The accuracy of self-reported high noise exposure level and hearing loss in a working population in Eastern Saudi Arabia

doi:10.1078/1438-4639-00291

International Journal of Hygiene and Environmental Health

Volume 207, Issue 3, 2004, Pages 227-234

https://doi.org/10.1078/1438-4639-00291 Get rights and content

Abstract

Objective: To determine the accuracy of questions in identifying subjects occupationally exposed to high noise level and those with hearing loss using noise dosimeter and pure-tone air conduction audiometry as the gold standards.

Design: A cross-sectional study involving 259 noise-exposed workers selected randomly from two factories in Eastern Saudi Arabia. Personal noise exposure was determined using a noise dosimeter. The hearing impairment for each subject was assessed using otoscopic examination and audiometry. Each subject completed a comprehensive questionnaire including questions about noise exposure and hearing loss.

Results: Eighty five percent of the total workers reported exposure to high noise level, compared to 76% found to be exposed to a high noise level defined as more than 85dB (A) as determined by noise dosimeter. The prevalence of audiometric hearing loss (threshold average of 25dB HL or more in any ear) was 32.4% for the low frequency average (0.5, 1 and 2kHz), 47.9% for the all frequency average (0.5, 1, 2. 4 and 8kHz) and 65.6% for the high frequency average (4 and 8kHz). However, the percentage of the subjects who reported hearing loss ranged between 3.9% and 85.3% depending on the question used as indicator of hearing loss.

The question “Do you consider the noise level where you are working now high?” was the most sensitive in correctly identifying subjects exposed to a noise level of more than 85dB (A) (sensitivity=93.4%) and subjects with hearing loss (sensitivity>86%) compared with other questions evaluated. However, it overestimated the prevalence rate determined by audiometry

Conclusion: We conclude that in industries where facilities for an objective assessment of noise exposure and hearing loss are not available, questions addressing noise exposure and hearing loss might be a useful alternative means for screening subjects exposed to high noise level and those with hearing loss for the purpose of designing and implementing hearing conservation program.

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The effect of occupational exposure to noise on ischaemic heart disease, stroke and hypertension: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury
2021, Environment International
Citation Excerpt :
Second, some studies (Gopinath et al., 2011; Huo Yung Kai et al., 2018; Ising et al., 1997; Suadicani et al., 2012) used self-reported measures of occupational noise exposure, which may be prone to recall bias or be reciprocally related to CVD. Nevertheless, standardized questions on the vocal effort needed to overcome ambient noise are considered valid proxies for a noise level >85 dBA (Ahmed et al., 2004; Neitzel et al., 2016; Neitzel et al., 2011; Schlaefer et al., 2009). Third, although the exposed groups across studies were largely comparable, in some studies (Chang et al., 2013; Eriksson et al., 2018b; Kersten and Backe, 2015; Stokholm et al., 2013a,b) the cut-off noise level was below 85 dBA.
The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from mechanistic data suggests that occupational exposure to noise may cause cardiovascular disease (CVD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from CVD that are attributable to occupational exposure to noise, for the development of the WHO/ILO Joint Estimates.
We aimed to systematically review and meta-analyse estimates of the effect of any (high) occupational exposure to noise (≥85 dBA), compared with no (low) occupational exposure to noise (<85 dBA), on the prevalence, incidence and mortality of ischaemic heart disease (IHD), stroke, and hypertension.
A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies up to 1 April 2019, including International Trials Register, Ovid MEDLINE, PubMed, Embase, Lilacs, Scopus, Web of Science, and CISDOC. The MEDLINE and Pubmed searches were updated on 31 January 2020. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts.
We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to noise on CVD prevalence, incidence or mortality, compared with the theoretical minimum risk exposure level (<85 dBA).
At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We prioritized evidence from cohort studies and combined relative risk estimates using random-effect meta-analysis. To assess the robustness of findings, we conducted sensitivity analyses (leave-one-out meta-analysis and used as alternative fixed effects and inverse-variance heterogeneity estimators). At least two review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide tools and approaches adapted to this project.
Seventeen studies (11 cohort studies, six case-control studies) met the inclusion criteria, comprising a total of 534,688 participants (39,947 or 7.47% females) in 11 countries in three WHO regions (the Americas, Europe, and the Western Pacific). The exposure was generally assessed with dosimetry, sound level meter and/or official or company records. The outcome was most commonly assessed using health records. We are very uncertain (low quality of evidence) about the effect of occupational exposure to noise (≥85 dBA), compared with no occupational exposure to noise (<85 dBA), on: having IHD (0 studies); acquiring IHD (relative risk (RR) 1.29, 95% confidence interval (95% CI) 1.15 to 1.43, two studies, 11,758 participants, I² 0%); dying from IHD (RR 1.03, 95% CI 0.93–1.14, four studies, 198,926 participants, I² 26%); having stroke (0 studies); acquiring stroke (RR 1.11, 95% CI 0.82–1.65, two studies, 170,000 participants, I² 0%); dying from stroke (RR 1.02, 95% CI 0.93–1.12, three studies, 195,539 participants, I² 0%); having hypertension (0 studies); acquiring hypertension (RR 1.07, 95% CI 0.90–1.28, three studies, four estimates, 147,820 participants, I² 52%); and dying from hypertension (0 studies). Data for subgroup analyses were missing. Sensitivity analyses supported the main analyses.
For acquiring IHD, we judged the existing body of evidence from human data to provide “limited evidence of harmfulness”; a positive relationship is observed between exposure and outcome where chance, bias, and confounding cannot be ruled out with reasonable confidence. For all other included outcomes, the bodies of evidence were judged as “inadequate evidence of harmfulness”. Producing estimates for the burden of CVD attributable to occupational exposure to noise appears to not be evidence-based at this time.
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Estimation of all-cause noise exposure for U.S. adults from national survey data
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Noise exposure and perceived hearing symptoms of metal fabrication workers in heating, ventilating and air conditioning manufacturing industry
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The accuracy of self-reported high noise exposure level and hearing loss in a working population in Eastern Saudi Arabia

Abstract

Annal Of Occupational Hygiene

Auris. Nasus. Larynx

Occupational noise exposure and hearing loss

American Industrial Hygiene Association Journal

Prevalence of chronic diseases and impairments among US farmers, 1986-1990

Am. J. Epidemiol

The accuracy of self-reported hearing loss in women aged 60–85 years

Am. J. Epidemiol

A comparison of self-reported hearing loss and audiometry in a cohort of New York farmers

J. Speech Lang. Hear. Res

Predictors of hearing loss in New York farmers

Am. J. Ind. Med

Introduction to audiology