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
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.
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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.
OBJECTIVE Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. METHODS: 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A); NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85 dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. RESULTS: After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) or diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. CONCLUSION: This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.
Chun Bae Kim, Sang Baek Koh, Jai Young Kim, Bong Suk Cha, Hong Ryul Choi, Jong Tae Lee, Chung Mo Nam, Sang Yun Lee, Seung jun Wang, Keeho Park, Dae Youl Kim
OBJECTIVES This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. METHODS: Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. RESULTS: All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studies were accomplished in a resting state, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. CONCLUSIONS: Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.
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).
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.
In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modern diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the 20~29 years old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 500,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked 1~5 years in the factories were 33.0%. Those who felt much for them workload were 43.9% and who worked more than 8 hours a day were 73.9 %. Those who were dissatisfied with their job and pay were 31.9% and 50.6%. The workers who responded ventilation condition of their worksites were bad were 51.9% and the dissatisfied with working environment of their wofksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.l%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to 80-90dB were 30.3%, 90-100dB were 26.4% and 50~70dB were 19.2%. 5. workers' stress symptoms were significantly related to marital status and their monthly income p< 0.05). Workers who were single and had lower monthly income showed higher PSl (Psychiatric symptom Index) scores than those who were married and had higher monthly income. Higher PSl scores were also significantly related to l~2 days night-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSl scores were significantly related to severe tinnitus and perceived hearing loss p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSl scores(p<0.01). Workers who reported that they did not feel they need earplugs showed significantly higher PSl scores(p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSl scores(p<0.001). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSl subparts were reported; Anxiety, Anger, Depression, and cognitive disorder(p<0.001). 8. According to the results of stepwise multiple regression analysis, factors affecting workers' PSl scores were perceived hearing loss(R2=0.160), noise exposure level jn worksite(R2=0.110), relationship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total R2 of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.
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.
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.
Noise is not only affecting the ear and the auditory cortex locally, but its influence is widely spread throughout the brain structures, e. g., the reticular formation, the brain stem nuclei or the subcortical forebrain area. Hence, any of the organism's activities can be hindered or stimulated by noise. High noise is a stressor and the catecholamine level can be used both as a stress marker and as an indicator of modified sympathetic nervous system activity. Several recent studies have found that the urinary excretion of catecholamines is increased due to high noise intensity, especially unexpectedly high and long lasting noise. The present study was conducted in order to examine the effects of noise stress on urinary excretion of catecholamines in rats and humans. Rats were exposed to 90 dB noises for 10, 30, and 60 minutes, 3 and 12 hours. 24 hour urinary samples were collected and the catecholamines were extracted by alumina and analyzed by HPLC-ECD. Catecholamine levels increased with time of exposure up to 60 minutes: norepinephrine concentration at 60 min of noise=1.038 ng/ml, epinephrine=0.636 ng/ml. Urine catecholamines of blue collar workers exposed to 90 dB of noise at the workplace were collected between 2 and 4 p.m. and compared to that of white collar workers exposed to 70 dB. Mean norepinephrine level of the blue collar workers was 0.89 ng/ml(+/-0.25), epinephrine 0.24 ng/ml(+/-0.09), and that of the white collar workers 0.48 ng/ml(+/-0.12), epinephrine 0.19 ng/ml(+/-0.05). It was concluded that noise acts as a stressor and increases the catecholamine levels in both rats and humans.
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.
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).
In order to assess the degree of atomospheric pollution and noise and to contribute the health improvement of residents in Pusan, the author measured the levels of CO, SO2, NO2, TSP, HCHO and noise in 8 areas(industrial, residential and park areas) from January to March in 1990. The results were as follows: 1. Sasang industrial area was significantly higher (2.85 +/- 0.84ppm) in the average concentration of CO than other areas. However, there no areas to affect the human body in terms of CO concentration. 2. In general, industrial area was significantly higher (0.134 +/- 0.084ppm) in the average concentration of SO2, than other areas, and it was the lowest (0.009 +/- 0.005ppm) in the Namchon-dong area. 3. Industrial (0.033 +/- 0.009ppm) and residential area (0.029 +/- 0.004ppm) were significantly higher in the average concentration of NO2 than Park area (0.009 +/-0.001ppm). However, there were no areas to affect the human body in terms of NO2 concentration. 4. Sasang industrial area was the highest (580.4 +/- 415.26 microgram/m3) at the average concentration of TSP and Hae-Un Dae area was the lowest (97.22 +/- 37.86 microgram/m3). But TSP concentration showed the level to affect the human body in most areas. 5. Industrial area was significantly higher (2.25 +/-1.15ppb) in the average concentration of HCHO than residential (1.13 +/- 0.25ppb) and park area (1.33 +/- 0.20ppb). 6. Industrial area was significantly higher (77.28 +/- 6.92dB(A)) in the level of noise than residential (65.77 +/- 3.76dB(A)) and park area (64.65 +/- 5.25dB(A)). In comparison with regional Standard Noise Level, however, the average noise level of residential and park area was higher than that of the Standard. In general, the level of pollution of industrial complex areas was relatively higher than those of residential and park areas. Among the industrial areas, sasang area was worst in most items. Both SO2, and TSP showed the level to affect the human body in most of studied areas. It is necessary to install a new Air Quality Standard for HCHO to screen our environmental pollution.
OBJECTIVES This study was conducted to evaluate the effects of the personal stereo system on the hearing in adolescents. METHODS: A total of 68 adolescents(age: 13-18 years) who visited the ENT Department at a University Hospital in Daegu were personally interviewed. The questionnaires were about general characteristics of the subjects, the time of personal stereo system use(year, hour) and place. Cumulative exposure to the personal stereo system was calculated by the product of the total years and the daily hours of their use. Pure tone audiometry was performed and the hearing threshold was measured at 500, 1000, 2000, 4000 and 8000 Hz. RESULTS: The average time of using a personal stereo system a day was about 3 hours and 75% of the subjects used a personal stereo system for 2-5 years. The elevation of threshold was more prominent in the subjects who used personal stereo systems for 4 years and more compared with those subjects who used them for 3 years and under. The elevation of hearing threshold was also more prominent in the subjects who used personal stereo systems for 4 hours and more a day compared with those subjects who used personal stereo systems for 3 hours and under a day. The elevation of hearing threshold was more prominent in the subjects who used personal stereo systems for 13 hour..years and more compared to the subjects who used them 12 hour..years and under. CONCLUSIONS: These results suggest that the elevation of hearing threshold can happen to adolescents who used personal stereo systems for a long time. In order to prevent hearing loss, we need to teach adolescents appropriate usage of the personal stereo system and hearing tests should be included in the periodic school-based physical examination for the adolescents.