Influence of well-known risk factors for hearing loss in a longitudinal twin study

Johnson, Ann-Chrístin; Bogo, Renata; Ahmed, Farah; Karlsson, K.; Muhr, Per; Sjöström, Mattias; Svensson, Eva B; Skjönsberg, Åsa; Svartengren, Magnus

doi:10.1080/14992027.2016.1265157

Cited by 8 publications

(5 citation statements)

References 156 publications

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“…NIHL as a result of occupational exposure affects 45 million people worldwide and is the most commonly reported occupational disease 21,22 . Exposure to an 85-dB TWA over 8 hours places an individual at an 8% excess risk of occupational NIHL, but even levels below the recommended 85-dB limit have been shown to increase the risk of NIHL 9,10,23 . Levels exceeding 85 dB permit even less exposure time to reach the permissible daily dose 9,10 .…”

Section: Discussionmentioning

confidence: 99%

Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons

Kwan

Lynch

DeFrance

et al. 2022

Journal of Bone and Joint Surgery

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Background:Noise-induced hearing loss (NIHL) affects the ability of an individual to communicate and can negatively impact quality of life. The risk to orthopaedic surgeons of developing NIHL as a result of occupational exposures in the operating room (OR) is currently unknown. Hearing protection is recommended for levels of >85 decibels (dB), irrespective of length of exposure. The primary goal of the present study was to determine whether orthopaedic surgeons are exposed to harmful noise levels in the OR that puts them at risk for developing NIHL.Methods:A prospective review was conducted with use of intraoperative audio recordings across 6 orthopaedic subspecialties. Recordings were made in ORs prior to the surgical start time to serve as baseline controls. Decibel levels were reported as the maximum dB level (MDL), defined as the highest sound pressure level during the measurement period, and as the time-weighted average (TWA), defined as the average dB level projected over an 8-hour time period. Noise doses were reported as the percentage of maximum allowable daily noise (dose) and as the measured dose projected forward over 8 hours (projected dose).Results:Three hundred audio recordings were made and analyzed. The average MDL ranged from 96.9 to 102.0 dB, with noise levels for all subspeciality procedures being significantly greater compared with the control recordings (p < 0.001). Overall, MDLs were >85 dB in 84% of cases and >100 dB in 35.0% of cases. The procedure with the highest noise dose was a microdiscectomy, which reached 11.3% of the maximum allowable daily noise and a projected dose of 104.1%. Among subspecialties, adult reconstruction had the highest dose and projected dose per case among subspecialties.Conclusions:The present results showed that orthopaedic surgeons are regularly exposed to damaging noise levels (i.e., >85 dB), putting them at risk for permanent hearing loss. Further investigation into measures to mitigate noise exposure in the OR and prevent hearing loss in orthopaedic surgeons should be undertaken.Clinical Relevance:Orthopaedic surgeons are at risk for NIHL as a result of occupational exposures in the OR.

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Section: Discussionmentioning

confidence: 99%

Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons

Kwan

Lynch

DeFrance

et al. 2022

Journal of Bone and Joint Surgery

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“…For example, in adults, Nondahl [42] between baseline smoking habits and the incidence of hearing loss at 500 to 3,000 Hz among 531 men, although with only 46 incident cases of hearing loss there may have been limited power to detect an association [43][44]. And Johnson's study [45] in a cohort of male twins, including 583 individuals (239 twin pairs and 105 individuals without their twin brother) also concluded that no increased risk for hearing loss was seen in smokers when compared to non-smokers.…”

Section: Discussionmentioning

confidence: 99%

Does Maternal Smoking Make a Difference in Newborn Hearing Screening with Otoacoustic Emissions?

Canet¹

2019

GJPNC

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Universal newborn hearing screening is both, crucial and routinely performed because only 50% of babies born with hearing loss carry a hearing loss risk factor. Early detection leads to an efficient treatment of the affected neonates, resulting in a better final prognosis [1][2][3]. Several techniques are used in newborn hearing screening. Otoacoustic emissions (OAEs) are low-level acoustic signals generated by the cochlea and passed through the middle ear into the external ear canal. OAEs are an objective indication of normal cochlear function. OAEs occur in nearly all ears with normal hearing and middle ear function. Transient evoked otoacoustic emission (TEOAE) testing is one of the most frequently used techniques because of its accuracy, simplicity, speed and low cost as described in diverse studies [2,4-6]. TEOAEs are evoked across a broad frequency range when stimulated by temporally short clicks, which have broad spectral bandwidths, and multiple cochlear locations may contribute to TEOAEs measured at any specific frequency. Researchers have compared the sensitivity of evoked OAE testing with pure-tone audiometry and concluded that OAE testing is more sensitive in detecting the early onset of cochlear pathologies before a change in hearing thresholds occur [7].A major drawback of TEOAE testing as a screening technique for newborns relates to the middle ear status, which can severely affect its pass rate. We must keep in mind that, the presence of debris and vermix in the external ear meatus of the newborn can result in false positive screenings. This factors lead to a greater than the actual hearing loss failure rate, thus a two-step newborn hearing screening protocol has been introduced in order to allow a better clearance of the middle and external ear, this means that when newborns fail TEOAE at discharge, an appointment is given to repeat the test in less than one month. This improves specificity of test without delaying adequate diagnosis.Another crucial factor is the newborn's age when the test is done.Data strongly suggests that the prime testing window is beyond 24-48 hrs. of life, as fluid in the middle ear and in the external meatus is normally significantly reduced on the second day of life. For this

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“…12,15,16 In a similar vein, a longitudinal twin study in the occupational health literature has shown that consistent exposures of 75 to 85 dBA (less than the NIOSH recommended doses) led to increased risk of noise-induced hearing loss. 17,18 We postulated that otology/neurotology ORs and temporal bone labs are especially susceptible to high levels of noise, due to high-speed drilling and suction-irrigator use during otologic and neurotologic approaches, which might predispose to subclinical hearing impairment given recent discoveries. Therefore, we measured average and peak sound levels as well as sound frequency distribution in multiple surgical settings to examine the risk for noise-induced and hidden hearing loss, with an emphasis on translabyrinthine approach given the lengthier duration of drilling and suction-irrigation use.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating Risk of Noise-Induced Hearing Loss in Otologic Surgery

Cass

Perkins

Bennett

et al. 2022

Ann Otol Rhinol Laryngol

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Objectives: To evaluate risk for noise-induced hearing damage from otologic surgery-related noise exposure, given recent research indicating that noise levels previously believed to be safe and without long-term consequence may result in cochlear synaptopathy with subsequent degeneration of spiral ganglion neurons, degradation of neural transmission in response to suprathreshold acoustic stimuli, and difficulty understanding in background noise. Methods: A prospective observational study of surgeon noise exposure during otologic and neurotologic procedures was performed in a tertiary care center. Surgeon noise exposure was recorded in A- and C-weighted decibel scales (dBA, dBC), including average equivalent (LAeq) and peak (LApeak, LCpeak) levels and noise dose. Results: Sound measurements taken at the ear with continuous recording equipment during cadaveric otologic surgery demonstrated LAeq 80-83 dBA, LApeaks of 105 dBA, LCpeaks of 127 dBC, with noise doses of 0.9% to 6.7%. Sound level measurements during live surgery translabyrinthine approaches yielded lower LAeq of 72 to 74 dBA and lower noise doses compared with temporal bone lab measurements. Raw sound recordings during live surgery demonstrated narrow band, high frequency, high amplitude spikes between 4 and 12 kHz. Conclusion: Noise exposure to surgeons, staff, and patients in the operating room is acceptable per NIOSH recommendations. Temporal bone lab noise exposures are greater, possibly due to poorly maintained drill systems and lack of noise shielding from microscope bulk, yet are also within NIOSH recommended levels.

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Influence of well-known risk factors for hearing loss in a longitudinal twin study

Cited by 8 publications

References 156 publications

Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons

Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons

Does Maternal Smoking Make a Difference in Newborn Hearing Screening with Otoacoustic Emissions?

Evaluating Risk of Noise-Induced Hearing Loss in Otologic Surgery

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