EVALUATION OF HEARING EFFORT IN WORKERS EXPOSED TO HIGH SOUND PRESSURE LEVELS IN A SCHOOL HOSPITAL

• Grant number: 23/09012-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2023
• End date: August 31, 2024
• Field of knowledge: Health Sciences - Speech Therapy
• Principal Investigator: Nelma Ellen Zamberlan Amorim
• Grantee: Juliana da Silva Minetti
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Purpose: to evaluate auditory effort and auditory speech perception in challenging situations in workers exposed to high sound pressure levels. Method: prospective, comparative, cross-sectional contemporary cohort study. The study will be carried out with workers exposed to noise in a teaching hospital and will have as a casuistry 60 individuals active in their activities in sectors of the hospital that are exposed to high sound pressure levels. Individuals will be divided into three groups of both sexes, aged between 18 and 60 years, with 20 participants in Study Group 1 (SG1), 20 participants in Study Group 2 (SG2) and 20 participants in the Control Group (GC), matched by age and sex. The inclusion criteria will be: for EG1, to be a worker exposed to high sound pressure levels 8 hours a day, for more than a year, in the age group of the study, to be a Brazilian Portuguese speaker, to present tonal auditory thresholds within normality standards , up to 25 dB HL, from 250 to 8000 Hz, and good understanding of the instructions provided; for EG2, being a worker exposed to high sound pressure levels 8 hours a day, for more than one year, in the age group of the study, being a Brazilian Portuguese speaker, having sensorineural hearing loss in at least one of the 250 frequencies at 8000Hz, bilaterally, and good understanding of the instructions. Individuals matched by sex and age to the EG will participate in the CG, with normal hearing, without exposure to high sound pressure levels in the work environment, with tonal auditory thresholds within the normal range, up to 25 dB, from 250 to 8000 Hz, without having difficulty understanding speech in noise, good understanding of instructions and no exposure to noise. The exclusion criteria: withdrawal from the evaluation process, individuals with difficulties in performing the speech perception test even without diagnosed hearing disorders, neurological and/or verbal fluency disorders, presence of a history of ear pathologies average, cerumen plug or difficulties in understanding sentences. Specifically, for the CG and EG1: adults or elderly people with hearing loss and complaints of difficulty understanding speech in noise. For EG2: adults or elderly, with mixed or conductive hearing loss and unilateral losses. The study will be carried out in two stages. In step 1, the following will be carried out: investigation of the environmental analysis and the auditory and extra-auditory effects on the worker's health (only EG); clinical interview; basic audiological assessment; in step 2: Assessment of speech perception - application of HINT sentences in silence and in the presence of noise with simultaneous recording of the auditory effort. The registration of the auditory effort during the performance of the "Speech perception test", when applied with and without competitive noise, will be carried out through subjective and objective evaluation. For the subjective evaluation, a visual analogue scale will be used, based on the participant's identification of "Show how difficult it was to perform the test?" For objective evaluation, pupillometry will be used. Data analysis: to analyze the data, the statistical program SPSS and Excel spreadsheets will be used. In the first stage, to characterize the work environments, tables and graphs will be prepared indicating the environments of the production sectors with the highest and lowest levels of sound pressure, presenting the values with descriptive measures such as mean, median, maximum noise level reached and minimum level of noise. For comparison of proportions, the Chi-square test or Fisher's exact test will be used, when necessary. To compare continuous or orderable measures between two groups, the Mann-Whitney test will be used, and the Kruskal-Wallis test will be used between 3 groups. To verify the linear association between the measurements, the Sperman correlation coefficient will be used. The significance level adopted will be 5% (0.05)