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   2018| July-August  | Volume 20 | Issue 95  
    Online since August 23, 2018

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Insights from the third international conference on hyperacusis: causes, evaluation, diagnosis, and treatment
Hashir Aazh, Marlies Knipper, Ali A Danesh, Andrea E Cavanna, Linus Andersson, Johan Paulin, Martin Schecklmann, Marja Heinonen-Guzejev, Brian C.J Moore
July-August 2018, 20(95):162-170
DOI:10.4103/nah.NAH_2_18  PMID:30136676
Background: Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities. Objective: The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis. Topics covered: The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis. Conclusions: Implications for research and clinical practice are summarised.
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Noise in the neonatal intensive care unit: a new approach to examining acoustic events
Shaylynn W Smith, Amanda J Ortmann, William W Clark
July-August 2018, 20(95):121-130
DOI:10.4103/nah.NAH_53_17  PMID:30136672
Introduction: Environmental noise is associated with negative developmental outcomes for infants treated in the neonatal intensive care unit (NICU). The existing noise level recommendations are outdated, with current studies showing that these standards are universally unattainable in the modern NICU environment. Study Aim: This study sought to identify the types, rate, and levels of acoustic events that occur in the NICU and their potential effects on infant physiologic state. Materials and Methods: Dosimeters were used to record the acoustic environment in open and private room settings of a large hospital NICU. Heart and respiratory rate data of three infants located near the dosimeters were obtained. Infant physiologic data measured at time points when there was a marked increase in sound levels were compared to data measured at time points when the acoustic levels were steady. Results: All recorded sound levels exceeded the recommended noise level of 45 decibels, A-weighted (dBA). The 4-h Leq of the open-pod environment was 58.1 dBA, while the private room was 54.7 dBA. The average level of acoustic events was 11–14 dB higher than the background noise. The occurrence of transient events was 600% greater in the open room when compared to the private room. While correlations between acoustic events and infant physiologic state could not be established due to the extreme variability of infant state, a few trends were visible. Increasing the number of data points to overcome the extreme physiologic variability of medically fragile neonates would not be feasible or cost-effective in this environment. Conclusion: NICU noise level recommendations need to be modified with an emphasis placed on reducing acoustic events that disrupt infant state. The goal of all future standards should be to optimize infant neurodevelopmental outcomes.
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Impacts of low frequency noise exposure on well-being: a case-study from portugal
Juliana A Alves, Ligia T Silva, Paula C Remoaldo
July-August 2018, 20(95):131-145
DOI:10.4103/nah.NAH_64_17  PMID:30136673
Introduction: The aim of this article is to assess the impacts of low frequency noise, emitted by high-voltage lines and power poles, on the perception of discomfort, comparing two different groups of inhabitants (exposed and unexposed groups) in two areas in the Northwest of Portugal. It proposes a new oriented methodology to assess discomfort due to the low frequency noise. Materials and Methods: Two predominantly urban areas were used to test the methodology: an “exposed” area with a high presence of the source under study and an “unexposed” area without records of power transmission lines. The research developed included measuring sound levels (in frequency bands from 10 to 160 Hz) with the help of a sound level meter in the two selected urban areas. Results: The real sound coming from the source was recorded and reproduced in an audiometric testing booth to determine the hearing threshold and discomfort of the volunteers. Using the criteria curve developed by DEFRA (Department for Environment, Food & Rural Affairs/University of Salford) in 2011, the results reveal that the sound levels recorded for the “exposed” group were higher than that for the “unexposed” group. The first recording showed an average of 68.9 dB and the second 64.6 dB, resulting in a significant difference of 4.3 dB between the two groups. After an attempt to isolate the source, the difference was 5.6 dB. Regarding the adapted audiometric tests, the real sound was used, which was collected 5 m between the receiver and the source. Conclusion: These results provide support that at this distance the noise was considered annoying.
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The effect of aircraft, road, and railway traffic noise on stroke − results of a case–control study based on secondary data
Anna Lene Seidler, Janice Hegewald, Melanie Schubert, Verena Maria Weihofen, Mandy Wagner, Patrik Dröge, Enno Swart, Hajo Zeeb, Andreas Seidler
July-August 2018, 20(95):152-161
DOI:10.4103/nah.NAH_7_18  PMID:30136675
Aim: To examine the stroke risks associated with aircraft, road traffic, and railway noise exposure in a large case–control study. Materials and Methods: All people aged ≥40 years living around the Frankfurt airport that were insured by one of three large statutory health insurance funds between 2005 and 2010 were included in the study (n = 1,026,670). Address-specific exposure to aircraft, road, and railway traffic noise was estimated for 2005. We used insurance claim data to identify 25,495 newly diagnosed cases of stroke between 2006 and 2010 and compared them with 827,601 control participants. Logistic regression analysis was used to calculate the odds ratios adjusted for age, sex, local proportion of people receiving unemployment benefits, and if available individual indicators of socioeconomic status (education, occupation). Results: For 24-h continuous aircraft noise exposure, neither increased risk estimates nor a positive linear exposure–risk relation was found. However, stroke risk was statistically significantly increased by 7% [95% confidence intervals (95%CI): 2–13%] for people who were exposed to <40 dB of 24-h continuous aircraft noise, but ≥6 events of maximum nightly sound pressure levels ≥50 dB. For road and railway traffic noise, there was a positive linear exposure–risk relation: Per 10 dB the stroke risk increased by 1.7% (95%CI: 0.3–3.2%) for road traffic noise and by 1.8% (95%CI: 0.1–3.3%) for railway traffic noise. The maximum risk increase of 7% (95%CI: 0–14%) for road traffic noise and 18% (95%CI: 2–38%) for railway traffic noise was found in the exposure category ≥65 to <70 dB. Conclusion: This large case–control study indicates that traffic noise exposure may lead to an increase in stroke risk. It furthermore suggests that maximum aircraft noise levels at night increase the stroke risk even when continuous noise exposure is low, and thus highlights the relevance of maximum noise levels for research and policies on noise protection.
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The assessment of exposure to occupational noise and hearing loss for stoneworkers in taiwan
Feng-Jung Huang, Chia-Jung Hsieh, Chi H Young, Shun-Hui Chung, Chun-Chieh Tseng, Lih-Ming Yiin
July-August 2018, 20(95):146-151
DOI:10.4103/nah.NAH_45_17  PMID:30136674
Introduction: Stoneworkers in Taiwan are exposed to occupational noise and suffer hearing impairment. A complete assessment of exposure and health effects is needed for a better understanding. Materials and Methods: We accessed nine stone factories, monitored the environmental and personal doses of noise, analyzed the frequency spectra of noise from various machines, and recruited 55 stoneworkers and 25 administrative staff as controls for pure tone audiometry testing. Results: The means (standard deviations) of 8-h time-weighted averages for environmental and personal monitoring were 85.0 (6.2) and 87.0 (5.5) dB(A), respectively, with seven of nine personal measurements being higher than the respective environmental results. The monitoring data suggest that occupational noise in the stonework environments should be a matter of great concern. Nearly all frequency spectra indicated peak values occurring between 2 and 4 kHz, which were within the bands for early noise-induced hearing loss (NIHL). The mean hearing threshold levels of the study participants were elevated in low and high frequencies (29.2 and 41.2 dB) compared to that of controls (∼25 dB for both bands). Linear regression analysis indicated no significance in the low frequencies (P = 0.207) but statistical significance in the high frequencies (P = 0.002) after adjustment for covariates, suggesting NIHL among the stoneworkers. Conclusion: Stoneworkers apparently display early signs of NIHL. Noises in the stonework factories with peaks in the high frequencies are harmful to hearing ability. Employers and workers have to comply with the regulation strictly to prevent further hearing damage.
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