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Screening for Noise Induced Hearing Loss Among Military Personnel In Eastern Province Saudi Arabia

Brig. Gen. Dr. Saud Al-Saif ORL-H&N surgery consultant, ORL-H&N surgery Department technical and medical director of the eastern province military hospitals director

King Fahad Military Medical Complex, Dhahran, KSA.

Dr. Mohamed M. Abdeltawwab Audiological Physician, ORL Department, King Fahad Military Medical Complex, Dhahran, KSA.

Brig. Gen. Dr. Saud Al-Saif King Fahad Military Medical Complex Email: dralsaif@hotmail.com Phone: +966505613888

Contact • Shulman J. B., Lambert P. R., Goodhill V. (2000). Acoustic Trauma and Noise-induced Hearing Loss. In, The Ear: Comprehensive Otology,

Rinaldo F. Canalis and Paul R. Lambert, Eds. Lippincott Williams & Wilkins. • American Academy of Audiology. (2003). Preventing Noise-Induced Occupational Hearing Loss. Retrieved March 3, 2007. • Dobie R. A. (1998). Noise-Induced Hearing Loss. In, Head and Neck Surgery-Otolaryngology, Second Edition, Byron J. Baily, ed. Lippincott-

Raven Publishers. • Dobie R.A. (1995). Prevention of Noise-Induced Hearing Loss. Archives of Otolaryngology-Head and Neck Surgery.121; 4: 385-391. • Pourbakht A., Yamasoba T. (2003). Cochlear damage caused by continuous and intermittent noise exposure. Hear Res. Apr 178(1-2): 70-8. • Abrashkin K.A., Izumikawa M., Miyazawa T., et al. (2006). The fate of outer hair cells after acoustic or ototoxic insults. Hear Res. Aug; 218(1-

2): 20-9. • Morata T. C. (1998). Assessing occupational hearing loss: beyond noise exposure. Scand Audiol Suppl.; 48: 111-6. • Occupational Safety & Health Administration. (2002). Hearing Conservation. Retrieved March 3, 2007. • Gelfand, S. (2001). Auditory System and Related Disorders. Essentials of Audiology: Second Edition (p. 202). New York: Thieme. • Rösler, G. (1994). Progression of Hearing Loss Caused by Occupational Noise. Scandinavian Audiology 23, 13-37.

References

The objective of this study is to determine the effect of noise exposure on hearing sensitivity of the screened study group, analysis of questionnaire of noise exposure and to compare between hearing impairment in different noise exposure categories. The screening study included 1879 subjects from the land force, air force, air defense and the navy. The screening procedure consists of two parts; First, a noise exposure survey filled by the study group then screening air conduction pure tone audiogram was done for each participant. Patients who did not pass the audiogram were referred further evaluated. The participants’ average duration of duty was 10.26 ± 8.06 years and 33.9 % of them were cigarette smokers. 10% of the total number of participants did not pass the audiogram and they were referred to audiology clinic. This hearing loss could be minimized with the proper use of the hearing protective devices on exposure to intense noise level.

Abstract

The results of the study are summarized in the charts below:

Introduction

1879 subjects are evaluated among military personnel in the eastern province of Saudi Arabia. 860 land force,358 air force, 378 air defense,283 from navy. They are asked to fill a questionnaire in Arabic (noise exposure survey), asking about the duration of service, smoking habit and questions related to exposure to noise and the use of hearing protective devices, history of ear problems and family history of hearing loss . Patient who did not pass the screening air conduction pure tone audiogram were referred to the ENT and audiology unit for further evaluation, complete history, otological examination, tympanometry and OAEs Statistical analysis was done using test of correlation between different groups and the mean and standard deviation. Value considered of statistical value when P < 0.05 and statistical non-significant when P > 0.05.

Methods and Materials

The percentage of abnormal audiogram was 10% in this study for the effect of basic military training 188 out of 1879 of the high-risk noise exposed subjects had high frequencies hearing loss. The percentage of affection in different categories were 10.8 % for the land forces, 8.9 % for the air force, 4.7% in air defense and it was 15.9 % for the navy. This hearing loss could be minimized with the proper use of the hearing protective devices on exposure to intense noise. In a study by Teo et al., 2008, the percentage of abnormal audiogram was 9.4 % in study for the effect of basic military training on hearing in Singapore Armed Force. In this study there were significant correlation between the use of hearing protective devices and the decrease of the possibility of NIHL.It was also noticed that there was significant correlation between the affection in hearing and the subjective symptomatology of the ear as tinnitus and vertigo. Veterans are at particular risk for noise induced hearing loss due to noise associated with military service (Price et al., 1989). there is a direct relation between a positive family history of hearing loss and higher chances for military personal hearing to be affected. 9.6 % of the total affected subjects have a positive family history of hearing loss.

Discussion

Noise induced hearing loss is preventable complication of exposure to the high sounds by the proper use of the hearing protective devices. The high risk military personnel should be educated about the importance of the hearing protective devices. It is mandatory to have frequent audiological evaluation for veteran to establish baseline hearing threshold and to follow them for any abnormality due to noise exposure.

Conclusions

Results

Noise-induced hearing loss (NIHL) is an increasingly prevalent disorder that results from exposure to high-intensity sounds, especially over a long period of time.[1] According to a position statement released by the American Academy of Audiology in 2003, it is a preventable hearing disorder that affects people of all ages and demographics.[2] The average, otherwise healthy, person will have essentially normal hearing at least up to age 60 if his or her ears are not exposed to high noise levels.[3]

Figure 6. the number of the screened subjects vs. affected in different categories

Figure 7. The number of smoker vs. non-smoker in different categories of the study group.

Figure 8. the number of screened subjects with history of visiting ENT clinic.

Figure 2. Survey participants military sectors Figure 1. Outreach to the field with a fully equipped mobile ENT unit

Figure 9. The number of the screened subjects shared in firearm training.

Figure 10. Hearing protection devices knowledge, use and availability.

Figure 11. Exposure to high noise

Figure 12. History of hearing loss and other ear complains

Figure 13. Family history of hearing loss and the affect of NIHL

Figure 3. The questioner (Arabic)

Translation: General information about the participant and the duration of service. 1. Have you ever been to the ENT clinic, if so have

you had an audiology test, if so what was the result?

2. Do you participate in any firearm activities? 3. Do you know about hearing protection devices? 4. If so, do you use any hearing protection

devices? 5. Does your unit supple any hearing protection

devices? 6. Are you exposed to high noise? 7. Do you have any hearing loss? 8. Do you have any other hearing related issues

such as vertigo and tinnitus? 9. Does anyone of your family members has the

same complication ? Figure 4. Hearing Protection Devices Figure 5. The questioner (English)

• Chen, & Tsai. (2003). Hearing Loss among Workers at an Oil Refinery in Taiwan. Archives of environmental health, 58(1), 55-58. • Arslan E., Orzan E (1998). Audiological management of noise induced hearing loss. Scand Audiol Suppl., 48: 131-45. • Teo KJ, Chia SE, Tan TC, Ali SM. Effect of basic military training on hearing in Singapore Armed Forces. Singapore Med J 2008; 49 (3): 243-

246. • Humes L.E., Joellenbeck L.M., & Durch J.S. (Eds). (2005). Noise and military service: Implication for hearing loss and tinnitus. Washington,

DC: National Academies Press. • Johnson C.D. (2002). Hearing and immittance screening. In J. Katz (Ed.)., Handbook of clinical audiology (5th ed., pp. 481-494). Philadelphia:

Lippincott, Williams & Wilkins. • Price GR, Kim HN, Lim DJ, Dunn D. Hazard from weapons impulses: histological and electrophysiological evidence. J Acoustic Soc Am. 1989;

85: 1245-54. • Mc Bride DJ, Williams S. Audiometric notch as a sign of noise induced hearing loss. Occup Environ Med. 2001; 58: 46-51. • Spooendlin HH. Anatomical changes following various noise exposures. In: Henderson D, Hamernik RP, Dosanjh DS, Mills J, editors. Effects of

noise on hearing. New York: Raven Press; 1976. P. 69-90. • Humes LE, Joellenbeck LM, & Durch JS. (2006). Institute of Medicine of the National Academies, Noise and Military Service Implications for

Hearing Loss and Tinnitus. In: Humes LE, Joellenbeck LM, Durch JS, editors. Washington, DC: The National Academy Press; 2006.