Prevalence of high frequency hearing loss consistent with noise exposure among people working with sound systems and general population in Brazil: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Music is ever present in our daily lives, establishing a link between humans and the arts through the senses and pleasure. Sound technicians are the link between musicians and audiences or consumers. Recently, general concern has arisen regarding occurrences of hearing loss induced by noise from excessively amplified sound-producing activities within leisure and professional environments. Sound technicians' activities expose them to the risk of hearing loss, and consequently put at risk their quality of life, the quality of the musical product and consumers' hearing. The aim of this study was to measure the prevalence of high frequency hearing loss consistent with noise exposure among sound technicians in Brazil and compare this with a control group without occupational noise exposure.</p> <p>Methods</p> <p>This was a cross-sectional study comparing 177 participants in two groups: 82 sound technicians and 95 controls (non-sound technicians). A questionnaire on music listening habits and associated complaints was applied, and data were gathered regarding the professionals' numbers of working hours per day and both groups' hearing complaint and presence of tinnitus. The participants' ear canals were visually inspected using an otoscope. Hearing assessments were performed (tonal and speech audiometry) using a portable digital AD 229 E audiometer funded by FAPESP.</p> <p>Results</p> <p>There was no statistically significant difference between the sound technicians and controls regarding age and gender. Thus, the study sample was homogenous and would be unlikely to lead to bias in the results. A statistically significant difference in hearing loss was observed between the groups: 50% among the sound technicians and 10.5% among the controls. The difference could be addressed to high sound levels.</p> <p>Conclusion</p> <p>The sound technicians presented a higher prevalence of high frequency hearing loss consistent with noise exposure than did the general population, although the possibility of residual confounding due to unmeasured factors such as socioeconomic status cannot be ruled out.</p

Outcome of cardiac surgery in patients with low preoperative ejection fraction

Background: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. Methods: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed. A subgroup analysis on patients with pre-operative LVEF ≤30 % was also performed. Results: A total of 7313 patients underwent cardiac surgery during the study period. Out of these, 781 patients (11 %) had a pre-operative LVEF ≤40 % and were included in the analysis. Mean pre-operative LVEF was 33.9 ± 6.1 % and in 290 patients (37 %) LVEF was ≤30 %. The most frequently performed operation was CABG (31 % of procedures), followed by mitral valve surgery (22 %) and aortic valve surgery (19 %). Overall perioperative mortality was 5.6 %. Mitral valve surgery was more frequent among patients who did not survive, while survivors underwent more frequently CABG. Post-operative myocardial infarction occurred in 19 (2.4 %) of patients, low cardiac output syndrome in 271 (35 %). Acute kidney injury occurred in 195 (25 %) of patients. Duration of mechanical ventilation was 18 (12-48) hours. Incidence of complications was higher in patients with LVEF ≤30 %. Stepwise multivariate analysis identified chronic obstructive pulmonary disease, pre-operative insertion of intra-aortic balloon pump, and pre-operative need for inotropes as independent predictors of mortality among patients with LVEF ≤40 %. Conclusions: We confirmed that patients with low pre-operative LVEF undergoing cardiac surgery are at higher risk of post-operative complications. Cardiac surgery can be performed with acceptable mortality rates; however, mitral valve surgery, was found to be associated with higher mortality rates in this population. Accurate selection of patients, risk/benefit evaluation, and planning of surgical and anesthesiological management are mandatory to improve outcome

Ações educativas com enfoque positivo em programa de conservação auditiva e sua avaliação Positive focus in educational interventions in a hearing conservation program and its evaluation

OBJETIVO: avaliar o conhecimento adquirido pelos trabalhadores de uma empresa frigorífica após uma ação educativa sobre proteção auditiva. MÉTODOS: foram comparadas as atitudes, intenções e comportamentos de proteção da audição adotados por 61 trabalhadores pré e pós-treinamento, avaliando a efetividade das mensagens através do uso de estímulos positivos. Foram utilizados os questionários "Crenças e Atitudes sobre Proteção Auditiva e Perda Auditiva", os quais foram aplicados antes e após a intervenção na forma de treinamento coletivo. RESULTADOS: os escores dos questionários sobre a percepção de suscetibilidade de adquirir uma perda auditiva e a percepção de obstáculos para uma ação preventiva se mostraram associados às variáveis sexo e tempo de empresa; a percepção de severidade das conseqüências de uma perda auditiva associada ao nível de ruído; normas sociais associada ao tempo de empresa, e a auto-eficácia associada ao resultado da audiometria. CONCLUSÃO: o treinamento com enfoque positivo ocasionou mudanças significativas na percepção de benefícios e de obstáculos de uma ação preventiva em comparação ao grupo de trabalhadores que não recebeu treinamento. Esse estudo possibilitará uma intervenção cujo foco será nas áreas consideradas mais deficitárias com a elaboração de propostas e materiais mais específicos e eficazes para os treinamentos que fazem parte do Programa de Conservação Auditiva. O uso de um questionário sobre as crenças e atitudes como o selecionado permite a identificação de temas que necessitam de clarificação em ações educativas.<br>PURPOSE: to evaluate the efficacy of an educational intervention on hearing protection in a group of 61 workers at a meat packing company. METHODS: one group of workers participated in a training session that used positive messages; the other group of workers received no intervention. The two versions of the NIOSH "Beliefs and Attitudes on Hearing Loss Prevention" questionnaire were used to assess changes before and after the intervention. Workers who received the training using positive messages showed significant changes in their perception of the benefits and obstacles to preventive action in comparison with the group that did not receive any intervention. RESULTS: the post-test scores for perception of susceptibility to developing a hearing loss and obstacles to preventive actions were significantly associated with gender and tenure; perception of severity of the consequences of a hearing loss was associated with noise level; social norms were associated with tenure; and self-efficacy was associated with audiometric thresholds. CONCLUSION: this study will make easier the development of interventions focused on the areas where workers lack information, and allow for educational materials for hearing loss prevention programs to be appropriately addressed to relevant obstacles. The use of a questionnaire on beliefs and attitudes such as the one selected for this study allows the identification of issues that require clarification in educational interventions