The effects of occupational noise exposure and age (Shehabi et al., 2023)

Purpose: Many workers in developing countries are exposed to unsafe occupational noise due to inadequate health and safety practices. We tested the hypotheses that occupational noise exposure and aging affect speech-perception-in-noise (SPiN) thresholds, self-reported hearing ability, tinnitus presence, and hyperacusis severity among Palestinian workers. Method: Palestinian workers (N = 251, aged 18–70 years) without diagnosed hearing or memory impairments completed online instruments including a noise exposure questionnaire; forward and backward digit span tests; hyperacusis questionnaire; the short-form Speech, Spatial and Qualities of Hearing Scale (SSQ12); the Tinnitus Handicap Inventory; and a digits-in-noise (DIN) test. Hypotheses were tested via multiple linear and logistic regression models, including age and occupational noise exposure as predictors, and with sex, recreational noise exposure, cognitive ability, and academic attainment as covariates. Familywise error rate was controlled across all 16 comparisons using the Bonferroni–Holm method. Exploratory analyses evaluated effects on tinnitus handicap. A comprehensive study protocol was preregistered. Results: Nonsignificant trends of poorer SPiN performance, poorer self-reported hearing ability, greater prevalence of tinnitus, greater tinnitus handicap, and greater severity of hyperacusis as a function of higher occupational noise exposure were observed. Greater hyperacusis severity was significantly predicted by higher occupational noise exposure. Aging was significantly associated with higher DIN thresholds and lower SSQ12 scores, but not with tinnitus presence, tinnitus handicap, or hyperacusis severity. Conclusions: Workers in Palestine may suffer from auditory effects of occupational noise and aging despite no formal diagnosis. These findings highlight the importance of occupational noise monitoring and hearing-related health and safety practices in developing countries. Supplemental Material S1. The findings of the original multiple regression models for all primary and secondary outcome measures treating both occupational noise exposure and age as continuous predictor variables. Supplemental Material S2. Clinical and Demographic Questionnaire (Arabic) Supplemental Material S3. Noise exposure questionnaire (Arabic) Supplemental Material S4. SSQ12 Questionnaire (Arabic) Supplemental Material S5. Tinnitus handicap inventory (Arabic) Supplemental Material S6. Khalfa hyperacusis questionnaire (Arabic) Supplemental Material S7. The distribution of occupational noise exposure scores across all study participants. Shehabi, A. M., Prendergast, G., Guest, H., & Plack, C. J. (2023). Noise exposure in Palestinian workers without a diagnosis of hearing impairment: Relations to speech-perception-in-noise difficulties, tinnitus, and hyperacusis. Journal of Speech, Language, and Hearing Research, 66(3), 1085–1109. https://doi.org/10.1044/2022_JSLHR-22-00461研究目的：发展中国家的诸多劳动者因健康与安全规范不完善，暴露于不安全的职业噪声环境中。本研究验证两项假设：职业噪声暴露与衰老会影响巴勒斯坦劳动者的噪声下言语感知（speech-perception-in-noise, SPiN）阈值、自我报告听力能力、耳鸣（tinnitus）患病率以及听觉过敏（hyperacusis）严重程度。 研究方法：本研究纳入251名巴勒斯坦劳动者（年龄18~70岁），所有受试者均未被诊断为听力或记忆障碍。受试者完成线上测评工具，包括噪声暴露问卷、顺向与逆向数字广度测试、听觉过敏（hyperacusis）问卷、简化版言语、空间与听力质量量表（short-form Speech, Spatial and Qualities of Hearing Scale, SSQ12）、耳鸣残障量表（Tinnitus Handicap Inventory）以及噪声下数字识别（digits-in-noise, DIN）测试。研究采用多元线性与逻辑回归模型验证假设，以年龄、职业噪声暴露作为预测变量，以性别、休闲噪声暴露、认知能力与受教育程度作为协变量，并通过邦费罗尼-霍尔姆法（Bonferroni–Holm method）控制16项比较的家族错误率。探索性分析评估了自变量对耳鸣残障的影响。本研究的完整试验方案已预先注册。 研究结果：研究观察到，随着职业噪声暴露水平升高，受试者的SPiN表现更差、自我报告听力能力下降、耳鸣患病率升高、耳鸣残障程度加重以及听觉过敏严重程度增加，但上述趋势均未达到统计学显著性。其中，职业噪声暴露水平更高可显著预测更严重的听觉过敏症状。衰老则与更高的DIN阈值、更低的SSQ12得分显著相关，但与耳鸣患病率、耳鸣残障程度或听觉过敏严重程度无显著关联。 研究结论：巴勒斯坦的劳动者即便未被正式诊断出听力异常，仍可能受到职业噪声与衰老带来的听觉功能损害。本研究结果凸显了发展中国家开展职业噪声监测以及落实听力相关健康与安全规范的重要性。 补充材料： S1：所有将职业噪声暴露与年龄作为连续预测变量的主、次要结局指标的原始多元回归模型结果。 S2：临床与人口学问卷（阿拉伯语） S3：噪声暴露问卷（阿拉伯语） S4：SSQ12量表（阿拉伯语） S5：耳鸣残障量表（阿拉伯语） S6：Khalfa听觉过敏问卷（阿拉伯语） S7：所有研究受试者的职业噪声暴露得分分布情况。 引用文献：Shehabi, A. M., Prendergast, G., Guest, H., & Plack, C. J. (2023). 无听力损伤诊断的巴勒斯坦劳动者的噪声暴露：与噪声下言语感知困难、耳鸣及听觉过敏的关联. 《言语、语言与听力研究杂志》, 66(3), 1085–1109. https://doi.org/10.1044/2022_JSLHR-22-00461