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Original Article
Cardiometabolic diseases according to the type and degree of hearing loss in noise-exposed workers
KyooSang Kim, Sun-Haeng Choi
Ann Occup Environ Med 2024;36:e3.   Published online February 19, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e3
AbstractAbstract AbstractAbstract in Korean PDF
Background

This study aimed to determine the association between cardiometabolic diseases, including metabolic syndrome, hypertension, and diabetes, and the type and degree of hearing loss in noise-exposed workers.

Methods

A total of 237,028 workers underwent air conduction pure tone audiometry in 2015 to assess their health and diagnose cardiometabolic diseases. The study defined metabolic syndrome, hypertension, and diabetes using blood pressure, fasting blood sugar, cholesterol, and triglyceride levels. Mid-frequency hearing loss was defined as ≥ 30 dB at 2,000 Hz, whereas high-frequency hearing loss was ≥ 40 dB at 4,000 Hz. The average air conduction hearing thresholds at these frequencies were used to determine hearing loss degrees.

Results

The odds ratio (OR) of combined exposure to noise and night-shift work in all cardiometabolic diseases was higher than that of noise exposure alone. The risk of cardiometabolic diseases was dose-response, with higher hearing loss causing higher ORs. The ORs of hypertension compared with the normal group were 1.147 (1.098–1.198), 1.196 (1.127–1.270), and 1.212 (1.124–1.306), and those of diabetes were 1.177 (1.119–1.239), 1.234 (1.154–1.319), and 1.346 (1.241–1.459) for mild, moderate, and moderate-severe hearing loss, respectively.

Conclusions

Workers who are exposed to noise tend to demonstrate high risks of hearing loss and cardiometabolic diseases; thus, bio-monitoring of cardiometabolic diseases, as well as auditory observation, is necessary.

소음 노출 근로자의 난청 유형 및 정도에 따른 심혈관대사성 질환
목적
본 연구는 소음 노출 근로자의 사회인구학적 특성, 직업적 특성, 야간 근무 및 난청 여부에 따른 대사증후군, 고혈압, 당뇨병을 포함한 심장-대사성 질환과의 관련성을 파악하고자 하였다.
방법
2015년 237,028명의 근로자들의 기도 순음청력검사를 시행하여 난청 유형과 정도를 평가하고 심장-대사성 질환을 진단하였다. 이 연구는 혈압, 공복 혈당, 콜레스테롤 및 중성지방 수치를 이용하여 대사증후군, 고혈압 및 당뇨병을 정의하였다. 중음역 난청은 2000 Hz에서 30 dB 이상으로 정의한 반면 고음역 난청은 4000 Hz에서 40 dB 이상으로 정의하였다. 난청의 중증도는 이들 주파수의 기도 순음 청력역치의 평균으로 정하였다.
결과
모든 심장-대사성 질환에서 소음 노출과 야간 교대근무에 복합 노출된 경우 소음에만 노출된 경우보다 오즈비가 높았다. 청력손실이 클수록 유의하게 오즈비가 높으며 심장-대사성 질환과의 용량-반응 관계를 보였다. 정상군에 비해 고혈압의 오즈비는 경도 난청의 경우 1.147 (1.098 - 1.198), 중등도 난청의 경우 1.196 (1.127 - 1.270), 중등고도 난청의 경우 1.212(1.124 - 1.306)였다. 정상군에 비해 당뇨병의 오즈비는 경도 난청의 경우 1.177 (1.119 - 1.239), 중등도 난청의 경우 1.234 (1.154 - 1.319), 중등고도 난청의 경우 1.346 (1.241 - 1.459)이었다.
결론
소음에 노출된 근로자는 난청 및 심혈관계 질환의 위험이 높은 경향이 있으므로 청각적 관찰 뿐만 아니라 심혈관계 질환에 대한 생체 모니터링이 필요하다.
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Original Article
The impact of alcohol consumption on hearing loss in male workers with a focus on alcohol flushing reaction: the Kangbuk Samsung Cohort Study
Jaehong Lee, Youshik Jeong, Jihoon Kim, Seonghyeon Kwon, Eunhye Seo, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2024;36:e1.   Published online January 22, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e1
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

Despite hearing loss being a prevalent chronic condition, estimated to nearly 20% of the global population by the World Health Organization, the specific association with individual lifestyle factors, particularly alcohol consumption, remains unclear. In South Korea, approximately 80% of the population engages in alcohol consumption, with a notably high prevalence among males, indicating a high-risk drinking pattern. Therefore, this study aimed to assess the correlation between alcohol consumption and hearing loss in male workers, as well as to analyze additional variables such as alcohol flushing reaction, with the intention of improving worker health.

Methods

The study was conducted from January 2012 to December 2019, targeting 114,114 participants who visited Kangbuk Samsung Hospital Total Healthcare Centers. Data were collected through pure-tone audiometry tests and alcohol-related questionnaire, and statistical analysis was performed using Cox regression analysis. Based on previous studies indicating a potential protective effect of light drinking on hearing loss, this group was designated as the reference. Additionally, stratified analyses were conducted based on the presence of alcohol flushing reaction and different working hours.

Results

The hazard ratio (95% confidence interval) for hearing loss was higher in the heavy drinking group (1.23 [1.11–1.37]) compared to the moderate drinking group (1.09 [0.98–1.20]). Stratified analyses revealed a significantly elevated the hazard ratio of hearing loss in groups with alcohol flushing reaction compared to those without this factor.

Conclusions

Our study demonstrated that moderate or heavy alcohol consumption in male workers can increase the risk of hearing loss, particularly in those with alcohol flushing reaction. These findings underscore the importance of addressing alcohol-related factors concerning hearing health among male workers.

알코올 안면홍조 중심으로 살펴본 남성 근로자에서 음주습관이 청력손실에 미치는 영향: 강북삼성 코호트연구
목적
청력손실은 세계보건기구(WHO)가 인구 20% 가까이로 그 유병률을 추정할 만큼 흔한 만성질환임에도 불구하고 개인의 생활습관 요인, 특히 음주에 따른 연관성은 아직 명확하게 밝혀진 바 없다. 한국건강증진개발원에 따르면 대한민국의 음주 인구는 80%에 육박하며 남성의 고위험 음주율이 특징적으로 높았다. 따라서 우리는 청력손실과 관련된 근로자 건강 증진을 도모하고자 남성 근로자에서 음주습관 및 청력손실 간 연관성 평가 및 알코올 안면홍조 추가 변수 분석을 수행하였다.
방법
연구는 2012년 1월부터 2019년 12월 사이 강북삼성병원 종합건강검진센터에 방문한 114,114명의 수검자들을 대상으로 이루어졌다. 순음청력검사 및 음주 설문으로 데이터를 수집하였고 통계 분석은 Cox 회귀분석을 실시하였다. 과거 연구들에서 가벼운 음주가 오히려 청력손실에 보호효과를 나타내었으므로 해당 그룹을 참조(reference)로 지정하였다. 추가적으로 알코올 안면홍조 여부에 따른 층화분석을 시행하였다.
결과
청력손실의 위험비(95% 신뢰구간)는 중간 음주 그룹 1.09(0.98-1.20)에 비해 대량 음주 그룹이 1.23(1.11-1.37)로 더 높았다. 층화분석에서는 알코올 안면홍조가 있는 음주 그룹에서의 청력손실 위험비가 그렇지 않은 음주 그룹보다 유의하게 높은 경향을 보였다.
결론
우리는 연구를 통해 남성 근로자들에서 중간 또는 대량 음주는 청력손실의 발생 위험을 높일 수 있고, 특히 알코올 안면홍조가 있는 남성 근로자들은 그 위험도가 더 증가함을 밝혀낼 수 있었다.

Citations

Citations to this article as recorded by  
  • Prevalence of Noise-Induced Hearing Loss among Truck Drivers: a Cross-Sectional Study in Lucknow
    Anupam Mehrotra, Sheo P. Shukla, Arvind K. Shukla, Manish K. Manar, Shivendra K. Singh, Monica Mehrotra
    Noise and Health.2025; 27(124): 72.     CrossRef
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Original Article
Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study
Jihoon Kim, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Seonghyun Kwon, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2023;35:e38.   Published online September 11, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e38
AbstractAbstract AbstractAbstract in Korean PDF
Background

Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs.

Methods

We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age.

Results

In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02–1.34); the OR was 0.99 (95% CI: 0.80–1.22) in those under 40 and 1.28 (1.08–1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92–1.19); the OR was 1.10 (95% CI: 0.90–1.35) in those under 40 and 1.20 (1.01–1.43) in those over 40.

Conclusions

This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

청력손실과 고감도 C-반응단백의 연관성
목적
청력손실은 심혈관질환 발생 및 사망률 증가와 관련 있다. 청력손실과 심혈관질환의 병인은 공통으로 염증반응을 포함한다. 몇몇 연구에서 청력손실 환자의 염증성 바이오마커 수치가 증가했음을 연구하였으나 유의하지 않은 결과를 제시하였다. 따라서 본 단면연구 및 종단연구에서는 청력손실이 심혈관질환과 어떠한 관련성이 있는지 알아보기 위해 청력손실과 염증성 바이오마커인 고감도 C-반응단백의 연관성을 연구하였다.
방법
2012년부터 2018년까지 우리 기관에서 건강검진을 받은 18세 이상의 근로자를 대상으로 단면연구를 수행하였다 (n=566,507). 이후 2012년부터 2018년까지 우리 기관에서 건강검진을 2회 이상 받은 18세 이상의 근로자를 대상으로 종단연구를 수행하였다 (n=173,794). 청력손실은 3분법에 의한 순음청력역치가 양측 모두 20 dB 이상인 경우로 정의하였다. 추적관찰 동안 고감도 C-반응단백의 증가는 혈중 농도 3 mg/L 초과인 경우로 정의하였다. 청력손실 발생에 따른 고감도 C-반응단백 증가의 위험을 분석하기 위해 로지스틱 회귀분석과 일반화 추정방정식을 활용하였다. 또한 연령에 따라 계층화하여 추가적인 분석을 하였다.
결과
단면연구에서 최종참가자 204,091명 중 난청 유병률은 0.02% 이었다. 다변량 보정 교차비는 1.17 (95% 신뢰구간 1.02-1.34) 이었다. 40세 이하와 초과인 군에서는 각각 0.99 (0.80-1.22) 와 1.28 (1.08-1.53) 이었다. 종단연구에서 추적관찰 동안 고감도 C-반응단백 수치는 청력손실군 2,349 명 중 272 명, 비청력손실군 116,301명 중 11,049 명에서 증가하였다. 다변수 보정 교차비는 1.05 (95% 신뢰구간 0.92-1.19) 이었다. 40세 이하와 초과인 군에서는 각각 1.10 (0.90-1.35) 과 1.20 (1.01-1.43) 이었다.
결론
본 단면연구 및 종단연구에서는 40세 초과하는 근로자에서 청력손실과 고감도 C-반응단백의 증가에 유의한 연관성이 있음을 확인하였다.
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Research Article
Speech-in-Noise Test results of compensation claimants for noise induced hearing loss in Korean male workers: Words-in-Noise Test (WIN) and quick-Hearing-in-Noise Test (HINT)
Ji Soo Kim, Joong Keun Kwon, Nam Jeong Kim, Ji Ho Lee
Ann Occup Environ Med 2021;33:e11.   Published online April 20, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e11
AbstractAbstract PDF
Background

Pure-tone audiometry is used as a gold standard for hearing measurement. However, since communication in the work environment occurs in noise, it might be difficult to evaluate the actual communication ability accurately based on pure-tone audiometry only. Therefore, the purpose of this study is to evaluate speech intelligibility in noisy environments by using Speech-in-Noise Tests and to check its relationship with pure-tone audiometry.

Methods

From January 2017 to September 2018, for 362 workers who visited a university hospital for the purpose of compensating for noise-induced hearing loss, several tests were conducted: pure-tone audiometry, speech reception threshold, speech discrimination score, and Speech-in-Noise Tests (Words-in-Noise Test [WIN] and quick-Hearing-in-Noise Test [quick-HINT]). The subjects were classified into serviceable hearing group and non-serviceable hearing group based on 40 dB hearing level (HL) pure-tone average. In both groups, we conducted age-adjusted partial correlation analysis in order to find out the relationship between pure-tone threshold, speech reception threshold, speech discrimination score and WIN and quick-HINT respectively.

Results

In non-serviceable hearing group, all results of partial correlation analysis were statistically significant. However, in serviceable hearing group, there were many results which showed little or no significant relationship between pure-tone threshold and Speech-in-Noise Tests (WIN and quick-HINT).

Conclusions

The relationship between Speech-in-Noise Tests and the pure-tone thresholds were different by the hearing impairment levels; in mild to moderate hearing loss workers, there was little or no relationship; in severe cases, the relationship was significant. It is not enough to predict the speech intelligibility of hearing-impaired persons, especially in mild to moderate level, with pure-tone audiometry only. Therefore, it would be recommended to conduct Speech-in-Noise Test.


Citations

Citations to this article as recorded by  
  • Cochlear Implantation after Stereotactic Radiosurgery for Vestibular Schwannoma: Initial Hearing Improvement and Longevity of Hearing Restoration
    Kurtis Young, Maeher R. Grewal, Rodney C. Diaz, Arthur W. Wu, Mia E. Miller
    Otology & Neurotology.2023; 44(3): 201.     CrossRef
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Research Article
The effect of earplug training on noise protection
Jung Won Kim, Seonhee Yang, Insung Chung, Mi-Young Lee
Ann Occup Environ Med 2019;31:e34.   Published online November 12, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e34
AbstractAbstract PDF
Background

Noise-induced hearing loss is an occupational disease, and workplace noise exposure is a major hazard in Korea. Although hearing protectors effectively reduce a worker's exposure to noise, their success is compromised by the wearer's inability to fit the protectors correctly, and there are no proper training methods for using hearing protectors in small-scale industries. This study aims to evaluate the effect of earplug training on hearing protection using field microphone-in-real-ear (F-MIRE) and prevent noise-induced hearing loss.

Methods

The study population comprised 172 noise-exposed manufacturing workers who visited occupational health facilities in Daegu, South Korea, between July 2014 and September 2017. Personal attenuation ratings (PARs) were calculated with F-MIRE. Paired t-tests were used to compare the differences in PAR (dB) before and after training, and generalized estimating equations (GEEs) were used to compare the differences in PAR according to the number of trainings.

Results

Mean PARs increased after the first and second training, and the differences were statistically significant. Among the 30 participants who received all 4 trainings, PARs were significantly higher after each training than before the training. As the number of training increased, the differences in PARs significantly increased. When comparing pretraining PARs for each training session, we found statistically significant differences between the first and second training and between the second and third training, but not between the third and fourth training.

Conclusion

In this study, the short- and long-term effects of earplug training were statistically significant. In particular, the PAR before and after the fourth training showed the greatest increase, and the PARs continued to increase during each training.


Citations

Citations to this article as recorded by  
  • The protective effect of wearing hearing protection devices in noise-induced hearing loss and its potential influencing factors in the Chinese adult population
    Linyan Shu, Zhixing Fan, Jia Tang, Guoyong Xu, Jianyu Guo, Taihua Long, Junle Wu, Minghui Xiao, Shijie Hu, Bin Xiao
    Science of The Total Environment.2025; 964: 178507.     CrossRef
  • Hearing protection field attenuation estimation systems and associated training for reducing workers’ exposure to noise
    Thais C Morata, Wei Gong, Christina Tikka, Alessandra G Samelli, Jos H Verbeek
    Cochrane Database of Systematic Reviews.2024;[Epub]     CrossRef
  • Evaluation of Hearing Conservation In-Processing Procedures at a U.S. Marine Corps Accession Point
    Devon Kulinski, Sara Murphy, Jolene Mancini, Douglas S. Brungart
    Perspectives of the ASHA Special Interest Groups.2024; 9(6): 1683.     CrossRef
  • Evaluating the Effectiveness of Earplugs in Preventing Noise-Induced Hearing Loss in an Auto Parts Factory in China
    Wei Gong, Liangliang Zhao, Ling Li, Thais C. Morata, Wei Qiu, Huiling Amy Feng, Baoli Zhu
    International Journal of Environmental Research and Public Health.2021; 18(13): 7190.     CrossRef
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  • 4 Crossref
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Research Article
The effect of diabetes on 4-year changes of hearing thresholds in male workers exposed to noise in a single company: a longitudinal study
Dae Yun Kim, A Ram Kim, Joo Hyun Sung, Choong Ryeol Lee, Jiho Lee
Ann Occup Environ Med 2019;31:e11.   Published online June 28, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e11
AbstractAbstract PDF
Background

Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions.

Methods

The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ2 tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level.

Results

The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54–7.29) in the left ear and 5.66 (95% CI, 2.01–15.98) in the right ear.

Conclusions

This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.


Citations

Citations to this article as recorded by  
  • Individual and combined effects of noise exposure and diabetes mellitus on hearing
    Lan Zhang, Hui Liao, Zongnan Li, Jianhui Yuan
    Noise and Health.2024; 26(123): 449.     CrossRef
  • Noise-induced Hearing Loss among Non-Medical Workers in a Healthcare Institution
    Manju Deena Mammen, Ann Mary Augustine, Anjali Lepcha, Jessie Sophia Sharma, Arockiaraj Arul Prakash, Ajay Philip
    The Indonesian Journal of Occupational Safety and Health.2023; 13(1): 13.     CrossRef
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Research Article
Environmental exposure of heavy metal (lead and cadmium) and hearing loss: data from the Korea National Health and Nutrition Examination Survey (KNHANES 2010–2013)
Gu Hyeok Kang, Jun Young Uhm, Young Gon Choi, Eun Kye Kang, Soo Young Kim, Won Oh Choo, Seong Sil Chang
Ann Occup Environ Med 2018;30:22.   Published online April 17, 2018
DOI: https://doi.org/10.1186/s40557-018-0237-9
AbstractAbstract PDF
Background

Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but large-scale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey.

Methods

The study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Low-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Among men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161–2.287) and women (OR = 1.502, 95% CI = 1.027–2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex.

Conclusions

The present study findings suggest that even exposure to low-level lead is a risk factor for high-frequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.


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Research Article
Insomnia and hearing impairment among occupational noise exposed male workers
Hyeong-Min Lim, WonYang Kang, Won-Ju Park, Keun-Ho Jang, Ji-Sung Ann, Jai-Dong Moon
Ann Occup Environ Med 2017;29:36.   Published online August 15, 2017
DOI: https://doi.org/10.1186/s40557-017-0195-7
AbstractAbstract PDF
Background

The aim of this study was to investigate the association between insomnia and hearing impairment among workers exposed to occupational noise.

Methods

This study included 809 male workers exposed to occupational noise. The participants underwent audiometric testing, and their insomnia was examined based on the Insomnia Severity Index test. Hearing impairment was defined as hearing threshold >25 dB hearing level in the range of 1–4 kHz.

Results

According to analysis of covariance, it was observed that pure tone audiometry thresholds at 1–2 kHz in the right ear and at 1 kHz in the left ear were significantly higher among workers with insomnia compared to those with no insomnia. Multiple logistic regression analysis of insomnia for hearing impairments was performed, which showed the odds ratio was 1.806 (95% confidence intervals: 1.022–3.188, p = 0.042) after adjustment for age, working period, noise level, snoring, use of protection devices, diabetes mellitus, hypertension, smoking, alcohol consumption, regular exercise, waist circumference, total cholesterol, triglyceride and high density lipoprotein cholesterol.

Conclusion

Insomnia could be associated with hearing impairment in workers who are exposed to occupational noise. Additionally, insomnia may be associated with decreased hearing at low frequencies. Especially, more efforts are required to improve the quality of sleep for workers who are exposed to loud occupational noise. Further well- designed prospective studies are needed to clarify the relationship between insomnia and hearing impairment.


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Research Article
The association between long working hours and hearing impairment in noise unexposed workers: data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012)
Jung-Woo Park, Jin-Soo Park, Seyoung Kim, Minkyu Park, Hyunrim Choi, Sinye Lim
Ann Occup Environ Med 2016;28:55.   Published online October 6, 2016
DOI: https://doi.org/10.1186/s40557-016-0140-1
AbstractAbstract PDF
Background

This study is aimed at finding out the relationship between long working hours, one of major job stress elements, and hearing impairment in unexposed workers to occupational and environmental noise.

Methods

This study was performed on 1628 regular, full-time wage workers between the age of 25-64 who indicated in the survey of having no experience of exposure to noise, normal otoscopic findings, and not suffering from diabetes based on the data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012). The average working hours per week was categorized into 40 h and lower group, more than 40 to 48 h group, more than 48 to 60 h group, and more than 60 h group. The groups were defined as suffering from low or high frequencies hearing impairment if the average hearing threshold for 0.5, 1, 2 kHz or 3, 4, 6 kHz in both ears exceeds 25 dB based on the pure tone audiometry. The association between average weekly working hours and hearing impairment was analyzed using logistic regression after gender stratification.

Results

The prevalences of low and high frequencies hearing impairment in male workers were 4.3 and 28.6 %, respectively, which were much higher than female’s prevalence of 2.7 and 11.1 %. For male workers, no significant association was found between average weekly working hours and low and high frequencies hearing impairment. For female workers, odds ratios (OR) of low and high frequencies hearing impairment were 4.22 (95 % confidence interval (CI) 1.09–16.27) and 4.49 (95 % CI 1.73–11.67), respectively, after controlling for several related factors, such as, age, Body Mass Index (BMI), socio-economic status, health-related behavioral, and occupational characteristics variables, in the final model in the group working more than 60 h compared to the group working 40 h and lower. In addition, a dose-response relationship was observed that ORs of low and high frequencies hearing impairment were increased according to increasing average weekly working hours.

Conclusions

The association between long working hours and hearing impairment in both low and high frequencies was significant in Korean female workers with a dose-response relationship. Therefore, the law to change the culture of long working hours should be enacted in order to protect the workers’ health and improve the quality of life in Korean workers.


Citations

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  • Role of occupational factors in noise-ınduced hearing loss: a single-center real-world data study
    Aynur Aliyeva, Elif Sari
    The Egyptian Journal of Otolaryngology.2025;[Epub]     CrossRef
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    Yao Song, Wendu Pang, Xiaohong Yan, Yaxin Luo, Yufang Rao, Ke Qiu, Minzi Mao, Di Deng, Junhong Li, Danni Cheng, Wei Xu, Jianjun Ren, Yu Zhao
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Research Article
Comparisons of hearing threshold changes in male workers with unilateral conductive hearing loss exposed to workplace noise: a retrospective cohort study for 8 years
Sang Jin Park, Joo Hyun Sung, Chang Sun Sim, Seok Hyeon Yun, Jeong Han Yeom, Joong-Keun Kwon, Jiho Lee
Ann Occup Environ Med 2016;28:51.   Published online September 22, 2016
DOI: https://doi.org/10.1186/s40557-016-0132-1
AbstractAbstract PDF
Background

The purpose of this study was to investigate hearing threshold changes of workers with unilateral conductive hearing loss who were exposed to workplace noise for 8-years.

Methods

Among 1819 workers at a shipyard in Ulsan, 78 subjects with an air-bone gap ≥10 dBHL in unilateral ears were selected. Factors that could affect hearing were acquired from questionnaires, physical examinations, and biochemistry examinations. Paired t-test was conducted to compare the hearing threshold changes over time between conductive hearing loss (CHL) ear and sensorineural hearing loss (SNHL) ear.

Results

The study included male subjects aged 48.7 ± 2.9, having worked for 29.8 ± 2.7 years. Hearing thresholds increased significantly in CHL ears and SNHL ears at all frequencies (0.5–6 kHz) during follow-up period (p < 0.05). The threshold change at 4 kHz was 3.2 dBHL higher in SNHL ears which was statistically significant (p < 0.05). When workers were exposed to noise levels of 85 dBA and above, threshold change at 4 kHz was 5.6 dBHL higher in SNHL ears which was statistically significant (p < 0.05). Among workers aged below 50, the threshold change values were lower in low-frequency (0.5–2 kHz) in SNHL ears, with a small range of changes, whereas in high-frequency (3–6 kHz), the range of changes was greater SNHL ears (p < 0.05). Among workers aged 50 and above, SNHL ears showed a wider range of changes in both high- and low-frequency areas (p < 0.05).

Conclusions

At high-frequencies, particularly at 4 kHz, the range of hearing threshold changes was lower in ears with conductive hearing loss than in contralateral ears. This is suggested as a protective effect against noise exposure.


Citations

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  • Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa
    Hyejeong Hong, David W. Dowdy, Kelly E. Dooley, Howard W. Francis, Chakra Budhathoki, Hae-Ra Han, Jason E. Farley
    American Journal of Audiology.2020; 29(2): 199.     CrossRef
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Research Article
Relationship of cigarette smoking and hearing loss in workers exposed to occupational noise
Joo Hyun Sung, Chang Sun Sim, Choong-Ryeol Lee, Cheol-In Yoo, Hun Lee, Yangho Kim, Jiho Lee
Ann Occup Environ Med 2013;25:8.   Published online July 3, 2013
DOI: https://doi.org/10.1186/2052-4374-25-8
AbstractAbstract PDF
Objectives

To investigate the effects of smoking on hearing loss among workers exposed to occupational noise.

Methods

From the results of a special workers health examination performed in 2011, we enrolled 8,543 subjects exposed to occupational noise and reviewed the findings. Using self-reported questionnaires and health examination results, we collected data on age, smoking status, disease status, height, weight, and biochemistry and pure tone audiometry findings. We divided the workers into 3 groups according to smoking status (non-smoker, ex-smoker, current smoker). Current smokers (n = 3,593) were divided into 4 groups according to smoking amount (0.05–9.9, 10–19.9, 20–29.9, ≥30 pack-years). We analyzed the data to compare hearing thresholds between smoking statuses using analysis of covariance (ANCOVA) after controlling for confounder effects.

Results

According to ANCOVA, the hearing thresholds of current smokers at 2 k, 3 k, and 4 kHz were significantly higher than that of the other groups. Multiple logistic regression for smoking status (reference: non-smokers) showed that the adjusted odds ratios of current smokers were 1.291 (95% confidence interval [CI]: 1.055–1.580), 1.180 (95% CI: 1.007–1.383), 1.295 (95% CI: 1.125–1.491), and 1.321 (95% CI: 1.157–1.507) at 1 k, 2 k, 3 k, and 4 kHz, respectively. Based on smoking amount, the adjusted odds ratios were 1.562 (95% CI: 1.013–2.408) and 1.643 (95% CI: 1.023–2.640) for the 10–19.9 and ≥30 pack-years group, respectively, at 1 kHz (reference: 0.05–9.9 pack-years). At 2 kHz, the adjusted odds ratios were increased statistically significantly with smoking amount for all groups. At all frequencies tested, the hearing thresholds of noise-exposed workers were significantly influenced by current smoking, in particular, the increase of hearing loss at low frequencies according to smoking amount was more prevalent.

Conclusions

Current smoking significantly influenced hearing loss at all frequencies in workers exposed to occupational noise, and heavier smoking influenced low-frequency hearing loss more greatly. There was a dose–response relationship between smoking amount and low-frequency hearing thresholds; however, this was not observed for high-frequency hearing thresholds. Therefore, well-designed prospective studies are needed to clarify the effects of smoking on the degree of hearing loss.


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    Vladimir F. Spirin, Svetlana V. Raikova, Nataliia E. Komleva, Andrey M. Starshov
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    Siti Najihah Abdul Salam, Nurul Farahana Kamaludin, Normah Awang, Anuar Ithnin, Dayana Hazwani Mohd Suadi Nata, Nur Zakiah Mohd Saat
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    Jae W. Hong, Ju H. Jeon, Cheol R. Ku, Jung H. Noh, Hyung J. Yoo, Dong-Jun Kim
    Medicine.2015; 94(10): e611.     CrossRef
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    Journal of Korean Medical Science.2015; 30(8): 1175.     CrossRef
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Original Article
The Characteristics of Tinnitus and Hearing Threshold: In Workers with Noise Induced Hearing Loss from a Hospital Setting
Nam Jeong Kim, Hyoung Ouk Park, Chang Sun Sim, Choong Ryeol Lee, Young Joo Kwon, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2012;24(4):431-440.   Published online December 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.4.431
AbstractAbstract PDF
OBJECTIVES
This study was carried out to define the relationship between the characteristics of tinnitus and hearing threshold (puretone and speech) in workers with noise induced hearing loss (NIHL).
METHODS
A total of 189 cases(378 ears) from workers with compensation claims for NIHL during 2004-2009 were investigated. Various factors, including age, work carriers, body mass index (BMI), blood pressure, noise exposure level of worksite hearing threshold, speech discrimination score, pitch match, and loudness of tinnitus were analyzed.
RESULTS
The average hearing threshold of all subject was 44.2 dBHL, puretone audiometry thresholds in subjects with tinnitus were lower than the non-tinnitus group (except at 8000 Hz). Using speech audiometry, the tinnitus group showed a lower speech recognition threshold and speech discrimination score. The tinnitus group also had an average tinnitus frequency of 4195.2 Hz, loudness of 73.6 dB, and tinnitus sensation average of 6.0 dBSL. These frequencies of tinnitus were in the lowest puretone audiometry frequencies. Tinnitus loudness had a strong relationship with puretone and speech audiometry thresholds.
CONCLUSIONS
In cases beyond moderate hearing loss, the tinnitus group had a better puretone (except 8000 Hz) and speech hearing status, and most comfortable loudness (MCL) level. In addition, puretone and speech audiometry thresholds increase with tinnitus loudness.

Citations

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  • The Relationship Between Tinnitus Frequency and Speech Discrimination in Patients With Hearing Loss
    Joo Hyung Oh, Taehun Lim, Joon Bum Joo, Ju Eun Cho, Pona Park, Jong Yang Kim
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2023; 66(3): 156.     CrossRef
  • Efficiency Improvement of the Hearing Test Procedure Using Linear Regression
    Heonzoo Lee, Sejin Kim, Rayoung Park, Sungsu Lee, Hyong-Ho Cho, Yonggwan Won
    Journal of Digital Contents Society.2022; 23(12): 2489.     CrossRef
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Original Article
The Effects of Aircraft Noise Exposure upon Hearing Loss, Anxiety, and Depression on Subjects Residing Adjacent to a Military Airbase
Yu Rim Jeong, Jae Beom Park, Kyoung Bok Min, Chan Lee, Hyun Gwon Kil, Won Wook Lee, Kyung Jong Lee
Korean Journal of Occupational and Environmental Medicine 2012;24(1):40-51.   Published online March 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.1.40
AbstractAbstract PDF
OBJECTIVES
To determine the level of aircraft noise exposure and how it relates to hearing loss, and to investigate the association between noise exposure and anxiety and depression in subjects residing adjacent to a military airbase.
METHODS
The study was conducted upon 898 inhabitants between the ages of 30-79, living near the military airbase in Jeonra-do. The subjects were divided into three noise-exposure groups: high-exposure, low-exposure, and a control group. The cut-values were 80 and 60 on the Weighted Equivalent Continuous Perceived Noise Level scale. A self-administered questionnaire including the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were completed. Pure tone audiometry tests were performed.
RESULTS
Hearing loss prevalence was defined by a >40 dB loss in bilateral ears or in one ear; the difference of <15 dB compared to the better side was 30.8%. The mean BAI/BDI score was 18.9+/-14.3/18.7+/-11.6, the number of abnormal subjects with BAIs > or =22 was 317 (35.3%), with BDIs > or =21 was 347 (38.6%). The pure tone average, BAI, and BDI scores were higher in the noise-exposure groups compared to the control. The BAI/BDI abnormal subjects showed a higher hearing threshold shift level compared to the normal scored subjects. The odd ratios for anxiety was significantly high in both noise exposure groups and the hearing loss, for depression was significantly high in high-exposure group and hearing loss.
CONCLUSIONS
Anxiety and depression were higher when exposure to high-level noise and further complicated by hearing loss. Further investigation is needed to determine the cause-effect relationship.

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  • Normal İşiten ve İşitme Kaybına Sahip Yetişkin Bireylerin Beck Depresyon Envanterine Göre Değerlendirilmesi ve Karşılaştırılması
    Ayşenur Ercan, Selva Zeren
    İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi.2024; (23): 865.     CrossRef
  • Correlation between Traffic Noise and Mental Health Indices in Cities: An Ecological Study
    Sukyung Noh, Sang-Yong Eom
    Journal of Environmental Health Sciences.2023; 49(6): 353.     CrossRef
  • Multiple Noise Analysis and Derivation of Noise Prediction Equations for Shelter System
    Jae-sang Cho, Sock-kyu Lee, In-gi Baek, Sang-hyun Kim, Jeung Lee, Ji-ho Choi
    Transactions of the Korean Society for Noise and Vibration Engineering.2016; 26(5): 616.     CrossRef
  • Anxiety symptoms and occupational stress among young Korean female manufacturing workers
    Kang Ho Lee, Chang Ho Chae, Young Ouk Kim, Jun Seok Son, Ja-Hyun Kim, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Young Saeng Jung
    Annals of Occupational and Environmental Medicine.2015;[Epub]     CrossRef
  • The Characterisitics of Tinnitus and Its Relationship to Depression from Tinnitus Acquired from Military Service
    Kyoo Sang Kim, Ji Hae Kim, Yong Hun Yoon
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2012; 55(12): 757.     CrossRef
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Original Article
Effect of Hand Transmitted Vibration on the Auditory System
Jae Kook Yoon, Cheol In Yoo, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2011;23(1):18-30.   Published online March 31, 2011
DOI: https://doi.org/10.35371/kjoem.2011.23.1.18
AbstractAbstract PDF
OBJECTIVES
This study was undertaken to estimate the effect of hand transmitted vibration exposure for long time period on the auditory system in shipyard grinder workers.
METHODS
From 2006 to 2009, the study was carried out on 87 grinder workers for hand transmitted vibration exposure group, with 81 welders who were served as the control group. All subjects were male; at baseline, none of the participants had ear disease or diabetes mellitus. Auditory threshold at different frequencies ranged from 0.25 kHz to 8 kHz for both ear was recorded; the following were also collected from the subjects: age, exposure duration, noise exposure level of investigation year, total cholesterol, systolic/diastolic blood pressure, and smoking history.
RESULTS
In comparison of two groups, mean of age, exposure duration, noise level, total cholesterol, systolic/diastolic blood pressure, smoking rate were not significantly different between the groups. Auditory thresholds of 0.25, 0.5 kHz frequencies in both ear, 1 kHz frequency in right ear, and 8 kHz frequency in left ear were higher in hand-transmitted vibration exposure group than that in the control group at a statistically significant level. After stratification by age 50 years, there were no significant differences between the two groups in less than 50-years old age group, but auditory threshold of 0.25, 0.5, 1 and 8 kHz frequency were significantly different between the two groups in above 50-years old age group. The differences between two groups ranged from 0.4 dB(HL) to 6.7 dB(HL). Multiple linear regression analysis showed that hand transmitted vibration exposure was significant only in 0.25, 0.5 kHz frequency and the regression coefficients of vibration exposure ranged from 3.826 to 5.028 in those frequencies.
CONCLUSIONS
The differences of hearing threshold between two groups only in the 50-years old group were possibly owing to changed peripheral vascular system with autonomic nervous system, and significances only in low frequencies such as 0.25, 0.5 kHz probably mean that hand vibration exposure have been transmitted to auditory organ over long term. Collectively, older people can be more susceptible to hearing loss in the presence of hand transmitted vibration exposure and auditory threshold at low frequency may be more affected by the hand transmitted vibration exposure than high frequency.

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  • The Health Effect of Hand Arm Transmitted Vibration
    Jung-Wan Koo
    Journal of the Ergonomics Society of Korea.2013; 32(4): 303.     CrossRef
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Original Article
Effects of Workplace Noise and Hearing Protective Devices on Worker's Speech Intelligibility
Hyoung Ouk Park, Chang Sun Sim, Joong Keun Kwon, Kyoo Sang Kim, Young Joo Kwon, Nam Jeong Kim, Min Suk Seo, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2010;22(2):154-165.   Published online June 30, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.2.154
AbstractAbstract PDF
OBJECTIVE: The objective of this study was to evaluate the degree of intelligible speech in workers wearing hearing protective devices and the differences in background noise type.
METHODS
A total 82 shipyard company employees and normal hearing volunteers were recruited as subjects from a company in Ulsan: subjects were classified to the hearing-impaired group or to the control group according to hearing status. They were tested pure tone and speech audiometry in varying test environments including signal-to-noise ratio and background noise type in a headphone and in a free field environment.
RESULTS
For both groups, the attenuation of hearing protective devices was greater at high frequencies. For the hearing-impaired group, speech discrimination scores differences between the unprotected and the protected ear were not significant between background noise type, when speech was presented at 65 dBA. However speech intelligibility in white noise background was lower than in the other background noise types when speech was presented at 75 dBA.
CONCLUSIONS
Workers' speech intelligibility increased with an increasing signal-to-noise ratio. Speech intelligibility was also dependent on background noise type. Workers and their colleagues were trained to pronounce words more loudly and more clearly when they wearing hearing protective devices or other communication methods that do not use sound signal should be considered.

Citations

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  • Effects of Hearing Protection Methods and Noise Directions on Bone-Conduction Sensitivity
    Woojae Han
    THE JOURNAL OF THE ACOUSTICAL SOCIETY OF KOREA.2013; 32(5): 423.     CrossRef
  • An experimental study on the improving noise characteristic of hydraulic power unit
    Gi Chun Lee, Yong Bum Lee
    Journal of the Korean Society of Marine Engineering.2013; 37(6): 638.     CrossRef
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Original Article
Effects of Cardiovascular Risk Factors on Hearing Loss
Jong Do Jeong, Hyunjoo Kim, Jae Yun Jung, Sangchul Roh, Ho Jang Kwon, Eun Jung Kim, Moo Yong Rhee
Korean Journal of Occupational and Environmental Medicine 2009;21(3):225-234.   Published online September 30, 2009
DOI: https://doi.org/10.35371/kjoem.2009.21.3.225
AbstractAbstract PDF
OBJECTIVE: To investigate the effects of cardiovascular risk factors on hearing loss by vascular damage, such as in atherosclerosis.
METHOD
This study was conducted as a part of a study for the health effects of air-craft noise from 13 July 2005 to 13 January 2006. In this study 810 residents were selected from 13 villages in Pyeongteck City. Participants in this study were stratified by gender. Individuals, who had conductive hearing loss, were excluded form this investigation. Cardiovascular risk factors were divided into medical risk factors (mean arterial pressure (MAP), blood glucose, triglyceride) and behavioral risk factors (smoking, alcohol). The degree of atherosclerosis was determined by aPWV. Pure tone air conduction hearing thresholds were obtained at frequencies of 1000 and 4000 Hz. As for statistic data analysis, multiple linear regression models were used to evaluate the relationship between factors on hearing loss and aortic pulse wave velocity. Structural Equation Modeling was used to analyze the relationship between factors.
RESULTS
According to multiple linear regression models among males, age, aircraft noise, aPWV were associated with hearing loss. In females, age and aircraft noise were associated with hearing loss. Thus cardiovascular risk factors were not directly involved in hearing loss. However, cardiovascular risk factors such as alcohol, MAP in males and MAP, blood glucose in females were statistically significant (p<0.05) on aPWV according to multiple linear regression modeling. According to analysis of structural equation modeling, an indirect relationship was observed between cardiovascular risk factors and hearing loss by atherosclerosis, which was measured by aPWV. In males, medical risk factors were significantly associated with atherosclerosis (beta+/-SE: 0.07+/-0.03, p=0.03). Atherosclerosis was also associated with hearing loss (beta+/-SE: 2.01+/-0.89, p=0.03). In females, medial risk factors was significantly associated with atherosclerosis (beta+/-SE: 0.08+/-0.02, p=0.00), but atherosclerosis was not significantly associated with hearing loss.
CONCLUSION
Although noise exposure is a known major threat to hearing loss, understanding of cardiovascular risk factors associated with hearing loss also take a significant role in preventing hearing loss. Therefore, scrutinization of the etiologic factors for hearing disability may introduce a detailed strategy to abate the prevalence of hearing loss.

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Original Article
Relationship of Aircraft-noise and the Result of Audiological Evaluation Among Residents Near U.S. Military Airbases in Pyeongtaek City
Jong Do Jeong, Hyunjoo Kim, Jae Yun Jung, Sangchul Roh, Ho Jang Kwon
Korean Journal of Occupational and Environmental Medicine 2009;21(2):154-164.   Published online June 30, 2009
DOI: https://doi.org/10.35371/kjoem.2009.21.2.154
AbstractAbstract PDF
Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city.
METHODS
Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10 km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was adjusted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational).
RESULTS
The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09~3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (p<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No significant difference in DPOAE was observed among noise-exposed males. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01~2.99) and 1.78(95% CI: 1.01~3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10~3.36) and 2.71(95% CI: 1.49~4.91) CONCLUSIONS: Aircraft noise may adversely affect hearing function and tinnitus.

Citations

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  • Occupational Hearing Loss in Korea
    Kyoo Sang Kim
    Journal of Korean Medical Science.2010; 25(Suppl): S62.     CrossRef
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Original Article
The Impact of Noise Expose on the Hearing Threshold Extended High Frequency
Nam Jeong Kim, Joong Keun Kwon, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2008;20(2):81-92.   Published online June 30, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.2.81
AbstractAbstract PDF
OBJECTIVES
To determine how extended high frequency is affected by noise exposure and other factors that maybe have adverse effects.
METHODS
Pure tone audiometry for usual frequencies (250-8000 Hz) and extended high frequencies (1000-16000 Hz) was conducted for 331 workers at a manufacturing company from 2004 to 2005. History of noise exposure, military service, tinnitus, alcohol drinking, smoking, ear diseases, and noisy hobbies were taken by interview. T-test, ANOVA, and multiple regression was conducted according to the frequency to evaluate the factors that could affect extended high frequency hearing.
RESULTS
The noise-exposed group had significantly poorer hearing than the noise-unexposed in the frequency range 2000-16000 Hz. The hearing deteriorated with increasing age through all the frequencies. High frequency hearing of 14000 Hz was significantly worse in the noise-exposed group in their 30s. Noise exposure during military service had a bad effect on hearing, especially for the noise-unexposed group. Tinnitus was associated with poorer hearing in both noise-exposed and noise-unexposed groups. Workers with noisy hobbies exhibited better hearing in the noise-unexposed group, contrary to our expectation. Extended high-frequency hearing was affected by aging, ear protection, and noisy hobbies. In extended high frequency, 14000 Hz was especially related with noise exposure history.
CONCLUSIONS
Extended high frequency, especially 14000 Hz, could be used as an indicator of noiseinduced hearing loss and should be considered as a screening test for workers in noisy environments.

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  • Stress of Noise on Dental Technician
    Ju Hee Lee
    Journal of Korean Acedemy of Dental Technology.2014; 36(2): 111.     CrossRef
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Original Article
Comparison of the Standard Threshold Shift Criteria for Evaluating Hearing Conservation Programs
Chang Sun Sim, Kyoung Sook Jeong, Yu Jung Kim, Na Ri Choy, Choong Ryeol Lee, Hun Lee, Jong Pil Jung, Ok Hyun Kim, Yo Weon Lee, Seung Rim Yang, Sung Soo Oh, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2006;18(3):179-188.   Published online September 30, 2006
DOI: https://doi.org/10.35371/kjoem.2006.18.3.179
AbstractAbstract PDF
OBJECTIVES
Workers from a factory was selected to compare 8 standard threshold shift criteria with the Korean diagnostic criteria of noise-induced hearing loss for this cohort study.
METHODS
From 1990 to 1999, 491 workers at a manufacturing company with complete record of the hearing test covering the range of 0.5~6 kHz for 10 consecutive years were finally selected. Eight standard threshold shift criteria (15 dB once, NIOSH (1972), 10 dB average 3~4 kHz, OSHA STS, AAOHNS, 15 dB twice, 15 dB 1~4 kHz, OSHA STS twice) along with the Korean standard for diagnosing the noise-induced hearing loss (the average hearing threshold at 0.5, 1 and 2 kHz) were compared to calculate the degree of the threshold shift and the minimum time required to detect the change.
RESULTS
Those workers showing at least one positive shift in the 'once'criteria of NIOSH (1972) were 92.5%; the 'average'criteria of 10 dB average 3~4 kHz were 35.8%; 'twice'criteria of 15 dB twice were 44.4%. The duration from the baseline to the year showing the first positive shift was from 3.2 +/- 3.1 years (NIOSH, 1972) to 6.0 +/- 2.1 years (OSHA STS twice). The percentage of true positive shift ranging from 20.4% (AAO-HNS) to 69.8% (NIOSH, 1972). There were 10 (2%) which met the Korean diagnostic criteria of noise-induced hearing loss.
CONCLUSIONS
Currently the concept of hearing threshold shift in diagnosing the hearing loss was adopted in Korea thus in this study we determined the validity and the effect of the various hearing threshold shift criteria and showed that NIOSH (1972) criteria was the best of all. In the future, hearing data from various manufacturing workers should be compared to thoroughly evaluate the threshold shift criteria and to establish adequate standard for Korean workers.

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Original Article
Evaluation of Ototoxicity by Mixed Organic Solvents Using the Upper Limit of Hearing
Ji Ho Lee, Cheol In Yoo, Choong Ryeol Lee, Hun Lee, Young Hee Choi, Nam Jung Kim, Yangho Kim
Korean Journal of Occupational and Environmental Medicine 2004;16(4):391-400.   Published online December 31, 2004
DOI: https://doi.org/10.35371/kjoem.2004.16.4.391
AbstractAbstract PDF
OBJECTIVES
This study evaluated the ototoxicity by mixed organic solvents on workers'hearing using the upper limit of hearing(ULH).
METHODS
Seven hundred ninety-seven male workers in the ship building industry who were evaluated by interview with an upper limit of hearing from August 2000 to July 2002 were enrolled in the study. The subjects were divided into 3 groups according to exposure profile and job: officers, field supporters, and painters. To assess the ototoxicity of mixed organic solvent exposure on hearing, with regard to confounders, the general liner model was used.
RESULTS
After controlling for the possible confounders, such as age, career, noise exposure level, tinnitus, alcohol intake, and smoking, the estimated mean for ULH of the painter group was higher than that of the officer and the field supporter groups. These differences of mean ULH were at the borderline of statistically significance(p=0.069).
CONCLUSIONS
The results of this study suggest that a relatively lower level of mixed organic solvent chronically affected the hearing organ or auditory pathway. ULH seems to be a useful method for early detection of the ototoxicity of organic solvents.

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Original Article
Ambient Noise Levels in the Audiometric Test Rooms Used for Special Periodic Health Examination
Kyoo Sang Kim, Yong Hyu Choi, Yong Lim Won, Seong Kyu Kang
Korean Journal of Occupational and Environmental Medicine 2004;16(3):316-328.   Published online September 30, 2004
DOI: https://doi.org/10.35371/kjoem.2004.16.3.316
AbstractAbstract PDF
OBJECTIVES
The ambient noise levels in the test rooms affect the workers's hearing threshold. The present study was designed to assess the ambient noise levels in the test rooms to determine if valid hearing tests, both pure-tone air conduction and bone-conduction, could be performed in these environments.
METHODS
In the present study, third octave band ambient noise sound pressure levels were measured in 124 audiometric test rooms used for clinical audiometry, and the results were compared with the ANSI third octave band maximum permissible ambient noise levels (MPANLs) for each test condition and frequency range.
RESULTS
The ambient noise SPLs were highest in the lower frequencies, and this decreased as the frequency increased. For the "ears covered"condition, about 24.2% of the rooms were in compliance (pass) with the MPANLs for the 125-8000 Hz, 35.5% were in compliance for the 250-8000 Hz range and 55.6% were in compliance for the 500-8000 Hz range. For the "ears not covered"condition, only about 8.1% of the rooms passed for the 125-8000 Hz, 13.7% of the rooms passed for the 250-8000 Hz range and 34.7% of the rooms passed for the 500-8000 Hz range. All 124 rooms met the OSHA MPANLs.
CONCLUSIONS
The results of this study strongly indicate that clinical audiometry is being conducted in test rooms having unacceptable or excessive ambient noise levels.

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  • Ambient Noise in Candidate Rooms for User-Operated Audiometry
    Christos Sidiras, Jacob Nielsen, Chris Bang Sørensen, Jesper Hvass Schmidt, René Gyldenlund Pedersen, Ellen Raben Pedersen
    Healthcare.2023; 11(6): 889.     CrossRef
  • Achievements, Problems, and Future Direction of the Quality Control Program for Special Periodic Health Examination Agencies in Republic of Korea
    Yong Lim Won, Kyung Sun Ko, Jae Oh Park, Yoon jung Choi, Hyeji Lee, Jung-min Sung, Mi-young Lee
    Safety and Health at Work.2019; 10(1): 125.     CrossRef
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Original Article
Hearing Thresholds in Electronics Sound Inspectors Exposed to Continuous and Impulsive Type Noises
Seong Ah Kim, Kyoo Sang Kim
Korean Journal of Occupational and Environmental Medicine 2004;16(3):227-235.   Published online September 30, 2004
DOI: https://doi.org/10.35371/kjoem.2004.16.3.227
AbstractAbstract PDF
OBJECTIVES
To investigate the relation between different types of exposure to noise and a classic sign of noise-induced hearing loss (NIHL); the audiometric notch.
METHODS
A cross-sectional epidemiological survey was carried out in electronics sound inspectors exposed to continuous and impulsive type noises. The noise levels in the working environments, and the audiometric hearing threshold levels were measured.
RESULTS
Electronics sound inspectors were exposed to impulsive noise ranging from 74.1 to 88.9 dBA. The hearing loss induced by impulsive noise was greater and was characterized by maximum loss at 6 kHz audiometric frequency, as opposed to the notch at 4 kHz that is typical of continuous noise.
CONCLUSIONS
The results suggest that the probable effect of impulsive noise on hearing should be considered even when the exposure is within the 85 dB equivalent A-weighted level. To diagnose NIHL it is important to elicit a detailed and accurate history of exposure to noise. Although the notch at 4 kHz is a well established clinical sign and may be valuable in confirming the diagnosis, the 6 kHz notch is variable and of limited importance.

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Original Article
The Predictive Study for Hearing Loss using Distortion Product Otoacoustic Emission in Mild Noise-Induced Hearing Loss
Sang Yong Oh, Won Chul Lee
Korean Journal of Occupational and Environmental Medicine 2003;15(3):290-298.   Published online September 30, 2003
DOI: https://doi.org/10.35371/kjoem.2003.15.3.290
AbstractAbstract PDF
OBJECTIVE: The aim of this study was to predetermine the discrimination standard point of distortion product otoacoustic emission(DPOAE) amplitudes, which discriminates the degree of the mild noise-induced hearing loss, and to estimate the accuracy and predictability of the discrimination standard point of DPOAE amplitudes. Therefore we were able to determine the usability of the DPOAE test in screening exam for mild noise-induced hearing loss.
METHODS
This study was analyzed 50 high frequency-impaired ears(from 25dB HL to 40dB HL at 4000Hz for which the response of DPOAE was not disappeared) and 81 normal ears through the correlation test between the amplitudes of DPOAE test and the threshold of the pure-tone audiometry test.
RESULT
The discrimination between >or=25dB and CONCLUSION
DPOAE test is considered as a more efficient early prevention method against noise-induced hearing loss if this test is conducted as part of the special medical checkup of industrial workers exposed to noise.

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Original Article
Characteristics and Affecting Factors of Tinnitus in Noise Exposed Workers
Kyoo Sang Kim, Ho Keun Chung
Korean Journal of Occupational and Environmental Medicine 2002;14(4):436-447.   Published online December 31, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.4.436
AbstractAbstract PDF
OBJECTIVES
Tinnitus is a relatively common complaint of workers who are exposed to noise. The aim of the study was to investigate the prevalence and characteristics of tinnitus as well as the factors related to the prevalence of tinnitus.
METHODS
A cross-sectional audiologic survey was combined with a questionnaire on tinnitus in a stratified random sample of 246 shipyard workers who had long-term exposure to noise.
RESULTS
Forty seven had tinnitus, giving a prevalence of 19.1 percent. The tinnitus was the here and now in 44.7 percent of cases, bilateral in 51.1 percent, and caused sleep disturbances in 12.8 percent. The prevalence of tinnitus was highest in shipfitters and those with longer exposure duration.The workers with tunnitus had consistently higher hearing thresholds at both high and low frequencies than those with no tinnitus.The workers with tinnitus had a significantly higher prevalence of hearing disorders such as conductive hearing loss, a C5-dip, and NIHL.Multivariative logistic regression indicated that past history of ear disease, working and military service exposure to noise were independently associated with tinnitus. The adjusted odds ratio estimates for tinnitus were 3.0 times greater (95%CI 1.4-6.4) for the group with a past history of ear diseases,2.3 times greater (95%CI 1.0-5.0) for the military noise exposed group,and 4.5 times greater (95%CI 1.8-11.1) for the working noise exposed group.
CONCLUSIONS
The results provide evidence that reports of tinnitus at the time of the annual audiometric testing may be useful in identifying workers at greater risk of developing significant shifts in their hearing thresholds. An awareness of the possible occurrence of tinnitus may encourage workers to cooperate more actively in a company's hearing conservation program.

Citations

Citations to this article as recorded by  
  • A systematic review of the reporting of tinnitus prevalence and severity
    Abby McCormack, Mark Edmondson-Jones, Sarah Somerset, Deborah Hall
    Hearing Research.2016; 337: 70.     CrossRef
  • The Characterisitics of Tinnitus and Its Relationship to Depression from Tinnitus Acquired from Military Service
    Kyoo Sang Kim, Ji Hae Kim, Yong Hun Yoon
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2012; 55(12): 757.     CrossRef
  • Occupational Hearing Loss in Korea
    Kyoo Sang Kim
    Journal of Korean Medical Science.2010; 25(Suppl): S62.     CrossRef
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  • 4 Download
  • 3 Crossref
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Case Report
Atypical Noise-induced Hearing Loss As a Workers'Impairment Criteria
Kyoo Sang Kim, Moon Suh Park, Seong Kyu Kang
Korean Journal of Occupational and Environmental Medicine 2002;14(3):334-345.   Published online September 30, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.3.334
AbstractAbstract PDF
OBJECTIVES
The problem of noise-induced hearing loss (NIHL) was objectively and systematically investigated by diagnosing three workers who complained of tinnitus and hearing disturbance.
METHODS
Atypical hearing loss is diagnosed as a work-related disease by using general medical methods, such as environmental survey, neurological examination, otoscopy, pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), auditory-evoked potentials, and interview on the history of past disease, family and occupation.
RESULTS
Three results were found according to the work-related hearing loss as follows; (1) hearing loss that is caused by exposure to continuous noise of less than 85 dB(A) or impact noise of greater than 135 dB peak, (2) mixed hearing loss that has progressed due to noise with past otitis media, and (3) atypical hearing loss that showed remarkable differences between air and bone conduction due to tinnitus.
CONCLUSIONS
The criteria for work-related hearing loss should be carefully investigated by considering exposure to impact noise, the effect of continuous noise on mixed hearing loss patients, and the hearing loss caused by tinnitus.

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Original Article
Job instability of Labor Market and Preplacement Health Examination: the Case of Hearing Loss
Sang Baek Koh, Kyoo Sang Kim, Sei Jin Chang, Bong Suk Cha, Jong Ku Park, Dong Mug Kang, Jai Young Kim, Soo Keun Kim, Hong Ryul Choi
Korean Journal of Occupational and Environmental Medicine 2002;14(1):57-68.   Published online March 31, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.1.57
AbstractAbstract PDF
OBJECTIVES
This study examines the problem of the preplacement health examination in terms of hearing loss case, where workers have been experiencing job instability in the labor market.
METHODS
In order to measure the 2-year job retention rate of employees in 79 shipbuilding subcontracted companies in Kyongnam province, we utilized the same methods as those used by Neumark et al(1999), and Bernhardt et al(1999). We surveyed 79 heath and safety personnel from the companies with a questionnaire to evaluate the present status of the preplacement health examination. We reviewed the preplacement health certificates(result of audiometric hearing thresholds) of 1,818 recruits issued by Daewoo hospital from January 1 to June 30, 2001.
RESULTS
The job retention rate was 40.3 %(male 38.53 %, female 52.01 %). Of the 79 health and safety personnel of companies, 44(55.7 %) perceived the preplacement health examination as a tool for the selection of recruits, 3(3.8 %) as a procedure for job fitting and 31(39.2 %) as both. Most of them were against the acceptance of recruits with hearing loss, spinal disease and hepatitis. Among the 1,818 workers who underwent the preplacement health examination, 530(29.1 %) were examined after employment, but 1,096(60.3 %) were examined before employment. The number with previous job experience was 1,591(87.5 %). In the audiometric hearing threshold results, the prevalence of hearing loss was positively correlated with age. There was a significant difference in the prevalence of hearing loss depending on previous job and number of quitting at 4,000 Hz.
CONCLUSIONS
The comparison of 2-year job retention rates before and after the Korean economic crisis of 1997 suggests that job stability has been aggravated especially for cohorts of long tenure, irregular job, and old age. This evidence shows that previous job and age play a role in determining worker employment based on perceived results from the preplacement health examination. This result suggests that a pre-employment health examination be substituted for the preplacement health examination based on the essential job functions and reasonable accommodation. Because it has little relevance in a wide range of employment and minor health problems, the results of this examination should not debar applicants from employment.

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Original Article
Relationship between the Use of Mobile Phones and Hearing Thresholds in Some White-collar Workers
Mi Young Lee, Choong Won Lee
Korean Journal of Occupational and Environmental Medicine 2002;14(1):47-56.   Published online March 31, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.1.47
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to investigate the relationship between the use of mobile phones and the levels of hearing thresholds in some clerical workers.
METHODS
Questionnaires were administered to 450 clerical workers between May and August 2000. The questionnaire included items concerning socio-demographic profile and noise-exposure history as well as use of mobile phone. The number of workers used in the final analysis was 394(Response rate 87.6%). Males numbered 308 and females 86. Hearing thresholds were measured in both ears using a pure-tone audiometer.
RESULTS
In a univariate analysis, the duration and time of mobile phone use per day were significant in regards to hearing threshold at 1000Hz in males(p<0.05). In a linear regression analysis with adjustment for age, education, military service, use of earphone, the group that used mobile phones for more than 49 months was more likely to have low hearing threshold at 1000Hz and 4000Hz in males(p<0.05) as compared to the reference group (CONCLUSIONS
These results suggested that only certain elements of use of a mobile phone may be associated with hearing thresholds and there is a complex relationship between the use of mobile phone and hearing thresholds that may differ in terms of frequency (1000Hz and 4000Hz) and gender.

Citations

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  • Effects of VR Viewing on Binocular Vision and Eye Movement : Focusing on Undergraduates Having a Major Related to Physical Education
    Hyun-Uk Park, Chang-Won Park
    The Korean Journal of Vision Science.2023; 25(3): 209.     CrossRef
  • Occupational Hearing Loss in Korea
    Kyoo Sang Kim
    Journal of Korean Medical Science.2010; 25(Suppl): S62.     CrossRef
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Original Article
Mitochondrial DNA A3243G mutation in noise-induced sensorineural hearing loss
Dong Hoon Shin, Won Ki Baek, In Sung Chung
Korean Journal of Occupational and Environmental Medicine 2000;12(3):319-326.   Published online September 30, 2000
DOI: https://doi.org/10.35371/kjoem.2000.12.3.319
AbstractAbstract PDF
OBJECTIVES
A different sequence change, in the mitochondrial tRNA gene, has been proposed as a candidate mutation in the sensorineurnal hearing loss. The purpose of current study is to identify the association between the noise-induced sensorineurnal hearing loss and the A to G mutation at nucleotide 3243 of mitochondrial DNA.
METHODS
Subjects were established by history and chart review, and audiological and clinical data were obtained. Blood was sampled from 101 controls, 50 noise-induced hearing loss, and 12 sensorineural deafness. The DNA of these individuals was extracted, and mitochondrial genome was analyzed by polymerase chain reaction. Subsequently, the coding sequence of mitochondrial genome was sequenced, and compared to the normal sequence, and all sequence variations were analyzed by restriction endonuclease ApaI.
RESULTS
Mitochondrial DNA mutation (3243A->G) was not detected by polymerase chain reaction (PCR) in any patients with noise-induced hearing loss, sensorineural hearing loss, and normal control without hearing loss in Koreans. The DNA sequencing of PCR products did not revealed an A to G substitution at nucleotide 3243 of mitochondrial DNA.
CONCLUSIONS
The noise-induced sensorineural hearing loss was not associated with mitochondrial DNA mutation (3243A->G)

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Original Article
Effects of transient threshold shift and ambient noise on sensitivity and specificity of first screening of special health examination for noise
Jong Uk Won, Moon Kyoo Bang, Joong Ho Song, Sedn Ah Jeong, Jae Suk Song, Jaehoon Roh
Korean Journal of Occupational and Environmental Medicine 2000;12(2):269-276.   Published online June 30, 2000
DOI: https://doi.org/10.35371/kjoem.2000.12.2.269
AbstractAbstract PDF
OBJECT: This study was performed to increase the sensitivity and specificity for screening the examinee of second hearing test.
METHODS
Study subjects were 219 workers who exposed more than average 80dB. They were taken the hearing test two times, before noise exposure and at 1 hour to 4 hours after worksite noise exposure. To investigate the ambient noise workers who were taken the hearing test in the test room which ambient noise was less than 45dB were classified Group I and the others were classified Group E. To calculate the sensitivity and specificity we made it gold standard whether worker had noise induced hearing loss.
RESULTS
Difference of hearing loss between before and after noise exposure for left and right ear was 11. 4 dB and 11. 7 dB respectively at 500 Hz, 8. 7 dB and 9. 6 dB at 1, 000 Hz, 6. 3 dB and 6. 9 dB at 2, 000 Hz and 6. 9 dB and 7. 4 dB at 4, 000 Hz in Group I. That for left ear and right ear was 5.8 dB and 4.9 dB at 500 Hz respectively, 5.4 dB and 6.4 dB at 1,000 Hz, 6.3 dB and 5.3 dB at 2,000 Hz, and 5.5 dB and 5.8 dB at 4,000 Hz in Group E. The sensitivity was 100 in both Groups and the specificity was increased to 58. 3 and 71. 8 in Group I and Group 3 respectively until 10 dB was deducted from hearing level at 1, 000 Hz and 4, 000 Hz.
CONCLUSION
When the screening hearing test was performed at worksite, we might deduct 10 dB from measured hearing level to increase the specificity without reduction of sensitivity.

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Original Article
Related factors of high frequency hearing loss in the noise-exposed male workers
Sang Je Jung, Kuck Hyeun Woo, Wan Deup Park, Jae Young Yu, Tae Sung Choi, Sang Woo Kim, Jin Seok Kim
Korean Journal of Occupational and Environmental Medicine 2000;12(2):187-197.   Published online June 30, 2000
DOI: https://doi.org/10.35371/kjoem.2000.12.2.187
AbstractAbstract PDF
OBJECTIVES
The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers.
METHODS
712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hi hearing loss or not.
RESULTS
The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P<0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smoking and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1.
CONCLUSIONS
High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.

Citations

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  • The effect of diabetes on 4-year changes of hearing thresholds in male workers exposed to noise in a single company: a longitudinal study
    Dae Yun Kim, A Ram Kim, Joo Hyun Sung, Choong Ryeol Lee, Jiho Lee
    Annals of Occupational and Environmental Medicine.2019;[Epub]     CrossRef
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