11. |
- Fredriksson, Sofie, 1983, et al.
(author)
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The effect of occupational noise exposure on tinnitus and sound-induced auditory fatigue among obstetrics personnel: a cross-sectional study.
- 2015
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In: BMJ Open. - : BMJ. - 2044-6055. ; 5:3
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Journal article (peer-reviewed)abstract
- Objective There is a lack of research on effects of occupational noise exposure in traditionally female-dominated workplaces. Therefore, the aim of this study was to assess risk of noise-induced hearing-related symptoms among obstetrics personnel. Design A cross-sectional study was performed at an obstetric ward in Sweden including a questionnaire among all employees and sound level measurements in 61 work shifts at the same ward. Participants 115 female employees responded to a questionnaire (72% of all 160 employees invited). Main outcome measures Self-reported hearing-related symptoms in relation to calculated occupational noise exposure dose and measured sound levels. Results Sound levels exceeded the 80dB LAeq limit for protection of hearing in 46% of the measured work shifts. One or more hearing-related symptoms were reported by 55% of the personnel. In logistic regression models, a significant association was found between occupational noise exposure dose and tinnitus (OR=1.04, 95% CI 1.00 to 1.09) and sound-induced auditory fatigue (OR=1.04, 95% CI 1.00 to 1.07). Work-related stress and noise annoyance at work were reported by almost half of the personnel. Sound-induced auditory fatigue was associated with work-related stress and noise annoyance at work, although stress slightly missed significance in a multivariable model. No significant interactions were found. Conclusions This study presents new results showing that obstetrics personnel are at risk of noise-induced hearing-related symptoms. Current exposure levels at the workplace are high and occupational noise exposure dose has significant effects on tinnitus and sound-induced auditory fatigue among the personnel. These results indicate that preventative action regarding noise exposure is required in obstetrics care and that risk assessments may be needed in previously unstudied non-industrial communication-intense sound environments.
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12. |
- Fredriksson, Sofie, 1983, et al.
(author)
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The effect of occupational noise on hearing-related symptoms - exploring mediating and modifying effect of annoyance and stress
- 2017
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In: Proceedings of the 12th ICBEN Congress on Noise as a Public Health Problem (Vol. 6, pp. 18-22)..
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Conference paper (peer-reviewed)abstract
- ABSTRACT Noise-induced hearing disorder is under reported in female-dominated occupations, hindering knowledge on associated risk factors. We performed a cross-sectional study in Sweden, including 4,718 female preschool teachers and 4,122 randomly selected women age 24-65. In hypothesised causal models, we explored the effect of occupational noise exposure (e.g. self-reported retrospective and current exposure, hearing protection) on hearing-related symptoms (hearing loss, speech perception, tinnitus, hyperacusis, soundinduced auditory fatigue). Noise annoyance, job-stress and stress response were assessed for mediating and modifying effects. Exposure to occupational noise significantly increased the risk of hearing-related symptoms among preschool teachers (RRs 1.19-1.42 in adjusted log-binomial regression models). Consistent with our hypothesis, annoyance mediated the effect of noise exposure on soundinduced auditory fatigue (indirect effect β=0.28). In contrast, annoyance modified the effect of noise exposure on both hyperacusis and speech perception. For sound-induced auditory fatigue and hyperacusis, job-stress exposure and stress response both modified the effect and significantly interacted with noise exposure. The models provide better understanding of possible mechanisms for developing hearing-related symptoms. These findings will be further explored using longitudinal design.
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13. |
- Fredriksson, Sofie, 1983, et al.
(author)
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The Impact of Occupational Noise Exposure on Hyperacusis: a Longitudinal Population Study of Female Workers in Sweden.
- 2021
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In: Ear and Hearing. - 1538-4667. ; 43:4, s. 1366-1377
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Journal article (peer-reviewed)abstract
- The aim was to assess the risk of hyperacusis in relation to occupational noise exposure among female workers in general, and among women working in preschool specifically.A retrospective longitudinal study was performed. Survey data were collected in 2013 and 2014 from two cohorts: randomly selected women from the population in region Västra Götaland, Sweden, and women selected based on having received a preschool teacher degree from universities in the same region. The final study sample included n = 8328 women born between 1948 and 1989. Occupational noise exposure was objectively assigned to all time periods from the first to the last reported occupation throughout working life, using the Swedish Job-Exposure Matrix (JEM) with three exposure intervals: <75 dB(A), 75 to 85 dB(A), and >85 dB(A). The JEM assigns preschool teachers to the 75 to 85 dB(A) exposure interval. The outcome hyperacusis was assessed by self-report using one question addressing discomfort or pain from everyday sounds. In the main analysis, a hyperacusis event was defined by the reported year of onset, if reported to occur at least a few times each week. Additional sensitivity analyses were performed using more strict definitions: (a) at least several times each week and (b) every day. The risk (hazard ratio, HR) of hyperacusis was analyzed in relation to years of occupational noise exposure, using survival analysis with frailty regression modeling accounting for individual variation in survival times which reflect, for example, noise exposure during years prior to onset. Occupational noise exposure was defined by the occupation held at year of hyperacusis onset, or the occupation held at the survey year if no event occurred. Models were adjusted for confounders including age, education, income, family history of hearing loss, and change of jobs due to noise.In total, n = 1966 hyperacusis events between 1960 and 2014 were analyzed in the main analysis. A significantly increased risk of hyperacusis was found among women working in any occupation assigned to the 75 to 85 dB(A) noise exposure group [HR: 2.6, 95% confidence interval (CI): 2.4-2.9], compared with the reference group <75 dB(A). The risk was tripled among preschool teachers specifically (HR: 3.4, 95% CI: 3.0-3.7), with the crude Kaplan-Meier curve showing a higher rate of onset early in the working life in preschool teachers compared with all the other exposure groups. The risk was increased, but not statistically significant in the main analysis, for the highest exposure group >85 dB(A), where only six hyperacusis events were identified (HR: 1.4, 95% CI: 0.6-3.1). In the sensitivity analysis, where hyperacusis was defined as occurring every day, the HR was significant also in the highest exposure group (HR: 3.8, 95% CI: 1.4-10.3), and generally slightly higher in the other exposure groups compared to the main analysis.This study indicates increased risk of hyperacusis already below the permissible occupational noise exposure limit in Sweden (85 dB LAeq,8h) among female workers in general, and in particular among preschool teachers. Prospective studies and less wide exposure intervals could confirm causal effects and assess dose-response relationships, respectively, although this study at present suggest a need for risk assessment, improved hearing prevention measures, and noise abatement measures in occupations with noise levels from 75 dB(A). The results could also have implications for management of occupational disability claims.
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14. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Validating self-reporting of hearing-related symptoms against pure-tone audiometry,otoacoustic emission, and speech audiometry
- 2016
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In: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 55:8, s. 454-62
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Journal article (peer-reviewed)abstract
- Objective: To validate self-reported hearing-related symptoms among personnel exposed to moderately high occupational noise levels at an obstetrics clinic. Design: Sensitivity, specificity, and predictive values were calculated for questionnaire items assessing hearing loss, tinnitus, sound sensitivity, poor hearing, difficulty perceiving speech, and sound-induced auditory fatigue. Hearing disorder was diagnosed by pure-tone audiometry, distortion Product otoacoustic emissions, and HINT (Hearing In Noise Test). Study sample: Fifty-five female obstetrics personnel aged 22–63 participated; including 26 subjects reporting hearing loss, poor hearing, tinnitus, or sound sensitivity, and 29 randomly selected subjects who did not report these symptoms. Results: The questionnaire item assessing sound-induced auditory fatigue had the best combination of sensitivity 85% (95% CIs 56 to 100%)and specificity 70% (95% CIs 55 to 84%) for hearing disorder diagnosed by audiometry or otoacoustic emission. Of those reporting sound-induced auditory fatigue 71% were predicted to have disorder diagnosed by otoacoustic emission. Participants reporting any hearing-related symptom had slightly worse measured hearing. Conclusions: We suggest including sound-induced auditory fatigue in questionnaires for identification of hearing disorder among Healthcare personnel, though larger studies are warranted for precise estimates of diagnostic performance. Also, more specific and accurate hearing tests are needed to diagnose mild hearing disorder.
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15. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Working in preschool increases the risk of hearing-related symptoms: a cohort study among Swedish women
- 2019
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:8, s. 1179-90
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Journal article (peer-reviewed)abstract
- © 2019, The Author(s). Purpose: To assess whether working in preschools increases the risk of hearing-related symptoms and whether age, occupational noise, and stressful working conditions affect the risk. Methods: Questionnaire data on hearing-related symptoms were analysed in women aged 24–65 (4718 preschool teachers, and 4122 randomly selected general population controls). Prevalence and risk ratio (RR) of self-reported hearing loss, tinnitus, difficulty perceiving speech, hyperacusis and sound-induced auditory fatigue were assessed by comparing the cohorts in relation to age and self-reported occupational noise and stressful working conditions (effort–reward imbalance and emotional demands). RR was calculated using log-binomial regression models adjusted for age, education, income, smoking, hearing protection, and leisure noise. Incidence rates and incidence rate ratios (IRR) were calculated for retrospectively reported onset of all symptoms except sound-induced auditory fatigue. Results: Compared to the controls, preschool teachers had overall more than twofold RR of sound-induced auditory fatigue (RR 2.4, 95% confidence interval 2.2–2.5) and hyperacusis (RR 2.3, 2.1–2.5) and almost twofold for difficulty perceiving speech (RR 1.9, 1.7–2.0). Preschool teachers had a threefold IRR of hyperacusis (IRR 3.1, 2.8–3.4) and twofold for difficulty perceiving speech (IRR 2.4, 2.2–2.6). Significantly although slightly less increased RR and IRR were observed for hearing loss and tinnitus. RR and IRR were generally still increased for preschool teachers when stratified by age and occupational exposure to noise and stress. Conclusions: This large cohort study showed that working as preschool teacher increases the risk of self-reported hearing-related symptoms, indicating a need of preventative measures.
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16. |
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17. |
- Gyllensten, Kristina, 1977, et al.
(author)
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Nurses’ and preschool teachers’ experiences of taking part in a participatory intervention project in communication-intense working environments
- 2022
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In: WORK: A Journal of Prevention, Assessment & Rehabilitation. - : IOS Press. - 1051-9815 .- 1875-9270. ; 73:3, s. 857-869
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Journal article (peer-reviewed)abstract
- Abstract BACKGROUND: Noise is a common workplace problem that can affect health and performance. High sound levels have been found in sectors that largely has been overlooked in noise research such as health care and education. In these communication-intense environments the work requires speech communication, thus making it difficult to wear hearing protection. OBJECTIVE: To explore nurses’ and preschool teachers’ experiences of taking part in a participatory intervention project aiming to improve the sound environment and the psychosocial work environment. METHODS: One preschool and one obstetrics ward took part in the study, and a qualitative design was used to evaluate the experience of the participatory intervention approach. RESULTS: Five main themes were found in the analysis: Awareness; Taking control of the sound environment; Influence of the building and interior design; Circumstances influencing the intervention process; and Motivation to maintain change. CONCLUSIONS: Despite demanding working situations and lack of financial resources, preschool and obstetrics staff described being creative in planning and implementing several different solutions to improve the sound environment at their workplaces, while interventions specifically improving the psychosocial work environment were fewer. Hence, our study suggest that a participatory intervention approach may facilitate participation and motivation, but resources and support are needed for a comprehensive and effective implementation.
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18. |
- Gyllensten, Kristina, 1977, et al.
(author)
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The experience of noise in communication-intense workplaces : a qualitative study
- 2023
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In: PLOS ONE. - : PLOS. - 1932-6203. ; 18:1
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Journal article (peer-reviewed)abstract
- Objective: The aim of the study was to explore and describe how workers in communication-intenseworkplaces in health care and preschools experience the sound environment. The depen-dence on vocal communication and social interaction poses a challenge using hearing pro-tection in these working environments.Method: A qualitative method was used, more specifically inductive thematic analysis was used, asthis approach was deemed suitable to explore the staff’s experiences of the sound environ-ment. Data were collected by interviews and to increase trustworthiness, several researcherswere involved in the data collection and analysis.Study sample: Workers from two preschools, one obstetrics ward and one intensive care unit took part inthe study.Results: Four main themes emerged from the thematic analysis: A challenging and harmful soundenvironment; Health-related effects of a challenging and harmful sound environment; Agood sound environment is not prioritised; and Resourceful and motivated staff.Conclusions: Workers in communication-intense workplaces in preschools, obstetrics care and intensivecare reported that there was a relationship between the sound environment and negativehealth effects. In addition, the results suggests that the high motivation for change amongstaff should be utilised together with an increased prioritization from the management toreach innovative context specific improvements to the sound environment in communicationintense working environments.
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19. |
- Persson Waye, Kerstin, 1959, et al.
(author)
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A Screening Approach for Classroom Acoustics Using Web-Based Listening Tests and Subjective Ratings
- 2015
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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 10:1
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Journal article (peer-reviewed)abstract
- Background Perception of speech is crucial in school where speech is the main mode of communication. The aim of the study was to evaluate whether a web based approach including listening tests and questionnaires could be used as a screening tool for poor classroom acoustics. The prime focus was the relation between pupils' comprehension of speech, the classroom acoustics and their description of the acoustic qualities of the classroom. In total, 1106 pupils aged 13-19, from 59 classes and 38 schools in Sweden participated in a listening study using Hagerman's sentences administered via Internet. Four listening conditions were applied: high and low background noise level and positions close and far away from the loudspeaker. The pupils described the acoustic quality of the classroom and teachers provided information on the physical features of the classroom using questionnaires. In 69% of the classes, at least three pupils described the sound environment as adverse and in 88% of the classes one or more pupil reported often having difficulties concentrating due to noise. The pupils' comprehension of speech was strongly influenced by the background noise level (p<0.001) and distance to the loudspeakers (p<0.001). Of the physical classroom features, presence of suspended acoustic panels (p<0.05) and length of the classroom (p<0.01) predicted speech comprehension. Of the pupils' descriptions of acoustic qualities, clattery significantly (p<0.05) predicted speech comprehension. Clattery was furthermore associated to difficulties understanding each other, while the description noisy was associated to concentration difficulties. The majority of classrooms do not seem to have an optimal sound environment. The pupil's descriptions of acoustic qualities and listening tests can be one way of predicting sound conditions in the classroom.
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20. |
- Persson Waye, Kerstin, 1959-, et al.
(author)
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Preschool teachers' perspective on how high noise levels at preschool affect children's behavior
- 2019
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In: PLOS ONE. - : PLOS. - 1932-6203. ; 14:3
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Journal article (peer-reviewed)abstract
- Early-age exposure to noise may have long-term health implications of which we have little knowledge of today. Age-specific hearing, learning inadequate coping strategies, and alterations in biological stress regulatory responses could play a role in the long-term health impacts. In Sweden about half a million children in the age between 1-5 years attend preschool. The noise exposure at preschools is intermittent and unpredictable and levels reach up to 84 dB LAeq (time indoors) with maximum levels of 118 dB LAF, mostly due to child activity. To increase the overall understanding of the possible implications of preschool noise environments for children, this paper describes children's behavioral and emotional reactions to and coping with their everyday sound environment from a teachers perspective. A postal questionnaire study performed in 2013-2014 with answers from 3,986 preschool teachers provided the data. Content analysis was combined with quantitative analysis. Eighty-two percent of the personnel considered that children's behavior was affected rather or very much by preschool noise. The most prevalent behaviors were categorized into: be heard, be distracted, show negative internal emotions, crowd, avoid, withdraw, be exhausted, and learning. The quantitative analyses confirmed an association between the perceived loudness and noise annoyance at preschool and affirmative reporting on noise affecting the children's behavior. Age of the personnel, with the youngest age group reporting noise related behavior less often, and age distribution of the class, with 1-5 years old seeming less affected by noise, were also indicated, while pedagogic orientation was not a significant factor. Future studies should address the long-term health effects of these behaviors.
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