Noise induced hearing loss has been extensively researched and commented on, yet it remains prevalent among industrial workers. The real-world attenuation properties of the Noise Clipper® custom-made hearing protection device and the comfort levels it afford are unknown. Furthermore, research in hearing conservation is seldom focused on the critical/biological thresholds for temporary threshold shift. Field studies on hearing protection devices have demonstrated that laboratory derived measures bear little relation to attenuation achieved in workers. Research has consistently demonstrated that noise reduction ratings that are derived from the laboratory real-ear-at-threshold method do not accurately represent the attenuation of noise that these devices actually provide and the matter remains unclear. Too many important variables are neglected in current real-ear-atthreshold evaluation protocols. This study used an alternative method, the microphone-inreal- ear approach where a dual-element microphone probe was inserted into the Noise Clipper® to measure noise reduction by recording the difference in noise levels outside and behind the device. The sub aims of the study were to record ambient noise levels and frequency spectra; to determine the attenuation characteristics; and to compare the attenuation thresholds to biological thresholds for temporary threshold shift. Using this protocol, measurements were made on 20 subjects in real world situations in order to match the attenuation characteristics of the Noise Clipper® to the actual noise exposure. The microphone-in-real-ear derived attenuation thresholds were compared to the real-earat- threshold values provided by the manufacturer of the Noise Clipper®. Additional subaims were to determine the comfort levels of the Noise Clipper® and record the selfreported wearing time of the device. Wearing comfort was evaluated using a bipolar rating scale. The researcher interviewed 240 mine workers at a platinum mine. Several comfort related sub-scales were used to quantify reported comfort levels. Simultaneously, usage time of the device was self-reported by each worker. Results of the microphone-in-real-ear measurements indicated that ambient noise levels fluctuated from day to day. The attenuation results indicated that most of the measurements suggested protection against noise induced hearing loss through the use of the Noise Clipper®. It was found that the REAT results over estimated the attenuation ability of the Noise Clipper® when compared to the results of the F-MIRE measurements. Eighty seven percent of the measurements indicated protection from thresholds below the biological threshold for temporary threshold shift. Seventy five percent of the workers indicated that the Noise Clipper® was comfortable to wear and 79% indicated that they used it for a full eight hour shift. The results provide an opportunity to assess the use of a protection device and its effectiveness among mineworkers combined with information regarding noise exposure levels. The findings highlight the importance of evaluating variability in terms of individual-specific protection. / Dissertation (MCommunication Pathology)--University of Pretoria, 2013. / Speech-Language Pathology and Audiology / unrestricted

Recent advances in the field of audiology have indicated that there has been a growing concern regarding the potential damage to the hearing mechanism induced by recreational noise exposure from personal music devices (PMD). Regular PMD use may have a long-term damaging effect on the outer- and inner hair cells of the cochlea which may result in a progressive hearing loss. As PMDs have advanced to a stage where the memory of the devices are able to contain hours of listening content, the environments where these devices are being used are rapidly expanding. Many young adults tend to use their PMDs whilst exercising. Exercise in itself induces physiological and metabolic changes such as increased blood flow and oxygen levels within the structures of the cochlea. The purpose of this study was to determine the differential impact and short-term effects of simultaneous cardiovascular workout and personal music device (PMD) use on the otoacoustic emissions of young adults. Seven female and five male subjects completed three testing conditions: (i) one hour exposure to PMD use in isolation, (ii) one hour exposure to cardiovascular workout in isolation, and (iii) one hour simultaneous exposure to PMD use and cardiovascular workout. Distortion product otoacoustic emissions (DPOAEs) were conducted prior to, as well as directly following each testing condition, as primary indicator of cochlear responses emitted through a preset stimulus frequency sequence measuring the 2f₁ - f₂ (75 – 70 dB SPL) and constructing a plot of DPOAE levels as a function of frequency. While each of the testing conditions on its own did not result in statistically significant changes of the DPOAE response, a highly significant different profile in the DPOAE response level increase/decrease for the higher frequencies (6-8 kHz) was obtained when comparing the different sessions to each other. Where exposure to cardiovascular workout showed a clear trend of an increased DPOAE response level between the pre-exposure and post-exposure testing from 2 kHz to 8 kHz with a maximum increase at 6 kHz, both the music only condition and the combined condition where the cardiovascular workout was combined with music resulted in a significant different profile. During combined exposure a clear trend of decreased DPOAE response amplitudes between the pre-exposure and post-exposure testing were seen for the higher frequencies. These findings may support the notion of a clear effect of cardiovascular workout on the otoacoustic emissions at higher test frequencies, measured by DPOAEs when performed with and without music exposure. / Dissertation (MLOG)--University of Pretoria, 2014. / tm2015 / Speech-Language Pathology and Audiology / MLOG / Unrestricted

Previous literature has demonstrated that supplemental magnesium may have a prophylactic effect on noise induced hearing loss (NIHL). The purpose of this study was to replicate the findings of a previous investigation concerning the beneficial effects of supplemental magnesium on TTS in humans. Forty participants with normal hearing were divided into two groups, experimental and control. The experimental group received a single, 150 mg dose of supplemental magnesium and the control group received a placebo. After an hour in a quiet environment, all participants were exposed to a narrowband noise centered at 2000 Hz and presented at 105 dB SPL. Audiometric thresholds were measured for the frequency range 250 Hz - 8000 Hz prior to the noise exposure, and then immediately, 30 minutes, and 60 minutes post-noise exposure. Both groups experienced TTS at and above 2000 Hz. The largest TTS was observed immediately following the noise exposure in both groups. There was no significant difference in TTS between the experimental group and the control group. It was concluded that a single dose of 150 mg of supplemental magnesium was not effective in reducing or preventing TTS.

Previous studies have shown that supplemental magnesium administered prior to exposure to noise has an alleviating effect on temporary threshold shift (TTS). These studies have only used audiometric thresholds to demonstrate changes in the auditory system. However, to help determine the effects on outer hair cells (OHCs), a more sensitive measure should be used. The purpose of this study was to determine if supplemental magnesium administration prior to noise exposure has a beneficial effect on acoustic overexposure using a double-blind research design. This was determined by measuring distortion product otoacoustic emissions (DPOAEs) to determine any changes in cochlear OHC function. DPOAE amplitude and signal-to-noise ratio (SNR) measurements were analyzed for two groups of twenty participants (an experimental group and a control group). The experimental group received 150 mg of magnesium gluconate one hour prior to noise exposure. The control group received a placebo pill that was identical in appearance to the magnesium pill. Following noise exposure, the greatest changes in DPOAE amplitude and SNR occurred for the frequencies that were one-half to one octave above the frequency of the stimuli used. The greatest changes in DPOAE measurements were present immediately post TTS-inducing stimulus, with only slight changes present after 30 minutes and no difference between 30 minutes and 60 minutes post-exposure. These results were the same for both groups. It was concluded that this dosage of supplemental magnesium had no apparent protective effect on DPOAEs following intense noise exposure.

This study aimed to investigate the effectiveness of the Quiet earplug noise protectors worn by a group of South African industrial workers exposed to excessive noise in the workplace. This was achieved by investigating the prevalence and amplitudes of distortion product otoacoustic emissions (DPOAEs), as they have been found to be sensitive to the effects of noise on the cochlea (Vinck, Van Cauwenberge, Leroy,&Corthals, 1999, p. 52). DPOAEs were recorded before and after noise exposure and were compared in order to determine whether the earplugs are providing sufficient protection against cochlear damage. DPOAEs were recorded using a test protocol where the primaries are fixed at L1 = 60dB SPL and L2 = 35dB SPL (L1 - L2 = 25dB) with an f2/f1 ratio of 1.18. The f2 frequencies were selected to correspond closely to the audiometric test frequencies of 2000Hz, 3000Hz, 4000Hz, 6000Hz and 8000Hz. The study found the prevalence of DPOAEs to be statistically stable and repeatable. This was true for DPOAEs measured successively during the same test sitting, as well as comparing prevalence determined before and after exposure to eight hours of noise. DPOAE prevalence alone was therefore not found to be a good indication of the temporary threshold shift (TTS) associated with the effects of noise on the cochlea. However, a significant finding of the study was that normal DPOAEs were recorded in only six right ears (24%) and seven left ears (28%) before noise exposure, even though all the subjects presented with hearing thresholds better than 25dB SPL. This may mean that cochlear pathology is already evident in some of the subjects tested. Further results of the study showed DPOAE amplitudes to be sensitive to the negative effects of excessive noise, as there was a significant difference between DPOAE amplitudes measured before and after the noise exposure. DPOAE amplitudes, specifically in the frequencies that are known to be affected by noise such as 4000Hz and 6000Hz, measured after the work-shift were significantly smaller than those measured before exposure to noise. Although correct usage of the earplugs could not be controlled for the duration of the noise exposure, each subject was instructed on the correct usage of the hearing protection before entering the noise zone. Bearing this limitation of the study in mind, because DPOAE amplitudes were reduced the implication is that the Quiet earplugs are not providing sufficient protection against the harmful effects of noise. / Dissertation (M (Communication Pathology))--University of Pretoria, 2005. / Speech-Language Pathology and Audiology / Unrestricted

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Abstract This research on military aviation noise was conducted because the personnel working with military aircraft were concerned about noise induced hearing damage. In addition, comprehensive data on hearing impairments and occupational exposure of military pilots in the Finnish Air Force was not available. Moreover, data on the effects of overflight noise of military jets was necessary for the evaluation of noise induced hearing deteriorations of members of the public who might be exposured accidentally for the low-level jets' overflights. The averaged noise exposure levels of pilots varied during a flight from 97 dB(A) to 106 dB(A) in the cockpit and from 83 dB(A) to 100 dB(A) at the entrance of the ear canal. Radio noise was 4–10 dB higher than background noise inside the helmet. The attenuation provided by air crew helmets varied from10 to 21 dB(A) in the laboratory, and was at the same level during real flights. The attenuation measured in the laboratory and in working conditions was about 30 dB(A) for earmuffs. An active noise cancellation (ANC) device decreased averaged noise exposure (LAeq8min) 4–8 dB over the noise attenuation of the same helmets when the ANC system was off. The noise of overflights by military jets were measured and the noise levels were lower than those known to cause the permanent threshold shifts. However, noise induced hearing damages might be possible in certain conditions. In order to assess the hearing loss risk of pilots, hearing thresholds were measured before and after one flight using both conventional and extended high frequency (EHF) audiometry. Minor temporary threshold shifts (TTS) were revealed. The risk of noise-induced damage at the studied exposure levels is, in all probability, rather small. A novel NoiseScan data management system proved to be an interesting tool in assessment of the risk of developing hearing impairment on the basis of known risk factors. Due to the small number of risk factors, the hearing of pilots was shown to be at considerably less risk than that of industrial workers in Finland.

In der vorliegenden Arbeit sind physiologische und anatomische Auswirkungen einer Lärmexposition auf subcortikale Strukturen des zentralen auditorischen Systems zu unterschiedlichen Zeitpunkten posttraumatisch untersucht worden. Dabei sollte zwischen akuten (TTS-Gruppe) und langfristigen Effekten (PTS-Gruppe) unterschieden werden. Normalhörende Mäuse wurden für 3 Stunden mit einem Bandrauschen (5-20 kHz) bei 115 dB SPL beschallt und mittels Hirnstammaudiometrie der Hörverlust bestimmt. In der TTS- und der PTS-Gruppe lag im Vergleich zur Kontrolle eine signifikante Hörschwellenverschiebung mit einem höheren Hörverlust in der TTS-Gruppe vor. Zur Untersuchung zentraler Veränderungen wurden neuronale Spontanaktivitäten mittels Einzelzellableitungen im Hirnschnitt ermittelt. Weiterhin sind histologisch die Zelldichten in den Versuchsgruppen bestimmt worden. Außerdem wurde ein manganverstärktes MRT durchgeführt, um die calciumabhängige Aktivität darzustellen. Die untersuchten auditorischen Strukturen waren der Nucleus cochlearis (CN), der inferiore Colliculus (IC) und der mediale Kniehöckers (MGB). Die Ergebnisse zeigen, dass es einen Unterschied in den akuten und langfristigen Auswirkungen einer Lärmexposition gibt. In der TTS-Gruppe sind ausschließlich die Kerngebiete des CN im Hirnstamm betroffen, was auf direkte Einwirkungen der Lärmexposition hindeutet und akute toxische Exzitation im Gewebe auslösen kann. In der PTS-Gruppe treten physiologische und anatomische Veränderung in höheren Strukturen der Hörbahn auf. Dabei kann es sich sowohl um späte direkte Lärmauswirkungen als auch um plastische Veränderungen handeln, die durch die lärminduzierte Deprivation ausgelöst wurden. Einerseits kommt es zu einem dramatischen Zellverlust in den untersuchten Gebieten. Zum anderen steigt die calciumabhängige Aktivität in einigen Strukturen stark an. Dies kann sowohl durch veränderte neuronale Aktivitätsmuster, aber auch durch plastische und neurodegenerative Prozesse bedingt sein. / In the present study, noise-induced physiological and anatomical changes in subcortical structures of the central auditory system were investigated at different posttraumatic stages. Thus, it should be distinguished between acute (TTS group) and long-term (PTS group) effects of noise damage. Normal hearing mice were exposed to a band noise (5-20 kHz) for 3 hours at 115 dB SPL. Auditory brainstem responses were measured to determine the produced hearing loss. A significant threshold shift was detectable in the TTS as well as in the PTS group. This effect was greater in TTS animals. To investigate central changes, neuronal spontaneous activities were recorded from single units in brain slices. Further, cell densities were determined by histological techniques. In addition, calcium dependent activity was measured using manganese enhanced MRI. Investigations were carried out in central auditory structures of the cochlear nucleus (CN), the inferior colliculus (IC) and the medial geniculate body (MGB). The results demonstrate a difference in acute and long-term effects of noise exposure. In the TTS group, only the CN in the brainstem was affected, indicating a direct noise impact leading to acute excitotoxicity. In the PTS group, physiological and anatomical changes could also be observed in higher structures of the auditory pathway. The effects can be related to long-lasting noise damage as well as neural plasticity caused by deprivation of auditory input. The results show a dramatic cell loss within the investigated structures. Further, there is an increase in calcium dependent activity in several auditory brain regions which can be caused by changes in neuronal activity patterns, neuroplasticity and neurodegenerative processes.