nÃo hà / A saÃde do trabalhador no Brasil tomou novo rumo com uma nova visÃo, mais ampla e integral do processo saÃde-doenÃa, considerando-se as questÃes relacionadas a acidentes e doenÃas ocupacionais sobre o trabalho. Dentre as vÃrias doenÃas estÃo a Perda Auditiva Induzida pelo RuÃdo (PAIR) e os trabalhadores que sÃo continuamente expostos a compostos quÃmicos em ambientes industriais. Entre estes, figuram os chamados compostos hexavalentes e os compostos formados por cromo trivalente. O objetivo desta pesquisa foi verificar se a exposiÃÃo simultÃnea de ruÃdo e cromo potencializa o aparecimento da perda auditiva ocupacional dos trabalhadores de curtume em Teresina-PI. As caracterÃsticas da populaÃÃo em estudo, sÃo todos os trabalhadores do sexo masculino, divididos em 3 grupos, sendo: Grupo I - exposto a cromo e ruÃdo (n = 9); Grupo II - exposto a ruÃdo (n = 9); Grupo III - controle (n =10) na faixa etÃria de 38,11  5,9 , 30,83  7,4 e 27,40  7,0 anos, respectivamente. Os trabalhadores do Grupo I e II trabalham em mÃdia 9 horas diÃrias e 22,2% do grupo I apresentam problemas cardiovasculares e 16,7% do grupo II alteraÃÃo da pressÃo arterial. Em relaÃÃo ao tempo de trabalho, verifica-se um maior tempo de trabalho para os trabalhadores expostos a cromo e ruÃdo em mÃdia 13 anos, estes desenvolvem suas atividades laborais em sua maioria nos setores de curtimento, classificaÃÃo de peles e Ribeira, sÃo os que estÃo em contato permanente com o cromo (55%), enquanto que os expostos a ruÃdo (grupo II) sÃo os trabalhadores dos setores de acabamento, rebaixamento e lixadeira de couro (83,3%). Quando relacionado à funÃÃo e de acordo com a categoria profissional os que mais se expÃem a ruÃdo e cromo sÃo os auxiliares de produÃÃo, (44,5% exposto a ruÃdo e cromo e 91,5% expostos a ruÃdo). Em relaÃÃo aos EPIs somente (55,6%) de trabalhadores expostos ao cromo e ruÃdo utilizam protetor auricular do tipo plug; e nenhuma proteÃÃo para o cromo. Nos expostos somente a ruÃdo o uso de EPI à de apenas 25%. Sobre sua percepÃÃo quanto a sua prÃpria audiÃÃo, todos os grupos referem-na como boa, apenas 20% dos que responderam do grupo I referiu-se a sua audiÃÃo como ruim. No grupo exposto somente a ruÃdo 8,3% relatam otalgia, enquanto que 100% dos expostos a cromo e ruÃdo fazem esse relato, apresentando significÃncia p< 0,05. Os trabalhadores do Grupo I e II queixam-se de tonturas frequentes (44% e 25%), zumbido (22,2% e 50%) respectivamente. Quanto ao resultado do exame audiomÃtrico, 100% do Grupo Controle e os expostos a RuÃdo apresentaram Limiares Auditivos dentro dos PadrÃes de Normalidade enquanto 22,2% dos expostos a cromo e ruÃdo apresentaram perda auditiva neurossensorial. Quando avaliados os parÃmetros de cromo na urina, ocorreu um aumento significante no valor da dosagem de cromo dos trabalhadores expostos a cromo e ruÃdo p<0,001 (2,76  0,76 ) em relaÃÃo aos expostos somente a ruÃdo p<0,05 (1,62  1,77), quando comparados com o controle. Assim salienta-se a necessidade de investigaÃÃo da perda auditiva em trabalhadores de curtume como estratÃgia de prevenÃÃo, associados a contÃnuos programas educacionais relacionados ao uso correto de equipamentos de proteÃÃo individual tanto na exposiÃÃo a substÃncias quÃmicas como para ruÃdo.

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Background The noise-exposed population in the mining industry in South Africa poses unique problems to the occupational audiologist working in this environment, due to the broad linguistic and cultural diversity in the audiology and mining environment. Unfortunately, the problems are also exacerbated by a high incidence of pseudohypacusis within this population who are incentivised by compensation for NIHL. A solution to these specific problems would be the reliable and valid use of an objective test of function such as the DPOAE. The rationale for the study therefore was to extend the body of knowledge about the use of DPOAEs in the noise-exposed mining population. Methodology The current study was divided into two phases: phase one’s objectives entailed the investigation of the characteristics of DPOAEs in a noise-exposed mining population; phase two aimed to develop a multivariate regression model that would facilitate the prediction of the hearing threshold levels from the DPOAE levels in this population. Objectives The objectives in phase one of the study were to investigate the bivariate correlations between DPOAE levels and air-conduction hearing threshold levels in noise-exposed gold miners, for the three stimulus procedures. The study also aimed to investigate the bivariate correlations between various pure-tone averages (PTA) and the DPOAE averages of f2 frequencies closest to those pure-tone frequencies. Similarly, the Speech Recognition Thresholds (SRT) were correlated with DPOAE averages of f2 frequencies closest to the PTA. xx The study further aimed to investigate the characteristics of DPOAEs in noiseexposed gold miners by comparing the average DPOAE levels for different age category groups, different ethnic groups and for different occupation types. Finally, phase one aimed to describe the characteristics of emission level and noise floor differences (DP-NF) in a DPOAE database of a noise-exposed gold mining population. Phase two of the study had the objective of developing a multivariate prediction model using stepwise regression analysis to identify which of the DPOAE frequencies produced the best prediction of the audiogram frequencies when multivariate inputs were used for each stimulus procedure. The objective was also to evaluate the use of the predicted audiograms’ calculated percentage loss of hearing (PLH) with that of the actual PLH. This retrospective record review used an audiological database from a mine in the North West province of South Africa that contained 4800 records. The required sample size to be representative of the population was statistically determined. The records were randomly selected resulting a sample size for the FB2-S group of 161, for the FB1-S group of 177 and the FB1-S group of 155 respectively. The hearing loss characteristics in the samples ranged from normal to profound losses with the majority being mild to moderate hearing losses. Results The findings of phase one showed negative correlations ranging from -0.327 to -0.573 for Frequency Band 1- Replicated (FB1-R) between DPOAE levels and air conduction hearing threshold levels. Similarly, Frequency Band 1-Single (FB1-S) and Frequency Band 2-Single (FB2-S) also showed negative correlations (ranging from -0.203 to -0.609 and -0.274 to -0.738 respectively). These correlation strengths have been confirmed previously by other published studies. xxi Correlations between groups of frequencies on an audiogram and averaged match groups of DPOAE frequencies by intensity levels, both for PTA and SRT, ranged between -0.323 and -0.661. No statistically significant differences were found between the DPOAE measurements and ethnic groups of African and Caucasian (Sample size of 175 for FB1-S, 137 for FB1-R and 161 for FB2-S). No differences were found between the DPOAE levels and the occupation types of mining team members, stopers and drillers. There was, however, a relational finding of a progressive decrement of DPOAE intensity levels by decade of age increase (Sample size of 37 for FB1-S, 45 for FB1-R and 155 for FB2-S). Mean DP levels in this population ranged from 1.5 to -14 dB SPL, and mean NF levels in the sample ranged from 0.1 to -16.8 dB SPL with the mean DP-NF difference ranges form 0.4 to 9.3 dBSPL. More than 60% of the data collected resulted in a DP-NF of less than 10 dB SPL. The simple correlation relationship between hearing threshold levels and DPOAEs did not sufficiently explain the variance within the sample and due to the fact that a number of the independent variables in the sample were highly correlated, there was a call to use a method that allows for multicolinearity (i.e. stepwise regression analysis) in order to develop a prediction model. Consequently, phase two of the study was able to compare actual air-conduction hearing threshold levels with those calculated with the prediction model, and then calculate predicted percentage loss of hearing (PLH) with actual PLH found in the noise-exposed gold miners. In phase two, with the use of the predictive models, the predicted hearing threshold levels were found to differ from the actual thresholds by no more than 7dB HL across all frequencies (average of 5 dB HL for FB1-R, 2 dB HL for FB1-S and 3 dB HL for FB2-S). The differences for each audiogram frequency between the actual and the predicted thresholds are represented on scatter plots in phase two of the thesis. The PLH of the predicted audiograms was calculated using the weighted xxii tables prescribed by the Compensation for Occupational Diseases and Injuries Act (COIDA). A comparison of the predicted PLH with the actual PLH indicated that the predicted PLH ranged between minus 1.3% PLH and plus 6.7% PLH of the actual PLH. Results of the study are discussed with regards to the clinical implications, and the implications for training occupational audiologists in South Africa. The results of this study will improve and inform practice in the mining environment and in the field of compensation for NIHL. By developing a reliable prediction tool which is implemented on an objective test proven to document the extent of damage incurred from noise-exposure, a clinician will gain greater confidence in an accurate diagnosis, thereby further safeguarding a vulnerable population. The results from this study are highly relevant to the mining industry and will add value to the industrial development of South Africa by informing the policy on hearing conservation and compensation, thereby increasing the awareness of the need for improved occupational health and safety conditions and sustainable development in the mining industry.

Bakgrund: Studier visar att hörselskador kan uppstå till följd av yttre påfrestningar så som exponering av buller och kraftiga tryckförändringar. Fallskärmshoppare exponeras för bägge dessa faktorer, vilket skulle kunna innebära en ökad risk för att utveckla hörselskador. Trots detta är området mycket sparsamt studerat. En ökad kunskap inom området medför att eventuella behov av preventiva åtgärder kan identifieras. Syfte: Syftet med studien var att undersöka förekomsten av upplevda hörselbesvär hos fallskärmshoppare, samt om det finns något samband mellan upplevda hörselbesvär och antal hopp, användning av öronproppar eller akustiska höjdvarnare. Metod: Studien genomfördes i form av en kvantitativ tvärsnittsstudie. En webbenkät skickades ut till samtliga aktiva fallskärmshoppare med registrerad e-postadress i två fallskärmsklubbar i Mellansverige. Totalt 244 fallskärmshoppare deltog i studien (svarsfrekvens 47,6 %). Resultat: Hörselrelaterade besvär i form av hörselnedsättning, tinnitus och smärta/obehag i öronen förekom hos 20-30 % av de studerade fallskärmshopparna. Det fanns däremot inga statistiskt signifikanta samband mellan upplevda hörselbesvär och antal fallskärmshopp, användning av öronproppar eller användning av akustiska höjdvarnare. Andelen som uppgav att de upplevde svårigheter att höra vad som sägs i ett samtal mellan flera personer var högre bland de studerade fallskärmshopparna jämfört med en åldersmatchad population i SCB:s befolkningsundersökning. Slutsats: Inga samband mellan antal fallskärmshopp och hörselrelaterade besvär kan ses, men resultatet tyder på att fallskärmshoppare upplever hörselnedsättning i större utsträckning jämfört med övriga befolkningen. Vidare studier krävs för att med säkerhet kunna avgöra om fallskärmshoppning innebär en risk för att utveckla hörselskador. / Background: Studies have shown that hearing loss can be caused by environmental factors like noise and changes in the pressure. Skydivers are exposed to several risk factors for hearing impairment, but there is a lack of studies investigating hearing loss among skydivers. More knowledge among the phenomena is needed to identify potential need of preventive work.  Aims: The aim of the study was to investigate the prevalence of self-perceived hearing symptoms among skydivers. The study also examined the relationship between self-perceived hearing symptoms and the use of earplugs and audible altimeters. Methods: The study was executed as a quantitative cross-sectional study. Webb-based questionnaires were sent out to all skydivers with registered e-mail in two skydiving clubs in Sweden. A total of 244 skydivers were studied (response rate 47.6 %) Results: Hearing symptoms such as hearing loss, tinnitus and ear pain was found in 20-30 % of the skydivers. The proportion who experienced difficulty in hearing was higher among the skydivers than an age-matched population from a SCB survey. However, no statistically significant correlations between self-perceived hearing symptoms and number of parachute jumps, use of earplugs or use of audible altimeters were found. Conclusion: No relationship between amount of skydiving and hearing symptoms could be found, but the results indicate that hearing loss is more common among skydivers compared to the general population. Further studies are required to investigate if skydivers are in risk of developing hearing loss.

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.

The aim of this study was to investigate noise levels in the New Zealand health industry. The goal was to investigate the room acoustics and the characteristics of the noise sources along with noise exposure of health care workers, in New Zealand, in dental clinics and orthopaedic cast clinics and assess whether they are at risk of noise-induced hearing loss (NIHL). A literature review was conducted to determine the definition, cause, and ways to prevent NIHL in relation to the dental clinics and orthopaedic cast clinics. Also determined from a review of the literature were ways to assess and monitor the acoustics of these spaces. Initially room acoustic measurements of background noise levels as well as reverberation times were made and frequency information on the major noise sources was obtained. This was followed by measurement of the daily noise dose exposure of staff working in the participating dental clinics and orthopaedic cast clinics. It was found that noise dose levels did not exceed the damage risk criterion set by The New Zealand Occupational Safety and Health Service of Leq8h of 85 dBA and therefore staff were considered to not be at risk of NIHL. However, the background noise levels measured may be putting healthcare workers at risk of non-auditory related effects of noise exposure, affecting work performance, cognitive abilities and vital communication between staff and patients. Healthcare workers may also be at risk of non-auditory health effects due to increased noise annoyance leading to raised stress levels, which may ultimately lead to pathophysiological changes in the myocardium. Future research in the area of noise levels in the New Zealand health industry should be performed to obtain noise data on a larger sample and look further at the non-auditory health effects of exposure to noise in the health industry.

This study assessed the role of otoacoustic emission screening for the early identification of noise-induced hearing loss in South African mineworkers. Transient otoacoustic emissions and distortion product otoacoustic emissions were recorded in 106 noise exposed mineworkers (212 ears) aged between 20 and 55 years, and in 17 non-exposed novice workers (34 ears) aged between 18 and 29 years. All subjects had normal hearing acuity, otoscopic examinations and immittance measurements. Four otoacoustic emission (OAE) measurements were taken per ear and repeated by a second audiologist for the evaluation of inter-test reliability. Age and number of years of noise exposure was additionally evaluated as well as the specificity and sensitivity of the tests for this population group. In general the OAEs were diminished at four KHz for both the exposed and non-exposed groups. Age was found to be the primary predictor of diminished OAE tracings. Poor inter-test reliability was obtained. These results indicate that further research is required within this population group before OAE testing can be implemented for screening for noise-induced hearing loss. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

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INTRODUÇÃO: Em consequência da modernização tecnológica e industrial, surgiram novos fatores que originaram estudos específicos e direcionados sobre os possíveis efeitos nocivos desta evolução no trabalhador. Dentre estes, está o ruído, agente físico que pode causar danos ao organismo humano com efeitos de curto e médio prazo. O ruído, ao atuar sobre o trabalhador pode alterar processos internos do organismo, com consequências fisiológicas e emocionais. A diminuição gradual da acuidade auditiva decorrente da exposição continuada a níveis elevados de pressão sonora é denominada perda auditiva induzida pelo ruído (PAIR), segundo o Comitê Nacional de Ruído e Conservação Auditiva. A PAIR é caracterizada por perda neurossensorial, irreversível, quase sempre bilateral e simétrica, não ultrapassando 40dB(NA) nas frequências graves e 75dB(NA) nas frequências agudas; manifesta-se, primeiramente, em 6kHz, 4kHz e/ou 3kHz, progredindo lentamente às frequências de 8kHz, 2kHz, 1kHz, 500Hz e 250Hz. (MTE, Portaria 19, 1998). Entre os fatores que influenciam no desencadeamento da PAIR, destacam-se as características físicas do ruído (tipo, espectro e intensidade da pressão sonora), o tempo de exposição e a suscetibilidade individual. A PAIR está entre as doenças do trabalho de maior prevalência, com agravante de tratar-se de uma doença irreversível. Acomete com mais frequência o setor industrial. Este estudo avalia a incidência de perda auditiva por ruído e a existência de uma associação positiva entre estes diagnósticos e a exposição a diferentes níveis de pressão sonora em trabalhadores de duas unidades de uma mineradora e pelotizadora de minério de ferro. MÉTODOS: Estudo de coorte histórica com 1.069 trabalhadores divididos em dois grupos, tendo como referência os níveis de pressão sonora aos quais estavam expostos (menor ou igual a 88 dB e acima de 88 dB). A avaliação da audição foi realizada por análise dos resultados das audiometrias realizadas nos exames admissionais e periódicos constantes dos prontuários médicos. Foram calculadas as incidências de perda auditiva de acordo com os grupos de exposição e o tempo médio de início das alterações auditivas em cada grupo. Foram realizadas análises descritivas das variáveis, comparação de médias (teste U de Mann-Whitney), teste de associação de qui-quadrado e, para estimar fatores de risco, modelos de regressão logística univariada e múltipla. RESULTADOS: Entre os participantes do estudo foram identificados 128 casos (11,97%) de perda auditiva. No grupo composto pelos trabalhadores que ficaram expostos aos níveis mais altos de pressão sonora encontra-se uma incidência de 11,84% em alterações de exames audiométricos, enquanto no grupo menos exposto obteve-se uma incidência de 12,4%. O tempo médio para o desencadeamento de alterações audiométricas foi de 3,07 anos (desvio padrão = 1,21) no grupo mais exposto e de 2,88 anos (desvio padrão = 1,53) no grupo menos exposto. Estar na faixa etária acima de 28 anos e 8 meses (RC = 3,33; IC 95%: 2,01 - 5,49) e trabalhar na Unidade 1 (RC = 1,64; IC 95%: 1,09 - 2,46) se mostraram fatores de risco robustos para perda auditiva induzida por ruído. CONCLUSÃO: A perda auditiva ocorre de maneira precoce, prioritariamente até o terceiro ano de exposição e faixa etária, e unidade de trabalho se mostraram os fatores de risco mais relevantes para a perda auditiva induzida por ruído. O estudo mostra a necessidade de uma integração maior entre as áreas de saúde ocupacional e segurança do trabalho na busca de ações preventivas e corretivas, que possam minimizar o surgimento de novos casos ou o agravamento dos já identificados. Este é um estudo preliminar que servirá de apoio a pesquisas futuras sobre o assunto / INTRODUCTION: As a result of technological and industrial modernization new factors have arisen which led to specific studies have focused on the possible harmful effects of this evolution on the worker. Among these factors is noise, a physical agent which can harm the human body with short and medium term effects. Noise can alter internal body processes, with physiological and emotional consequences. The gradual reduction of hearing acuity resulting from a continued exposure to high levels of noise pressure is called noise-induced hearing loss (NIHL), according to the National Committee of Noise and Hearing Conservation. NIHL is characterized by a permanent sensorioneural impairment, almost always bilateral and symmetrical, not exceeding 40dB (NA) at lower frequencies and 75dB (NA) at higher frequencies. It first manifests at 6kHz, 4kHz and/or 3kHz, slowly progressing to the frequencies of 8kHz, 2kHz, 1kHz, 500Hz and 250Hz. (MTE, Ruling 19, 1998). Among the factors which trigger NIHL are the physical characteristics of the noise (type, spectrum and intensity of sound pressure), duration of exposure, and individual susceptibility. NIHL is among the most common occupational diseases, with the aggravating aspect of being irreversible. It is most often found in the industrial sector. This study will evaluate the incidence of noise-induced hearing loss and the existence of a positive association between these diagnoses and the exposure to different levels of sound pressure in workers at two operational units of a iron ore mining and pelletizing organization. METHODS: historical cohort study with 1069 workers, divided in two groups, using as baseline the sound pressure levels to which they were exposed (less than or equal to 88 dB and above 88 dB). The hearing assessment was carried out by means of an analysis of the results of the audiometry exam upon induction and at regular intervals, as recorded in the medical history of the individual. A calculation was made of the degree of hearing loss according to the groups of exposure, and the average time it took for hearing changes to be observed in each group. RESULTS: Among the participants in the study, 128 (11.97%) cases of hearing loss were identified. In the group formed by workers who had been exposed to the highest levels of sound pressures, we found an incidence of 11.84% of changes in the audiometry exams, while in the group subject to lesser exposure we observed an incidence of 12.4%. The average time for the development of hearing impairment was 3.07 years (standard deviation = 1.21) in the group with greater exposure, and 2.88 years (standard deviation = 1.53) in the group with lesser exposure. Robust risk factors for noise-induced hearing loss included being aged over 28 years and 8 months (RC = 3,33; IC 95%: 2,01 - 5,49) and working at Unit 1 (RC = 1,64 ; IC 95%: 1,09 - 2,46). CONCLUSION: Early hearing impairment occurs mainly before the end of the third year of exposure, and age bracket and work location proved to be the most relevant risk factors for noise-induced hearing loss. The study showed the need for a greater integration among the occupational health and safety areas to seek the design and implementation of preventive and corrective actions to minimize the development of new cases or the aggravation of those already identified. This is a preliminary study which will serve as a basis for a more detailed subsequent data analysis

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.