Journal of Preventive Medicine and Public Health

Brief Report

Reproductive Health Services for Adolescents With Hearing Impairment in Indonesia: Expectations and Reality: Ni Luh Putu Suariyani, Desak Putu Yuli Kurniati, Desak Nyoman Widyanthini, Luh Putu Wulandari Artha; J Prev Med Public Health. 2020;53(6):487-491. Published online October 20, 2020; DOI: https://doi.org/10.3961/jpmph.20.033

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Abstract PDF: Objectives
Reproductive health education is essential for adolescents with hearing impairment. Since they communicate using specialized language (i.e., sign language), specialized reproductive health services in sign language is a necessity. This study aimed to describe the needs, availability, and expectations of reproductive health services among adolescents with hearing impairment. Methods: This study used a qualitative approach. It was carried out at a school for children with special needs in the city of Denpasar, Bali, Indonesia. Data were collected by in-depth interviews. The informants were 6 adolescents with hearing impairment aged 16-17 years and 4 other key informants, including school staff and health officers. The data were then analyzed using the thematic method. Results: We found that the informants had insufficient knowledge regarding reproductive health. There was no specific subject in the curriculum regarding this issue. Teachers did not specifically provide reproductive health information. The health service unit in the school had not been utilized well for this purpose. Furthermore, no reproductive health services were provided due to the limited number of healthcare workers who could use sign language. Conclusions: The awareness and intentions of adolescents with hearing impairment regarding access to reproductive health services remain low. Health service units at schools should be optimized to enable schools to provide reproductive health information and services for these adolescents.; Summary

English Abstract

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City.: Hyunjoo Kim, Sangchul Roh, Ho Jang Kwon, Ki Chung Paik, Moo Yong Rhee, Jae Yun Jeong, Myung Ho Lim, Mi Jin Koo, Chang Hoon Kim, Hae Young Kim, Jeong Hun Lim, Dong Hyun Kim; J Prev Med Public Health. 2008;41(5):307-314.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.307

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OBJECTIVES
We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. METHODS: The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. RESULTS: The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% CI) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% CI 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% CI 2.14-11.64) for those highly exposed to fighter noise. CONCLUSIONS: The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.

Summary

Citations

Citations to this article as recorded by

Association between noise exposure and diabetes: A systematic review and meta-analysis
Mohammad Javad Zare Sakhvidi, Fariba Zare Sakhvidi, Amir Houshang Mehrparvar, Maria Foraster, Payam Dadvand
Environmental Research.2018; 166: 647. CrossRef
The Prevalence of Functional Gastrointestinal Disorders in the Chinese Air Force Population
Wenming Wu, Xu Guo, Yunsheng Yang, Lihua Peng, Gaoping Mao, Hyder Qurratulain, Weifeng Wang, Gang Sun
Gastroenterology Research and Practice.2013; 2013: 1. CrossRef
Overview of the Environmental Damage, Property Loss, and Health Impairment of Residents around a US Air Force Firing Range
Hyun-Sul Lim
Korean Journal of Environmental Health Sciences.2011; 37(3): 173. CrossRef

Original Articles

The Effect of Working Noise Exposure and Military Background on the Hearing Threshold.: Kyoo Sang Kim, Ho Keun Chung; Korean J Prev Med. 2003;36(2):137-146.

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Abstract PDF: OBJECTIVES
Impaired hearing is a prevalent occupational hazard, not only in industry, but also in the armed forces. In military life, noise has unusual characteristics, and constitutes a serious hazard to hearing. The aim of this study was to analyze the hearing threshold data in order to compare the hearing loss among shipyard workers, representing different workers, and a military service background. METHODS: A cross-sectional audiological survey, combined with a questionnaire study, was conducted on a stratified random sample of 440 shipyard workers, with long-term exposure to noise. The employees were divided into four groups, according to their working and military service backgrounds, in relation to their exposure to noise. RESULTS: As expected, the working and military noise exposure group (Group I) had significantly poorer hearing than the other groups. The high frequencies (2-8 kHz) showed the greatest difference in terms of poorer hearing in both ears. The prevalence of noise-induced hearing loss (NIHL) was highest in Group I. A logistic regression analysis was applied to determine the dependence of the NIHL in relation to age, smoking, drinking, working duration, ear protection, past history of ear diseases, and working and military service backgrounds, on the noise exposure. The important factors found to be related to the NIHL, in relation to noise exposure were: age, work duration, and working and military service backgrounds. The adjusted odds ratio estimates for NIHL in the right ear were 4.5 times greater (95% CI 1.7-11.6) for the military noise exposed group, and 7.9 times greater (95% CI 2.0-31.3) for the working noise exposed group than in the controls. The hearing thresholds at the pure-tone average and 4 kHz were significantly increased with age and work duration with both the working and military service backgrounds. CONCLUSIONS: From these results, specific preventive programs were planned, which should be assessed by epidemiological surveillance of the military noise exposed population.; Summary

Evaluation of Puretone Threshold Using Periodic Health Examination Data on Noise-exposed Workers in Korea .: Kyoo Sang Kim, Yangho Kim, Jung Keun Choi, Jung Sun Park, Young Han Moon; Korean J Prev Med. 1999;32(1):30-39.

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Abstract PDF: OBJECTIVES
This study was carried out to evaluate hearing impairment judgement and to investigate the differences in various diagnostic criteria for noise-induced hearing loss (NIHL) among workers who required for close observation (C). METHODS: Out of 731,029 workers who had taken the specific periodic health examination in 1994, we used the audiometric data on 37,999 workers (C) eliminating the employees who had previous otologic problems. Many investigators have being using different criteria for the evaluation of hearing impairment. In this study, we used the criteria of early (1989-1994), current, compensation for NIHL in Korea, 2-, 3-, 4-divided classification and hearing loss at 4,000 Hz and compared the evaluation results. RESULTS: The prevalences of C and workers who had occupational disease (D1) diagnosed for NIHL were 11.1 % and 0.44 %. There were significant difference in the prevalences of C and D1 depending on different province of Korea. Pure tone averages (PTAs) were not appropriately applied in their evaluation. 97% of workers whom we studied on were below the level of mild hearing loss judged by ISO standard. However, there were wide variations in the prevalence rate of mild hearing loss by diagnostic criteria. Thus, there were different judgements in determining the degree of NIHL depending on which diagnostic criteria were utilized. PTAs were found 20.54 (Rt) and 20.74 (Lt) when the method of 3-divided classification was applied for audiometric data. The degree of hearing impairment of the left ear was more severe than that of right ear. The prevalence of normal hearing threshold below 20 dB was 75.4% and the range of difference in both ear was below 10 dB. Right sided hearing threshold levels were 21.08 dB (500 Hz), 18.44 dB (1,000 Hz), 22.09 (2,000 Hz) and 52.36 dB (4,000 Hz). There was typical high frequency loss (C5-dip at 4,000 Hz) above 30 - 40 dB in normal hearing level. The increasing trend in hearing threshold level was gradually decreased by the increase of PTAs. The difference between PTAs and threshold at 4,000 Hz was about 10 dB. CONCLUSIONS: We could found that PTAs in the previous examination were not appropriately evaluated. This study revealed that they did not use unique criteria for managing the workers of NIHL. For the prevention of NIHL, it was found that the quality control on diagnosis and comprehensive management program were required, especially for those of hearing loss (C).; Summary

Basic Study on the Hearing-threshold Levels of Workers with Noise-induced Hearing Loss in Korea.: Yeon Soon Ahn, Young Han Moon, Sang Yeal Lee, Kyung Nam Lee; Korean J Prev Med. 1999;32(1):17-29.

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Abstract PDF: OBJECTIVES
This study was carried out to analyze the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1). METHODS: We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1) examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. RESULTS: Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6dB(Rt). Among workers with noise-induced shearing loss(D1), 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. CONCLUSIONS: This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise-induced hearing loss(D1). We found the differences of the real number by the statistics of the department of labour and the expected number of worker's compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.; Summary

Effect of cigareet smoking on air-conduction hearing threshold level in adult men.: Jin Seok Kim, Min Hae Yeh, Byung Yeol Chun, Kuck Hyeun Woo, Yune Sik Kang, Keon Yeop Kim, Young Sook Lee; Korean J Prev Med. 1998;31(2):285-292.

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Abstract PDF: To investigate the effect of smoking on the hearing threshold, l,887 adult male workers who visited health care center during the period l January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity, were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity,(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.; Summary

Evaluation of factors affecting sensory neural hearing loss.: Seong Chul Hong, Seong wook Bae, Jong Young Lee; Korean J Prev Med. 1998;31(2):249-264.

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Abstract PDF: Reports on a potential relationship between sensory neural hearing loss(SNHL) and cardiovascular or hematologic factor show that the results are controversial. A detailed analysis of risk factors in the development of SNHL was carried out in 3,050 non-noise exposed healthy worker. The mean hearing threshold of both ears at 500, 1000, 2000, 4000, 8000Hz was measured and the effect of age, possible cardiovascular risk factor and hematologic factor (blood viscosity and hemostatic factors) on SNHL were evaluated. First, each of these were associated with loss of hearing sensitivity when univariately and multivariatively analysed. In a multiple regression model, age, sex, body mass index, WBC and total cholesterol level were independently associated with the mean of hearing sensitivity decrease at 4000 and 8000Hz. Second, study subjects were divided into two group (normal vs SNHL) and we compare the possible risk between both groups, and analysed univariate and multivariative logistic model. In a multiple logistic regression model, age, sex, body mass index, WBC and total cholesterol level, total protein, platelet were independently associated with SNHL. Our results show that we have some reliable indices of susceptibility to SNHL using cardiovascular measures or biochemical factor, but future, more extensive studies are required.; Summary

Evaluation on Hearing Conservation Program in the Noisy Industries.: M S Kwak, J T Lee, J H Kim, S H Urm, D H Kim, Byung Chul Son, C H Lee; Korean J Prev Med. 1997;30(4):815-829.

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Abstract PDF: This study was performed to assist the employer to establish the effective program for hearing conservation of noisy industry. The study subjects were health care managers of an industry and the study industries were divided into two groups(Group I, 37 industries; have the workers diagnosed as noise-induced hearing loss, Group II, 41 industries; not have the workers diagnosed as noise-induced hearing loss) and the question method carried out through the face to face interview. The contents of questionnaire for OSHA's hearing conservation program(HCP) consisted of seven components: 5 questions of monitoring of employee noise exposures(component 1), 6 questions of the institution of engineering, work practice, and administrative controls for excessive noise(component 2), 8 questions of the provision of each overexposed employee with an individually fitted hearing protector with an adequate noise reduction rating(component 3), 14 questions of employee training and education regarding noise hazards and protection measures(component 4), 9 questions of baseline and annual audiometry(component 5), 3 questions of procedures for preventing further occupational hearing loss by an employee whenever such an event has been identified(component 6), and 1 question of recording keeping(component 7), thus total numbers of questions was 46. The numbers of statistically significant difference(p<0.05) between two groups were 2(25.0%) among 8 questions of component 3, 10(71.4%) among 14 questions of component 4, 3(33.3%) among 8 questions of component 5, 2(66.7%) among 3 questions of component 6, and 17(37.0%) among total 46 questions of questionnaire. Above results showed that the level of HCP acceptance in group I was lower than in group II. Thus employer's understanding about HCP should be precede for the effective hearing conservation program of employee and the adequate hearing protector, training and education, baseline and annual audiometry, and procedures for preventing further occupational hearing loss for hearing conservation would be more emphasized.; Summary

Association between air conduction hearing threshold and blood viscosity in normal adult males.: Sang Woo Kim, Jong Young Lee, Wan Seup Park, Kuck Hyeun Woo; Korean J Prev Med. 1997;30(3):623-629.

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Abstract PDF: This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).; Summary

Application of HHIE-S(Hearing Handicap Inventory for the Elderly-Screening version) to screening test of noise-induced hearing loss.: Mi Young Lee, Suk Kwon Suh, Choong Won Lee; Korean J Prev Med. 1996;29(3):539-554.

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Abstract PDF: The study conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the puretone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every fifth person from 6,700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1kHz and 4kHz was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1kHz and 4kHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2kHz and 50dB at 4kHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.; Summary

A study on the attitude affecting the preventive behavior for hearing conservation.: Kyung Yong Rhee, Kwan Hyung Yi; Korean J Prev Med. 1996;29(2):371-384.

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Abstract PDF: The purpose of this study is to investigate attitude factor related to hearing conservation and to find attitude affecting the preventive behavior for hearing conservation. The research method used in this study was self-administered questionnaire samples of the study were composed of 353 workers exposed noise selected randomly in 10 ship-building manufacturing companies. Authors extracted following 9 factors related hearing conservation from 26 attitude propositions prepared from previous study results and health belief model; (l) general perceived susceptibility, (2) relative perceived susceptibility compared with colleagues, (3) concern to the personal protective devices, (4) perceived severity and concern to the hearing capacity, (5) concern to the hearing and noise assessment, (6) concern to the control noise and hearing conservation, (7) group pressure and reason of wearing protective devices, (8) apathy of hearing loss from noise, (9) knowledge about hearing conservation Attitude factors affecting the preventive health behavior were general perceived susceptibility, concern to the noise control and hearing conservation, and concern to the personal protective devices in the case of wearing personal protective devices. But in the case of avoiding noise exposure as preventive health behavior, perceived severity and concern to the hearing capacity was a significant attitude factor with knowledge about hearing conservation.; Summary

The effects of age adjustment on the diagnosis of noise induced hearing loss.: Jong Uk Won, Yeon Soon Ahn, Jae Hoon Roh; Korean J Prev Med. 1995;28(3):651-662.

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Abstract PDF: In Korea there is no specific method of age adjustment in noise induced hearing loss(NIHL). we attempted the age adjustment to understand the effects of age on the diagnosis of NIHL. We used the International Standard Organization 1999 as an age adjustment method. We used the 1,617 otologically normal person's hearing data from a health examination center, and 206 workers diagnosed as NIHL. we concluded as follows; 1. The ISO 7029 function used for age specific hearing loss is not suited to Korean people. 2. The mean of age specific hearing loss is 11.0 6.2dB, and the older of age, the more decrease on hearing loss, especially in 4000Hz. 3. The difference of NIHL between before age adjustment and after age adjustment in the 3rd decade is 5.4dB, in the 4th decade is 6.7dB, in the 5th decade is 8.5dB, in the 6th decade is 10.4dB, and in the 7th decade is 12.9dB. The older, the more is the difference. 4. After age adjustment, the number of workers diagnosed as NIHL decreases to 60% of unadjusted.; Summary

A Follow-up Study on the Personal Noise Exposed Dose and Hearing Loss.: Won Sool Kim, Young Seoub Hong, Yang Seak Kim, Sang Ju Lee, Kyung Il Park, Kap Yull Jung, Joon Youn Kim; Korean J Prev Med. 1994;27(2):286-298.

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Abstract PDF: For the purpose of presenting the basic data for the establishment of control measures on the long-term noise exposed workers, this study was carried or on the relationship between personal noise exposed dose and hearing loss on the 67 male workers whose hearing threshold had exceeded 40dB in 4,000Hz, from 1990 to 1992. Conclusively, the level of hearing loss was significantly related to personal noise exposed dose which was measured by the personal noise dosemeter was more efficient rather than the noise level of workplace for the evaluating the long-term change of hearing acuity. And although in the case of not-diagnosed as noise induced hearing loss, it was suspected that the active control programs such as improvement of noisy environment or early transfer to proper workplace were needed on the workers who exposed with over 90dB in personal noise exposed dose.; Summary

A study on diagnostic criteria of noise-induced hearing loss among workers in an iron foundry.: Ji Yong Kim, Hyun Sul Lim, Hae Kwan Cheong, Ok Ryun Moon; Korean J Prev Med. 1993;26(3):371-386.

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Abstract PDF: This study was carried out to evaluate diagnostic criteria of noise-induced hearing loss (NIHL) among workers in an iron foundry. Of 1,093 workers under the observation of noise-specific health examination, 184 workers were selected by way of first and second screening audiometric examination. A questionnaire survey, otological examinations, Rinne test and audiometric test were performed and the results were as follows; The degree of hearing impairment in the left ear was more severe than in the right ear(p<0.05). The difference between hearing threshold of the first and the second hearing test at 1,000 Hz was about 5 dB with a narrow range of deviations while the difference at 4,000 Hz was about -7dB with a wide range. Of the total study workers, 84.8% were tested within 15 hours away from noise exposure, and the rest after 16 hours. This study has identified that mean hearing loss at 4,000 Hz showed a significant statistical difference among the two study groups while mean hearing loss by 4-divided classification did not. The same phenomena were observed between the group with and without tinnitus and between the group with and without difficulty in hearing(p<0.05). Among 184 workers, 10 workers(5.4%) diagnosed as NIHL by old diagnostic criteria in contrast to 150 workers diagnosed as NIHL by the new diagnostic criteria. There was a significant difference between the two groups in the average hearing loss at 4,000 Hz and 4-divided classification(p<0.01), but there were no significant difference in age, the duration of employment, blood pressure and the duration wearing the personal hearing protector(p>0.05). If we apply Early Loss Index(ELI) method, some workers in younger age group diagnosed as NIHL by the new diagnostic criteria were fallen into within the normal range. In the mean time older age group show reverse results in contrast to the above finding. It is too early to confirm the value of the usage of the new diagnostic criteria in hearing examination. Further study is called for to verify the value of this criteria.; Summary

Long term noise exposure of steel mill workers, hearing loss and blood pressure.: Myung Wha Ha, Doohie Kim; Korean J Prev Med. 1991;24(4):496-506.

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Abstract PDF: A cross-sectional study was conducted to investigate the effect of long term noise exposure on blood pressure among steel mill workers. The workers participated in periodic medical examinations performed from August 27 to September 6 in 1990. Examined were 1,034 workers with high-level noise exposure(average 91.8+/-5.2 dB{AA)), and 390 workers with low-level noise exposure(average 75.2+/-4.6 dB(A)). No significant difference was found in systolic or diastolic blood pressure between the two exposure groups. Prevalence of hypertension (> or = 160 mmHg systolic or > or = 100 mmHg diastolic) was higher in a younger age group (< or = 40 years old) of high-level noise exposure than of low-level noise exposure. However, the difference was not statistically significant. Furthermore, in younger ages, prevalence of. hypertension appeared to be higher in the hearing loss group (> or = 25dB at 1000 Hz or > or = 40 dB at 4000 Hz in at least one ear) than in the normal hearing group. From multiple regression analysis, hearing loss, body mass index, age, alcohol and family history of hypertension were proven to be predictors of diastolic blood pressure (p<0.02). When regression was performed for each age group, hearing loss was a strong predictor of diastolic pressure in the younger age group (p<0.01).; Summary

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