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Aim: The purpose of this review is to describe acoustic pollution in neonatal and paediatric intensive care units, sources and effects of noise on patients and health care professions and interventions to reduce it., Method: The literature review was carried out using four main databanks from November 2016 to December 2016 through variously combined keywords and Mesh. 237 papers were detected. Presence of full text and pertinence were selection criteria., Outcome: 43 papers and 2 guidelines were selected. The issue of acoustic pollution was more intensely investigated in neonatal intensive care settings since 2008-2009; research was present in quite numerous countries, although the majority of the studies were carried out in the USA. Most studies show acoustic levels above recommended levels. Many researches attempt to identify the source of noise (monitor, incubators, ventilatory circuits, conversations) and the effects of intense noise like stress, loss of hearing, alterations of vital signs. Interventions to address the issue involve some changes in the staff behaviour through education, drawing the attention of the caregivers to the problem, through modifications of the settings and the use of specific materials to limit noise., Conclusions: A prolonged exposure to noise can cause serious damage to the patients in the short and long term; the contribution of the nursing staff to limit and control acoustic pollution is thus important.

Background: aircraft noise has been associated with several health effects. Because of the great success of low-cost flights, small airports have been turned into international airports thus exposing nearby residents to an increase in noise levels and potential disturbances and health disorders., Objective: to estimate the exposure levels and evaluate the health impact of aircraft noise on residents nearby six airports in Italy (Rome: Ciampino; Milan: Linate and Malpensa; Pisa; Turin; Venice) focusing on hypertension, acute myocardial infarction (AMI), annoyance and sleep disturbances., Methods: residents in the local Municipalities considered at 31.12.2010 were included in the study and their addresses were geocoded. Aircraft noise exposure in 2011 was defined using the Integrated Noise Model linked to each participant's address. Lden (<55, 55-60, 61-65, 65-70 dB), Lnight, Leq (day and night) were calculated. Available exposure-response relationships were used to estimate the number of additional cases of hypertension, AMI, annoyance and sleep disturbances in the local population., Results: 73,272 persons exposed to aircraft noise levels >55dB were considered: 55,915 (76.3%) were exposed to 55-60 dB; 16,562 (22.6%) to 60-65 dB; 795 (1.2%) to 65-70 dB. Exposure to aircraft noise levels above 55 dB was estimated to be responsible each year of 4,607 (95%CI 0-9,923) additional cases of hypertension; 3.4 (95%CI 0-10.7) cases of AMI; 9,789 (95%CI 6,895-11,962) cases of annoyance; 5,084 (95%CI 1,894-10,509) cases of sleep disturbances., Conclusions: a significant impact of airport noise on the health of residents nearby six Italian airports was estimated. Epidemiological evaluation and noise mitigation measures should be introduced to protect the health of residents.

Primary headaches account for 90% of all the forms of headache. The disease is characterized by high occurrence in the working-age population and by significant impact in countries with high economic and social development. These two epidemiological aspects carry significant economic costs that can be estimated calculating loss of working days due to illness and appreciable loss of labour productivity. In an occupational setting several circumstances are known to cause the onset of attacks in workers who already suffer from primary headache. In this sense, the following factors have an important role: interruption of the circadian sleep-wake rhythm, sleep deprivation, physical/mental distress, not ergonomic postures (mainly those involving the cervical-brachial district), prolonged use of display screen, acoustic discomfort. Among chemicals, in the current conditions of exposure, the olfactory characteristics seem of primary importance rather than the more "conventional" mechanism of toxicity. The main aim of this study is to provide useful information to occupational physicians on the management of workers suffering from primary headache, with regard either to the formulation of the judgement of suitability, or to their auxiliary role in the planning and organization of work. A second aim involves the identification of specific preventive measures in order to reduce the probability of occurrence of a headache attack. This also minimizes the risk of accidents and injuries and ensures workers' efficiency. After these considerations, we suggest guidelines for a flow chart (aimed to understand worker's suitability for his/her specific task). This guarantees not only safety and health of workers who suffer from the illness, but also safeguards any third worker from a possible consequence due to less working capacity and reduction of attention of employees working with a headache attack. In conclusion we also identify three critical factors: the diagnosis of the form of primary headache, the characteristics of the work and the effects due to pharmacological therapy. The study and characterization of these elements are a crucial step for a proper formulation of the judgement of suitability to work. We report a decision process for judgement formulation at the end of this article. It is organized with a hierarchical model, the first steps are the clinical examination and history, the last step, if necessary or advisable, is the neurological visit and a periodic verification of the adherence to treatment prescribed and the follow-up.

Non-auditory effects of noise involve several systems and functions, the most important of which are the cardiovascular, the vestibular and the psychic. Although several studies correlated noise exposure to some pathologies, like hypertension and anxiety disorders, and recent analysis carried out on cavy explained part of their pathophysiology, their multiple causes and the variability of individual reactions are still important limits to their classification.

The aim of the study was to assess the impact of noise pollution on blood pressure values of a sample population in the metropolitan area of Rome. A case-control study was carried out. Cases were patients with hypertension recruited at the Hypertension Center of the Teaching Hospital "Agostino Gemelli" in Rome, whereas controls were healthy people recruited at the same center. Noise exposure was assessed using place of residence of participants, and this related to monitoring air pollution data of Rome. 241 individuals entered the study, 161 cases (80 males and 81 females) and 80 controls (42 males and 38 females), aged on average 55,65 (+/- 12.66) and 57.08 (+/- 14.64) year, respectively. Multivariate analysis showed that being a case is directly associated to increasing age (the risk increases of 5% for each increase of 1 year), salt use (OR = 2.76; 95% CI: 1.18 - 8.48), exposure to a noise level over 65 dBA (OR = 2.09; 95% CI: 1.01 - 4.47), and inversely to physical activity (OR = 0.49; 95% CI: 0.23 - 1.00). These results, could be considered in city and urban green planning, having the last element a mitigating effect on population health.

Patients referred to Neonatal Intensive Care Units are particularly vulnerable because they are in a critical or sensitive period of development. When physicians were first able to really save preemies 40 years ago, not much thought was given to their brain development. The babies we care for are so early that the brain cells are still migrating to where they will finally rest in developed brain. We are shaped, to an extent, by our environment. In early life, the environment takes on a particularly important role. So treatments may over-stimulate areas of the brain with unknown consequences. For this reason minimally invasive treatments together with attention to the environment will favour a care developmentally appropriate for pre-term babies. Use of nasalCPAP, early rescue surfactant, synchronized mechanical ventilation, together with temperature, light and noise control could help to obtain these results. Pain control, music therapy, massage, kangaroo care and a family centred care are essential to optimize results obtained from the intensive care.

In the last thirty years, several studies have demonstrated a correlation between exposure to noise and the development of alterations and/or pathologies in organs and apparatus, apart from the auditory one. Exposure to noise can induce biochemical, physiological, or psychosocial modifications that can remain either inside the range of biological normality or alter and compromise the psychophysical well-being of the individual depending on the extent of the functional alterations of organic systems and psychosocial functions; both the reversibility and duration of the alterations and the adaptation could be related to the recovery capabilitiy of the human organism and to the environmental condition. Among the factors that can influence the effects of noise we can find: intrinsic characteristics of the physical insult (pressure, sound intensity, emission frequency), extrinsic characteristics (duration of the exposure, way of emission, presence of impulsive components, masking effects), spectral characteristics (infrasounds, ultrasounds, time of recovery) genetic factors (susceptibility) and acquired factors of the human organism (acoustic isolation of the living houses and the social necessity for the industrial activities that generate noise). Other factors that influence the damage are the surprise effect, the semantic content and the identification of the noise source. It can be hypothesized that the extra-auditory effects of noise show themselves through a series of nervous circuits that use the autonomic nervous system and interfere on neuro-immune-endocrine parameters. The organs which are more studied are: cardiovascular, gastro-enteric and endocrine systems, nervous system and psychological effects, respiratory system, fetus and effects on reproductive system, immune system and genetic material.

This study evaluated the indoor air quality of 26 classrooms of secondary schools in the city of Cassino (Italy). Two types of school buildings were assessed: buildings specifically designed as schools, and former dwellings converted to schools. Measurements were taken in both winter and spring months, before students entered the classrooms and while the classrooms were occupied. Lower thermal comfort levels were observed during the winter months; in fact, during the winter, ideal temperature, humidity and air speed parameters were found in only a small percentage of classrooms and students were found to experience thermal discomfort as a result. Air velocity was often found to be inadequate both in winter and spring months and in both types of school buildings evaluated. Illumination levels measured during the winter months with both natural daylight and mixed illumination, were found to be below 200 lux, the minimum recommended level recommended by the ministerial decree 18.12.1975. Noise levels above the maximum level recommended by the ministerial decree 01.03.1991 were also frequently observed. The symptoms most frequently reported by students were headache, difficulties in concentrating, cough, and unusual tiredness. The various discomfort situations observed in both types of school buildings point toward a need for greater attention toward indoor air quality of schools as this can have affect students' attention, concentration, productivity and comfort.

The present paper tries to identify the occupational risk factors (physical, chemical, biological, psychological), variable depending on jobs and tasks, to which the heterogeneous public safety/security workers are exposed. The fight against criminality and public order maintenance imply (sometimes fatal) traumatic risks, and expose to psychophysical and sensorial tiring, unfavourable macro- and microclimatic conditions, the risk of baropathy (air navigation, underwater activities), noise (generated by firearms and several other sources), vibrations and shakings (automatic weapons, transport vehicles), the risk of electric injury, ionizing (X and gamma rays) and non-inonizing (ultraviolet rays, microwaves and radiofrequencies, electromagnetic fields) radiations. Chemical hazards include carbon monoxide and other combustion products (fires, urban traffic), substances released in chemical accidents, tear gases, lead (firing grounds, metal works, environmental pollution), solvents, lubrificants and cutting oils (mechanic repair and maintenance), laboratory materials and reagents, irritant and/or sensitizing agents contained in gloves. The main biological risks are tetanus, blood-borne diseases (viral hepatitis, AIDS), aerogenous diseases (e.g., tuberculosis, Legionnaire's disease, epidemic cerebrospinal meningitis), dog- or horse-transmitted zoonosis. Finally, emotional, psychosomatic and behavioural stress-related disorders (e.g., burn-out syndrome, post-traumatic stress disorder) are typically frequent. The presence of numerous and diversified hazards among public safety/security forces imposes the adoption of occupational medicine measures, including risk assessment, health education, technical and environmental prevention, personal protective devices, sanitary surveillance and biological monitoring, clinical interventions (diagnosis, therapy and rehabilitation of occupational accidents and illnesses), prompt medico-legal evaluation of occupational-related compensation claims.

After defining noise and describing the physical characteristics that determine its noxious capability, the paper discusses the etiopathogenesis, clinical features and diagnostic criteria (anamnestic, audiometric, exclusion of other causes) of noise-induced damage. In conclusion, the legislative (preventive) and medico-legal issues of noise pathology are presented.

The opening of the new Malpensa 2000 Airport worried people living in the neighbouring towns about possible effects of acoustic and air pollution on health status. For this reason, Varese Health Unit set up a study involving housewives and General Practitioners. This study has been carried out in 3 Areas: A Area, bordering the airport, B Area, at intermediate distance, and C Area, at long distance. On the whole, 932 housewives (18 to 64 years old) and 92 General Practitioners, were involved. The questionnaire, distributed to housewives between May 1st and November 30th 2000, was filled out in the doctor's surgery who furthermore added clinical data. Chi-square statistics were calculated to test the association between living area and personal data, behavioural and environmental characteristics, and reported disorders. To describe possible interrelationships between living Area and the answers supplied by housewives and General Practitioners the multiple correspondence multivariate analysis technique was applied. The housewives living next to the airport (A area) frequently report insomnia, nocturnal waking, anxiety and difficulty in hearing words. The multivariate analysis has shown a relationship between recently increasing noise noted by the housewives, and the area where they live, as well as a noticeable coherence between the answers given by the housewives and those given by the General Practitioners, who reported higher frequencies of cephalgy, allergies, anxiety neurosis, medical consultation, benzodiazepine's and sleeping disorder's prescriptions in A Area compared to C Area. The airport's presence seems to be associated with the onset of subjective disorders in neighbouring population. Some of these disorders, in particular neuropsychological ones, are clinically confirmed by General Practitioners, and are consistent with different noise exposure levels.

Noise is a sound which is unwanted, either because of its effect on humans, its effect on fatigue or multifunctions of physical equipment, or its interference with the perception or detection of other sounds. It is a part of environmental pollution which can, in certain circumstances, reach worrying levels for the population (130 dB cause pain). Unsuitable exposure to noise for even short periods of time is responsible for symptomology involving the hearing organs (hypoacusis) and other parts of the body such as the cardiovascular, muscular and digestive systems via the connection between the central and the autonomous nervous systems. Noise in communal eating areas can be classed as coming from 3 sources: 1) operation of cooking machinery; 2) banging of pans and equipment; 3) voices of both staff and diners. The intensity of noise on these premises varies generally between 60 and 80 dB (discomfort threshold). The Regulations governing this subject are D.Lgs n.277 of 15/8/1991 regarding the protection of employees, D.P.C.M. of 1/3/1991 which establishes the maximum levels of noise both in the home and outside, and the more recent D.P.C.M. of 21/5/1999 referring to noise in public places, which includes restaurants. To contain the exposure to noise in public eating places, we believe that action should be taken at legal levels with stricter limits than the recently passed level of 105 dB, in the building planning departments and also with technological intervention in order to reduce the effects that noise has on the auditive and extra-auditive organs and thus limit possible sublimal messages which certainly do not benefit the psycho-physical well-being of the diners.

The aim of the study was to assess the state of hearing levels in young Italian subjects via an epidemiological study, and also, by means of a questionnaire, to assess the attitude of young people to music, how they listen to music and how they perceive the risk of noise-induced hearing damage. The sample studied consisted of 391 youths undergoing their first medical examination for military service. The hearing threshold was assessed by means of a semiclinical tonal audiometry with sound-proof earphones calibrated to ISO Standard 389 following the method of ISO Standard 6189. At the end of the study 315 youths were judged eligible for the study, 81% of whom lived in the city of Milan. 63% said they went to a discotheque 1-4 times a week and 3% said they listened to music with earphones at maximum volume. These conditions are considered to be potentially dangerous for hearing since among youths leaving discotheques disorders have been observed that are indicative of hearing fatigue: lowering of the hearing level 7%, buzzing in the ears 37%, sense of muffled sound 12%. In the group studied, environmental noise was a factor of disturbance for sleep (13%), for study and reading (43%), listening to the radio, to music and watching TV (29%). Only 7 youths said their hearing was "not normal", but the thresholds were all higher than audiometric zero, which are clearly worse than the values observed in similar studies reported in the literature. This study reports the mean values, SD, minimum and maximum and centile values of the distribution of hearing thresholds, separately for right and left ears. A comparison was made between the hearing in the group least exposed: a significant difference was observed only for the right ear while for the left ear there was only a tendency. The authors conclude that hearing in young people to-day is worse than in the past, whatever be the causes, and that due account should be taken of this state of affairs, by encouraging prevention programmes for noise-induce hearing loss at all levels and on every possible occasion.

The EEH (Equal Energy Hypothesis) postulates that permanent hearing loss (PTS) produced by exposure to noise is a function of sound energy of the exposure. The validity of EEH for continuous noise exposure was confirmed by large scale demographic studies and experiments in controlled laboratory setting. However, for impulse noise, EEH may not be as valid. This study was designed to test the applicability of EEH in impulse noise exposure in chinchillas. 9 groups of chinchillas were exposed to impulse noise. The intensity of the impulses (113, 125 and 137 dB SPL) and the rate (900, 3,600 and 14,400 impulses/hour) of the 9 exposure conditions were counterbalanced so that the 9 groups received the same total energy. PTS was obtained at 0.5, 2. and 8.0 kHz, by recording the evoked potentials from a chronic electrode implanted in the inferior colliculus. The cochleas were dissected and evaluated using conventional histological surface preparations and examined through scanning electron microscopy (SEM) employing a JEOL 35 microscopy. In our experimental conditions only the 113 dB SPL exposures were consistent with EEH (PTS less than 20 dB). The 125 dB SPL peak level is a critical value in that the validity of EEH also depends on exposure duration. As duration increases, so does PTS. At a 137 dB SPL peak level, EEH is not applicable. The amount of PTS is higher than 50 dB. It slightly increases when the impulse rate per hour becomes higher. In all cases examined PTS is less at 0.5 kHz than at 2.0 or 8 kHz. In these animals excellent informations concerning the sensory cell losses and cells damage was obtained with SEM.

The Authors evaluated patterns of click-evoked otoacoustic emissions (EOE) in a group of 184 patients exposed to noise in their working environment. The aim of the study was to detect changes in EOE patterns in this group compared to the EOE of healthy subjects. The clinical history of each subject was recorded and otoscopy, pure tone audiogram and impedance tests (tympanometry, stapedial reflex threshold) were carried out in all patients. Noise-induced hearing loss found in 97 patients, unilateral sensorineural hearing loss in 17, other hearing disorders in 24 and normal auditory threshold in 46. EOE recording was carried out in the group of patients with noise-induced hearing loss (97), in the group with normal threshold (46) and in a control group of 15 healthy subjects. EOE recording was obtained using the ILO 88 Otodynamic Analyzer. We introduce a probe into the external ear canal using a non-linear click stimulus (intensity at approximately 85 dB spl) at a 20/sec. rate with a 20 msec. window. Normal EOE were found in the control group. Abnormal EOE were found in 79 cases (81%) of the noise-induced hearing loss group, and in 22 (48%) of the normal threshold group. These data show that noise-exposed subjects have alterations of EOE such as threshold shift missing frequency bands, even in absence of an auditory threshold shift. When EOE were present, the frequency spectrum often showed lack of emissions at high frequencies. This study confirms that cochlear exposure to noise may produce significant alterations of EOE and that this test may be considered highly sensitive in detecting early cochlear damage in chronic acoustic trauma. Therefore, EOE may be used in screening and follow-up of high risk populations such as noise-exposed subjects.

In industrial setting impulse noise rarely occurs in isolation. Impulses are more often superimposed on a background of continuous noise. Since measurement of peak sound pressure level or energy considerations may not provide a sufficient index of danger to hearing, examining the frequency spectra of the noises appeared to be important. Seven groups of five chinchillas were used in this study. Four groups were exposed to octave bands of noise centered at 0.5, 2 or 4 kHz having intensities of 95, 90 and 86 dB SPL respectively or impulse noise of 113 dB peak SPL applied on time per 1 second. Three groups were exposed to the combination of impulse noise and one of the above continuous noises. Each exposure lasted five days. PTS was calculated on each animal using auditory evoked potentials. The cochleas were dissected and evaluated using conventional histological surface preparation and examined with scanning electron microscopy (SEM) employing a JEOL 35 microscope. The groups exposed to only the impulse or to continuous noise alone developed neither PTS nor hair cell loss. Considerable values of PTS and sensory cell loss were observed in animals exposed to impulse noise in combination with 2 and 4 kHz of continuous noise. This interaction effect increases as the spectral overlapping between the impulse and continuous noise increases. In these animals excellent information concerning the sensory cell losses or cell damage was obtained with SEM. The results of the present study demonstrate that interaction between impulse and continuous noise can indicate increased hazard, which is highly dependent not only upon the total energy of the complex exposure but also on the degree of spectral overlapping between impulse and continuous noise.

On the basis of a previous pilot study a multiple-choice questionnaire about hearing disabilities was developed. The questionnaire (SDU) allowed 20 items. The answers were tailored to the single question and scaled in increasingly order of disability (form A) or in random order (form B). Modalities of administration (self-report or interview) and form (A or B) were randomized in a group of 123 adult subjects with different degree of hearing impairment. Only one factor, attributable to hearing disability, was extracted by a factor analysis. This factor explains a major variance ratio of items related to speech perception in difficult listening context. A good correlation (r = .74) was found between SDU total score and hearing threshold in the better ear. No difference in mean score, variance and time of reduction of the SDU was found between form A and B. The Authors so propose the use of form A because of a more easy compute of the total score. Self-report was more time-consuming respect to interview (11.7' vs. 8.4'). Furthermore, self-report was non possible in 13.8% of subjects for severe virus impairment and illiteracy and in 6.1% some form of support was necessary. No difference of mean score and variance between self-report and interview was found. SDU represents a tool for hearing disability evaluation useful in aural rehabilitation protocols. The principal advantage is high applicability thanks to short time required, simplicity of task and flexibility in the modality of administration.

Interaction between continuous and impulse noise was studied. One group of chinchillas was exposed to octave band of noise of 0.5 kHz 95 dB SPL intensity. Three groups were exposed to impulse noises of 113, 119 and 125 prak SPL emitted at 1 imp/sec, 1 imp/4 sec and 1 imp/16 sec respectively. Three groups were exposed to noise created by a combination of above continuous and impulse noises. All exposures lasted for 5 days. Hearing thresholds were measured in 35 animals using auditory evoked potentials. The combined continuous and impulse noises showed equal energy contents, but the groups exposed to 119 and 125 dB impulse noise intensities developed an exacerbation of PTS and cell hair loss. Therefore, the critical level, under which the damage associated with noise exposure is related to the total noise energy (Equal Energy Hypothesis) was reduced when impulse noise was added to continuous noise.

The hepatic noradrenergic innervation and the glycogen cellular content, after acoustic stress, were studied by the fluorescence and P.A.S. methods, respectively, in 7-month-old male albino rats exposed to continuous intense noise for 60' and 8 hours. While the 60'-treatment did not cause noteworthy changes in adrenergic fibers and a decrease in PAS-positive material, the 8 h.-treatment induced a significant increase of catecholamines content, in addition to a non homogeneous response to PAS reaction by hepatocytes surrounding the portal spaces or the lobular central veins. The authors ascribe the effect of the 8 h.-treatment to a partial adaptation of hepatocytes to acoustic stress.

The effect of road noise on blood catecholamines, cAMP and certain cardiovascular and metabolic parameters was studied in a group of young untreated essential hypertensives. It was found that the 10' stimulus increased both systolic and diastolic pressure values. Blood catecholamines rose only after 5'. The most significant increase was in adrenaline as opposed to noradrenaline and dopamine. Significant changes were noted in cAMP and triacylglycerols (10' and 15' after commencement of the stimulus respectively). Comparison with previous results in normotensives suggested that the catecholamine response to stress is primarily alpha-receptorial when blood pressure is normal and beta-adrenergic in hypertension.

In evaluation of annoyance level due to road traffic, many criterions of noise exposure and degrees of basic adverse effect have been proposed through composite numerical values. In the present study procedures and units proposed by various AA. are recognizded and mathematical prediction models which correlate the influence of traffic density, composition, speed and geometry of road on emitted noise level are evaluated. At last limits of noise exposure levels set up in many countries or promulgated by Authorities with respect to the health and well being of man and in function of zoning urban areas, are referred.

Exposure to traffic noise for ten minutes increased diastolic pressure without affecting systolic pressure and heart rate. Plasma catecholamine levels were enhanced only five minutes after noise stimulation. Noradrenaline increased more significantly than dopamine and adrenaline. No changes in plasma cAMP levels and hematochemical parameters ( cholesterol , glucose, triglycerides , uric acids) were observed. Data suggest that traffic noise can be considered a stress-full stimulus and its effect on diastolic pressure can be correlated to alpha-receptor stimulation.

In the present report a method for the practical noise measurement in the factory environment is developed. The acoustic noise present is normally composed of the noise emitted from several machines more or less simultaneously and the measurement problem often consists in determining an average noise level that is then compared with some accepted noise criteria and on the basis of this comparison decisions may be taken as to necessary changes in the environment. The method extends the dynamic referred to as "impulse" use, that is a characteristic meter response which closely approaches the rise time of the human ear and stores, averages and forgets the short duration signal in a way similar to that of the human brain. The measured average noise level gives a better explanation of the audiometrically detectable occupation noise-induced hearing loss.

The pathogenic effects derived by the emission of noises and vibrations, essentially, are conditioned from three etiological factors. The first of those is the energetic level of the sound emission, whereas the second is the exposure time and the last is the spectral composition. We, making reference to sound source, can associate to the first etiological factors the influence of impulsive components present in the noise; whereas to the second the importance of the functional recovery time of auditory acuity and, at last, to the third etiological factors the annoyance caused by the superimposition of pure tone or of tight band noise, contained in 1/3 of octave. The specific effects, caused by the noise exposure, affect the auditory system (acoustic trauma, auditory weariness, noise deafness) and the vestibular system (vertigo, sickness, trouble of balance). Those effects are fortly dependent to the entity of the sound energy accepted in a calculated time interval (LEP), and after the end of noise expositions they aren't developed. The specific effects became permanent when the degeneration of the Corti's cells occurred. The noise deafness, in first time, impair the frequencies included between 3000 and 6000 Hz, particularly it concerns the thigh band of 4000 Hz. Those lesions happen after a prolonged exposition to LEP greater than 80-85 dBA, and its evolutions, usually, follow a succession of clinical stages that can be monitored through audiometric controls to allow the necessary preventive measures. The nonspecific effects, derived to the noise exposition can be divided in: 1) neuroendocrinologic and psychological effects; 2) psychosomatic effects; 3) psychosocial effects. The psychological effects (anxiety, depression, conflict condiction) are strictly related with neuroendocrinological responses to the sound impact, this, for the smaller entity of stimulation, is identical to locality reaction, on the contrary for more violent stimulations those determine and adaptative reaction (Selye syndrome) that consist in a excitement of the thalamus and pituitary gland, this determines a multiple endocrine hyperactivity followed from a inhibition period or, possibly, an adaptation period. The noise exposure determines, besides, same E.E.G. alterations and a reduction of walls' tone of the brain's arteries. The psychosomatic effects of the noise appear with emission greater than or equal to 70 dBA and these can be distinguished in: cardiovascular effects, gastrointestinal effects, respiratory effects, visual and genitals effects. The noise in these cases, mainly, acts as a risk's factors. The noise is, again, the cause of the arising of psychosocial effects. These can be classified as: interference on the transmission and understanding of the words, perfect healthy respect the efficiency and the learning capacity of the exposed subject, interference on the duration and quality of the sleep.(ABSTRACT TRUNCATED AT 400 WORDS)

The purpose of the present study was to compare the most common hearing damage criteria, based upon pure tone audiometric data. We examined 1086 workers with different intensity and duration of noise exposure. After consecutive selections, 455 subjects, subdivided into four exposure groups, were studied. The 12 considered criteria showed a widespread difference in their sensitivity: the percentage of hearing impaired subjects ranged from 3.3 to 24.2% in the whole population. The most sensitive criteria evaluated the hearing loss at 2 and 4 KHz. The evaluation of the hearing loss at 3 and 6 KHz did not modify the percentage of subjects bearing an handicap. The authors suggest the average hearing loss at 2 and 4 KHz as a criterion to be used for preventing and epidemiological purposes.

n this paper a comprehensive method for description and measurement of industrial noise is presented keeping the following aspects into account: 1) evaluation by data collection questionnaire of work environment, working variables, noise sources, noise exposure, etc.; 2) noise measurement with particular regards to noise characteristics (steady noise, intermittent, fluctuating, irregular, impulsive), to sampling methods (position, duration, etc.) also in wiew to drawing up "noise maps"; 3) noise data processing ( LAEQ , LEX); on this aspect many applying examples are specified; 4) noise data representation and recording, also using computer aids. The AA draw the attention to adopt, also in anticipation of the European noise standards, a standardized method for industrial noise evaluation.

The present report describes how the problem of noise at the "Nuovo Pignone" has been solved. The many improvements carried out and the consequent reduction of sound pressure levels on the workers as well as on the environment surrounding workshops, foundries and tank construction, are described. The technical importance of the control of noise at the gas turbine testing units is also stressed.

The results of a study conducted on individuals exposed to aeronautical environment noise (flight personnel, runway operators, mechanics etc.) are reported. A particular suprathreshold automatic audiometric technique, called P.A.T. (automatic Peyser test) was used because there was evidence that it was more trustworthy than other suprathreshold tests and because this test permits a graphic follow-up of the dynamic evolution of "uditive fatique" phenomenon. The conclusion is drawn with this method it is possible to evaluate more precisely both the entity of the damage and on possible suffering of Corti's organ in individuals exposed to noise, and the simplicity of the test is underlined. Moreover the test is advantageous because it can be done using the normal routine diagnostic apparatus.