Noise is considered to be a physical form of environmental pollution which can influence the health of exposed persons. Excessive exposure to noise can interfere with performance at work and with the ability to relax or sleep. Also it may impair hearing and it can evoke other physiological and pathological symptoms to the detriment of health. The sources of noise may be local or general. Industrial processes are an important source of indoor or localised noise. Persons exposed to noise as a consequence of their employment are legally protected to some extent by European Directives and National Regulations which limit the maximum permissible noise levels to 85-90dB. A research project was launched with the full co-operation of the Don and Low Group of Companies, Forfar and Perth, Scotland. Study indicates that the proportion of employees who have noise-induced hearing loss is higher amongst those who work in higher than 85dB, (e.g. Group 1 < 85dB-11%; Group 2 85<90dB-44%; Group 3 90<95dB-44%; Group 4≥95dB-39% = 138% in total). In all groups social and economic status, sex, age and average number of years' service are almost identical. In general, the study indicates a higher number of employees suffered from ear problems between groups exposed to 85dB and more, (e.g. perforated eardrum, noise tinnitus, vertigo, wax in ears). The danger of noise has been studied in detail regarding the general health of employees as follows: 1. Sleep disturbance It appeared that most of the cases who suffered from sleep disturbance were found amongst employees exposed to greater than 85dB, averaging about 33%. On the other hand, only 8% of the employees in category <85dB complained of sleep disturbance. 2. Blood Pressure According to job categories 10% of employees had heart problems in job category higher than 85dB, but only one case reported heart problems in job categories less than 85dB. 3. Stress Smoking was one of the subjects studied in detail in this project and the results were significant. An average of 40% of employees were smokers among groups exposed to higher than 85dB compared to 10% of smokers among employees exposed to less than 85dB. Industrial accidents occur at a higher rate among employees who worked in noisy environments (~85dB) with regard to reported or unreported accidents. From the result of the research, industrial noise should be studied in a more comprehensive way to measure all effects of noise regarding employees health by using the statistical data and always noise should be controlled at source. Industrial noise is still a major danger to employees. From the results in this study it appears there is a need for more co-operation between employer and employee and not just depend on the health and safety regulations and try to solve the problem.

Audiologists are challenged with various neurological diseases, such as Multiple Sclerosis. This disease causes demyelination of the white matter in the central nervous system resulting in desynchronisation of neural impulses. Despite controversy in the literature many studies illustrated some degree of auditory involvement associated with this disease. The auditory brainstem response has dominated the field during the assessment of the auditory system of patients with Multiple Sclerosis. Although this objective test procedure is useful during the assessment of the auditory nerve on a brainstem level, it reveals its own set of limitations when used in isolation as a single test procedure. A multiple test battery approach has shown promise in addressing the limitations of any single test procedure. This approach aims to assess the auditory nervous system of patients with Multiple Sclerosis on different levels (sensory and neural). The aim of the current study was to determine the effectiveness of a clinically appropriate battery of test procedures during the assessment of the auditory nervous system of 25 adult subjects with Multiple Sclerosis. The subjects were divided into two groups: Group 1 consisted of fifteen (15) subjects without a history of noise exposure, whereas the ten (10) subjects in Group 2 had previously been exposed to noise. A combined experimental-descriptive research design was selected in order to describe both the qualitative and quantitative results obtained during the study. The following test procedures were included in the test battery: • A self-assessment questionnaire allowing subjects to report on hearing abilities, related auditory-vestibular symptoms and communicative competence during every day life; • Puretone audiometry, distortion product otoacoustic emissions as well as the cochlear microphonic; and • Auditory brainstem response recording using both the rarefaction and condensation click polarities consecutively. The results indicated that a high percentage of subjects experienced vestibular symptoms such as dizziness and vertigo by the time the study was conducted. The presence of tinnitus and hearing difficulties were uncommon among subjects. Despite this, more than half of the subjects experienced difficulty with communication in the presence of background noise. Puretone audiometry demonstrated that some of the subjects presented with mild high-frequency hearing losses. However other configurations with impaired hearing thresholds were also observed. Most of the subjects’ auditory brainstem response recordings displayed abnormalities using either the rarefaction or condensation click polarity. The use of the condensation click polarity displayed more ABR abnormalities compared to the rarefaction click polarity. Several subjects displayed additional cochlear involvement while a smaller percentage of subjects presented only with neural involvement. / Dissertation (M (Communication Pathhology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / unrestricted

Objectives: The aim of the study was to describe the prevalence and nature of auditory and otological manifestations in adults with HIV/AIDS according to clinical examinations and self-reported symptoms. Auditory profiles of HIV individuals were compared to that of a matched control group. Study design: A descriptive, cross-sectional group design was utilized in the first section of the study while a comparative, control matched research design was used to compare the HIV group and matched control group. Methods: Two hundred HIV positive adult patients attending the Infectious Disease Clinic of the 1 Military Hospital were included through convenience sampling. Participants were interviewed, medical files were reviewed and clinical examinations, including otoscopy, tympanometry, pure tone audiometry and distortion product oto-acoustic emissions, were completed. A control group of 184 individuals were compiled, matched to 184 of the HIV infected participants according to age, gender, ethnicity as well as working environment. Audiological thresholds at 0.5kHz – 4kHz were compared among these groups. Results: A prevalence of self-reported tinnitus (26%), vertigo (25%) hearing loss (27.5%), otalgia (19%) and pruritis (38%) was recorded. The onset of hearing loss was reported to be mostly (82%) of a slow progressive nature. Abnormalities in tympanometry, otoscopy and oto acoustic emissions were found in respectively 41%, 55% and 44% of participants. Hearing loss greater than 25 dB (PTA) was recorded in 14% of participants compared to 39% for hearing loss greater than 15 dB (PTA). Although not statistically significant (p<.05), self reported vertigo, self reported hearing loss, OAE abnormalities, hearing loss (PTA>15dB and PTA>25dB) and occurrence of mild hearing loss occurred throughout the CDC categories which were used as a measure of disease progression. A statistically significant increase (p<.05) in sensorineural hearing loss was seen with disease progression. In the comparative section, statistically significant (p<.05) worse thresholds were found in the HIV group as opposed to the control group at all frequencies (0.5 kHz – 4 kHz). Conclusions: Auditory and otological symptoms occurred frequently in this sample, while an increase in some symptoms as well as hearing loss was seen throughout disease progression. Sensorineural hearing loss increased significantly through disease progression. Hearing loss occurred more frequently in HIV individuals as opposed to individuals in the control group, while hearing loss occur more frequently in the more advanced stages of HIV infection. / Dissertation (MCommunication Pathology)--University of Pretoria, 2011. / Speech-Language Pathology and Audiology / Unrestricted

Noise-induced hearing loss and tinnitus are the two most prevalent service-connected disabilities for veterans receiving compensation (Department of Veterans Affairs, 2010). While it is possible to protect against noise-induced hearing damage with hearing protection devices (HPDs) and hearing protection enhancement devices (HPEDs), military personnel resist using HPDs/HPEDs that compromise their situational awareness, including ability to localize enemy gunfire. Manufacturers of a new generation of "pass-through" level-dependent HPEDs claim these devices preserve normal or near-normal hearing. A research study was conducted to evaluate localization of suprathreshold gunshot's report (from blank ammunition) with one passive (3M's Single-Ended Combat Arms earplug) and three electronic level-dependent HPEDs (Peltor's Com-Tac II electronic earmuffs and Etymotic's EB 1 and EB 15 High-Fidelity Electronic BlastPLG earplugs), in comparison to the open ear in an in-field test environment with ambient outdoor noise and in 82 dBA diesel truck noise with nine normal and four impaired hearing participants. Statistical analysis showed worse localization accuracy and response time with the Com-Tac II earmuffs than with the other tested HPEDs. Performance with all HPEDs was worse than that with the open ear, except on right-left confusions, in which the Com-Tac II stood alone as worst, and in response time, for which the EB 1 earplug was equivalent to the open ear. There was no significant main effect of noise level. There was generally no significant effect of hearing ability. However, participants with impaired hearing had more right-left confusions than those with normal hearing. Subjective ratings related to localization generally corroborated objective localization performance. Three follow-up experiments were performed: (1) an assessment of the effect of microphone position on localization with the EB 15, which showed a limited advantage when the microphone was positioned near the opening of the ear canal compared to when it was facing outwards; (2) an assessment of Etymotic's QuickSIN test as a predictor localization performance, which showed little correlation with localization performance; and (3) an assessment of the acoustic properties of the experiment site, which was inconclusive with regards to the direction of dominant sound energy from gunshots from each of the shooter positions. / Ph. D.

La dysplasie fibromusculaire artérielle (DFM) est un groupe de pathologies vasculaires non inflammatoires, et non athéromateuses de la paroi artérielle. Elle est caractérisée par la sténose, l'occlusion, l’anévrisme ou la dissection des artères de petit et moyen calibres, en particulier les artères rénales et le tronc supra-aortique. La DFM est un facteur de risque de l’hypertension et de l’accident vasculaire cérébral. Elle touche essentiellement les femmes (80% des cas) de moins de 50 ans. La prévalence en population générale est inconnue et les estimations varient de 0.4% pour les formes cliniques à 4% dans une cohorte de donneurs de reins. Une agrégation familiale a été démontrée et une composante génétique suggérée. L'objectif de mon travail de thèse était de caractériser les bases génétiques la DFM. Dans la première partie, nous avons analysé des variants génétiques rares générés par séquençage d'exomes chez 16 cas apparentés de DFM issus de 7 fratries. Aucun gène majeur n’était muté pour l’ensemble des fratries ou pour au moins 3 fratries sur 7. Cependant, nous avons pu mettre en évidence puis validé un enrichissement en variants rares à fort potentiel fonctionnel de quatre gènes candidats pour la DFM (MYLK, OBSCN, DYNC2H1, RNF213) en combinant l’approche de séquençage d’exomes et l’étude d’association gène entier de 62767 variants rares (MAF < 5%) générés par génotypage avec la puce Exome-chip chez 249 cas non apparentés de DFM et 689 témoins. Cependant, l’implication de ces gènes dans la DFM doit être confirmée dans d’autres familles, et par des études de validations fonctionnelles. Dans la seconde partie, nous avons étudié l'association avec la DFM de 25606 variants fréquents (MAF ≥ 5%) de l’Exome-chip. Les résultats majeurs obtenus ont été répliqués dans une première étude (402 cas de DFM et 2537 témoins) puis dans 3 autres études incluant 512 cas de DFM et 669 témoins. La méta-analyse de l’ensemble a permis d’associer à la DFM le polymorphisme rs9349379-A situé dans l’intron du gène PHACTR1 (OR=1,39 [1,39-1,54] ; P=7,36 ×10-10). Ce variant est aussi un facteur de risque pour la maladie coronaire, la migraine et la dissection de l’artère cervicale. Des études complémentaires conduites chez 2458 volontaires non malades ont permis de montrer que l’allèle à risque pour la DFM, rs9349379-A est associé avec une augmentation de l’épaisseur intima média (P=1,97×10-4) et du rapport de la paroi sur la lumière artérielle (P=0,002), deux paramètres décrits comme augmentés chez les cas de DFM dans des études antérieures. Ensuite, PHACTR1 a été détecté par immunohistochimie dans l’endothélium et les cellules musculaires lisses de carotides dysplasiques et non dysplasiques avec une expression augmentée de PHACTR1 pour les porteurs de l’allèle à risque de DFM dans des cultures primaires de fibroblastes humains (N=86, P=0,003). Enfin, l’invalidation de Phactr1 chez le poisson zèbre conduit à une dilatation des vaisseaux indiquant un défaut du développement vasculaire. Ce travail confirme le caractère multifactoriel et hétérogène de la DFM et ouvre de nouvelles perspectives pour évaluer l’ensemble de la variabilité génomique des patients de DFM par des approches massives de génétique épidémiologique. / Fibromuscular dysplasia (FMD) is a group of nonatherosclerotic and noninflammatory vascular diseases leading to stenosis, aneurysm, dissection and/or occlusion of medium-sized arteries, in particular the renal and extracranial cervical arteries. Clinical manifestations of FMD are hypertension, dizziness, pulsatile tinnitus, transient ischemic attack or stroke, according to the involved arterial beds. FMD occurs predominantly (80% of cases) in females under 50 years with a variable prevalence estimation from 0.4% for asymptomatic clinical relevant forms to 4% in potential renal donors. The pathogenesis of FMD is unknown and a genetic origin is suspected given its demonstrated familial aggregation. The aim of my thesis work was to characterize genetic basis of FMD. In the first part of this thesis, we analyzed whole exome sequencing data in 16 related FMD cases from seven families. No gene harbors variants that were shared by all affected members in at least three out seven families. Using combined strategy of whole exome sequencing and gene based association study of 62,767 rare variants (MAF < 5%) generated by Exome‐chip arrays in 249 unrelated FMD cases and 689 controls, we have identified and validated an enrichment of rare and putatively functional variants in four candidates genes (MYLK, OBSCN, DYNC2H1 and RNF213). This results need to be validated in other FMD families and by functional analysis. In the second part, we analyzed 25,606 common variants (MAF ≥ 5%) generated by Exome‐chip array. Top loci were replicated in first replication study (402 cases and 2,537 controls) and in 3 others studies (512 cases and 669 controls). Meta-analysis of all including 1,154 unrelated FMD cases and 3,895 controls allowed identification of association between FMD and rs9349379-A (OR=1.39 [1.39-1.54]; P=7.4×10‐10). rs9349379 is intronic to PHACTR1, a risk locus for coronary artery disease, migraine, and cervical artery dissection. The analyses of geometrical parameters of carotids from 2,458 healthy volunteers indicated higher intima media thickness (P = 1.97×10‐4) and wall to lumen ratio (P = 0.002) in rs9349379‐A carriers, suggesting indices of carotid hypertrophy as previously described in carotids of FMD patients. Immunohistochemistry detected PHACTR1 in endothelium and smooth muscle cells of FMD and normal human carotids. The expression of PHACTR1 by genotypes in primary human fibroblasts showed higher expression in rs9349379‐A carriers (N=86, P=0.003). Phactr1 knockdown in zebrafish resulted in dilated vessels indicating subtle impairment of vascular development. This work confirms the multifactorial and heterogeneous genetic architecture of the FMD and opens new opportunities to evaluate all of genomic variability of FMD patients with massive genetic epidemiology approaches.

INTRODUÇÃO: A Esclerose Múltipla é uma doença desmielinizante e autoimune, na qual ocorre a destruição da bainha de mielina por autoanticorpos. Esta destruição causa uma diminuição na velocidade de condução do impulso nervoso alterando, assim, as funções cerebral e neural. Para ocorrer o funcionamento adequado do sistema auditivo, tanto na sua porção periférica quanto na central há necessidade que o mesmo esteja íntegro. OBJETIVO: Este estudo tem como objetivo verificar a ocorrência de alterações nos potenciais evocados auditivos de curta (PEATE), média (PEAML) e longa (P300) latências em adultos audiologicamente normais com diagnóstico de Esclerose Múltipla do tipo remitente recorrente ou surto remissivo. MÉTODO: Para o grupo controle foram avaliados 25 indivíduos com histórico de desenvolvimento neurológico normal e sem queixa de zumbido, sendo 19 do gênero feminino e seis do masculino, com idade variando entre 25 e 55 anos (média de 35,16 anos de idade). Para o grupo pesquisa foram avaliados 25 indivíduos com Esclerose Múltipla do tipo remitente-recorrente ou surto-remissivo, seis do gênero masculino e 19 do feminino, com idades entre 25 e 53 anos (média de 34,88 anos de idade). Todos os indivíduos participantes da pesquisa realizaram audiometria tonal e vocal, medidas de imitância acústica e os potenciais evocados auditivos de curta, média e longa latências. RESULTADOS: Os resultados demonstraram ocorrência de alterações nos potenciais evocados auditivos de tronco encefálico e de média latência e no potencial cognitivo, em indivíduos com Esclerose Múltipla. Com relação ao potencial evocado auditivo de tronco encefálico, verificou-se aumento de latência das ondas III e V e dos interpicos I-III e I-V, sugerindo alteração de tronco encefálico baixo. No que diz respeito ao potencial evocado auditivo de média latência observou-se atraso nas latências das ondas Na e Pa e, para o potencial cognitivo, evidenciou-se aumento da latência do P300. Conclusão: Indivíduos com Esclerose Múltipla do tipo remitente recorrente apresentam alterações eletrofisiológicas observadas nos resultados dos potenciais evocados auditivos de curta e média latências e no potencial cognitivo, sugerindo comprometimento em diferentes locais do sistema nervoso auditivo central / INTRODUCTION: The Multiple Sclerosis is a demyelinating disease and autoimmune, which is the destruction of the myelin sheath of a selfantibodies. This destruction causes a decrease in impulse driving speed of nervous changing thus the brain and neural functions. To place the proper functioning of the auditory system, both in its peripheral portion as the central need that it is full. PURPOSE: This study aims to determine the occurrency of changes in auditory evoked potentials of short (PEATE), middle (PEAML) and long (P300) latencies in adults audiologically normal diagnosed with Multiple Sclerosis remitting type of applicant or remissive outbreak. METHOD: For the control group were evaluated 25 individuals with a history of normal neurological development and without complaint from tinnitus, and 19 females and six males, with ages ranging between 25 and 55 years (average of 35.16 years of age) . To search the group were evaluated 25 individuals with Multiple Sclerosis-remitting type of applicant or flareremissive, six males and 19 females, aged between 25 and 53 years (average of 34.88 years of age). All individuals participating in the search conducted tone audiometry and speech, acoustic immitance measures brainstem auditory evoked potential, middle latency response and cognitive potential RESULTS: The results showed occurrencies of changes in brainstem auditory evoked potential and middle latency and cognitive potential in individuals with Multiple Sclerosis. Regarding the potential of brain stem auditory evoked, there was an increase in latency wave III and V and interpeaks I-III and IV, suggesting change in brainstem down. Regarding the auditory evoked potential of average latency there was delay in latencies of Na and Pa waves, and the potential for cognitive, showed an increase of latency of P300. Conclusion: Individuals with multiple sclerosis relapsing remitting type of applicant presents electrophysiological changes seen in the results of sound evoked short and middle latency and the potential cognitive suggesting impairment from different parts of the central auditory nervous system

O ruído ocupacional é considerado o problema que mais atinge o sistema auditivo do trabalhador brasileiro, perturba o trabalho, o descanso, o sono e a comunicação nos seres humanos; prejudica a audição e pode causar ou provocar reações psicológicas, fisiológicas e talvez até patológicas, afetando diretamente a qualidade de vida. A perda auditiva induzida por níveis de pressão sonora elevados (PAINPSE) é considerada uma entre as dez principais etiologias de perdas auditivas populacionais, sendo que, de todas as causas de lesão auditiva, é a que apresenta maior possibilidade de prevenção. Os efeitos auditivos encontrados em trabalhadores portadores da PAINPSE imitam a funcionalidade auditiva, provocando alteração de sensibilidade auditiva, alterações na seletividade de frequências, na resolução temporal e espacial, recrutamento e zumbido. Tais alterações influenciam diretamente a discriminação auditiva, dificultando a percepção, principalmente, dos sons da fala, podendo, também, alterar o padrão de fala de acordo com o grau da perda. O investimento em implantação de programas de conservação auditiva possibilita minimizar os problemas de saúde geral e auditiva, assim como a ocorrência da PAINPSE, promovendo melhor qualidade de vida ao trabalhador. Um trabalho intensivo de promoção da saúde auditiva ou prevenção de perdas auditivas deve ser enfatizado, principalmente para trabalhadores expostos a níveis elevados de ruído ocupacional, além da utilização, de forma adequada, de equipamento de proteção auditiva individual. Sendo assim este estudo teve por objetivo elaborar um material multimídia em tele-educação sobre prevenção de perdas auditivas de origem ocupacional para ser disponibilizado pelas equipes de profissionais do Centro de referência em saúde do trabalhador (CEREST), Rede Nacional de Atenção Integral à Saúde do Trabalhador (RENAST) e agentes comunitários, em consonância com os objetivos do CEREST. A elaboração do CD-ROM contribuirá para os programas de educação em saúde auditiva fornecendo informações a respeito dos riscos causados por níveis de pressão sonora elevada (NPS). / Occupational noise is considered the issue that most affects the hearing system of the Brazilian worker, disrupts work, rest, sleep and communication in humans, impairs hearing and may cause or provoke psychological reactions, physiological and maybe even pathological, affecting directly to quality of life. Hearing loss induced by high sound pressure levels (PAINPSE) is considered one of the top ten causes of hearing loss population, and of all-cause hearing damage, it has the greatest possibility of prevention. Hearing loss induced by high sound pressure levels (PAINPSE) is considered one of the top ten causes of hearing loss population, and of all-cause hearing damage, it has the greatest possibility of prevention. Auditory effects found in workers with PAINPSE mimic the functionality of the hearing, causing changes in hearing sensitivity, alterations in frequency selectivity, the temporal and space resolution, recruitment and tinnitus. These changes directly affect hearing discrimination, making the perception, especially speech sounds, it can also change the default speech according to the level of loss. Investment in implementation of hearing conservation programs enables minimizing the general health problems and hearing, as well as the occurrence of PAINPSE, promoting better quality of life to the worker. A intensive work health promotion hearing or hearing loss prevention should be emphasized, especially for workers exposed to high levels of occupational noise, and the use, as appropriate, of individual hearing protection equipment. Therefore, this study had the objective elaborate a multimedia teleducation materials on prevention of occupational hearing loss to be provided by teams of professionals from health reference center worker (CEREST), National Network of Integrated Healthcare Workers (RENAST) and community, in line with the objectives of CEREST. The development of the CD-ROM will help education programs in hearing health providing information about the risks caused by high sound pressure levels (SPL).

O ruído ocupacional é considerado o problema que mais atinge o sistema auditivo do trabalhador brasileiro, perturba o trabalho, o descanso, o sono e a comunicação nos seres humanos; prejudica a audição e pode causar ou provocar reações psicológicas, fisiológicas e talvez até patológicas, afetando diretamente a qualidade de vida. A perda auditiva induzida por níveis de pressão sonora elevados (PAINPSE) é considerada uma entre as dez principais etiologias de perdas auditivas populacionais, sendo que, de todas as causas de lesão auditiva, é a que apresenta maior possibilidade de prevenção. Os efeitos auditivos encontrados em trabalhadores portadores da PAINPSE imitam a funcionalidade auditiva, provocando alteração de sensibilidade auditiva, alterações na seletividade de frequências, na resolução temporal e espacial, recrutamento e zumbido. Tais alterações influenciam diretamente a discriminação auditiva, dificultando a percepção, principalmente, dos sons da fala, podendo, também, alterar o padrão de fala de acordo com o grau da perda. O investimento em implantação de programas de conservação auditiva possibilita minimizar os problemas de saúde geral e auditiva, assim como a ocorrência da PAINPSE, promovendo melhor qualidade de vida ao trabalhador. Um trabalho intensivo de promoção da saúde auditiva ou prevenção de perdas auditivas deve ser enfatizado, principalmente para trabalhadores expostos a níveis elevados de ruído ocupacional, além da utilização, de forma adequada, de equipamento de proteção auditiva individual. Sendo assim este estudo teve por objetivo elaborar um material multimídia em tele-educação sobre prevenção de perdas auditivas de origem ocupacional para ser disponibilizado pelas equipes de profissionais do Centro de referência em saúde do trabalhador (CEREST), Rede Nacional de Atenção Integral à Saúde do Trabalhador (RENAST) e agentes comunitários, em consonância com os objetivos do CEREST. A elaboração do CD-ROM contribuirá para os programas de educação em saúde auditiva fornecendo informações a respeito dos riscos causados por níveis de pressão sonora elevada (NPS). / Occupational noise is considered the issue that most affects the hearing system of the Brazilian worker, disrupts work, rest, sleep and communication in humans, impairs hearing and may cause or provoke psychological reactions, physiological and maybe even pathological, affecting directly to quality of life. Hearing loss induced by high sound pressure levels (PAINPSE) is considered one of the top ten causes of hearing loss population, and of all-cause hearing damage, it has the greatest possibility of prevention. Hearing loss induced by high sound pressure levels (PAINPSE) is considered one of the top ten causes of hearing loss population, and of all-cause hearing damage, it has the greatest possibility of prevention. Auditory effects found in workers with PAINPSE mimic the functionality of the hearing, causing changes in hearing sensitivity, alterations in frequency selectivity, the temporal and space resolution, recruitment and tinnitus. These changes directly affect hearing discrimination, making the perception, especially speech sounds, it can also change the default speech according to the level of loss. Investment in implementation of hearing conservation programs enables minimizing the general health problems and hearing, as well as the occurrence of PAINPSE, promoting better quality of life to the worker. A intensive work health promotion hearing or hearing loss prevention should be emphasized, especially for workers exposed to high levels of occupational noise, and the use, as appropriate, of individual hearing protection equipment. Therefore, this study had the objective elaborate a multimedia teleducation materials on prevention of occupational hearing loss to be provided by teams of professionals from health reference center worker (CEREST), National Network of Integrated Healthcare Workers (RENAST) and community, in line with the objectives of CEREST. The development of the CD-ROM will help education programs in hearing health providing information about the risks caused by high sound pressure levels (SPL).

Made available in DSpace on 2016-04-27T18:12:15Z (GMT). No. of bitstreams: 1 dissertacao.pdf: 416311 bytes, checksum: 6d42df4a4ba3be204ae74895c6628e34 (MD5) Previous issue date: 2006-07-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / When we think about music, it is difficult to imagine that it may cause a hearing damage. Nevertheless, when played at high sound pressure levels, music can be harmful to man. Rock and roll is performed in excessive sound pressure levels. Several studies have demonstrated that rock concert s sound levels can range from 100 to 115 dB (A), with peak levels of 150 dB (A). Objective: to study the rock and roll musician´s hearing, analyzing the results of the audiological evaluation and verifying whether time of musical exposure is a source of variability. Methods: a questionnaire with objective of raising the personal data, health, exposure to amplified music, complaints and variable was applied to the musicians, that could influence the found results. 23 rock and roll musicians (46 ears) were evaluated by means of pure tone audiometry, immitance audiometry and transient/distortion product evoked otoacoustic emissions. Results: the main auditory complaints were: intolerance for loud sounds (48%) and tinnitus (39%). The results also revealed that all musicians (100%) presented hearing thresholds within normal range; however, 19 ears (41%) had presented audiometric notch in 4000-6000 Hz. 100% of the ears presented type A tympanogram and acoustic reflexes present in 500, 1000 and 2000 Hz bilaterally. In 4000 Hz, 65,2% of the reflexes were present and 34,8%, absent. TEOAEs were presented in 39% and absent in 61%. In the OAEPD test more than 50% of the ears had response presence on the evaluated frequencies. Conclusions: the results had shown that although hearing loss was not present in the studied population, already exists alteration in the OAE register, which suggests alteration of the cochlear function. In relation to the exposure time, the results demonstrated that the musicians with career time over 10 years statistically presents significant difference compared to those with career time minor than 10 years / Ao pensarmos na música, fica difícil imaginar que esta possa causar algum dano à audição. Porém, quando executada em níveis excessivos de pressão sonora, a música pode provocar efeitos auditivos prejudiciais ao homem. O Rock and roll tem como uma de suas principais características os níveis sonoros elevados. Diversos estudos já constataram que os níveis encontrados em concertos de Rock variam de 100 a 115 dB (A), alcançando picos de 150 dB (A). Objetivo: estudar a audição de músicos de Rock and roll, analisando os resultados da avaliação audiológica e investigar a influência da variável tempo de exposição à música amplificada na audição. Método: foi aplicado um questionário em 23 músicos, com objetivo de levantar os dados pessoais, de saúde, de exposição à música amplificada, queixas e variáveis que pudessem influenciar os resultados encontrados. Os 23 músicos foram avaliados (46 orelhas) por meio da audiometria tonal liminar, audiometria vocal, medidas de imitância acústica e emissões otoacústicas (evocadas por estímulo transiente EOAT e produto de distorção EOAPD). Resultados: as principais queixas auditivas encontradas foram: intolerância para sons intensos (48%) e zumbido (39%). Todos os músicos avaliados (100%) apresentaram limiares auditivos dentro dos padrões de normalidade bilateralmente, porém 19 (41%) das orelhas apresentaram entalhe audiométrico em 4000-6000 Hz; 100% das orelhas apresentaram timpanograma tipo A bilateralmente e reflexo acústico contralateral presente em 500, 1000 e 2000 Hz bilateralmente. Em 4000 Hz, 65,2% dos reflexos acústicos estavam presentes e 34,8% ausentes. 39% apresentaram EOAT presentes e 61% ausentes. No teste de EOAPD houve presença de resposta nas freqüências avaliadas em mais de 50% das orelhas. Conclusões: os resultados mostraram que apesar de não ocorrer perda auditiva na população estudada, já existe alteração no registro das EOA, o que sugere alteração da função coclear. Com relação ao tempo de exposição, os resultados demonstraram que os músicos com carreira superior a 10 anos apresentaram diferença estatisticamente significante comparados aos que estão expostos há menos tempo

Submitted by Secretaria Pós de Produção (tpp@vm.uff.br) on 2017-07-27T20:01:54Z No. of bitstreams: 1 D2014 - Helder Cesar Tinoco.pdf: 6602828 bytes, checksum: c205d6b3a325570344d5e51284eee91e (MD5) / Made available in DSpace on 2017-07-27T20:01:54Z (GMT). No. of bitstreams: 1 D2014 - Helder Cesar Tinoco.pdf: 6602828 bytes, checksum: c205d6b3a325570344d5e51284eee91e (MD5) / O ruído ocupacional é responsável por cerca de 20% das perdas auditivas induzidas por ruído (PAIR). Doença oriunda da exposição aos níveis elevados de pressão sonora ao longo dos anos gera perdas auditivas progressivas e irreversíveis, além de sintomas tais como: zumbidos, tontura, dor de cabeça, distúrbios gástricos, estresse e alterações transitórias na pressão arterial, podendo ainda prejudicar a visão, atenção, memória, sono e humor. Neste contexto, o objetivo desta pesquisa é apresentar uma sistemática para verificação dos fatores de risco que impactam na perda auditiva induzida pelo ruído na indústria e na utilização de equipamento de proteção individual auditiva – EPI. Para isso, inicialmente foi realizado um levantamento do estado da arte, com base na estruturação de um quadro referencial teórico dos subconstructos relacionados ao assunto em tela, desde agosto de 2012 até setembro de 2014, baseado numa pesquisa bibliográfica de publicações indexadas ou catalogadas na base de dados do portal de Periódicos Capes. Como opção metodológica, a partir da revisão de literatura definiu-se um total de 14 subconstructos para a pesquisa, sendo eles: idade; sexo; perdas auditivas; conforto do EPI; índice de risco; formação; barreiras; cultura de segurança; percepção do risco; percepção dos efeitos; expectativa; valorização dos resultados; comportamento de risco e produtos químicos ototóxicos. O presente trabalho - incidindo sobre uma amostra de 278 trabalhadores industriais expostos a níveis de pressões sonoras superiores a 80 dB (A) – utilizou como instrumento de análise de dados a análise multivariada pelas técnicas de correlação de Pearson e regressão linear múltipla, aplicadas sobre as variáveis identificadas. Para consolidação dos resultados, a análise fatorial permitiu obter uma estimativa dos efeitos diretos e indiretos de um conjunto de fatores relacionados à PAIR e ao uso do EPI. Concluiu-se que um efetivo entendimento dos empregados acerca do risco ocupacional perante o agente físico ruído mostrou influenciar no uso do EPI auditivo. Verificou-se ainda que a percepção dos efeitos gerados pela PAIR parece influenciar no desenvolvimento desta doença ocupacional, podendo inclusive influenciar positivamente para o desenvolvimento de comportamentos seguros pelos empregados. / Occupational noise is responsible for about 20% of noise-induced hearing loss (NIHL). Disease arising from exposure to high sound pressure levels over the years causes progressive and irreversible hearing loss, and symptoms such as tinnitus, dizziness, headache, stomach upset, transient changes in blood pressure, stress, vision disturbances, attention, memory, sleep and mood. In this context, the objective of this research is to present a systematic check of the risk factors that impact the industry in noise-induced hearing loss in industry and in the use of hearing protective equipment - PPE. A survey of the state of the art was done based on the structure of a framework of theoretical subconstructs related to the subject was conducted from August 2012 until September 2014, based on a literature search of publications indexed or cataloged in the database of the website Capes. As a methodological option, from the literature review defined a total of 13 subconstructs for research, which are: age; sex; hearing loss; risk index; training; barriers; safety culture; risk perception; perception of effects; expectation and valuation of results; risk behavior and chemicals ototoxic drugs. This work - focusing on a sample of 278 industrial workers exposed to sound pressure levels above 80 dB (A) - used as a tool for data analysis multivariate analysis by multiple linear techniques Pearson correlation and regression, applied on variables identified. To consolidate the results, the factor analysis yielded an estimate of direct and indirect of a set of factors related to NIHL effects. It was concluded that an effective understanding of employees about occupational exposures to physical agents showed noise influence the use of hearing PPE. It was also found that the perception of the effects generated by PAIR appears to influence the development of this occupational disease, and may also positively influence the development of safety behavior by employees.