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Purpose: This study evaluates the exposure of call center operators (CCOs) to occupational noise, its association with auditory and nonauditory symptoms, and the feasibility of monaural and binaural headsets. Method: We measured the noise exposure sound pressure levels (SPLs) with the microphone-in-real-ear technique and administered a questionnaire on auditory/nonauditory symptoms and headset preference. Results: We assessed 79 CCOs with normal hearing. Overall, 98.7% of the participants reported at least one auditory symptom, and 88.6% reported at least one nonauditory symptom after using the headset. We found significant associations between the headset volume setting and the number of auditory and nonauditory symptoms and between sharp increases in sound level and tinnitus. The microphone-in-real-ear diffuse-field–related SPLs with monaural headsets (85.5 dBA) were significantly higher than those with binaural headsets (83.1 dBA). Binaural headsets were the preference of 84.8% of the subjects. The SPLs of the binaural headsets were significantly lower than those of the monaural headsets in the subjects who preferred the binaural headsets. Conclusions: CCOs with normal hearing reported auditory and nonauditory symptoms, highlighting the need for attention and further investigation. The binaural headsets were preferable, as they were associated with a lower SPL and a higher call quality. Supplemental Material: https://doi.org/10.23641/asha.18361463

Objectives. This study aimed to compare speech intelligibility in noise with and without hearing protection devices (HPDs). Methods. Fifty-one workers were distributed into three groups: noise-induced hearing loss group (NIHLG), normally hearing noise-exposed group (NG) and normally hearing non-exposed to noise group (CG). A free field system was used to emit monosyllables (65, 70 and 75 dB) and pink noise in different signal-to-noise ratios (SNRs) (0, −5, −10 and −15). Results. In situations with HPDs, all groups showed a decrease in the percentage of correct responses with an increase in noise level. The HPD had little effect on speech intelligibility in the NIHLG and NG. Considering the effect caused by the HPD on speech intelligibility, it was observed that the group with the greatest loss was the CG for SNRs of −5, −10 and −15. Conclusion. Although speech intelligibility is influenced by the hearing threshold, the noise level and SNR are crucial for good speech intelligibility, either with or without an HPD. It is highlighted that the NG had worse results when compared with the CG, which may indicate changes in the auditory pathway resulting from continuous noise exposure, even in the absence of changes in the audiometric thresholds.

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435

Introduction: Noise in the school environment has been a major concern in many countries around the world. Students need a favorable signal-to-noise ratio in the classroom to ensure adequate speech intelligibility, which is directly dependent on the acoustics of the classroom and favorable noise levels in these environments. Objective: To evaluate the effectiveness of physical, organizational, and educational interventions to achieve noise reduction in a school. Methods: Presentations on the effects of noise were made to school administrators, teachers, and students (educational activities), and also to the students’ families. Then, thermoacoustic treatment, changes in break times, equipment maintenance, and scheduling of students’ departure were applied. Sound pressure levels were measured before and after interventions for the unoccupied and occupied classroom conditions (n = 11 classrooms) and of the school’s outside areas (n = 4). Self-administered printed pre- and postintervention multiple-choice questionnaires were completed by the students in the classroom. Measures of the signal-to-noise ratio of the teachers’ voice before and after the interventions were also conducted (n = 3 classrooms). The interventions included installation of an acoustic ceiling, installation of air-conditioning, and replacement of the existing furniture with wood furniture. Results: Comparing the pre- and postintervention questionnaires, the Annoyance Index was reduced from 0.78 to 0.59. The tinnitus reported by the individuals increased significantly in the postintervention questionnaire (p < 0.001). Significant reductions in noise levels in both unoccupied and occupied classrooms were observed. There was also an improvement in the mean signal-to-noise ratio in the evaluated classrooms (n = 3) from +7.5 to +8.4 dB. Conclusion: Subjective measures and objective assessments demonstrated that both physical and educational interventions had a positive effect on short-term changes in habits and noise reduction in the school environment.

Background Discrepancies between attenuation obtained in the laboratory and the field are caused by several factors associated with hearing protection devices (HPDs). The effects of some factors can be minimized with proper training provided to HPD users. Objective To evaluate the effectiveness of an educational intervention for improving the correct use of earplugs as HPDs in workers exposed to occupational noise by using the F-MIRE method and by comparing pre- and post-training attenuation values and pass/fail rates. Methodology The personal attenuation ratings (PARs) of two types of earplugs were obtained (140 individuals) using E-A-Rfit™ equipment. Each HPD was evaluated under two scenarios: first after the user only read the packaging instructions, and then after the user read guidelines and participated in a training program. The results obtained were automatically classified by the software as "Approved" or "Failed". Results There was a significant post-training increase in the binaural PAR values for both HPDs. The percentages of passes pre- and post-training showed that training users in the proper fit of the HPD was effective; both types had statistically significant differences. Conclusion This study found a statistically significant increase in PARs and the number of workers passing evaluations after HPD fit training, demonstrating the effectiveness of this educational intervention.

Objective: to verify the effect of a vestibular rehabilitation program on workers with dizziness from the Division of Nutrition and Dietetics at a University Hospital. Methods: a total of 13 employees between 42 and 65 years of age participated, of whom, 1 was male, and 12, females. They were evaluated before and after the vestibular rehabilitation program using the Dizziness Handicap Inventory, Work Ability Index and Visual Analog Scale. The program was conducted in groups at the workplace. Statistical analysis was performed using the analysis of variance test for paired factors and the chi-square test. Results: in the pre- and post-vestibular rehabilitation comparison, significant differences were found in the Dizziness Handicap Inventory and Visual Analogue Scale scores. In the qualitative analysis of the Work Ability Index, an increase was observed in the number of workers who considered their ability to work to have improved. Conclusion: vestibular rehabilitation conducted in groups and in the working environment was effective in improving dizziness complaint in workers at the Division of Nutrition and Dietetics. It is believed that the positive experience of this program may be extended to other areas.

Introdução: O ruído é um dos principais agentes de poluição ambiental, que em intensidades elevadas, poderá causar a perda auditiva induzida por níveis de pressão sonora elevadas (PAINPSE). A PAINPSE é o segundo tipo de perda auditiva neurossensorial mais frequente, e considerada uma das principais doenças ocupacionais. Para evitar os prejuízos da exposição ao ruído ocupacional, legislações determinam o monitoramento e o desenvolvimento de ações para reduzir os efeitos da exposição, sendo o uso de dispositivos de proteção auditiva (DPA) a mais empregada. Contudo é comum que o trabalhador relate dificuldades para se comunicar com o DPA, o que pode induzi-lo ao uso inadequado. Os estudos já realizados apresentam discordâncias sobre os efeitos do DPA para a inteligibilidade da fala, além de serem poucos os que compararam participantes com perdas auditivas com normo-ouvintes. Objetivos: Avaliar a inteligibilidade de fala em trabalhadores expostos a ruído durante o uso de DPA. Métodos: Trata-se de um estudo transversal, aprovado pelo Comitê de Ética em Pesquisa da instituição nº 130/14, com amostra de 36 participantes, todos do sexo masculino e expostos ao ruído. Foram divididos em grupo normo-ouvintes (G1), com 20 participantes e com perda auditiva (G2), com 16 participantes. Todos os participantes realizaram avaliação da inteligibilidade de fala em campo acústico, utilizando listas de monossílabas e sentenças, em situações de uso do DPA no silêncio e no ruído e sem o uso do DPA no ruído. Resultados: Na avaliação da inteligibilidade de fala com DPA utilizando as monossílabas, ambos os grupos apresentaram porcentagens de acertos superiores à 95% na situação de silêncio. Na presença do ruído com o DPA, não foi detectado efeito de interação envolvendo grupo (p>=0,106) e nem efeito de grupo (p=0,182), mas houve efeito de interação entre intensidade de fala e relação sinal/ruído (S/R) (p=0,006). Na avaliação da inteligibilidade de fala no ruído sem o DPA, foi detectado efeito de interação entre uso do DPA e relação S/R (p=0,010) sobre a média das porcentagens de acertos. Na avaliação com listas de sentenças, a porcentagem de acertos com DPA foram superiores a 98% no silêncio; contudo, no ruído houve piora, com efeito de interação entre intensidade de fala e relação S/R (p=0,010) e entre grupo e relação S/R (p=0,039). Na comparação do uso/não uso do DPA, houve efeito de interação entre uso do DPA e as relações S/R (p=0,009) sobre a média das porcentagens de acertos. Conclusões: Para ambos os grupos, houve piora da inteligibilidade de fala com o aumento da intensidade do ruído; contudo, a dificuldade foi maior para o G2. Na comparação das situações com/sem o uso do DPA, o uso dificultou a inteligibilidade de fala, mas não houve diferença significante entre as situações. Por fim, ressalta-se a importância de realizar mais estudos dos efeitos do DPA na comunicação, além de inserir nas avaliações ocupacionais testes que avaliam a fala no ruído, para determinar as dificuldades que podem surgir no ambiente ocupacional, e assim desenvolver medidas que beneficiem os trabalhadores que necessitam se comunicar durante as atividades laborais Introduction: Noise is one of the main agents of environmental pollution, and at high intensities, it may provoke noise-induced hearing loss (NIHL). NIHL is the second most frequent type of sensorineural hearing loss and it is considered one of the main occupational diseases. In order to avoid the effects of the exposition to occupational noise, legislation determines the monitoring and development of actions to reduce the effects of such exposure and one of the most applied measure is the mandatory use of hearing protection devices (HPD). However, workers often report difficulties to communicate when using the HPD, what may induce them to use it improperly. Previous studies showed divergences between the effects of HPD on speech intelligibility; besides, few studies compared participants with hearing loss to those with normal hearing. Purpose: To assess speech intelligibility of workers exposed to noise during the use of HPD. Methods: This is a cross-sectional study, approved by the Institution\'s Ethics Committee (nº 130/14) and counted on a sample of 36 participants, all males and exposed to noise. They were distributed into a normal hearing group (G1), with 20 participants and hearing loss group (G2), with 16 participants. All participants were submitted to an assessment of speech intelligibility in free field, using monosyllable and sentence lists, when using the HPD in silence and noise situation, and also without the use of HPD in noise. Results: In the assessment of speech intelligibility with HPD using the monosyllables, both groups presented percentages of correct answers above 95%. In the presence of noise with HPD, there was no interaction effect involving group (p>=0.106) or group effect (p=0.182), but there was found an interaction effect between speech intensity and signal-to-noise ratio (SNR) (p=0.006). In the assessment of speech intelligibility in noise without HPD, an interaction effect between HPD use and SNR (p=0.010) was detected over the mean percentage of correct answers. In the evaluation with lists of sentences, the percentage of correct answers with HPD were superior to 98% in the silence; however, in noise, there was a decrease on the interaction effect between speech intensity and SNR (p = 0.010) and between group and SNR (p = 0.039). In the comparison with/without use of HPD, there was found an interaction effect between hearing protection use and SNR (p = 0.009) on the mean percentage of correct answers. Conclusions: For both groups, it was noticed that speech intelligibility decrease with the increasing of noise intensity; nevertheless, the difficulty was greater for the group with hearing loss. In the comparison of situations with and without the use of HPD, its use made speech intelligibility more challenging, but no significant difference between the situations was found. Finally, it is important to highlight the importance of further studies regarding the effects of HPD on communication and, besides, inserting speech-in-noise tests in occupational examination in order to determine the difficulties that may arise in the occupational environment and thus, develop measures that benefits the workers who need communicate during their labor activities

OBJETIVO: Verificar a efetividade de uma ação educativa de treinamento, com ênfase na importância da proteção auditiva, para trabalhadores expostos a ruído ocupacional. MÉTODOS: Participaram 78 funcionários do gênero masculino. Todos os indivíduos passaram por avaliação audiológica completa e responderam a um questionário no momento do início do atendimento. Para a segunda aplicação do questionário, os participantes foram randomicamente divididos em dois grupos: Grupo Pesquisa, constituído por 44 funcionários, que responderam ao questionário após passarem por treinamento educativo, e Grupo Controle, constituído por 34 funcionários, que responderem ao questionário antes de passar por treinamento educativo. O treinamento foi feito com base em material gráfico com figuras e textos, sob a forma de conversa. Os temas abordados foram: importância da audição, efeitos do ruído sobre a saúde, importância da prevenção da perda auditiva e da utilização do protetor auditivo, conservação e higienização dos protetores, níveis de ruído no ambiente de trabalho e atenuação do ruído fornecida pelos protetores auditivos. O questionário continha 14 perguntas de múltipla escolha que abordavam os mesmos temas explorados no treinamento educativo. RESULTADOS: Houve aumento significativo do número de acertos durante a 2ª aplicação do questionário, somente para o Grupo Pesquisa, em todas as comparações realizadas. CONCLUSÃO: Ações educativas realizadas com trabalhadores expostos a ruído ocupacional são efetivas. Além disso, o questionário é uma ferramenta estável e viável para a verificação da efetividade de programas educativos PURPOSE: To verify the effectiveness of an educational action in the form of training, emphasizing the importance of hearing protection for workers exposed to occupational noise. METHODS: The study included 78 male individuals. All participants answered a questionnaire before they were submitted to audiological evaluation. For the second application of the questionnaire, participants were randomly divided into two groups: Research Group, constituted by 44 subjects that received educational training before the second questionnaire application, and Control Group, comprising 34 individuals that answered the questionnaire before the educational training. Training was based on material with graphic images and text, in the form of conversation. The topics covered included: the importance of hearing, noise effects on health, importance of preventing hearing loss and using hearing protection, conservation and cleaning of hearing protectors, levels of noise in the workplace and noise attenuation provided by hearing protectors. The questionnaire contained 14 multiple choice questions that addressed the same themes explored in the educational training. RESULTS: There was a significant increase of correct responses in the second application of the questionnaire, only in the Research Group, in all comparisons. CONCLUSION: Educational action performed with workers exposed to occupational noise are effective, and the questionnaire is a stable and viable tool to evaluate the effectiveness of educational programs

Purpose: To determine the efficacy of hearing protector insertion by comparing attenuation values measured by objective (MIRE) and subjective (REAT) methods in groups with and without training. Methods: The study included 80 male subjects assigned to experimental (with training) and control (without training) groups. The following procedures were performed: occupational history, objective and subjective assessment of hearing protectors. Only subjects in the experimental group received training and guidance on proper hearing protector insertion. Results: Attenuation values were significantly higher in the experimental group than in the control group at all frequencies (500, 1000, 2000, and 4000 Hz) investigated through the objective (MIRE) and subjective (REAT) methods. In addition, attenuation values in the control group were lower than those provided by the hearing protector manufacturer. Conclusion: Both objective and subjective attenuation tests demonstrated the efficacy of training on insertion of hearing protectors because the group that received training on proper hearing protection insertion exhibited higher attenuation values than the untrained group. RESUMO Objetivo: Determinar a eficácia da colocação do protetor auditivo comparando os valores de atenuação obtidos pelos métodos objetivo (MIRE) e subjetivo (REAT) em grupos com e sem treinamento. Métodos: Participaram do estudo 80 indivíduos do sexo masculino, separados em grupo pesquisa (com treinamento) e controle (sem treinamento). Os procedimentos realizados foram: anamnese e avaliações objetiva e subjetiva do protetor auditivo. Apenas os indivíduos do grupo pesquisa receberam treinamento e orientações para colocar corretamente o protetor auditivo. Resultados: Os valores de atenuação no grupo pesquisa foram maiores com diferenças estatisticamente significantes em relação ao grupo controle em todas as frequências (500, 1000, 2000 e 4000 Hz) investigadas por meio dos métodos objetivo (MIRE) e subjetivo (REAT). Além disso, os valores de atenuação no grupo controle foram menores do que as previstas pelo fabricante do protetor auditivo. Conclusão: Ambos os métodos de avaliação da atenuação (objetivo e subjetivo) demonstraram a eficácia da colocação do protetor auditivo. Entretanto, o grupo que recebeu treinamento para colocação adequada do protetor auditivo apresentou valores de atenuação maiores do que o grupo sem treinamento.

Purpose To evaluate the effectiveness of the attenuation of a hearing protector (HP) in a real work situation using the field-microphone-in-real-ear method (f-MIRE). Methods Eighteen individuals of both genders (mean age of 47.17±8 years) participated in this study. In the workplace, the personal attenuation level of the HP was assessed using the f-MIRE method, followed by orientation about the importance of using the HP, cleaning and storing the device, and training for effective placement. Results The analyses showed a significant statistic attenuation for all of the collected data (total noise, by frequency band and dose) when the noise levels in the lapel microphone and the probe microphone were compared. In the comparison of the attenuation values provided by the manufacturer and those found in this study, we observed higher values for the manufacturer in all frequency bands. No difference was observed for the noise levels in the different activities and times evaluated. Conclusion The findings of this study enabled us to know the personal level of attenuation of the HP during a real work situation, which was within the limits of tolerance. It was also possible to collect information about the environmental noise to which these workers are exposed. We noticed situations where this level exceeded the safety values, and therefore it is recommended the use of the HP. It is important that more studies are conducted using the f-MIRE method, because it may be an ally to assess the effectiveness of the HP attenuation in the workplace.

To verify the effectiveness of an educational action in the form of training, emphasizing the importance of hearing protection for workers exposed to occupational noise.The study included 78 male individuals. All participants answered a questionnaire before they were submitted to audiological evaluation. For the second application of the questionnaire, participants were randomly divided into two groups: Research Group, constituted by 44 subjects that received educational training before the second questionnaire application, and Control Group, comprising 34 individuals that answered the questionnaire before the educational training. Training was based on material with graphic images and text, in the form of conversation. The topics covered included: the importance of hearing, noise effects on health, importance of preventing hearing loss and using hearing protection, conservation and cleaning of hearing protectors, levels of noise in the workplace and noise attenuation provided by hearing protectors. The questionnaire contained 14 multiple choice questions that addressed the same themes explored in the educational training.There was a significant increase of correct responses in the second application of the questionnaire, only in the Research Group, in all comparisons.Educational action performed with workers exposed to occupational noise are effective, and the questionnaire is a stable and viable tool to evaluate the effectiveness of educational programs.