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Pure-tone audiometry and auditory brainstem responses in noise-induced deafness

Noorhassim I, Kaga K, Nishimura K

Am J Otolaryngol, 1996 1 1;17(1):31-5.
PMID: 8801813

PURPOSE: The objective of this study is to find the relationship between pure-tone audiometry results and the auditory brainstem response wave abnormalities.
SUBJECTS AND METHODS: The pure-tone audiometry (PTA) and auditory brainstem responses (ABRs) from 22 patients (44 ears) with diagnosed noise-induced permanent hearing loss were studied. Three indices of PTA were average thresholds of 0.5 kHz/, /1 kHz, and 2 kHz (PTA1); 2 kHz and 4 kHz (PTA2); and 4 kHz (PTA3) were subdivided into 3 thresholds of hearing. Their relationships with ABR results were analysed. The patterns of PTA from various groups of ABR wave patterns were studied.
RESULTS: In this study, the abnormal ABR wave patterns were detected in 72.7% of the ears. The ears with prolonged ABR wave latency, absent early waves, prolong interpeak wave I-V latency was 20.5%, 18.2%, and 21.1%, respectively. Normal ABRs were recorded in 27.3% of the ears despite marked thresholds elevation of the PTA at high frequencies. Other relationships between PTA results and ABR wave results were discussed.
CONCLUSION: There were relationships between severity of noise-induced hearing loss indicated by PTA and the patterns of ABR wave abnormalities among workers with noise-induced permanent hearing loss.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis*
Tuning into the travel health risks of music tourism

Lu TS, Flaherty GT

J Travel Med, 2018 01 01;25(1).
PMID: 30346571 DOI: 10.1093/jtm/tay106
Matched MeSH terms: Hearing Loss, Noise-Induced/prevention & control*
Fulltext Blast injuries of the ear

Singh AP, Prasad U, Kumar N

Singapore Med J, 1983 Dec;24(6):367-73.
PMID: 6681493

Clinical synopsis and investigations on fourteen patients with blast injuries of the ear successfully treated at the ENT Unit of the University Hospital, Kuala Lumpur, revealed few interesting observations in addition to usual findings. The most outstanding one was the absence of sensorineural deafness, although it has been claimed as one of the most constant features. Conservative management alone was found to be of significant value.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis*
Fulltext Noise-induced hearing loss among quarry workers in a north-eastern state of malaysia: a study on knowledge, attitude and practice

Ismail AF, Daud A, Ismail Z, Abdullah B

Oman Med J, 2013 Sep;28(5):331-6.
PMID: 24044059 DOI: 10.5001/omj.2013.96

Noise is known to be one of the environmental and occupational hazards listed in the Factory and Machinery Act 1967. Quarries with loud deafening sounds from trucks and machineries pose the risk of noise-induced hearing loss to workers. This study was designed to assess the knowledge, attitude and practice towards noise-induced hearing loss and to determine the prevalence of noise-induced hearing loss and its associated factors among quarry workers in a north-eastern state of Malaysia.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext Hearing loss and contributing factors among airport workers in Malaysia

Nasir MH, Rampal KG

Med J Malaysia, 2012 Feb;67(1):81-6.
PMID: 22582554 MyJurnal

Sensorineural hearing loss is a common and important source of disability among the workers and often caused by occupational noise exposure. Aims of the study were to determine the prevalence and contributing factors of hearing loss among airport workers. A cross-sectional study was carried out at an airport in Malaysia. This study used stratified sampling method that involved 358 workers who were working in 3 different units between November 2008 and March 2009. Data for this study were collected by using questionnaires eliciting sociodemographic, occupational exposure history (previous and present), life-style including smoking habits and health-related data. Otoscopic and pure-tone audiometric tests were conducted for hearing assessment. Noise exposure status was categorize by using a noise logging dosimeter to obtain 8-hour Time-Weighted Average (TWA). Data was analyzed by using SPSS version 12.0.1 and EpiInfo 6.04. The prevalence of hearing loss was 33.5%. Age >40 years old (aOR 4.3, 95%CI 2.2-8.3) is the main risk factors for hearing loss followed by duration of noise exposure >5 years (aOR 2.5, 95%CI 1.4-4.7), smoking (aOR 2.1, 95%CI 1.2-3.4), duration of service >5 years (aOR 2.1, 95%CI 1.1-3.9), exposure to explosion (aOR 6.1, 95%CI 1.3-29.8), exposure to vibration (aOR 2.2, 95%CI 1.1-4.3) and working in engineering unit (aOR 5.9, 95%CI 1.1-30.9). The prevalence rate ratio of hearing loss for nonsmokers aged 40 years old and younger, smokers aged 40 years old and younger, non-smokers older than 40 years old and smokers older than 40 years old was 1.0, 1.7, 2.8 and 4.6 respectively. This result contributes towards better understanding of risk factors for hearing loss, which is relatively common among Malaysian workers.

Matched MeSH terms: Hearing Loss, Noise-Induced/etiology*; Hearing Loss, Noise-Induced/epidemiology
Screening of dental staff nurses for noise induced hearing loss

Daud MK, Noh NF, Sidek DS, Abd Rahman N, Abd Rani N, Zakaria MN

B-ENT, 2011;7(4):245-9.
PMID: 22338236

The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis; Hearing Loss, Noise-Induced/epidemiology*
Fulltext Noise exposure and noise induced hearing loss among Kuala Lumpur traffic point duty personnel

Thomas N, Mariah AN, Fuad A, Kuljit S, Philip R

Med J Malaysia, 2007 Jun;62(2):152-5.
PMID: 18705450 MyJurnal

Thirty-two points in Kuala Lumpur were selected where traffic personnel were on duty. Sound level readings were taken three times a day. Generally, the traffic noise levels were between 75 dBA to 85 dBA. The maximum sound level recorded was 108.2 dBA. Noise emitted by traffic equipment and vehicles were up to 133 dBA. Results of audiometric tests revealed that out of 30 who were tested, 24 or 80% were positive for noise-induced hearing loss. A questionnaire survey revealed a lack of knowledge on occupational safety and personal protective equipment.

Matched MeSH terms: Hearing Loss, Noise-Induced/etiology*; Hearing Loss, Noise-Induced/prevention & control
Fulltext The Noise Exposure Structured Interview (NESI): An Instrument for the Comprehensive Estimation of Lifetime Noise Exposure

Guest H, Dewey RS, Plack CJ, Couth S, Prendergast G, Bakay W, et al.

Trends Hear, 2018;22:2331216518803213.
PMID: 30295145 DOI: 10.1177/2331216518803213

Lifetime noise exposure is generally quantified by self-report. The accuracy of retrospective self-report is limited by respondent recall but is also bound to be influenced by reporting procedures. Such procedures are of variable quality in current measures of lifetime noise exposure, and off-the-shelf instruments are not readily available. The Noise Exposure Structured Interview (NESI) represents an attempt to draw together some of the stronger elements of existing procedures and to provide solutions to their outstanding limitations. Reporting is not restricted to prespecified exposure activities and instead encompasses all activities that the respondent has experienced as noisy (defined based on sound level estimated from vocal effort). Changing exposure habits over time are reported by dividing the lifespan into discrete periods in which exposure habits were approximately stable, with life milestones used to aid recall. Exposure duration, sound level, and use of hearing protection are reported for each life period separately. Simple-to-follow methods are provided for the estimation of free-field sound level, the sound level emitted by personal listening devices, and the attenuation provided by hearing protective equipment. An energy-based means of combining the resulting data is supplied, along with a primarily energy-based method for incorporating firearm-noise exposure. Finally, the NESI acknowledges the need of some users to tailor the procedures; this flexibility is afforded, and reasonable modifications are described. Competency needs of new users are addressed through detailed interview instructions (including troubleshooting tips) and a demonstration video. Limited evaluation data are available, and future efforts at evaluation are proposed.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis*; Hearing Loss, Noise-Induced/epidemiology*
Hearing loss after noise exposure

Govindaraju R, Omar R, Rajagopalan R, Norlisah R, Kwan-Hoong N

Auris Nasus Larynx, 2011 Aug;38(4):519-22.
PMID: 21236610 DOI: 10.1016/j.anl.2010.12.006

The higher field strength magnetic resonance imaging (MRI) such as 3 Tesla (T) and above generates noise that has potential detrimental effects on the hearing. Temporary threshold shifts following MRI examination have been reported for MRI with lower field strength. Such effect, however, have not been reported so far for a 3T MRI. We report a case that exemplifies the possible detrimental effects of a 3 T MRI generated noise on the auditory system. Our patient underwent investigation of his chronic backache in a 3 T MRI unit and developed hearing loss and tinnitus post-MRI examination. Hearing assessment was done using pure tone audiogram, distortion product otoacoustic emission (DPOAE) and brainstem electrical response audiometry (BERA) which revealed a unilateral sensorineural hearing loss which recovered within 3 days. However the tinnitus persisted. This is possibly a case of temporary threshold shift following noise exposure. However a sudden sensorineural hearing loss remains the other possibility.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis; Hearing Loss, Noise-Induced/etiology*; Hearing Loss, Noise-Induced/physiopathology
Fulltext Overview of occupational noise management in Malaysia

Noraidah Ismail, Sarah Rahmat

International Journal of Allied Health Sciences, 2018;2(3):445-458.
MyJurnal

This paper aims to synthesize available literature on occupational noise in Malaysia and to relate this to the current noise management practices and control. The review focuses on several main
scopes; i) history of occupational noise management in Malaysia; ii) legislative developments and legal precedents of occupational noise in Malaysia ; and iii) the hearing conservation programs (HCP) and hearing loss prevention programs (HLPP). Narrative review and synthesis. Related publications and references were identified through several ways: i) by structured searches in PubMed, Google scholar, Web of Knowledge and Science Direct using the combinations of ‘occupational noise’, ‘noise induced hearing loss; ‘hearing’, ‘knowledge’, awareness’, ‘hearing conservation program’, ‘hearing protection devices’ as key words ii) by inspecting the reference lists of relevant articles. The number of publications within the audiology which address this topic, is rather limited. All the above mentioned scopes were discussed and synthesis of literature from other related fields such as medical, health and occupational safety and health were also referred to facilitate the discussion. This paper concludes that there are an emerging trend for the studies of occupational noise Malaysia in the literature. However, the effectiveness of HCP in Malaysia, and to what extent it is accepted and being implemented is yet to be investigated.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext Effectiveness of a Novel Index System in Preventing Early Hearing Loss among Furniture Industry Skills Training Students in Malaysia

Abdul Rahim KA, Jewaratnam J, Che Hassan CR, Hamid MD

Int J Environ Res Public Health, 2020 10 31;17(21).
PMID: 33142732 DOI: 10.3390/ijerph17218032

Occupational noise-induced hearing loss (ONIHL) is the most reported occupational disease in Malaysia. ONIHL is aggravated by the presence of early hearing loss amongst the youth prior to entering a real working environment. At technical and vocational education training (TVET) institutions, students may develop early ONIHL because training workshops are designed imitating the industrial working environment to produce skilled workers. The exceeding noise level at workshops and recent risk of non-occupational noise can cause early ONIHL among these students. Therefore, ONIHL must be addressed at the early stage of producing skilled workers. Octa hearing conservation index (OHCI) system is developed as a management and monitoring tool for hearing conservation program (HCP) in TVET institutions. Six existing and two new HCP components were used to build the index system. A pilot test on the effectiveness of the OHCI system was conducted in a selected TVET institution for six months. The post-HCP shows a 52.6% improvement compared to the pre-HCP. The implementation of HCP has shown improved awareness on the hazards of loud noise exposure and active use of hearing protection devices among participants. The OHCI system has a great potential as a tool to improve HCP implementation in TVET institutions, and eventually, industry.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext Environmental and occupational health impact of bauxite mining in Malaysia: a review

Lee, K.Y., Ho, L.Y., Tan, K.H., Tham, Y.Y., Ling, S.P., Qureshi, A.M., et al.

International Medical Journal Malaysia, 2017;16(2):137-150.
MyJurnal

In the perspective of recent bauxite mining in Malaysia, this review aims to identify the potential
environmental and health impacts on miners and surrounding communities. The environmental issues of
bauxite mining include, air, water and soil pollution due to bauxite dust; leaching of bauxite into water
sources resulting in reduced soil fertility as well as affecting agricultural food products and aquatic life.
Bauxite occupational exposure affects the health of miners, and has negative consequences on the health of
surrounding communities, such as increased respiratory symptoms, contamination of drinking water, other
potential health risks from ingestion of bauxite and heavy metals, including noise-induced hearing loss and
mental stress. This review discusses the processes of bauxite mining, its constituents and residual trace
elements, and their impact on the environment and health of exposed workers and communities. It also
explores the Malaysian legal requirements and standards of occupational exposure to bauxite.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext A study of occupational noise exposure among public transportation workers in Malaysia

Siti Norhafiza Abd Razak, Nurul Hazwani Mohd Yusoff, Farah Hana Mukhtar, Norsehah Abdul Karim, Noor Hasyimah Abu Rahim

Journal of Occupational Safety and Health, 2015;12(1):69-72.
MyJurnal

Working for a minimum of 8 hours, 6 days a week might have exposed the workers of public transportation to
high noise risks. However, occupational exposures in their workplace have not been adequately characterized and
identified. Assessment of occupational noise exposure among workers at five public transportation stations was made
using Sound Level Meter and through questionnaire survey. The data obtained was combined to estimate the work
shift exposure level and health impacts to the workers by using statistical analysis. The respondents participated in the
survey to identify the symptoms of noise-induced hearing loss and other health-related problems. Results of the study
indicated that occupational noise exposure among workers for Mean Continuous Equivalent Level, Leq= 76.17 dB(A)
presents small risks of developing a hearing disability. Some of the workers show symptoms of noise-induced hearing
loss and are annoyed by the sources of noise present at the public transportation.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext Noise measurement and awareness at construction site – A case study

Siti Nadia Mohd Bakhori, Mohamad Zaki Hassan, Feiruz Ab’lah, Aadil Nausherwan, Mohd Azlan Suhot, Mohd Yusof Daud, et al.

Journal of Advanced Research Design, 2017;31(1):9-16.
MyJurnal

The construction industry is one of the major sectors in Malaysia. Apart from providing
facilities, services and goods it also offers employment opportunities to local and
foreign workers. In fact, the construction workers are exposed to high risk of noises
being generated from various sources including excavators, bulldozers, concrete mixer
and piling machines. Previous studies indicated that the piling and concrete work were
recorded as the main source that contributed to the highest level of noise among
others. Therefore, the aim of this study is to obtain the level of noise exposure during
piling process and to determine the awareness of workers against noise pollution at
the construction site. Initially, the reading of noise level was obtained at construction
site by using a digital sound level meter (SLM) and noise exposure to the workers was
mapped. Readings were taken from four different distances; 5, 10, 15 and 20 meters
from the piling machine. Furthermore, a set of questionnaire was also distributed to
assess the knowledge of regarding noise pollution at the construction site. The result
showed that the mean noise level at 5 meters distance was more than 90 dB, which
exceeded the recommended level. Although the level of awareness of regarding the
effect of noise pollution is satisfactory but majority of workers (90%) still did not wear
ear muffs during working periods. Therefore, the safety module guidelines related to
noise pollution controls should be implemented to provide a safe working environment
and prevent initial occupational hearing loss.

Matched MeSH terms: Hearing Loss, Noise-Induced
Fulltext Knowledge, attitude and practice of sawmill workers towards noise-induced hearing loss in kota bharu, kelantan

Rus RM, Daud A, Musa KI, Naing L

Malays J Med Sci, 2008 Oct;15(4):28-34.
PMID: 22589635

The purpose of this study was to determine the sawmill workers' knowledge, attitude and practice (KAP) in relation to noise-induced hearing loss (NIHL). A cross-sectional study was conducted involving 83 workers from 3 factories in Kota Bharu, Kelantan. Questionnaires were distributed to obtain the socio-demography, knowledge, attitude and practice level in relation to noise-induced hearing loss (NIHL). The weak areas identified in the knowledge section were treatment aspects (15.5%), signs and symptoms of NIHL (20.2%) and risk factors (31%). As for attitude; the prevention aspects were the lowest (25.3%), followed by risk taking attitude (26.2%), and causes of hearing loss (42.1%). Overall, the practice was not encouraging at all. It is important to have an education program to raise workers' awareness and to improve their attitude and practices towards noise-induced hearing loss.

Matched MeSH terms: Hearing Loss, Noise-Induced
Evaluation of early hearing damage in personal listening device users using extended high-frequency audiometry and otoacoustic emissions

Sulaiman AH, Husain R, Seluakumaran K

Eur Arch Otorhinolaryngol, 2014 Jun;271(6):1463-70.
PMID: 23812554 DOI: 10.1007/s00405-013-2612-z

Although sound exposure from personal listening devices (PLDs) could potentially lead to noise-induced hearing loss (NIHL), the actual hearing risk associated with the use of these devices is still unclear. In this study, early hearing effects related to PLD usage were evaluated in 35 young adult PLD users (listening for >1 h/day, at >50% of the maximum volume setting of their devices) and their age- and sex-matched controls using a combination of conventional and extended high-frequency audiometry as well as transient-evoked otoacoustic emission (TEOAE) and distortion product of otoacoustic emission (DPOAE) measurements. The mean listening duration of the PLD users was 2.7 ± 1.0 h/day while their estimated average listening volume was 81.3 ± 9.0 dBA (free-field corrected). Typical signs of NIHL were not detected in the audiogram of PLD users and their audiometric thresholds at most of the conventional test frequencies (0.25-8 kHz) were comparable with those obtained from controls. However, compared with the controls, mean hearing thresholds of PLD users at many of the extended high-frequencies (9-16 kHz) were significantly higher. In addition, TEOAE and DPOAE amplitudes in users were reduced compared with controls. The deterioration of extended high-frequency thresholds and the decrease in DPOAE amplitudes were more evident in the users' right ears. These results indicate the presence of an early stage of hearing damage in the PLD user group. Preventive steps should be taken as the initial hearing damage in these users could eventually progress into permanent NIHL after many years of PLD use.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis*
Hearing risk associated with the usage of personal listening devices among urban high school students in Malaysia

Sulaiman AH, Seluakumaran K, Husain R

Public Health, 2013 Aug;127(8):710-5.
PMID: 23474376 DOI: 10.1016/j.puhe.2013.01.007

To investigate listening habits and hearing risks associated with the use of personal listening devices among urban high school students in Malaysia.

Matched MeSH terms: Hearing Loss, Noise-Induced/etiology*
Fulltext The noise exposed factory workers: the prevalence of sensori-neural hearing loss and their use of personal hearing protection devices

Maisarah SZ, Said H

Med J Malaysia, 1993 Sep;48(3):280-5.
PMID: 8183139

A total of 524 industrial workers were studied. They consisted of 442 noise exposed and 82 non-noise exposed workers. The purpose was to compare the prevalence of sensori-neural hearing loss among the noise exposed and the non-noise exposed workers, to study their knowledge on the hazard of noise to hearing and the workers' attitude towards the hearing protection devices. The prevalence of sensori-neural hearing loss was significantly higher among the noise exposed workers, i.e., 83% versus 31.7% (p < 0.01). However, the prevalence of hearing impairment was much lower for both groups, being 30.1% for the noise exposed and 3.7% for the non-noise exposed group. Although hearing protection devices were provided to 80.5% of the workers, only 5.1% were wearing them regularly. The possibility of developing hearing loss due to exposure to excessive noise was only known by 35.5% of the noise exposed workers. This awareness was found to have a positive correlation with the workers' compliance to the hearing protection devices. Our findings highlight the need for workers to be educated on the hazards of excessive noise exposure to hearing.

Matched MeSH terms: Hearing Loss, Noise-Induced/epidemiology*
A study on compliance to hearing conservation programme among industries in Negeri Sembilan, Malaysia

Nor Saleha IT, Noor Hassim I

Ind Health, 2006 Oct;44(4):584-91.
PMID: 17085919

Noise is one of the hazards faced by workers. A cross-sectional study was conducted among industries in Negeri Sembilan with the objective to assess their compliance to Hearing Conservation Programme (HCP). The other objectives of this study were to determine the factors influencing it and to show the industries' compliance to each element of the programme. It was also to identify the association between compliance to HCP and the prevalence of hearing impairment and standard threshold shift. Data for this study were collected using questionnaires sent by mail and also the results of the latest audiometric tests. A total of 167 industries were analysed for this study. It was found that 41.3% of these industries fully complied to the programme. It was also found that the industries preferred to provide hearing protection device (92.8%) and least complied to noise control (61.1%). There were significant associations (p<0.05) between compliance and number of employees, status of ownership and the presence of officer in charge of hearing conservation programme. Having at least 150 employees actually raised the compliance to HCP in two folds (beta = 0.717, OR = 2.048, C.I 95% = 1.063 to 3.944). The prevalences of hearing impairment and standard threshold shift were 23.9% and 5.2% respectively. There was no significant association between the prevalence for hearing impairment and compliance to HCP. The prevalence for standard threshold shift was inversely related to compliance. This study showed that compliance percentage need to be improved as an effort to prevent the hearing problems among workers exposed to noise.

Matched MeSH terms: Hearing Loss, Noise-Induced/etiology; Hearing Loss, Noise-Induced/epidemiology; Hearing Loss, Noise-Induced/prevention & control*
Fulltext Empowering occupational health doctors through the occupational safety & health (noise exposure) regulations 2019

Manivasagam, Dayanath

Journal of Occupational Safety and Health, 2019;16(1):1-7.
MyJurnal

The Department of Occupational Safety and Health Malaysia (DOSH) is the authority responsible to safeguard the occupational safety, health and welfare of workers in Malaysia. Occupational noise-related hearing disorders are the leading type of occupational diseases recorded by DOSH every year. Occupational Health Doctor (OHD) is a competency recognized by DOSH and their scope of duties in industries is currently confined to conduct medical surveillance for workers with hazardous chemical exposure and confined space medical fitness examination. The duties of OHD are good to be expanded by empowering more of their roles in industrial activities involving other legislations under DOSH. The noise exposure regulation under the Factories and Machinery Act (FMA) 1967 has been governing the worker’s exposure to hazardous industrial noise and preventing noise-induced hearing loss (NIHL) since 1989. However, the provisions of the regulation need to be strengthened in some essential medical elements of the Hearing Conservation Programme (HCP) for a comprehensive prevention of NIHL at the workplace. Recently enacted Occupational Safety and Health (Noise Exposure) Regulations 2019 offer a wider coverage of workers in ten sectors of industries applicable under the Occupational Safety and Health Act (OSHA) 1994. The current regulatory requirements for management of workplace noise have many improvements compared to the existing law. Enhancement in the medical requirements of industrial audiometry is made prominent by involving OHDs to interpret audiograms and conduct medical examination for workers. The reporting of occupational noise-related hearing disorders to DOSH is outlined better in the new regulation. The occurrence of NIHL and other related hearing disorders are expected to reduce eventually after the introduction of Occupational Safety and Health (Noise Exposure) Regulations 2019. The OHDs will play a pivotal role in industrial audiometry and prevention of hearing disorders among the working population.

Matched MeSH terms: Hearing Loss, Noise-Induced

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