Purpose The goal of this study was to compare clinical and research-based cochlear-implant (CI) measures using telehealth versus traditional methods. Method This prospective study used an ABA design (A: laboratory, B: remote site). All measures were made twice per visit to assess within-session variability. Twenty nine adult and pediatric CI recipients participated. Measures included: electrode impedance, electrically evoked compound action potential (ECAP) thresholds, psychophysical thresholds using an adaptive procedure, map thresholds and upper comfort levels, and speech perception. Subjects completed a questionnaire at the end of the study. Results Results for all electrode-specific measures revealed no statistically significant differences between traditional and remote conditions. Speech perception was significantly poorer in the remote condition, which was likely due to the lack of a sound booth. In general, subjects indicated that they would take advantage of telehealth options at least some of the time, if it were available. Conclusions Results from this study demonstrate that telehealth is a viable option for research and clinical measures. Additional studies are needed to investigate ways to improve speech perception at remote locations that lack sound booths, and to validate the use of telehealth for pediatric services (e.g., play audiometry), sound-field threshold testing, and troubleshooting equipment.

The potential effects of acoustical environment on speech understanding are especially important as children enter school where students' ability to hear and understand complex verbal information is critical to learning. However, this ability is compromised because of widely varied and unfavorable classroom acoustics. The extent to which unfavorable classroom acoustics affect children's performance on longer learning tasks is largely unknown as most research has focused on testing children using words, syllables, or sentences as stimuli. In the current study, a simulated classroom environment was used to measure comprehension performance of two classroom learning activities: a discussion and lecture. Comprehension performance was measured for groups of elementary-aged students in one of four environments with varied reverberation times and background noise levels. The reverberation time was either 0.6 or 1.5 s, and the signal-to-noise level was either þ10 or þ7 dB. Performance is compared to adult subjects as well as to sentence-recognition in the same condition. Significant differences were seen in comprehension scores as a function of age and condition; both increasing background noise and reverberation degraded performance in comprehension tasks compared to minimal differences in measures of sentence-recognition.

Objectives The purpose of this study was to determine how combinations of reverberation and noise, typical of many elementary school classroom environments, affect normal-hearing school-aged children’s speech recognition in stationary and amplitude-modulated noise, and to compare their performance to that of normal-hearing young adults. Additionally, the magnitude of release from masking in the modulated noise relative to stationary noise was compared across age in non-reverberant and reverberant listening conditions. Finally, for all noise and reverberation combinations the degree of change in predicted performance at 70% correct was obtained for all age groups using a best-fit cubic polynomial. Design Bamford-Kowal-Bench sentences and noise were convolved with binaural room impulse responses representing non-reverberant and reverberant environments to create test materials representative of both audiology clinics and school classroom environments. Speech recognition of 48 school-aged children and 12 adults was measured in speech-shaped and amplitude modulated speech-shaped noise, in the following three virtual listening environments: non-reverberant, reverberant at a 2 m distance, and reverberant at a 6 m distance. Results Speech recognition decreased in the reverberant conditions and with decreasing age. Release from masking in modulated relative to stationary noise decreased with age and was reduced by reverberation. In the non-reverberant condition, participants showed similar amounts of masking release across ages. The slopes of performance-intensity functions increased with age, with the exception of the non-reverberant modulated masker condition. The slopes were steeper in the stationary masker conditions, where they also decreased with reverberation and distance. In the presence of a modulated masker, the slopes did not differ between the two reverberant conditions. Conclusions The results of this study reveal systematic developmental changes in speech recognition in noisy and reverberant environments for elementary school-aged children. The overall pattern suggests that younger children require better acoustic conditions to achieve sentence recognition equivalent to their older peers and adults. Additionally, this is the first study to report a reduction of masking release in children as a result of reverberation. Results support the importance of minimizing noise and reverberation in classrooms, and highlight the need to incorporate noise and reverberation into audiological speech-recognition testing in order to improve predictions of performance in the real world.

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Subjects with normal hearing (NH) and with sensorineural hearing loss (SNHL) judged the overall loudness of six-tone complexes comprised of octave frequencies from 0.25 to 8 kHz. The level of each tone was selected from a normal distribution with a standard deviation of 5 dB, and subjects judged which of two complexes was louder. Overall level varied across conditions. In the "loudness" task, there was no difference in mean level across the two stimuli. In the "sample discrimination" task, the two complexes differed by an average of 5 dB. For both tasks, perceptual weights were derived by correlating the differences in level between matched-frequency tones in the complexes and the loudness decision on each trial. Weights obtained in the two tasks showed similar shifts from low to high frequency components with increasing overall level. Simulation of these experiments using a model of loudness perception [Moore and Glasberg (2004), Hear Res. 188, 70-88] yielded predicted weights for these stimuli that were highly correlated with predicted specific loudness, but not with the observed weights.

Purpose The current study evaluated the effect of remote system and acoustic environment on speech perception via telehealth with cochlear implant recipients. Method Speech perception was measured in quiet and in noise. Systems evaluated were: Polycom visual concert (PVC) and a hybrid presentation system (HPS). Each system was evaluated in a sound-treated booth and a quiet office. Results For speech in quiet, there was a significant effect of environment with better performance in the booth compared to the office; there was no effect of system (PVC or HPS). Speech in noise revealed a significant interaction between environment and system. Subjects’ performance was poorer for PVC in the office while performance in the sound booth was not significantly different for the two systems. Results from the current study were compared to results for the same group of subjects from an earlier study; results suggested poorer performance at remote sites in the previous study was primarily due to environment, not system. Conclusions Speech perception was best when evaluated in a sound-treated booth. HPS was superior for speech in noise in a reverberant environment. Future research should focus on modifications to non sound-treated environments for telehealth service delivery in rural areas.

Resumo Introdução: trabalhadores estão sujeitos a riscos decorrentes da exposição ambiental e ocupacional ao benzeno, situação ainda mais crítica quando associada a fatores como desigualdade social, múltipla exposição, suscetibilidade individual, degradação ambiental e às possíveis interações entre os contaminantes ambientais. Além disso, nem sempre as regulamentações são estabelecidas e/ou atualizadas apenas a partir de achados científicos, pois são processos permeados por conflitos de interesses. Objetivo: realizar análise crítica sobre a identificação de risco e avaliação da exposição ao benzeno. Métodos: revisão bibliográfica e documental do marco normativo brasileiro e internacional sobre exposição ao benzeno, com relação aos aspectos toxicológicos, de exposição ocupacional e ambiental e de avaliação de risco. Discussão: o controle da exposição ao benzeno permeia o campo da disputa técnico-política de saúde e segurança, constituindo-se em marco regulatório resultante de consenso de entendimentos. Esses entendimentos são marcados pela disputa entre a proteção à saúde e a gestão empresarial das condições de trabalho, em detrimento das evidencias científicas. Em tal contexto, os Limites de Exposição Ocupacional podem variar significativamente entre os países e agências, apesar do reconhecimento universal de que não há limites seguros para exposição ao benzeno, por ser um composto carcinogênico.

Environmental and occupational exposure to benzene from fuels is a major cause for concern for national and international authorities, as benzene is a known carcinogen in humans and there is no safe limit for exposure to carcinogens. The objective of this study was to evaluate the genotoxic effects of chronic occupational exposure to benzene among two groups of workers: filling station workers (Group I) and security guards working at vehicles entrances (Group II), both on the same busy highway in Rio de Janeiro, Brazil. Sociodemographic data on the workers were evaluated; the concentration of benzene/toluene (B/T) in atmospheric air and individual trans,trans-muconic acid (ttMA) and S-phenylmercapturic acid (S-PMA) were measured; oxidative stress was analyzed by catalase (CAT), glutathione S-transferase (GST), superoxide dismutase (SOD), thiol groups (THIOL) and malondialdehyde (MDA); genotoxicity was measured by metaphases with chromosomal abnormalities (MCA) and nuclear abnormalities, comet assay using the enzyme formamidopyrimidine DNA glycosylase (C-FPG), and methylation of repetitive element LINE-1, CDKN2B and KLF6 genes. Eighty-six workers participated: 51 from Group I and 35 from Group II. The B/T ratio was similar for both groups, but Group I had greater oscillation of benzene concentrations because of their work activities. No differences in ttMA and S-PMA, and no clinical changes were found between both groups, but linearity was observed between leukocyte count and ttMA; and 15% of workers had leukocyte counts less than 4.5 × 109 cells L−1, demanding close worker’s attention. No differences were observed between the two groups for THIOL, MDA, MCA, or nuclear abnormalities. A multiple linear relationship was obtained for the biomarkers MCA and C-FPG. A significant correlation was found between length of time in current job and the biomarkers C-FPG, MCA, GST, and MDA. Although both populations had chronic exposure to benzene, the filling station workers were exposed to higher concentrations of benzene during their work activities, indicating an increased risk of DNA damage.