate noise exposures and the contributions of occupational and nonoccupational activities among three groups of Swedish workers (office workers, day care workers, and military flight technicians), and to evaluate risk factors for elevated hearing threshold levels. Forty-five subjects were recruited across the three groups. Each subject completed a risk factor questionnaire along with Békésy audiometry at frequencies between 125 and 8000 Hz. Subjects also wore a noise dosimeter continuously for 1 week, and documented their occupational and nonoccupational activities using a time-activity log. Subjects in all groups completed >7400 h of dosimetry, and had weekly exposures between 76 and 81 dBA. Day care workers had the highest daily exposures, and flight technicians had the highest weekly exposures. Most daily and weekly exposures exceeded the 70 dBA exposure limit recommended for prevention of any hearing loss. Subjects' perceptions of their exposures generally agreed well with measured noise levels. Among office workers, exposures were predominately nonoccupational, while among flight technicians nonoccupational and occupational activities contributed roughly equally, and among day care workers occupational exposures were dominant. Extreme exposures and cumulative noise exposure were associated with an increased risk of hearing threshold levels >10 dB hearing level. Effective hearing loss prevention programs may be needed in occupations not historically considered to be at high risk of noise-induced hearing loss (e.g., day care workers). Prevention efforts need to address nonoccupational exposures as well as occupational exposures, as nonoccupational activities may present the dominant risk of noise-induced hearing loss for some workers.

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Recreational noise exposure and its impact on hearing is a problem to which increasing attention is being paid. In Spanish, it is necessary to have a reliable and valid instrument that is capable of describing the extent of noise exposure. The aim was to create and validate an instrument to determine listening habits and levels of recreational noise exposure in young people. We performed a transversal questionnaire validation study using university students. We assessed the validity of the content and appearance of the "Recreational Hearing Habits Questionnaire" (CHAR in Spanish) through experts' judgment. Then we piloted the administration of semantic adaptation with 30 students. Finally, the instrument was applied to 335 Chilean university students, obtaining with these indicators that demonstrated convergent validity of the construct, criterion and reliability. We used exploratory and confirmatory factor analysis, as well as correlation and agreement tests. It was confirmed that 14 questions in the questionnaire have a good item-test correlation, having also a factorial structure that indicates the existence of three-dimensions. The questionnaire has good internal consistency and convergent validity with the Noise Exposure Questionnaire. In addition, the score obtained in the CHAR is a predictor of the presence of notch at frequencies of 4 kHz in the right ear and 6 kHz in the left. The CHAR is useful for determining listening habits and thereby recreational noise exposure, indicating good psychometric properties.

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Manual pure tone audiometry is considered to be the gold standard for the assessment of hearing thresholds and has been in consistent use for a long period of time. An increased legislative requirement to monitor and screen workers, and an increasing amount of legislation relating to hearing loss is putting greater reliance on this as a tool. There are a number of questions regarding the degree of accuracy of pure tone audiometry when undertaken in field conditions, particularly relating to the difference in conditions between laboratory calibration and clinical or industrial screening use. This study analyzed the output sound pressure level of four different commercial audiometers, all using TDH39 headphones and each of which had recently undergone calibration at an appropriate laboratory. Levels were measured using a Bruël and Kjaer Head and Torso simulator, which accurately replicates the size and shape of a human head, including the ears. A clinical environment was simulated by a trained audiometrist replacing the headphones for each test. Tests were undertaken at three presentation levels, and at the frequencies of 250 Hz, 500 Hz, 1 kHz, 2 kHz, 4 kHz and 6 kHz. The results showed a high level of test-retest variability, both between different audiometers and within the same audiometer. Maximum variation of sound pressure level at the ear for the same tone presentation was 21 decibels, with a particularly high level of variation at 6 kHz for all meters. An audiometer with attenuating cups exhibited significantly higher variation than ones using supral-aural headphones. Overall the variation exhibited suggests that there is a higher degree of potential error with screening pure tone audiometry than is commonly assumed and that results particularly at the 6 kHz frequency need to be assessed carefully alongside other methods such as speech audiometry.

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Renexin, a compound of cilostazol and ginkgo biloba extract, has been reported to produce neuroprotective effects through antioxidant, antiplatelet, and vasodilatory mechanisms. This study was designed to investigate the protective effects of renexin on hearing, the organ of Corti (OC), and medial olivocochlear efferents against noise-induced damage. C57BL/6 mice were exposed to 110 dB SPL white noise for 60 min and then randomly divided into three groups: high- and low-dose renexin-treated groups and noise only group. Renexin were administered for 7 days: 90 mg/kg to the low-dose, and 180 mg/kg to the high-dose groups. All mice, including the controls underwent hearing tests on postnoise day 8 and were killed for cochlear harvest. We compared the hearing thresholds and morphology of the OC and cochlear efferents across the groups. The renexin-treated groups recovered from the immediate threshold shifts in a dose-dependent manner, while the noise group showed a permanent hearing loss. The renexin-treated ears demonstrated less degeneration of the OC. The diameters of the efferent terminals labeled with α-synuclein were preserved in the high-dose renexin-treated group. In the western blot assay of the cochlear homogenates, the treated groups displayed stronger expressions of α-synuclein than the noise and control groups, which may indicate that noise-induced enhanced activity of the cochlear efferent system was protected by renexin. Our results suggest that pharmacologic treatment with renexin is hopeful to reduce or prevent noise-induced hearing loss as a rescue regimen after noise exposure.

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Many music organizations are opposed to restrictive noise regulations, because of anxiety related to the possibility of a decrease in the number of adolescents attending music events. The present study consists of two research parts evaluating on one hand the youth's attitudes toward the sound levels at indoor as well as outdoor musical activities and on the other hand the effect of more strict noise regulations on the party behavior of adolescents and young adults. In the first research part, an interview was conducted during a music event at a youth club. A total of 41 young adults were questioned concerning their opinion toward the intensity levels of the music twice: Once when the sound level was 98 dB(A), L_{Aeq, 60min} and once when the sound level was increased up to 103 dB(A), L_{Aeq, 60min} . Some additional questions concerning hearing protection (HP) use and attitudes toward more strict noise regulations were asked. In the second research part, an extended version of the questionnaire, with addition of some questions concerning the reasons for using/not using HP at music events, was published online and completed by 749 young adults. During the interview, 51% considered a level of 103 dB(A), L_{Aeq, 60min} too loud compared with 12% during a level of 98 dB(A), L_{Aeq, 60min} . For the other questions, the answers were similar for both research parts. Current sound levels at music venues were often considered as too loud. More than 80% held a positive attitude toward more strict noise regulations and reported that they would not alter their party behavior when the sound levels would decrease. The main reasons given for the low use of HP were that adolescents forget to use them, consider them as uncomfortable and that they never even thought about using them. These results suggest that adolescents do not demand excessive noise levels and that more strict noise regulation would not influence party behavior of youngsters.

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