Audiological findings of family farmers exposed to pesticides

PURPOSE

To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides.

METHODS

Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions.

RESULTS

Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group.

CONCLUSION

There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

Auditory and Vestibular Findings in Brazilian Adults Affected by COVID-19: An Exploratory Study

INTRODUCTION

The aim of the study was to describe auditory and vestibular findings in Brazilian adults after COVID-19 in a municipality from the outskirts of the São Paulo state.

METHODS

This was a transversal and exploratory study comprising sixteen participants infected by the SARS-CoV-2 virus, confirmed through RT-PCR detection, aged 20 to 55 years. Subjects underwent anamnesis, vestibular and auditory testing. Fisher's exact test was used to evaluate medication use, chemical and physical exposure, and occupational risk and McNemar test was used to compare auditory and vestibular symptoms pre- and post-COVID-19.

RESULTS

Most patients were women (75%) and had been exposed to the virus over 90 days before testing (50%). 18.8% used hydroxychloroquine, 68.8% used ivermectin, and 87.5% used azithromycin to treat COVID-19. Auditory complaints were reported by 31.2% and vestibular by 18.7%. There was no statistical difference before and after the disease. Other reported symptomatology was hair loss, pain, fatigue, memory loss, difficulty to concentrate, and headache. Auditory findings were relevant in contralateral acoustic reflex, in the distortion-product otoacoustic emissions, and in the brainstem auditory evoked potential, characterizing a neurosensorial compromise. 43.74% of patients had altered vectonystagmography. When comparing both ears, no statistical relevance was found; however, when results were crossed with medication use and exposures, there was statistical relevance in the amplitude of the V wave for medications and absolute latency of the V wave to exposure to physical agents.

DISCUSSION/CONCLUSION

This study demonstrated auditory and vestibular findings of neurosensorial nature, considering hearing and of a peripheral vestibulopathy. As it is a study of transversal nature, it is not possible to extend results to general population; yet it may be a finding to future studies.

Findings on the Central Auditory Functions of Endemic Disease Control Agents

This study aimed to assess the central auditory functions of endemic disease control agents. This cross-sectional cohort study comprised two groups: the exposed group, with 38 male endemic disease control agents with simultaneous occupational noise and pesticide exposure; and the control group, with 18 age- and sex-matched workers without occupational noise and/or pesticide exposure. All participants underwent pure-tone audiometry, brainstem auditory evoked potentials, dichotic digits test, and transient-evoked otoacoustic emissions suppression effect. There was a significant inter-group difference in waves III and V absolute latencies, and interpeak I-III and I-V latencies bilaterally, with worse results found in the exposed group. Abnormal dichotic digits test results occurred more often in the exposed group, with a significant association between pesticide- and noise-exposure and the abnormal results (p = 0.0099). The transient-evoked otoacoustic emissions with suppression effect did not yield significant inter-group differences. It was concluded that pesticide and noise exposure induce harmful effects on the central auditory functions, particularly on the brainstem and figure-ground speech-sound auditory skills.

Audição em fumantes: uma revisão

RESUMO Dentre os fatores que influenciam o aparecimento de alterações auditivas pode-se citar o tabagismo, já que estudos revelam que o uso do tabaco pode causar um efeito ototóxico na audição. O objetivo do presente estudo foi analisar as produções científicas sobre o efeito do cigarro no sistema auditivo. A metodologia constou de levantamento dos periódicos indexados nas bases de dados, e foram incluídos na revisão de literatura os artigos científicos nacionais e internacionais, publicados em língua portuguesa ou inglesa, entre os anos de 2009 a 2016. Posteriormente a seleção e análise dos artigos na íntegra, foram classificados de acordo com a sua natureza, caracterizando-os em cinco categorias: base de dados, título do artigo científico, autor, ano e país da publicação. Em seguida, foram analisados os critérios utilizados pelos autores dos respectivos artigos, levando em consideração a amostra populacional, a faixa etária e o sexo. Por fim, foram feitas as análises dos exames auditivos utilizados em fumantes e os critérios de exclusão de cada estudo. Assim, por meio dos estudos publicados conclui-se que o uso do tabaco influencia no aparecimento de perda auditiva, prejudicando principalmente os limiares auditivos das altas frequências e inclusive a transmissão neural da informação auditiva.

Evoked otoacoustic emissions in workers exposed to noise: A review

INTRODUCTION

 The otoacoustic emissions test is an essential tool in the evaluation of auditory function, since it allows the early detection of cochlear damage of occupational origin.

OBJECTIVE

 To present a review of the literature and analyze the effectiveness of the clinical application of the otoacoustic emissions test in workers exposed to noise.

METHODS

 A bibliographical search covering a period of 10 years was performed in the Virtual Health Library including published articles in national and international journals indexed in the internationally recognized databases for the health sciences, LILACS, SCIELO, and MEDLINE, using the terms "otoacoustic emissions" and "occupational exposure." The type of published article (national/international), the type and intensity of the stimulus most commonly used for the evoked otoacoustic emissions, the gender and age of the subjects, and the conclusions from the retrospective studies were all taken into consideration.

RESULTS AND CONCLUSIONS

 A total of 19 articles were analyzed, 7 national and 12 international, covering subjects from 17 to 77 years of age, mostly men. The type of stimulus most commonly used for the evoked otoacoustic emissions was the distortion method (12). Through this review, we have concluded that testing of evoked otoacoustic emissions in workers exposed to noise is an important tool in the early diagnosis of noise-induced cochlear hearing disorders.