Annals of Occupational and Environmental Medicine

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

Abstract Abstract in Korean PDF PubReader ePub: 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

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: 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.

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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

Abstract Abstract in Korean PDF PubReader ePub: 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

Abstract PDF PubReader ePub

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

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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

Abstract PDF PubReader ePub

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.

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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
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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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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

Abstract PDF PubReader ePub

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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Mingming Liang, Xianwei Guo, Xiuxiu Ding, Qiuxia Song, Hao Wang, Ning Li, Wanying Su, Qiwei Liang, Yehuan Sun
Ecotoxicology and Environmental Safety.2022; 247: 114279. CrossRef
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Journal of Inorganic Biochemistry.2022; 234: 111901. CrossRef
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Bin Zhou, Adrienne Gentry, Qian Xu, Jamie L. Young, Xiaofang Yan, Kelly Pagidas, Yu Yang, Walter H. Watson, Maiying Kong, Lu Cai, Jonathan H. Freedman
Toxicology Reports.2021; 8: 718. CrossRef
Metal Exposures, Noise Exposures, and Audiometry from E-Waste Workers in Agbogbloshie, Ghana
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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

Abstract PDF PubReader ePub

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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Kening Jiang, Adam P. Spira, Nicholas S. Reed, Frank R. Lin, Jennifer A. Deal
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The sound of safety: exploring the determinants of prevention intention in noisy industrial workplaces
Hyeon Jo, Eun-Mi Baek
BMC Public Health.2024;[Epub] CrossRef
Associations of sleep characteristics in late midlife with late-life hearing loss in the Atherosclerosis Risk in Communities-Sleep Heart Health Study (ARIC-SHHS)
Kening Jiang, Adam P. Spira, Rebecca F. Gottesman, Kelsie M. Full, Frank R. Lin, Pamela L. Lutsey, Emmanuel E. Garcia Morales, Naresh M. Punjabi, Nicholas S. Reed, A. Richey Sharrett, Jennifer A. Deal
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Duration and Quality of Sleep and Risk of Self-reported Hearing Loss: The UK Biobank Study
Humberto Yévenes-Briones, Francisco Félix Caballero, Daniela B. Estrada-deLeón, Ellen A. Struijk, Arthur Eumann Mesas, José R. Banegas, Fernando Rodríguez-Artalejo, Esther Lopez-García
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Sohrab Amiri
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Obstructive sleep apnea risk and hearing impairment among occupational noise-exposed male workers
Seunghyeon Cho, Won-Ju Park, Ji-Sung Ahn, Dae-Young Lim, Su-Hwan Kim, Jai-Dong Moon
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Kening Jiang, Adam P Spira, Nicholas S Reed, Frank R Lin, Jennifer A Deal, Lewis Lipsitz
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Andrew J MacGregor, Antony R Joseph, Rachel R Markwald, Amber L Dougherty
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Hashir Aazh, Marja Heinonen-Guzejev, Brian C. J. Moore
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Hashir Aazh, Brian C. J. Moore
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Nathan A. Clarke, Derek J. Hoare, Edward C. Killan
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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

Abstract PDF PubReader ePub

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.

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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;25:8-8. Published online July 3, 2013; DOI: https://doi.org/10.1186/2052-4374-25-8

Abstract PDF PubReader ePub

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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Marwin Li, Natalie M. Perlov, Jena Patel, Dev Amin, Ayan Kumar, Zachary D. Urdang, Thomas O. Willcox, Rebecca C. Chiffer
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Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis
Dialechti Tsimpida, Evangelos Kontopantelis, Darren M. Ashcroft, Maria Panagioti
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Ratnaningtyas Wahyu Kusuma Wardani, Globila Nurika, Indah Lutfiya, Erwin Dyah Nawawinetu
Journal of Vocational Health Studies.2020; 3(3): 89. CrossRef
A systematic review of the impact of cigarettes and electronic cigarettes in otology
S Patel, N Wooles, T Martin
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Dialechti Tsimpida, Evangelos Kontopantelis, Darren Ashcroft, Maria Panagioti
BMJ Open.2019; 9(9): e031030. CrossRef
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Nattagorn Choochouy, Pornpimol Kongtip, Suttinun Chantanakul, Noppanun Nankongnab, Dusit Sujirarat, Susan R Woskie
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T I N Prihatini, N P Adi, S Wibowo
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Dongming Wang, Zhichao Wang, Min Zhou, Wenzhen Li, Meian He, Xiaomin Zhang, Huan Guo, Jing Yuan, Yue Zhan, Kun Zhang, Tao Zhou, Weijia Kong, Weihong Chen
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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

Abstract 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.

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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
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Heonzoo Lee, Sejin Kim, Rayoung Park, Sungsu Lee, Hyong-Ho Cho, Yonggwan Won
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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

Abstract 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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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

Abstract 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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Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. 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

Abstract 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

Abstract 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.

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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

Abstract 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

Abstract 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

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

Abstract 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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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

Abstract 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

Abstract 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

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

Abstract 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

Abstract 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

Abstract 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.

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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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Original Article

The Association of the Serum Magnesium with Hearing Loss Among Noise Exposed Male Workers: Wan Seoup Park, Jong Young Lee, Sang Jae Jung, Jae Young Yoo, Tae Sung Choi, Sung Chul Hong, Sung Chan No; Korean Journal of Occupational and Environmental Medicine 2000;12(1):12-25. Published online March 31, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.1.12

Abstract PDF: OBJECTIVES
This study was conducted to investigate that the chronic noise exposure is associated with decreased serum magnesium concentrations and evaluate whether decreased serum magnesium is associated with noise induced hearing loss.
METHODS
One hundred seventy-eight male workers exposed to noise were selected and classified three groups by the degree of hearing loss. Hearing threshold levels were less than 30 dB at 1,000 Hz or less than 40 dB at 4,000 Hz in group I, more than 30 dB at 1,000 Hz or more than 40 dB at 4,000 Hz and 15 dB and less of pure tone average(PTA: (500 Hz+1,000 Hz+2,000 Hz)/3) in group II, more than 30 dB at 1,000 Hz or more than 40 dB at 4, 000 Hz and over 15 dB of PTA in group III.
RESULTS
Serum magnesium concentrations were 2. 42+/-0. 26 nc/dt in group I, 2. 35+/-0.23 mg(dl in group II, 2.26+/-0.24 ne/dl in group III, respectively and significantly different between group I and group III (p<0. 01). It was negatively correlated with duration of the noise exposure as correlation coefficient(r) of -0.194 (p<0.05). Analysis of the multiple regression on hearing threshold levels showed that serum magnesium, diastolic blood pressure, duration of the noise exposure were statistically significant at 4,000 Hz(p<0.05). While only age was statistically significant at 1,000 Hz(p<0.05).
CONCLUSIONS
These results suggest that chronic noise exposure may induces decrease in serum magnesium concentrations and that its decreased concentration is related with noise induced hearing loss.

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Original Article

Health Effects of Aircraft Noise on Residents Living Near an Airport: Kyung Jong Lee, Jae Beom Park, Jae Yeon Jang, Sun Mi Cho, Se Wi Lee, Jong Goo Kim, Soon Young Lee, Jong Ja Kwak, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 1999;11(4):534-545. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.534

Abstract PDF

Objectives
; This study was conducted to reveal the health effects of aircraft noise on the residents live near the military airport.
METHODS
We sampled systematically 87 residents as the high exposed group, 58 residents as the low exposed group according to the geographical distance from the airport. We also sampled 67 residents as the control group lived far from the airport. Noise levels were measured for conform the exposures. Self-administered questionnaires for symptoms, air conduction hearing threshold level, blood pressure blood cholesterol with health examinations, and SCL-90-R were introduced to get the data from the residents.
RESULTS
The Ld/n at the area near the airport was 72.4 dB, however that of control area was 67. 7 dB. The value of pure tone average, high pure tone average, and threshold of 4,000 Hz were decreased with exposure level significantly. Linear regression analysis showed that the noise exposure level of the airport was related to the hearing threshold at pure tone average, threshold of 4,000 Hz, and high pure tone average. The systemic and diastolic blood pressure showed dose-response relationship with noise exposure. The prevalence of hypertension was higher in exposed group, but not statistically significant. In linear regression, noise level was related to systolic and diastolic blood pressure with other variables such as age, sex, BMI (Body Mass Index), and family history of hypertension. SCL-90-R showed that exposed group had higher score significantly in neurotic and psychologic variable and felt the various somatic symptoms.
CONCLUSIONS
These results suggest that aircraft noise would influence hearing loss at low frequencies as well as 4,000 Hz and higher frequencies, systolic and diastolic blood pressure, and psychological response.

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Influence of noise exposure on cardiocerebrovascular disease in Korea
Myoungjin Oh, Kwangsoo Shin, Kyungah Kim, Jungwoo Shin
Science of The Total Environment.2019; 651: 1867. CrossRef
Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City
Hyunjoo Kim, Sangchul Roh, Ho-Jang Kwon, Ki Chung Paik, Moo-Yong Rhee, Jae-Yun Jeong, Myung Ho Lim, Mi-Jin Koo, Chang-Hoon Kim, Hae Young Kim, Jeong-Hun Lim, Dong-Hyun Kim
Journal of Preventive Medicine and Public Health.2008; 41(5): 307. CrossRef

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Original Article

Comparison of Post-Health Care of Workers with Noise Induced Hearing Loss between Medium Sized Industries and a Large Automobile Industry: Seung Hae Han, Soo Keun Kim; Korean Journal of Occupational and Environmental Medicine 1999;11(2):229-240. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.229

Abstract PDF: In order to compare post-health care between medium sized enterprises(50-300 employees) and a large enterprise(an automobile manufacture plant) and to evaluate factors related to post?health care performance of workers with noise induced hearing loss, this study was carried out. One hundred and eighty nine workers were surveyed to the questionnaire on general and occupational characteristics, receipt of the examination result, perception and attitudes toward special health examination, contentedness with post-health care performance on the examination result and reason not to have post-health care performance. The results were as follows: 1. The employee in large enterprise perform post-health care higher than medium sized enterprises and main control method was taking ear protective device. The 27.5% of workers with NJHL did not perform any post-health care. 2. Comparing with large enterprise, medium-sized enterprises had more interview with workers of NJHL and some enterprises performed more health education and more improvement of working environment. But there were a few medium-sized enterprises which did not provide ear protective device and had indifference manager. 3. The variables that significantly related to the post-health care of manager side was receipt of health examination result(p < 0.05), the post-health care of worker side were size of enterprise, age(p <0.05) and receipt of health examination result(p <0. 1).

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Case Report

Sudden Sensorineural Hearing Loss Caused by Noise Exposure to Intense Sound: Kyoo Sang Kim, Jinsook Kim, Keehyun Park; Korean Journal of Occupational and Environmental Medicine 1998;10(4):618-626. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.618

Abstract PDF

Sudden deafness may be defined as a sensorineural hearing loss that develope over a period of hours or a few days. The severity of the hearing loss may vary from mild to total loss of perception of the most intense sound. The loss of hearing may be permanent, or the hearing may spontaneously return to normal or near normal. Proposed explanations for sudden idiopathic sensorineural loss revolve primarily around viral or vascular etiologies. In addition to noise-induced deafness, which can be divided into a slowly progressive deafness caused by prolonged intense noise exposure and acute acoustic trauma caused by a single exposure to very intense sound. 45- and 52-year-old healthy male smokers with no previous otologic history, noted the acute loss of hearing with tinnitus in his right ear during his unusual intense noise exposed activities. There were no other associated symptoms of dizziness or visual change. After several days without improvement, they presented to the department of otolaryngology. Physical examination, neurologic evaluation, and otorhinolaryngologic examination were essentially within normal limits except for the hearing loss on the right ear. An audiogram revealed a severe primarily sensorineural sensitivity loss on the right. Routine laboratory studies were within normal limits. Two patients denied previous barotrauma, atypical or unusual drug usage, and unusual physical exertion or strain. We observed evidence of cochlear abnormality. The presence of cochlear dysfunction is supported by acoustic reflex threshold and auditory brain-stem response. These findings strengthened the probability of an acoustic trauma origin for the sudden sensorineural hearing loss.

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Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Original Article

The Effects of Knowledge and Attitude about Noise on Hearing Conservation Behavior and Hearing Loss: Jung Wan Koo, Chung Yill Park, Chee Kyung Chung, Kang Sook Lee, Hyeon Woo Yim, Young Gyu Phee, Soon Young Oh, Wan Shik Ham; Korean Journal of Occupational and Environmental Medicine 1998;10(4):476-483. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.476

Abstract PDF

This study was conducted to investigate knowledge and attitude factor related to hearing conservation and to evaluate the effect of knowledge and attitude about noise on hearing conservation behavior and hearing loss among workers exposed to noise. We investigated the questionnaires of knowledge and attitude about noise and hearing conservation behavior and hearing loss among 355 study subjects from March, 1998 to June, 1998. The results were as follows; We extracted following 5 factors from 26 questionnaire items of knowledge and attitude about noise; knowledge of noise and concern to the control noise (factor 1), general perceived susceptibility (factor 2), relative perceived susceptibility compared with colleagues(factor 3), concern to the hearing protective devices(factor 4), concern to the hearing and noise assessment (factor 5). Knowledge and attitude factors affecting the hearing conservation behavior were general perceived susceptibility in the case of wearing hearing protective devices and knowledge of noise and concern to the control noise in the case of suggestion for hearing conservation. But, in the case of intentional avoiding noise exposure, concern to the hearing protective devices was a significant factor with concern to the hearing and noise assessment. Knowledge and attitude factors affecting hearing loss in 1 kHz were relative perceived susceptibility compared with colleagues and concern to the hearing protective devices, and in 4 KHz were relative perceived susceptibility compared with colleagues and general perceived susceptibility.

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Relationship between occupational injuries and the provision of safety and health information: data from the 4th Korean working conditions survey
Ju-il Seo, Gab-Sik Shin, Min Gi Kim, Young-Sun Min
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
The Research of Safety Effects by using a Hearing Protection(Ear Plug) in the Military
Sung Ho Hwang, Myo Kyoung Joo, Jae Bum Park
Journal of the Korean Society of Safety.2013; 28(4): 103. CrossRef
Predictors of Hearing Protection Behavior Among Power Plant Workers
Youngmi Kim, Ihnsook Jeong, Oi-Saeng Hong
Asian Nursing Research.2010; 4(1): 10. CrossRef

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Original Article

The Correlation of Cardiovascular Risk Factors and Hearing Loss: Sung Pil Jung, Soo Young Kim, Tae Yong Lee, Young Chae Cho, Dong Bae Lee; Korean Journal of Occupational and Environmental Medicine 1998;10(2):189-202. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.189

Abstract PDF

To investigate the effects of cardiovascular risk factors on hearing loss, hearing threshold and cardiovascular risk factors such as blood pressure, hematologic values, and serum lipid levels of 3,827 persons who visited the Health Center of a University Hospital in Kumi for health examination from January 1, 1995 to July 31, 1997 were analysed. The results were summarized as follows ; 1. Hearing threshold was shifted highly in both sex groups with age increased. Smoking did not influence increase of hearing loss, but drinking alcohol amount increased hearing threshold when sex was adjusted. The most highly increased hearing threshold showed among farmers group, but next was blue collars group. Hearing threshold increasing basis with BMI increased. 2. Systolic and diastolic blood pressure and hematocrit value increased the hearing threshold in both sex groups, but hemoglobin value did not related to the hearing threshold. 3. Total cholesterol, LDL-cholesterol, triglyceride, and atherosclerosis index were significantly increased with the grade of hearing lose increased, when age was adjusted. 4. In the logistic regression analysis, the atherosclerosis index, age, and hematocrit value revealed risk factors which contributed in that orders, though the values were small they showed statistical significances, but the risks were lowered when hemoglobin values increased, in both sex groups. Consequently, hyperlipidemia was significantly related to the hearing loss when age was adjusted.

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Spatio-temporal Characteristics of the Frequency of Weather Types and Analysis of the Related Air Quality in Korean Urban Areas over a Recent Decade (2007-2016)
Hyeong-Sik Park, Sang-Keun Song, Seung-Beom Han, Seongbin Cho
Journal of Environmental Science International.2018; 27(11): 1129. CrossRef

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Original Article

Comparison of Diagnostic Criteria of Noise Induced Hearing Loss using Special Periodic Health Examination Data in Korea: Joohon Sung, Soo Hun Cho, Daehee Kang, Yeong Su Ju, Mi Na Ha, Ho Jang Kwon, Dork Ro Yun, Sangwhan Han; Korean Journal of Occupational and Environmental Medicine 1996;8(3):509-518. Published online December 31, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.3.509

Abstract PDF

Although noise-induced hearing loss (NIHL) is the most prevalent occupational disease in Korea, only 10% of the diagnosed cases are compensated. Old (1989-94) and current diagnostic criteria, criteria for workers' compensation of NIHL in Korea, compensation formulas of American Medical Association/American association of Ophthalmology and Otolaryngology (AMA/AAOO), the Committee on Hearing, Bio-Acoustics, Biomechanics (CHABA), American Academy of Otolaryngology (AAO) recommendation were compared. Each criterion was applied on the audiomety data of 4044 workers (8023 ears), who had received the second line screening test of Special Periodic Health Examination Program for noise-exposed workers during 1991-2. First, the resulting proportions of NIHL cases by employing each criterion were compared and strength of agreement was measured using kappa value. Temporary Threshold Shift (TTS) was corrected by noise free interval, and the reduction ratio of NIHL cases was calculated. Theoretical progression model of NIHL was reconstructed from previous studies on the natural course of NIHL to evaluate the change of diagnosis result of each criterion in the model. The kappa value between old and current criteria was 0.19, 0.55 for current criteria and workers' corn. criteria, ranging from 0.08 to 0.78, highest coincidence was observed between current criteria and CHABA formula. The current criteria produce most similar results with CHABA formula. If TTS is corrected for NFI, there is about 14 % reduction of NIHL cases. The results of applying on NIHL progression model divided the formulas roughly into 3 groups, of which compensation criteria was the most, old criteria and AAO the least conservative. In conclusion. The result of 4 KHZ audiometry should be excluded in evaluation of hearing level and a new hearing conservation program should be set out. Current diagnostic criteria has an ambiguity in that managerial concept for prevention arid! purpose of compensation is mixed up. The current diagnostic criteria and compensation criteria could be incorporated'into 'a new formula which is based on the state of the art test for estimating everyday hearing disability.

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Noise-induced hearing loss in Asia
Adrian Fuente, Louise Hickson
International Journal of Audiology.2011; 50(sup1): S3. CrossRef

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Original Article

Noise-Induced Temporary Threshold Shift and its Recovery in Industry: Soo Hun Cho, Mi Na Ha, Sang Hwan Han, Young Soo Joo, Ju Hon Sung, Jong Won Kang, Dork Ro Yun, Bong Bin Song, Myung Hag Lee, Seon Tae Kim; Korean Journal of Occupational and Environmental Medicine 1996;8(2):320-329. Published online September 30, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.2.320

Abstract PDF: To determine the recovery time from noise-induced temporary threshold shift (TTS), a prospective field study was conducted at three worksites where workers are known to be exposed high level of noise. Subjects were selected according to answers on a questionnaire which inquired about otological history and previous noise exposure, including avocational, military and occupational exposures. After excluding employees with past otologic problems, recent exposure to high level noise, and under medications, total 92 employees participated in the study. Among 92 participants, complete consecutive audiometric examinations were carried out at 0~2 hours, 5~7 hours, 14~16 hours after worktime noise exposure on 26 participants wearing hearing protectors and 22 participants wearing no protective devices. The difference between the hearing level 0~2 hours after noise exposure and 5~7 hours is statistically significant by paired t-test(p<0.01). The median recovery times calculated from the data of 22 participants wearing no protective hearing devices are 15.6 hours at 4000 Hz, and 7.7 hours, 10.3 hours, 8.4 hours at 1000 Hz, 2000 Hz and 8000 Hz respectively. These data suggest that when measuring the pure tone audiometry for noise exposed workers, at least 16 hours noise-free interval is required.

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