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The characteristics of Noise Induced Hearing Loss (NIHL) in gold miners of different ages and occupation types were examined and the incidence of tinnitus, vertigo/balance problems and nausea were determined. The results indicate that as a subject group these had symmetrical bilateral, mild hearing loss in the frequencies below 2000 Hz deteriorating to a moderate sloping hearing loss in the frequencies above 2000 Hz, and the loss did not demonstrate the expected “notch” at 4000 Hz that is usually found in NIHL. The average deterioration in the pure tone thresholds of gold miners was 3.5 dB at 500Hz; 2.75dB at 1000Hz, 15.37 dB at 2000Hz, 19.12 dB at 3000Hz; 20.87dB at 4000 Hz and 14.16dB at 6000 Hz for every ten years of age. The pattern of hearing loss varies for the different occupation types with machine operators being the most severely affected. The majority of tinnitus sufferers were in the age range 30-60 years and 57.8 % were in the under 60 years old category, while in the over 60 years the incidence was 4.8 %. The incidence of vertigo and nausea were found to be 27% in this population. The results of this study will equip the audiologist to better deal with diagnostic testing, successful hearing aid fitting and aural rehabilitation of this population. The study highlights the need for greater awareness and the imparting of detailed information to gold miners about the impact of noise on their hearing. / Dissertation (MCommunication Pathology)--University of Pretoria, 2009. / Speech-Language Pathology and Audiology / unrestricted

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Background: During live concerts attendees are exposed to excessive high intensity sounds for durations considered dangerous to the auditory system. Thus, regular live music concert attendees are at risk for developing Music Induced Hearing Loss (MIHL) due to their recreational habits. Although MIHL is preventable, current hearing conservation is limited at live music venues. As personal hearing protection is poor within this community, a need for alternative hearing conservation strategies is evident. Method: The objectives of this multi-method quantitative research study was to determine whether venue-based hearing conservation strategies in live music venues are a plausible means of reducing the risk of music induced hearing loss. Four live rock and heavy metal music venues in Johannesburg (South Africa) were included in the study. The current venuebased hearing conservation strategies as well as the acoustic and structural characteristics of these venues are described. In addition, the Sound Pressure Levels (SPLs) were measured throughout the venues. The variance of the mean SPLs between different areas within these venues were then calculated and effects of the structural characteristics on the variance of the sound levels within the venues were determined. Results: The results indicated that hearing conservation including awareness programs and availability of Hearing Protection Devices (HPDs) are not currently occurring in the music venues. Music venues further do not comply with the OHSA (2003) regulations nor are they compliant in terms of the acoustic and structural recommendations for reducing the intensity levels in music venues. Statistical analysis indicated at least one pair of significant differences in the mean SPLs recorded in the different areas in each venue. Results further indicated trends in the variance of intensity levels between different areas confirming a positive relationship between each of these five trends and the variance of sound levels. Thus, this study indicates that venue-based hearing conservation strategies may be a plausible means for reducing the risk for MIHL in attendees at live music venues. Implications: Implications of this study are discussed in relation to clinical and practice guidelines for both audiologists, and occupational health personnel, whilst the need for changes in legislation are highlighted.

Student Number : 0213468X - MPh dissertation - School of Public Health - Faculty of Health Sciences / Background: Noise Induced Hearing Loss (NIHL) is increasingly being regarded as one of the most important Occupational diseases, especially in the mining industry. As most mining houses have put systems in place to try and control this problem it remains to be seen if existing controls are effective in achieving the intended objective of preventing hearing loss. This study was conducted in one of the big South African Diamond mines, which has a well resourced Hearing Conservation Program. Objectives: This study was conducted with the purpose of establishing if there has been additional incidence of NIHL in noise exposed workers during the observation period of five years. The other objective of this study was to determine the effect of age. Study design and method: The population in this study was made up of permanent employees of the mine. They were divided into low risk and high risk groups according to the noise/acoustic zoning of their work areas by the mine’s Occupation Hygiene Section, with the low exposure group acting as the control group. A retrospective record review was done using the Occupational Health records in the mine’s Occupational Health Centre. The period of observation spanned 1 January 1999 – 31 December 2004 (inclusive). Trends of the collated data were used to compare the two exposure groups with regard to the various outcomes that are commonly associated with hazardous noise exposure. Results: The outcomes that were analyzed in this study were: Incidence Rates for NIHL, Notching and Down-sloping. All these were observed to have occurred more among the exposed group during the period of observation. The incidence rates, in particular, were found to 92.8 per thousand person years in the high exposure group and 52.3 per thousand person years in the low exposure group. The statistical test that was used was the z-test and the results were z=5.844 with a p<0.05. Having decided on a significance level of 5% for the statistical test, this result was found to be statistically significant. This can be regarded as some proof that the exposed group had a worse outcome than their non-exposed counterparts. Another observation that was made was that the incidence of NIHL was proportionately higher among the older study subjects. Conclusion: Since the exposed group of workers was found to show statistically significant incidence of NIHL compared to the low exposure group it shows that the current Hearing Conservation Program (HCP) that is employed by the mine is not effective in preventing NIHL. However there were some limitations in the study design that preclude generalization of these results. Therefore a recommendation was made for a prospective cohort study to address these limitations.

Hearing Health and Listening Habits of High School Students and Parent Perspectives in East Tennessee Nicole Richart, B.S., Marcy K Hite, Au.D., Ph.D., and Shannon Bramlette, Au.D., Department of Audiology and Speech-Language Pathology, College of Clinical and Rehabilitative and Health Sciences, East Tennessee State University, Johnson City, TN. Childhood noise induced hearing loss (NIHL) is a serious health concern with increasing prevalence. Previous studies have recommended including hearing conservation programs in schools, yet it is often missing from curriculum. Several studies have been conducted with high school students to determine listening habits and preconceived ideas of NIHL and hearing conservation, focusing on personal listening devices. Overall, those results suggest that most high school students are unaware of the dangers of noise exposure to auditory health, both in the short- and long term. The purpose of this study was to adapt previously developed surveys for use with East Tennessee high school students and their parents to identify sources of childhood noise exposure in addition to personal listening devices and to assess the level of hearing conservation education, if any, students have previously received. The results would also be used to determine if further hearing conservation education would be beneficial for this population. This study is unique in that both the student’s and the student’s parent’s perspectives were assessed. Students were asked to answer questions regarding types of noise exposure, duration of exposure, signs of early hearing loss, and use of hearing protection when in high noise exposure environments. The parent survey asked the parent of the child to assess these same areas as they believe their child experiences and/or behaves. Data would have been compared between the student and their parent’s responses to evaluate differences between student’s self-assessment and their parent’s assessment of their child’s listening habits and knowledge of hearing conservation. Data analysis would have been completed both within and between groups, looking for overall attitudes held within the student and parent populations as well as evaluating the differences between student and parent attitudes. It was expected that students would under-report their noise exposure per week, parents would over-report their child’s noise exposure, and both groups would report having little knowledge relating to hearing conservation. Overall, we would expect the results to show there is an increased need for hearing conservation education in schools. One East Tennessee high school agreed to participate, however after multiple reminders there were no surveys completed by students or parents, most likely due to COVID-19. Efforts to recruit other area schools to participate were unsuccessful. The necessity for this study still remains, and so continuation of recruitment and data collection would be ideal. Future efforts to improve recruitment outcomes could include scheduling an in-person or virtual meeting with high school administration to discuss the study to better facilitate participation. Additionally, the parent consent and survey distribution process could be streamlined to encourage a higher rate of participation in the study.

According to research and authorities both young people and musicians are in need of hearing health knowledge in order to protect their own hearing. The purpose of this study was to investigate music teacher trainees’ experiences and thoughts concerning hearing health education at their music teacher programmes and internships. A sociocultural framework was used in this study. Semi-structured interviews were utilised to collect viewpoints and experiences from participants. The study involved 4 music teacher trainees, from three different music teacher training programmes. Two students were from the same music teacher programme. The data was analysed using thematic analysis. A sociocultural perspective was also used when analysing the data. The results indicate that music teacher students are not examined in hearing conservation. They do not seem to receive formative assessment in hearing conservation or hearing loss prevention. The staff is not necessarily knowledgeable in hearing conservation, even though they educate future music teachers. The staff does not seem to teach hearing conservation. Some supervisors at the internships were knowledgeable in hearing conservation and appeared to help their younger students understand risks. Other supervisors were not as knowledgeable and could be perceived as relatively passive when their students found themselves in risky sound environments without hearing protection. Social interactions which focused on hearing conservation or hearing loss prevention seemed to be quite absent at higher education and internships in Sweden. In conclusion, according to research and authorities, both youth and musicians are at risk and lack understanding of the risks in their sound environments. Music teachers are expected to teach hearing care according to the curriculum in Sweden, but many music teacher students do not feel well equipped to teach hearing care. It is important to have knowledgeable music teachers who can teach hearing care, as today's youth need this knowledge. The results and conclusions of this study suggest that society needs to equip music teachers at various levels of education with knowledge of hearing care. Several music education students in this study also expressed a desire for more hours of hearing care education at their music teacher programmes. These groups, music teachers and future music teachers, need knowledge of hearing care and hearing loss prevention to create cultures that emphasize hearing care and hearing health.

Objective: To determine safe output sound pressure levels (SPL) for sound amplification devices to preserve hearing sensitivity after usage. Design: A mathematical model consisting of the Modified Power Law (MPL) (Humes & Jesteadt, 1991) combined with equations for predicting temporary threshold shift (TTS) and subsequent permanent threshold shift (PTS) (Macrae, 1994b) was used to determine safe output SPL. Study sample: The study involves no new human subject measurements of loudness tolerance or threshold shifts. PTS was determined by the MPL model for 234 audiograms and the SPL output recommended by four different validated prescription recommendations for hearing aids. Results: PTS can, on rare occasion, occur as a result of SPL delivered by hearing aids at modern day prescription recommendations. The trading relationship of safe output SPL, decibel hearing level (dB HL) threshold, and PTS was captured with algebraic expressions. Better hearing thresholds lowered the safe output SPL and higher thresholds raised the safe output SPL. Conclusion: Safe output SPL can consider the magnitude of unaided hearing loss. For devices not set to prescriptive levels, limiting the output SPL below the safe levels identified should protect against threshold worsening as a result of long-term usage.

This study focused on designing a training programme for audiometricians, using the principles of instructional design. Instructional design is the continuing, systematic development of instructional specifications, utilizing researched strategies and principles to create detailed outcomes for the development, implementation, evaluation and maintenance of training programmes. An audiometrician is defined by SANS (10083:2004), as a person registered with the Health Professions Council of South Africa as an audiometrician, hearing aid acoustician or someone trained in audiometry. Audiometricians are adult learners. Therefore, in addition to instructional design principles, the principles of adult learning were also incorporated in the training programme. The successful training of audiometricians may ensure that noise induced hearing loss is significantly reduced when audiometric monitoring is appropriately implemented as part of a hearing conservation programme. Training for audiometricians is critical in this process as incorrect audiometric monitoring may negatively influence the outcomes of a hearing conservation programme. This study followed a descriptive research design where the results were described in a quantitative manner. Data was collected by means of electronically mailed questionnaires. All participants were practicing audiometricians at the time of the study and were registered with the South African Society for Occupational Health Nursing. All participants had an audiometric certificate as qualification. For the analysis of data, 181 completed questionnaires were used. The results were analyzed and described in terms of the respondents’ own experience regarding audiometry; their opinions regarding the topics they have been taught in audiometry; the duration of their own training programmes and their opinions regarding a future training programme for audiometricians. Based on the results of the above analysis, the instructional design programme for audiometricians was developed. The obtained results were used to determine what the topics, content, duration, learning outcomes and learner evaluation methods should be in the development of a training programme for audiometricians. This research study developed a training programme for audiometricians in order to ensure that all future audiometricians have the necessary knowledge to perform comprehensive hearing evaluations, interpret audiometric findings and thereby assist in reducing noise induced hearing loss in the industrial sector through hearing conservation programmes. AFRIKAANS : Hierdie studie is toegespits op die ontwerp van ‘n onderrigprogram vir oudiometriste waarin die beginsels van onderrigontwerp toegepas is. Onderrigontwerp behels die deurlopende en stelselmatige ontwikkeling van onderrigspesifikasies deur gebruik te maak van nagevorsde strategieë en beginsels om gedetailleerde uitkomste vir die ontwikkeing, evaluering en onderhoud van opleidingsprogramme daar te stel. ‘n Oudiometris word gedefinieer deur wetgewing (SANS 10083:2004) as ‘n person wat geregistreer is by die Health Professions Council of South Africa as ‘n oudiometris, gehoorapparaat akoestikus of iemand wat opgelei is in oudiometrie. Oudiometriste is volwasse leerders. Om hierdie rede is nie net die beginsels van onderrigontwerp nie, maar ook die beginsels van volwasse leer in die onderrigprogram geïnkorporeer. Suksesvolle onderrig van oudiometriste kan verseker dat die voorkoms van geraas-geïnduseerde gehoorverlies verminder, mits oudiometriese monitering toepaslik as deel van ‘n program vir gehoorkonservering geïntegreer word. Opleiding vir oudiometriste is krities belangrik in hierdie proses want indien oudiometriese monitering verkeerd gedoen word, kan dit die gehoorkonserveringsprogram in totaliteit negatief beïnvloed. ‘n Beskrywende navorsingsontwerp is in hierdie studie gebruik en die resultate is kwantitatief beskryf. Data is deur middel van vraelyste wat elektronies versend is, versamel. Al die deelnemers was ten tye van die studie praktiserende oudiometriste wat by die South African Society for Occupational Health Nursing geregistreer was. Elkeen was in besit van ‘n oudiometriese sertifikaat as kwalfikasie. Vir data-ontleding is 181 voltooide vraelyste gebruik. Die data was geanaliseer en beskryf in terme van die respondente se eie ervaring ten opsigte van oudiometrie; hul mening omtrent die temas wat by hul opleiding ingesluit was; die duur van hul opleidingsprogramme en hul idees omtrent ‘n toekomstige opleidingsprogram vir oudiometriste. Die onderrigontwerp-program is op grond van die resultate van bognoemde analise ontwikkel. Die resultate wat verkry is, is gebruik om die temas, inhoud, duur, leeruitkomste en evalueringsmetodes in die ontwikkeling van ‘n opleidingsprogram vir oudiometriste te bepaal. Hierdie studie is gerig op die ontwikkeling van ‘n opleidingsprogram vir oudiometriste met die doel om te verseker dat hulle oor die nodige kennis beskik om omvattende gehoorevaluerings uit te voer, om oudiometriese bevindinge te interpreteer en daardeur, in gesondheidssorgprogramme, by te dra tot die vermindering van geraas-geïnduseerde gehoorverlies in die industriële sektor Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2012. / Speech-Language Pathology and Audiology / unrestricted

MPH / Department of Public Health / Hearing Conservation Programme (HCP) has been reported to be effective in protecting the hearing of South African workers who are exposed to occupational noise. In order to reduce Noise Induced Hearing Loss (NIHL) among these workers, a team work that includes an Occupational Audiologist in the proper implementation of hearing conservation programme is needed. The aim of this study was to assess the implementation of hearing conservation programme amongst farm workers in Vhembe District, Limpopo Province in South Africa.A quantitative research approach using cross sectional survey design was used to assess the implementation of the programme among farm workers in Vhembe District, Limpopo Province in South Africa. A self administered questionnaire with both open and closed ended questions was administered to both males and female respondents aged between 19 and 50 years. A total population of 260 farm workers were systematically selected and a sample size of 76 respondents were randomly selected and participated in the study. Permission to conduct the study was obtained from the Ethics Committee of the University of Venda and the office in charge of royal macadamia. The data collected was analyzed using the Statistical package of Social Sciences (SPSS) version 23,0 software. A test-retest method was used to ensure reliability and findings of the study and formed the basis of recommendations. The results of the study indicate that 82,9% of the workers who were exposed to noise for more than 14hours were not using hearing protection devices even though they were supplied. The training on the effects of noise on hearing was received by a quarter (25%) of the farm workers leaving out a large portion of 75% of workers not knowledgeable about the hearing conservation programme. A very small percentage of 3,9% indicated that they had a documented hearing loss against a large number of 96,1%. The findings show that only engineering noise controls are available and there were no provision of noise maps as part of monitoring hearing conservation programme.The farm workers need to be motivated to wear hearing protection devices in order to conserve their hearing. The management of the farm may organize an in-service training regarding the proper implementation of hearing conservation programme.Dermacation of noise zones would remind workers to put on their ear protectors before entering the noise area as part of monitoring the hearing conservation programme.