Cochrane method for systematic review and meta-analysis of interventions to prevent occupational noise-induced hearing loss – abridged

Abstract

Purpose Assess the effect of non-pharmaceutical interventions at work on noise exposure or occupational hearing loss compared to no or alternative interventions. Research strategies Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. Selection criteria Randomized Controlled Trials (RCT), Controlled Before-After studies (CBA) and Interrupted Time-Series studies (ITS) evaluating engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance were included. Case studies of engineering controls were collected. Data analysis Cochrane methods for systematic reviews, including meta-analysis, were followed. Results 29 studies were included. Stricter legislation can reduce noise levels by 4.5 dB(A) (very low-quality evidence). Engineering controls can immediately reduce noise (107 cases). Eleven RCTs and CBA studies (3725 participants) were evaluated through Hearing Protection Devices (HPDs). Training of earplug insertion reduces noise exposure at short term follow-up (moderate quality evidence). Earmuffs might perform better than earplugs in high noise levels but worse in low noise levels (very low-quality evidence). HPDs might reduce hearing loss at very long-term follow-up (very low-quality evidence). Seventeen studies (84028 participants) evaluated hearing loss prevention programs. Better use of HPDs might reduce hearing loss but other components not (very low-quality evidence). Conclusion Hearing loss prevention and interventions modestly reduce noise exposure and hearing loss. Better quality studies and better implementation of noise control measures and HPDs is needed.

Dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores: um estudo de base populacional

“…Apesar dos esforços voltados à implantação de programas de prevenção da perda auditiva ocupacional, como os programas de conservação auditiva, observa-se que os níveis de ruído reduzem no ambiente de trabalho, mas as medidas de controle, por voltarem-se majoritariamente para o uso dos equipamentos de proteção individual (EPI), ainda necessitam ser fortalecidas, tendo em vista sua efetividade apenas em curto prazo 66 . A Saúde do Trabalhador, que envolve ações de assistência, promoção, vigilância e prevenção dos agravos, sofreu um avanço considerável a partir da consolidação das políticas públicas de atenção integral em Saúde do Trabalhador 67 .…”

Complexities with context: Cultural and linguistic diversity challenges in preventive audiology in Africa

“…Therefore, transparency and justice around data access for surveillance analysis, compliance and research is encouraged. However, in some studies, research has reported some inconsistencies in HCP data accessed from the mines' MLSs, which has led to data analysis limitations and biased research findings (Heyer et al 2011;Tikka et al 2020). The potential unconscious bias has been linked to the use of historical data accessed from the mines' MLSs, which have not necessarily been acquired utilising standardised protocols nor captured in a user-friendly and user-efficient manner, negatively influencing quality hearing health care service provision.…”

Towards a Holistic Model Explaining Hearing Protection Device Use among Workers

“…Typical HPDs used in the industrial sector are earplugs which are inserted in the earcanals and earmuffs which are worn over the ears [1]. However, the effectiveness of this last strategy is questionable [2][3][4][5] since HPDs are sometimes not used at all or used inconsistently and/or incorrectly. Understanding these unhealthy behaviors and their origins is therefore of utmost importance in order to propose solutions to improve the efficiency of this means of protection against NIHL.…”