Role Of Occupational Factors in Noise-Induced Hearing Loss: A Single-Center Real-World Data Study

Role Of Occupational Factors in Noise-Induced Hearing Loss: A Single-Center Real-World Data Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Role Of Occupational Factors in Noise-Induced Hearing Loss: A Single-Center Real-World Data Study Aynur Aliyeva, Elif Sari This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5620797/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background : This research explores the prevalence of occupational noise-induced hearing loss (NIHL) among ENT clinic patients and the related factors. We aim to assess the prevalence of NIHL, examine noise-exposed workers' characteristics, and identify factors causing high-frequency hearing loss (HFHL). Methods: 160 workers were divided into two groups based on noise exposure duration: less than five years and over five years. We compared hearing thresholds, demographics, hearing aid usage, and preventive measures between these groups. Audiometric evaluations gauged hearing levels at various frequencies. Demographic data, including age, gender, education, and smoking habits, were collected. Results: Most participants were male (84.4%) and under 40 (63.1%). 44.4% had worked over 5 years, 29.4% used hearing aids, and 51.9% had tinnitus. Audiometry showed increased hearing thresholds at higher frequencies, especially 4 kHz, 6 kHz, and 8 kHz. Regression showed tinnitus and longer job durations as significant predictors of NIHL. Conclusion: The study reveals the vulnerability of noise-exposed workers to HFHL. Tinnitus is a primary predictor, and long job durations also affect hearing. The findings underscore the importance of hearing conservation, especially for workers with tinnitus and prolonged noise exposure. Noise-induced hearing loss Occupational factor Tinnitus Hearing impairment. Background Noise-induced hearing loss (NIHL) is a sensorineural hearing deficit caused by exposure to loud sounds. While leisure and recreational activities are recognized causes, occupational noise exposure remains a significant contributing factor (1). This article explores the role of occupational factors in NIHL and underscores the importance of protective measures among ENT policlinic workplace environments. As per the WHO, workplace noise is a significant yet often underestimated health risk. It impacts millions of workers globally, primarily in industries like construction, manufacturing, agriculture, mining, transportation, and the military. These sectors involve heavy machinery and equipment that generate sound levels capable of harming the delicate structures in the human ear. Prolonged workplace noise exposure can lead to gradual hearing loss over several years, exceeding the recommended thresholds of 85 dB for an 8-hour shift or 120 dB for impact noise. It initially impairs higher frequencies but can eventually affect lower frequencies (2). Noise-induced damage primarily affects the hair cells in the cochlea, the inner ear structure responsible for translating sound vibrations into electrical signals for the brain. Continuous exposure to loud noise causes these hair cells to become overstimulated and eventually die. Unlike certain animals, humans cannot regenerate these hair cells, making the resultant hearing loss permanent (3). Individual susceptibility to NIHL can vary based on genetics, age, and previous noise exposures. Some workers might develop hearing loss in a noisy environment after just a few years, while others in the same setting might remain unaffected. This variance highlights the importance of personalized protective measures. To combat NIHL, many countries have established regulations and guidelines. For example, the Occupational Safety and Health Administration (OSHA) has set permissible noise exposure limits in the United States. Employers must implement a hearing conservation program if workers are exposed to average noise levels above 85 dB over an 8-hour shift. This includes regular hearing tests, training, and provision of ear protection (4 ). Occupational noise exposure plays a substantial role in the incidence of NIHL. Recognizing the significant health and socioeconomic implications, industries need to adopt stringent safety standards and protective measures. Through collective efforts, the prevalence of NIHL can be minimized, ensuring a healthier workforce and more sustainable economic progress (5). In ….., there's a knowledge gap concerning the prevalence of occupational NIHL in outpatient settings. Occupational NIHL, being complex yet preventable, necessitates a deeper understanding of the affected population, particularly considering its socioeconomic implications. This study seeks to determine the prevalence of occupational NIHL at a single institution by delving into an exhaustive retrospective data analysis. The analysis also examines the hearing differences between workers exposed to detrimental occupational noise for under five years versus those with over five years of exposure. Additionally, the study identifies the rate of hearing impairments among those exposed to noise and evaluates diverse factors spanning demographics, socioeconomics, and the nature of employment. Methods Study Design and Setting: This study was designed at the University of Health Sciences, XXX Education and Research Hospital. The ethics committee approved this study. The ethical full approval number is 1101217/04 (approval XXX and date XXX). The study concentrated on the most recent ENT outpatient clinic medical evaluations, explicitly targeting patients diagnosed with "Sensory Neural Hearing Loss." Data were extracted from records spanning July 2016 to December 2018. Participant Selection: Data records pertaining to 1,845 individuals diagnosed with "Sensorineural Hearing Loss" were evaluated from the selected facilities. The primary focus for inclusion in this analysis was individuals with "Noise-Induced Hearing Loss" due to occupational factors. Patients were excluded if they: 1. Suffered from traumatic or syndromic hearing loss, 2. Had hearing deficits stemming from intracranial lesions, 3. Exhibited cognitive impairment, 4. Were below the age of 18, 5. Had undergone prior ear surgeries, 6. Presented with sudden hearing loss, or 7. Demonstrated pressure-compartment hearing deficits (especially those above 60 years) Additional exclusion criteria encompassed prior ear infections, noise exposure during military service, a familial history of hearing impairment, and conductive hearing loss (air-bone gap > 10 dB). Of the qualified pool, 160 workers were stratified based on their exposure duration: the patients to hazardous occupational noise for less than five years and with more than five years of exposure. Power Analysis Utilizing the Open-Epi online calculator (Version 3.3a, OpenEpi, Atlanta, GA, USA), a power analysis determined that a sample of 90 workers exposed for less than five years and 70 workers exposed for more than five years would be sufficient. This sample size ensures the detection of a minimum NIHL prevalence difference of 15% between the groups, operating with a prevalence ratio of 1.4, a power of 98.3%, and a confidence level set at 95% (α = 0.05). Statistical analysis Data was analyzed using IBM SPSS Statistics v.22 for Mac (IBM Corp., Armonk, NY, USA). Descriptive statistics illustrated both qualitative (frequencies and percentages) and quantitative (mean and standard deviation) data. The analysis began by contrasting workers with under 5 years of experience with those having over 5 years to pinpoint the prevalence of occupational NIHL. A deeper case-control analysis was then conducted on those with more than 5 years of experience to identify factors linked to NIHL. In our sample of 160 workers, hearing thresholds (in dB) at certain audiometry frequencies (Hz) were showcased by their mean and standard deviation, divided by both work duration (less than or more than 5 years) and age groups (less than or more than 40 years old). Four age-specific groups were derived for this purpose. The study determined the prevalence rates of both general hearing impairment and NIHL. Odds ratios (OR) with 95% confidence intervals (CI) were computed using univariate logistic regression to understand the likelihood of hearing impairment or NIHL based on work duration. A breakdown of the 160 workers showed the average hearing thresholds across two age segments and two job durations (< 5 years and ≥ 20 years). Multiple linear regression helped identify predictors of hearing thresholds at tested frequencies. Further, odds of NIHL (dependent variable) in relation to various factors like sociodemographics, work-related aspects, and medical conditions (independent variables) were calculated using univariate logistic regression. A subsequent multivariate logistic regression was used to model NIHL to comprehend their independent impacts, focusing on significant factors like age, job duration, and tinnitus. Model adequacy was assessed with Nagelkerke's R^2 and the Hosmer and Lemeshow goodness-of-fit test. All statistical evaluations were made with a 5% significance level (α = 0.05). Data Collection A specialized data extraction template was crafted to glean pertinent information from the records, encompassing Sociodemographic, Anamnestic-Medical, and Occupational Characteristics. Patient records were meticulously scrutinized for sociodemographic details like age, educational background, marital status, and tobacco use. Occupational specifics like job tenure, nature of the job, and work patterns. Medical conditions and the presence of tinnitus were also cataloged.The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Pure Tone Audiometry Test Data Review : In a retrospective analysis of routine medical evaluations from selected factories, we reviewed data from a pure-tone audiometer, which had been used to measure hearing acuity in both ears across seven octave intervals. These intervals included ascending pure tones at frequencies of 0.25, 0.5, 1, 2, 4,6, and 8 kHz, with intensity levels ranging from -10 to 120 dB. During this data review, normal hearing at a specific frequency was characterized by a binaural hearing level of 25 dB or below. Also, speech discrimination (SD) and Pure Tone Average were (PTA) added to the data Results A comprehensive overview of the sociodemographic and workplace characteristics of the 160 noise-exposed workers is crucial in understanding the diverse composition of the study population and its potential implications for NIHL (Table 1 ). Gender distribution among the participants revealed a majority of male workers (84.4%), constituting 135 individuals, while female workers accounted for a smaller proportion (16.6%), totaling 25 individuals. The age distribution indicated that a significant proportion of the participants were aged 40 or younger (≤ 40 years), representing 63.1% of the cohort (101 individuals). In contrast, 36.9% of participants (59 individuals) were older than 40 years. Job duration was categorized into two groups: those with job durations of 5 years or less (≤ 5 years) and those with job durations exceeding 5 years (> 5 years). The analysis revealed that 55.6% of participants (89 individuals) belonged to the former category, while 44.4% (71 individuals) fell into the latter group. Concerning the utilization of hearing aids, 29.4% of participants (47 individuals) reported using hearing aids, while the majority (70.6%) indicated that they did not use hearing aids (112 individuals). Participants' employment nature was diverse, encompassing mine workers (35%, 56 individuals), factory workers (25%, 40 individuals), construction workers (20.6%, 33 individuals), and others, including those working in bazaars, offices, and markets (19.4%, 31 individuals). Marital status was categorized as single (24.4%, 39 individuals), married (60%, 96 individuals), and divorced (15.6%, 25 individuals), providing insights into the marital diversity within the study population. Smoking status was categorized into three groups: never-been smokers (26.3%, 42 individuals), ex-smokers (16.6%, 25 individuals), and current smokers (58.1%, 93 individuals), highlighting variations in smoking habits among participants. The study assessed the prevalence of tinnitus, revealing that 51.9% of participants (83 individuals) reported experiencing tinnitus, while 48.1% (76 individuals) did not report tinnitus symptoms. Educational attainment ranged from never having attended school (35%, 56 individuals) to basic education (29.4%, 47 individuals), high school completion (16.6%, 25 individuals), and the highest level of education attained (19%, 32 individuals), showcasing the educational diversity within the cohort. Participants' use of preventive measures, specifically the use of headphones, demonstrated that 20.6% of participants (33 individuals) utilized headphones for hearing protection, while the majority (79.4%, 127 individuals) did not employ this preventive measure. These sociodemographic and workplace characteristics comprehensively overview the diverse study population. In subsequent analyses, they form a crucial foundation for exploring the predictors and risk factors associated with NIHL. Table 1 Sociodemographic and workplace data ( n = 160) Data Percentage (%) Characteristic Frequency ( n = 160) Gender M Ratio 5.4: 1 84.4 135 F 16.6 25 Age (years) ≤ 40 Mean Age 33,5 ± 11,3 63.1 101 > 40 36.9 59 Job duration (years) ≤ 5 Mean average 4,3 ± 1,9 55.6 89 > 5 44.4 71 Utilization of hearing aids yes 29.4 47 no 70.6 112 Nature of employment Mine worker 35 56 Factory worker 25 40 Construction worker 20.6 33 Other ( Bazaar, Office, Market) 19.4 31 Marital Status Single 24.4 39 Married 60 96 Divorced 15.6 25 Smoking status Never been smoker 26.3 42 Ex-smoker 16.6 25 Current smoker 58.1 93 Tinnitus Yes 51,9 83 No 48,1 76 Educational Never been to school. 35 56 Basic education 29.4 47 High school 16.6 25 Highest educational 19 32 Prevention (Headphone) Yes 20,6 33 No 79,4 127 Hearing Threshold Levels Among All Workers: The audiometric evaluation of hearing threshold levels among all 160 noise-exposed workers revealed notable trends. As depicted in Table 2 , the hearing thresholds increased progressively with higher audiometry frequencies. The most substantial hearing thresholds were observed at 8000 Hz, with a mean of 57,6 ± 11,0 dB, also at 4000 Hz (46,3 ± 15,3 dB) and at 6000 Hz (53,4 ± 11,2) the means were very. This pattern indicates the commonly associated HFHL, characterized by elevated thresholds at frequencies ranging from 4000 Hz to 8000 Hz. The PTA across all frequencies was computed at 40,09 ± 12,02 dB, providing an overall measure of hearing sensitivity. Furthermore, the SD percentage was assessed at 83.15%, reflecting the participants' ability to discern speech in noisy environments. Table 2 Hearing Threshold Levels (dB) at Audiometry Frequencies (Hz) Among Noise-Exposed Workers Variables 250 Hz 500 Hz 1000 Hz 2000 Hz 4000 Hz 6000 Hz 8000 Hz PTA SD Total participation, ( n = 160, dB ) 29,6 ± 6,6 31,6 ± 9,5 39,04 ± 10,6 43,5 ± 12,3 46,3 ± 15,3 53,4 ± 11,2 57,6 ± 11,0 40,09 ± 12,02 83,15 ± 12,1 Job duration (years) > 5 (more than) ( n = 70, dB ) 32,3 ± 7,6 33,3 ± 9,6 42,6 ± 11,2 46,3 ± 13,7 55,2 ± 16,7 61,3 ± 15,2 68,3 ± 12,8 44,4 ± 12,8 72,5 ± 9,5 ≤ 5 (less than) ( n = 90, dB ) 28,8 ± 5,1 31,2 ± 8,3 37,4 ± 10,8 43,2 ± 10,2 39,8 ± 13,2 41,4 ± 8,1 34,9 ± 8,9 37,9 ± 10,625 87,6 ± 6,5 P value 0,318 0,425 0,337 0,21 0,032* 0,041* 0,023* 0,359 0,0512 Abbreviations : SD Speech Discrimination, dB Decibel, Hz Hertz, PTA Pure-tone average p- value ≤ 0.05 * Impact of Job Duration on Hearing Thresholds: The study stratified workers based on their job tenure to investigate the relationship between job duration and hearing sensitivity. Workers with job durations exceeding 5 years (> 5 years) demonstrated higher hearing thresholds compared to their counterparts with job durations of 5 years or less (≤ 5 years). This distinction was most prominent at 4000 Hz, 6000 Hz, and 8000 Hz frequencies, with statistically significant differences (0,032, 0,041, 0,023; p < 0.05) observed. Longer job durations were associated with elevated hearing thresholds at these frequencies, indicating a potential link between extended noise exposure and HFHL. The study's comprehensive analysis of hearing threshold levels among noise-exposed workers highlights the presence of HFHL in this occupational group. Notably, longer job durations appear to be associated with elevated hearing thresholds, particularly at 4000 Hz, 6000 Hz, and 8000 Hz. These findings emphasize the importance of hearing conservation efforts in workplaces with extended noise exposure to prevent and mitigate the risk of high-frequency hearing impairment. Using sociodemographic and workplace data, a logistic regression analysis was conducted to predict the likelihood of NIHL among 160 noise-exposed workers. The model's goodness of fit was evaluated using several statistical measures, including Model X², Cox & Snell R², Nagelkerke's R², and Hosmer & Lemeshow X² (Table 3 ). Three key predictors were considered in the analysis (Tinnitus Status, Age, and Work Duration). The logistic regression model revealed significant associations between the predictors and the likelihood of NIHL among noise-exposed workers: Table 3 Multivariate Logistic Regression of Independent Predictors of NIHL Among Noise-Exposed Workers (n = 160) Variables Coefficient Adjusted OR 95% CI P value Tinnitus 0.831 2.126 (0.99, 3.70) 0.044* Age (year) 0.032 1.013 (0.97, 2.01) 0.324 Duration(year) 0.049 1.165 (1.01, 1.23) 0.047* - Model X²: 24.51 (p < 0.001) - Cox & Snell R²: 0.06 - Nagelkerke’s R²: 0.08 - Hosmer & Lemeshow X²: 13 (p = 0.11) Abbreviations: NIHL (Noise-induced hearing loss), OR (Odds ratio), CI (Confidence interval) *Note: Odds ratios (OR) are adjusted for all variables in the above table, with age and job duration treated as continuous variables and tinnitus as a dichotomous variable. Statistical significance is denoted as p- value ≤ 0.05 * Tinnitus Status (Yes vs. No): Workers with tinnitus had 2.126 times higher odds of experiencing NIHL than those without tinnitus (p = 0.044, 95% CI: 0.99, 3.70). Age (≤ 40 vs. > 40): The odds of NIHL among workers aged over 40 were not statistically significant compared to those aged 40 or younger (p = 0.324, 95% CI: 0.97, 2.01). Work Duration (> 5 years vs. ≤ 5 years): Workers with more than 5 years of work experience had 1.165 times higher odds of NIHL compared to those with 5 years or less of experience (p = 0.047, 95% CI: 1.01, 1.23). The logistic regression analysis highlighted the significance of tinnitus status and work duration as predictors of NIHL among noise-exposed workers. Workers with tinnitus had notably higher odds of NIHL, suggesting a potential link between tinnitus and hearing loss in occupational settings. Additionally, those with longer work durations were at a heightened risk of developing NIHL. The findings of this logistic regression analysis underscore the importance of tinnitus status and work duration in predicting NIHL among noise-exposed workers. These results emphasize the need for targeted hearing conservation efforts, especially for workers with tinnitus and those with longer work durations, to prevent and mitigate the risk of NIHL in occupational settings (Table 3 ). There were no statistically significant differences between other factors (smoking, education, marital status) and hearing hearing threshold levels. Discussion Hearing loss is the most widespread sensory impairment globally, with NIHL emerging as a significant global public health concern. NIHL is a form of progressive sensorineural hearing loss stemming from prolonged exposure to loud noise. As industrialization advances rapidly, the risk of NIHL escalates for individuals. According to the World Health Organization (WHO), an alarming 10% of the global population finds itself exposed to noise pollution; among them, 5.3% grapple with NIHL. Furthermore, 16% of adult hearing loss cases can be attributed to workplace noise exposure. In our study of the 1,845 individuals diagnosed with SSHL patients, we found only 160 NIHL, which is 9% of that limited population, and it is related to literature data. Occupational NIHL takes precedence as the most prevalent occupational disease worldwide, affecting over 10% of workers in developed countries (6,7). In terms of NIHL occurrence, individual factors such as sex and age play significant roles. In our study, the average age of the workers stood at 33,5 ± 11,3 years, and it was evident that the risk of high-frequency NIHL increased with advancing age. Additionally, gender emerged as a noteworthy risk factor for HFNIHL, with a notably higher prevalence among men compared to women (8). These findings align with existing research, which consistently demonstrates similar trends. For instance, in developed regions of China, most cases of occupational noise-induced deafness were observed in young adults, averaging around 40 years of age. Several other studies have also highlighted that in occupations with high noise exposure, the prevalence of NIHL is significantly higher among men than women, typically affecting young and middle-aged individuals. Although most studies have accounted for age adjustments in their hearing threshold assessments, it remains evident that age can still exert an influence on the occurrence of HFNIHL(9,10). The findings of our study shed light on several important parameters that have also been explored in previous research, providing valuable insights into their relationships and implications for occupational NIHL. One key parameter we investigated was job duration, categorized as job durations of 5 years or less (≤ 5 years) and those exceeding 5 years (> 5 years). Our analysis revealed that 55.6% of participants had job durations of 5 years or less, while 44.4% had job durations exceeding 5 years. This distribution aligns with the duration of noise exposure, a well-established risk factor for NIHL. Previous studies have consistently shown that prolonged exposure to occupational noise increases the risk of hearing loss (10,11). Our findings reinforce this trend, highlighting the importance of monitoring and protecting the hearing health of individuals with longer job durations. The assessment of tinnitus prevalence is essential as it is often associated with NIHL. In our study, 51.9% of participants reported experiencing tinnitus. This aligns with previous research, which has consistently shown that noise exposure is a significant risk factor for tinnitus. The high prevalence of tinnitus in our study population underscores the need for comprehensive hearing assessments and interventions. Tinnitus profoundly affects one's quality of life and is a more direct contributor to mental stress than hearing loss alone. In the study conducted by Kang et al., which focused on patients with occupational NIHL, they found a correlation between the severity of hearing loss and the intensity of tinnitus sounds. However, it's important to note that the loudness of tinnitus was not documented in our current study. (12–15). Our study examined hearing threshold levels among 160 noise-exposed workers and revealed trends that align with existing research. Hearing thresholds increased progressively with higher audiometry frequencies, with the most substantial hearing thresholds observed at 4000 Hz, 6000 Hz, and 8000 Hz, indicating HFHL, a common consequence of noise exposure. The PTA across all frequencies was 40.09 dB, emphasizing the overall hearing sensitivity impairment in the study population. The SD percentage of 83.15% highlighted the communication challenges faced by these individuals due to their hearing impairment. Related to the literature in the study by E. Henderson et al.the findings revealed no significant increases in noise-induced threshold shifts (NITSs), noise-induced threshold shifts, or low-frequency hearing loss between the survey periods, except for a notable increase in NITS prevalence among female youths. This increase in NITS prevalence among females was attributed to heightened exposure to recreational noise and reduced use of hearing protection, emphasizing the importance of hearing conservation efforts in this demographic. (16–18). We also investigated the impact of job duration on hearing thresholds, categorizing workers based on job tenure. Workers with job durations exceeding 5 years demonstrated significantly higher hearing thresholds at 4000 Hz, 6000 Hz, and 8000 Hz frequencies, reaffirming the link between extended noise exposure and HFHL. Logistic regression analysis identified tinnitus status and longer work durations as predictors of NIHL among noise-exposed workers. A. Nickpour et al. conducted a 15-year historical cohort study involving 6,632 male steelworkers to explore the relationship between shift work and NIHL. The results indicated a higher hazard risk of ear problems related to both low-frequency hearing (LFH) and high-frequency hearing in routinely rotating shift workers (RRS) compared to day workers. Among weekly rotating shift workers, ear problems were primarily associated with LFH. Furthermore, shift workers were more likely to develop hearing problems within a shorter time frame than day workers (19–21). Our study's findings underscore the urgency of hearing conservation efforts, particularly for workers with tinnitus symptoms and those with extended job durations. Tinnitus is an early warning sign of potential hearing damage, warranting immediate action to protect workers' hearing. The association between longer work durations and increased NIHL risk emphasizes the importance of regular monitoring, education, and noise control measures in occupational settings. In conclusion, our study reinforces the established relationship between noise exposure and hearing impairment, highlighting the need for comprehensive interventions to prevent and mitigate the risk of HFHL in workplaces. Also, our study's exploration of these parameters contributes to the understanding of NIHL and underscores the multifaceted nature of this public health concern. These findings can inform future interventions and policies to reduce the prevalence of NIHL and improve the overall well-being of individuals exposed to occupational noise. Limitations : The study's sample size of noise-exposed workers may not fully encompass the diversity of occupational settings and noise exposure levels, potentially reducing the generalizability of the findings. Moreover, the research relies solely on retrospective data analysis within a single center, suggesting the need for broader, multicentric studies for a more comprehensive understanding. While the study briefly mentions protective measures like hearing aids and headphones, it lacks an exhaustive evaluation of their effectiveness or an exploration of alternative interventions for preventing NIHL in occupational settings. Furthermore, the study is limited by the absence of data quantifying the intensity of tinnitus, preventing an examination of its potential correlation with the degree of hearing impairment in individuals affected by NIHL. Conclusion In conclusion, this study underscores the pervasive impact of occupational noise exposure on workers' hearing health, highlighting NIHL as a significant global public health concern. The findings confirm the well-established association between prolonged noise exposure and HFHL, emphasizing the need for vigilant monitoring and comprehensive hearing conservation efforts in workplaces. The study identifies key predictors of NIHL, including tinnitus symptoms and extended job durations, emphasizing their importance in early detection and intervention. Furthermore, the study underscores the multifaceted nature of this public health issue, calling for tailored interventions and policies to mitigate the risk of NIHL and enhance the overall well-being of noise-exposed individuals. Overall, this research contributes valuable insights to the ongoing efforts to combat NIHL and improve workers' hearing health worldwide. Declarations Ethics Approval and Consent to participate : This study was designed at the University of Health Sciences, Izmir Bozyaka Education and Research Hospital. The ethics committee approved this study. Ethical full approval number is 1101217/04 (approval N = 04 and date 11/01/2017).All the participants provided written informed consent to participate in the study. Funding: The authors declared that this study had received no financial support Author Contribution Conception: ES, AA; Design: ES, AA; Supervision: ES, AA; Fundings: None; Materials: ES, AA; Data Collection and/or Processing: ES, AA; Analysis and/or Interpretation: AA; Literature: ES, AA; Review: ES, AA; Writing: AA, ES; Critical Review: ES, AA References Natarajan, N., Batts, S., & Stankovic, K. M. (2023). Noise-Induced Hearing Loss. Journal of clinical medicine, 12(6), 2347. https://doi.org/10.3390/jcm12062347 Tikka, C., Verbeek, J. H., Kateman, E., Morata, T. C., Dreschler, W. A., & Ferrite, S. (2017). Interventions to prevent occupational noise-induced hearing loss. The Cochrane database of systematic reviews, 7(7), CD006396. https://doi.org/10.1002/14651858.CD006396.pub4 Kurabi, A., Keithley, E. M., Housley, G. D., Ryan, A. F., & Wong, A. C. (2017). Cellular mechanisms of noise-induced hearing loss. Hearing research, 349, 129–137. https://doi.org/10.1016/j.heares.2016.11.013 Fairfax R. E. (2020). The Occupational Safety and Health Administration's Impact on Employers: What Worked and Where to Go From Here. American journal of public health, 110(5), 644–645. https://doi.org/10.2105/AJPH.2020.305624 Chen, K. H., Su, S. B., & Chen, K. T. (2020). An overview of occupational noise-induced hearing loss among workers: epidemiology, pathogenesis, and preventive measures. Environmental health and preventive medicine, 25(1), 65. https://doi.org/10.1186/s12199-020-00906-0 National Institute for Occupational Safety and Health (NIOSH) Noise and hearing loss prevention: facts and statistics. Available: http://www.cdc.gov/niosh/topics/noise/stats.html Zhou, J., Shi, Z., Zhou, L., Hu, Y., & Zhang, M. (2020). Occupational noise-induced hearing loss in China: a systematic review and meta-analysis. BMJ open, 10(9), e039576. https://doi.org/10.1136/bmjopen-2020-039576 Zhu W, Ding B, Sheng H, et al.. Occupational noise-induced deafuess diaqnosis analysis in Jiangsu from 2006 to 2009]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2015;33:671–3. Seixas NS, Neitzel R, Stover B, et al.. 10-year prospective study of noise exposure and hearing damage among construction workers. Occup Environ Med 2012;69:643–50. 10.1136/oemed-2011-100578 Lie A, Skogstad M, Johannessen HA, et al. Occupational noise exposure and hearing: a systematic review. Int Arch Occup Environ Health 2016;89:351–72. 10.1007/s00420-015-1083-5 Nelson DI, Concha-Barrientos M, Driscoll T, Steenland K, Fingerhut M, Punnett L, et al. The global burden of selected occupational diseases and injury risks: methodology and summary. Am. J. Ind. Med. 2005;48(6):400–418. doi: 10.1002/ajim.20211 Mirza R, Kirchner B, Dobie RA, Crawford J. Occupational noise-induced hearing loss. J. Occup. Environ. Med. 2018;60:e498–e501. doi: 10.1097/JOM.0000000000001423 Ralli M, Balla MP, Greco A, Altissimi G, Ricci P, Turchetta R, et al. Workrelated noise exposure in a cohort of patients with chronic tinnitus: analysis of demographic and audiological characteristics. Int J Environ Res Public Health. 2017;14(9):1035. https:// doi. org/ 10. 3390/ ijerp h1409 1035. Hong O, Chin DL, Phelps S, Joo Y. Double jeopardy: hearing loss and tinnitus among noise-exposed workers. Workplace Health Saf. 2016;64(6):235–. https:// doi. org/ 10. 1177/ 21650 79916 629975. Kang HJ, Jin Z, Oh TI, Kim SS, Park DY, Kim SH, et al. Audiologic characteristics of earing and tinnitus in occupational noise-induced hearing loss. J Int Adv Otol. 2021;17(4):330–4. https:// doi. org/ 10. 5152/ iao. 2021. 9259. Elsaidy WH, Mahmoud AA. Prevalence of noise induced hearing loss among employees at wood industry in Damietta governorate. IJMA. 2020;2(1):253–9. https:// doi. org/ 10. 21608/ ijma. 2020. 20970. 1055. Basner M, Babisch W, Davis A, Brink M, Clark C, Janssen S, et al. Auditory and non-auditory effects of noise on health. Lancet. 2014;383:1325–32.https:// doi. org/ 10. 1016/ S0140- 6736(13) 61613-X. Henderson, E., Testa, M. A., & Hartnick, C. (2011). Prevalence of noise-induced hearing-threshold shifts and hearing loss among US youths. Pediatrics, 127(1), e39–e46. https://doi.org/10.1542/peds.2010-0926 Lie A, Engdahl B, Hoffman HJ, Li CM, Tambs K. Occupational noise exposure, hearing loss, and notched audiograms in the HUNT Nord-Trøndelag hearing loss study, 1996-1998. Laryngoscope. 2017;127(6):1442–1450. doi: 10.1002/lary.26256 Nikpour, A., Gholami Fesharaki, M. (2022). Time to Noise-Induced Hearing Loss among Different Type of Shift Work among Steel Workers: A Survival Study. Iranian journal of public health, 51(3), 669–675. https://doi.org/10.18502/ijph.v51i3.8945 Nelson DI, Concha-Barrientos M, Driscoll T, Steenland K, Fingerhut M, Punnett L, et al. The global burden of selected occupational diseases and injury risks: methodology and summary. Am. J. Ind. Med. 2005;48(6):400–418. doi: 10.1002/ajim.20211 Pelegrin AC, Canuet L, Rodríguez ÁA, Morales MP. Predictive factors of occupational noise-induced hearing loss in Spanish workers: a prospective study. Noise Health. 2015;17(78):343–349. doi: 10.4103/1463-1741.165064. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 12 Feb, 2025 Reviews received at journal 18 Jan, 2025 Reviews received at journal 14 Jan, 2025 Reviewers agreed at journal 12 Jan, 2025 Reviewers agreed at journal 07 Jan, 2025 Reviewers agreed at journal 07 Jan, 2025 Reviewers invited by journal 07 Jan, 2025 Editor assigned by journal 27 Dec, 2024 Submission checks completed at journal 27 Dec, 2024 First submitted to journal 10 Dec, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5620797","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":395054967,"identity":"1687de01-e998-467b-b73f-e90f9a9a442f","order_by":0,"name":"Aynur Aliyeva","email":"data:image/png;base64,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","orcid":"","institution":"Division of Otorhinolaryngology-Head and Neck Surgery, The Catholic University St.Mary Hospital Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Aynur","middleName":"","lastName":"Aliyeva","suffix":""},{"id":395054968,"identity":"d172c77e-b869-498d-a4ac-8dc85d5f18ee","order_by":1,"name":"Elif Sari","email":"","orcid":"","institution":"Department of Otorhinolaryngology-Head and Neck Surgery Istanbul Aydın University VM Medikal Park Florya Hospital","correspondingAuthor":false,"prefix":"","firstName":"Elif","middleName":"","lastName":"Sari","suffix":""}],"badges":[],"createdAt":"2024-12-11 04:23:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5620797/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5620797/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":72590990,"identity":"7c52d162-5230-45c0-bf55-f1c836152cc1","added_by":"auto","created_at":"2024-12-30 07:11:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":489051,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5620797/v1/6eaf198d-ce43-4275-ac40-715df9c26615.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Role Of Occupational Factors in Noise-Induced Hearing Loss: A Single-Center Real-World Data Study","fulltext":[{"header":"Background","content":"\u003cp\u003eNoise-induced hearing loss (NIHL) is a sensorineural hearing deficit caused by exposure to loud sounds. While leisure and recreational activities are recognized causes, occupational noise exposure remains a significant contributing factor (1). This article explores the role of occupational factors in NIHL and underscores the importance of protective measures among ENT policlinic workplace environments.\u003c/p\u003e \u003cp\u003eAs per the WHO, workplace noise is a significant yet often underestimated health risk. It impacts millions of workers globally, primarily in industries like construction, manufacturing, agriculture, mining, transportation, and the military. These sectors involve heavy machinery and equipment that generate sound levels capable of harming the delicate structures in the human ear. Prolonged workplace noise exposure can lead to gradual hearing loss over several years, exceeding the recommended thresholds of 85 dB for an 8-hour shift or 120 dB for impact noise. It initially impairs higher frequencies but can eventually affect lower frequencies (2).\u003c/p\u003e \u003cp\u003eNoise-induced damage primarily affects the hair cells in the cochlea, the inner ear structure responsible for translating sound vibrations into electrical signals for the brain. Continuous exposure to loud noise causes these hair cells to become overstimulated and eventually die. Unlike certain animals, humans cannot regenerate these hair cells, making the resultant hearing loss permanent (3).\u003c/p\u003e \u003cp\u003eIndividual susceptibility to NIHL can vary based on genetics, age, and previous noise exposures. Some workers might develop hearing loss in a noisy environment after just a few years, while others in the same setting might remain unaffected. This variance highlights the importance of personalized protective measures. To combat NIHL, many countries have established regulations and guidelines. For example, the Occupational Safety and Health Administration (OSHA) has set permissible noise exposure limits in the United States. Employers must implement a hearing conservation program if workers are exposed to average noise levels above 85 dB over an 8-hour shift. This includes regular hearing tests, training, and provision of ear protection (4 ). Occupational noise exposure plays a substantial role in the incidence of NIHL. Recognizing the significant health and socioeconomic implications, industries need to adopt stringent safety standards and protective measures. Through collective efforts, the prevalence of NIHL can be minimized, ensuring a healthier workforce and more sustainable economic progress (5).\u003c/p\u003e \u003cp\u003eIn \u0026hellip;.., there's a knowledge gap concerning the prevalence of occupational NIHL in outpatient settings. Occupational NIHL, being complex yet preventable, necessitates a deeper understanding of the affected population, particularly considering its socioeconomic implications. This study seeks to determine the prevalence of occupational NIHL at a single institution by delving into an exhaustive retrospective data analysis. The analysis also examines the hearing differences between workers exposed to detrimental occupational noise for under five years versus those with over five years of exposure. Additionally, the study identifies the rate of hearing impairments among those exposed to noise and evaluates diverse factors spanning demographics, socioeconomics, and the nature of employment.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Setting:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was designed at the University of Health Sciences, XXX Education and Research Hospital. The ethics committee approved this study. The ethical full approval number is\u0026nbsp;1101217/04 (approval XXX and date XXX). The study concentrated on the most recent ENT outpatient clinic medical evaluations, explicitly targeting patients diagnosed with \u003cem\u003e\"Sensory Neural Hearing Loss.\"\u003c/em\u003e Data were extracted from records spanning July 2016 to December 2018.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Selection:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData records pertaining to 1,845 individuals diagnosed with \u003cem\u003e\"Sensorineural Hearing Loss\"\u003c/em\u003e were evaluated from the selected facilities. The primary focus for inclusion in this analysis was individuals with \u003cem\u003e\"Noise-Induced Hearing Loss\"\u003c/em\u003e due to occupational factors. Patients were excluded if they:\u003c/p\u003e\n\u003cp\u003e1. Suffered from traumatic or syndromic hearing loss,\u003c/p\u003e\n\u003cp\u003e2. Had hearing deficits stemming from intracranial lesions,\u003c/p\u003e\n\u003cp\u003e3. Exhibited cognitive impairment,\u003c/p\u003e\n\u003cp\u003e4. Were below the age of 18,\u003c/p\u003e\n\u003cp\u003e5. Had undergone prior ear surgeries,\u003c/p\u003e\n\u003cp\u003e6. Presented with sudden hearing loss, or\u003c/p\u003e\n\u003cp\u003e7. Demonstrated pressure-compartment hearing deficits (especially those above 60 years)\u003c/p\u003e\n\u003cp\u003eAdditional exclusion criteria encompassed prior ear infections, noise exposure during military service, a familial history of hearing impairment, and conductive hearing loss (air-bone gap \u0026gt; 10 dB).\u003c/p\u003e\n\u003cp\u003eOf the qualified pool, 160 workers were stratified based on their exposure duration: the patients to hazardous occupational noise for less than five years and with more than five years of exposure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePower Analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Utilizing the Open-Epi online calculator (Version 3.3a, OpenEpi, Atlanta, GA, USA), a power analysis determined that a sample of 90 workers exposed for less than five years and 70 workers exposed for more than five years would be sufficient. This sample size ensures the detection of a minimum NIHL prevalence difference of 15% between the groups, operating with a prevalence ratio of 1.4, a power of 98.3%, and a confidence level set at 95% (α = 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Statistical analysis\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData was analyzed using IBM SPSS Statistics v.22 for Mac (IBM Corp., Armonk, NY, USA). Descriptive statistics illustrated both qualitative (frequencies and percentages) and quantitative (mean and standard deviation) data. The analysis began by contrasting workers with under 5 years of experience with those having over 5 years to pinpoint the prevalence of occupational NIHL. A deeper case-control analysis was then conducted on those with more than 5 years of experience to identify factors linked to NIHL. In our sample of 160 workers, hearing thresholds (in dB) at certain audiometry frequencies (Hz) were showcased by their mean and standard deviation, divided by both work duration (less than or more than 5 years) and age groups (less than or more than 40 years old). Four age-specific groups were derived for this purpose. The study determined the prevalence rates of both general hearing impairment and NIHL. Odds ratios (OR) with 95% confidence intervals (CI) were computed using univariate logistic regression to understand the likelihood of hearing impairment or NIHL based on work duration. A breakdown of the 160 workers showed the average hearing thresholds across two age segments and two job durations (\u0026lt; 5 years and ≥ 20 years). Multiple linear regression helped identify predictors of hearing thresholds at tested frequencies. Further, odds of NIHL (dependent variable) in relation to various factors like sociodemographics, work-related aspects, and medical conditions (independent variables) were calculated using univariate logistic regression. A subsequent multivariate logistic regression was used to model NIHL to comprehend their independent impacts, focusing on significant factors like age, job duration, and tinnitus. Model adequacy was assessed with Nagelkerke's R^2 and the Hosmer and Lemeshow goodness-of-fit test. All statistical evaluations were made with a 5% significance level (α = 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA specialized data extraction template was crafted to glean pertinent information from the records, encompassing Sociodemographic, Anamnestic-Medical, and Occupational Characteristics. Patient records were meticulously scrutinized for sociodemographic details like age, educational background, marital status, and tobacco use. Occupational specifics like job tenure, nature of the job, and work patterns. Medical conditions and the presence of tinnitus were also cataloged.The datasets used and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePure Tone Audiometry Test Data Review\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eIn a retrospective analysis of routine medical evaluations from selected factories, we reviewed data from a pure-tone audiometer, which had been used to measure hearing acuity in both ears across seven octave intervals. These intervals included ascending pure tones at frequencies of 0.25, 0.5, 1, 2, 4,6, and 8 kHz, with intensity levels ranging from -10 to 120 dB. During this data review, normal hearing at a specific frequency was characterized by a binaural hearing level of 25 dB or below. Also, speech discrimination (SD) and Pure Tone Average were (PTA) added to the data\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA comprehensive overview of the sociodemographic and workplace characteristics of the 160 noise-exposed workers is crucial in understanding the diverse composition of the study population and its potential implications for NIHL (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Gender distribution among the participants revealed a majority of male workers (84.4%), constituting 135 individuals, while female workers accounted for a smaller proportion (16.6%), totaling 25 individuals. The age distribution indicated that a significant proportion of the participants were aged 40 or younger (\u0026le;\u0026thinsp;40 years), representing 63.1% of the cohort (101 individuals). In contrast, 36.9% of participants (59 individuals) were older than 40 years. Job duration was categorized into two groups: those with job durations of 5 years or less (\u0026le;\u0026thinsp;5 years) and those with job durations exceeding 5 years (\u0026gt;\u0026thinsp;5 years). The analysis revealed that 55.6% of participants (89 individuals) belonged to the former category, while 44.4% (71 individuals) fell into the latter group. Concerning the utilization of hearing aids, 29.4% of participants (47 individuals) reported using hearing aids, while the majority (70.6%) indicated that they did not use hearing aids (112 individuals). Participants' employment nature was diverse, encompassing mine workers (35%, 56 individuals), factory workers (25%, 40 individuals), construction workers (20.6%, 33 individuals), and others, including those working in bazaars, offices, and markets (19.4%, 31 individuals). Marital status was categorized as single (24.4%, 39 individuals), married (60%, 96 individuals), and divorced (15.6%, 25 individuals), providing insights into the marital diversity within the study population. Smoking status was categorized into three groups: never-been smokers (26.3%, 42 individuals), ex-smokers (16.6%, 25 individuals), and current smokers (58.1%, 93 individuals), highlighting variations in smoking habits among participants. The study assessed the prevalence of tinnitus, revealing that 51.9% of participants (83 individuals) reported experiencing tinnitus, while 48.1% (76 individuals) did not report tinnitus symptoms. Educational attainment ranged from never having attended school (35%, 56 individuals) to basic education (29.4%, 47 individuals), high school completion (16.6%, 25 individuals), and the highest level of education attained (19%, 32 individuals), showcasing the educational diversity within the cohort. Participants' use of preventive measures, specifically the use of headphones, demonstrated that 20.6% of participants (33 individuals) utilized headphones for hearing protection, while the majority (79.4%, 127 individuals) did not employ this preventive measure. These sociodemographic and workplace characteristics comprehensively overview the diverse study population. In subsequent analyses, they form a crucial foundation for exploring the predictors and risk factors associated with NIHL.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic and workplace data (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eData\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCharacteristic Frequency\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRatio\u003c/p\u003e \u003cp\u003e5.4: 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMean Age\u003c/p\u003e \u003cp\u003e33,5\u0026thinsp;\u0026plusmn;\u0026thinsp;11,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt; 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eJob duration (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le; 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMean average\u003c/p\u003e \u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;1,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt; 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUtilization of hearing aids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eNature of employment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMine worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFactory worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eConstruction worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eOther ( Bazaar, Office, Market)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSmoking status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNever been smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEx-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eCurrent smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTinnitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNever been to school.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eBasic education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHighest educational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevention (Headphone)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eHearing Threshold Levels Among All Workers:\u003c/h3\u003e\n\u003cp\u003eThe audiometric evaluation of hearing threshold levels among all 160 noise-exposed workers revealed notable trends. As depicted in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the hearing thresholds increased progressively with higher audiometry frequencies. The most substantial hearing thresholds were observed at 8000 Hz, with a mean of 57,6\u0026thinsp;\u0026plusmn;\u0026thinsp;11,0 dB, also at 4000 Hz (46,3\u0026thinsp;\u0026plusmn;\u0026thinsp;15,3 dB) and at 6000 Hz (53,4\u0026thinsp;\u0026plusmn;\u0026thinsp;11,2) the means were very. This pattern indicates the commonly associated HFHL, characterized by elevated thresholds at frequencies ranging from 4000 Hz to 8000 Hz. The PTA across all frequencies was computed at 40,09\u0026thinsp;\u0026plusmn;\u0026thinsp;12,02 dB, providing an overall measure of hearing sensitivity. Furthermore, the SD percentage was assessed at 83.15%, reflecting the participants' ability to discern speech in noisy environments.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHearing Threshold Levels (dB) at Audiometry Frequencies (Hz) Among Noise-Exposed Workers\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e250 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e500 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1000 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2000 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4000 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6000 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8000 Hz\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ePTA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal participation,\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;160, \u003cem\u003edB\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29,6\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;6,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31,6\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;9,5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39,04\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;10,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43,5\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;12,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46,3\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;15,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e53,4\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;11,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e57,6\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;11,0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40,09\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;12,02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e83,15\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;12,1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eJob duration (years)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt; 5 (more than)\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;70, \u003cem\u003edB\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32,3\u0026thinsp;\u0026plusmn;\u0026thinsp;7,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33,3\u0026thinsp;\u0026plusmn;\u0026thinsp;9,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42,6\u0026thinsp;\u0026plusmn;\u0026thinsp;11,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46,3\u0026thinsp;\u0026plusmn;\u0026thinsp;13,7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55,2\u0026thinsp;\u0026plusmn;\u0026thinsp;16,7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e61,3\u0026thinsp;\u0026plusmn;\u0026thinsp;15,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e68,3\u0026thinsp;\u0026plusmn;\u0026thinsp;12,8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e44,4\u0026thinsp;\u0026plusmn;\u0026thinsp;12,8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e72,5\u0026thinsp;\u0026plusmn;\u0026thinsp;9,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le; 5 (less than)\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;90, \u003cem\u003edB\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28,8\u0026thinsp;\u0026plusmn;\u0026thinsp;5,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31,2\u0026thinsp;\u0026plusmn;\u0026thinsp;8,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37,4\u0026thinsp;\u0026plusmn;\u0026thinsp;10,8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43,2\u0026thinsp;\u0026plusmn;\u0026thinsp;10,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39,8\u0026thinsp;\u0026plusmn;\u0026thinsp;13,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e41,4\u0026thinsp;\u0026plusmn;\u0026thinsp;8,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e34,9\u0026thinsp;\u0026plusmn;\u0026thinsp;8,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e37,9\u0026thinsp;\u0026plusmn;\u0026thinsp;10,625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e87,6\u0026thinsp;\u0026plusmn;\u0026thinsp;6,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,318\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,032*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,041*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,023*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0,359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,0512\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAbbreviations\u003c/em\u003e: \u003cem\u003eSD\u003c/em\u003e Speech Discrimination, \u003cem\u003edB\u003c/em\u003e Decibel, \u003cem\u003eHz\u003c/em\u003e Hertz, \u003cem\u003ePTA\u003c/em\u003e \u0026nbsp;Pure-tone average\u003c/p\u003e \u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue\u0026thinsp;\u0026le;\u0026thinsp;0.05 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eImpact of Job Duration on Hearing Thresholds:\u003c/h2\u003e \u003cp\u003eThe study stratified workers based on their job tenure to investigate the relationship between job duration and hearing sensitivity. Workers with job durations exceeding 5 years (\u0026gt;\u0026thinsp;5 years) demonstrated higher hearing thresholds compared to their counterparts with job durations of 5 years or less (\u0026le;\u0026thinsp;5 years). This distinction was most prominent at 4000 Hz, 6000 Hz, and 8000 Hz frequencies, with statistically significant differences (0,032, 0,041, 0,023; p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) observed. Longer job durations were associated with elevated hearing thresholds at these frequencies, indicating a potential link between extended noise exposure and HFHL. The study's comprehensive analysis of hearing threshold levels among noise-exposed workers highlights the presence of HFHL in this occupational group. Notably, longer job durations appear to be associated with elevated hearing thresholds, particularly at 4000 Hz, 6000 Hz, and 8000 Hz. These findings emphasize the importance of hearing conservation efforts in workplaces with extended noise exposure to prevent and mitigate the risk of high-frequency hearing impairment.\u003c/p\u003e \u003cp\u003eUsing sociodemographic and workplace data, a logistic regression analysis was conducted to predict the likelihood of NIHL among 160 noise-exposed workers. The model's goodness of fit was evaluated using several statistical measures, including Model X\u0026sup2;, Cox \u0026amp; Snell R\u0026sup2;, Nagelkerke's R\u0026sup2;, and Hosmer \u0026amp; Lemeshow X\u0026sup2; (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Three key predictors were considered in the analysis (Tinnitus Status, Age, and Work Duration). The logistic regression model revealed significant associations between the predictors and the likelihood of NIHL among noise-exposed workers:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate Logistic Regression of Independent Predictors of NIHL Among Noise-Exposed Workers (n\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTinnitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(0.99, 3.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.044*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(0.97, 2.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.324\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration(year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(1.01, 1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.047*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e- Model X\u0026sup2;: 24.51 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003cp\u003e- Cox \u0026amp; Snell R\u0026sup2;: 0.06\u003c/p\u003e \u003cp\u003e- Nagelkerke\u0026rsquo;s R\u0026sup2;: 0.08\u003c/p\u003e \u003cp\u003e- Hosmer \u0026amp; Lemeshow X\u0026sup2;: 13 (p\u0026thinsp;=\u0026thinsp;0.11)\u003c/p\u003e \u003cp\u003eAbbreviations: NIHL (Noise-induced hearing loss), OR (Odds ratio), CI (Confidence interval)\u003c/p\u003e \u003cp\u003e*Note: Odds ratios (OR) are adjusted for all variables in the above table, with age and job duration treated as continuous variables and tinnitus as a dichotomous variable.\u003c/p\u003e \u003cp\u003eStatistical significance is denoted as \u003cem\u003ep-\u003c/em\u003evalue\u0026thinsp;\u0026le;\u0026thinsp;0.05 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eTinnitus Status\u003c/b\u003e (Yes vs. No): Workers with tinnitus had 2.126 times higher odds of experiencing NIHL than those without tinnitus (p\u0026thinsp;=\u0026thinsp;0.044, 95% CI: 0.99, 3.70).\u003c/p\u003e \u003cp\u003e \u003cb\u003eAge\u003c/b\u003e (\u0026le;\u0026thinsp;40 vs. \u0026gt; 40): The odds of NIHL among workers aged over 40 were not statistically significant compared to those aged 40 or younger (p\u0026thinsp;=\u0026thinsp;0.324, 95% CI: 0.97, 2.01).\u003c/p\u003e \u003cp\u003e \u003cb\u003eWork Duration\u003c/b\u003e (\u0026gt;\u0026thinsp;5 years vs. \u0026le; 5 years): Workers with more than 5 years of work experience had 1.165 times higher odds of NIHL compared to those with 5 years or less of experience (p\u0026thinsp;=\u0026thinsp;0.047, 95% CI: 1.01, 1.23).\u003c/p\u003e \u003cp\u003eThe logistic regression analysis highlighted the significance of tinnitus status and work duration as predictors of NIHL among noise-exposed workers. Workers with tinnitus had notably higher odds of NIHL, suggesting a potential link between tinnitus and hearing loss in occupational settings. Additionally, those with longer work durations were at a heightened risk of developing NIHL.\u003c/p\u003e \u003cp\u003eThe findings of this logistic regression analysis underscore the importance of tinnitus status and work duration in predicting NIHL among noise-exposed workers. These results emphasize the need for targeted hearing conservation efforts, especially for workers with tinnitus and those with longer work durations, to prevent and mitigate the risk of NIHL in occupational settings (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere were no statistically significant differences between other factors (smoking, education, marital status) and hearing hearing threshold levels.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eHearing loss is the most widespread sensory impairment globally, with NIHL emerging as a significant global public health concern. NIHL is a form of progressive sensorineural hearing loss stemming from prolonged exposure to loud noise. As industrialization advances rapidly, the risk of NIHL escalates for individuals. According to the World Health Organization (WHO), an alarming 10% of the global population finds itself exposed to noise pollution; among them, 5.3% grapple with NIHL. Furthermore, 16% of adult hearing loss cases can be attributed to workplace noise exposure. In our study of the 1,845 individuals diagnosed with SSHL patients, we found only 160 NIHL, which is 9% of that limited population, and it is related to literature data. Occupational NIHL takes precedence as the most prevalent occupational disease worldwide, affecting over 10% of workers in developed countries (6,7).\u003c/p\u003e \u003cp\u003eIn terms of NIHL occurrence, individual factors such as sex and age play significant roles. In our study, the average age of the workers stood at 33,5\u0026thinsp;\u0026plusmn;\u0026thinsp;11,3 years, and it was evident that the risk of high-frequency NIHL increased with advancing age. Additionally, gender emerged as a noteworthy risk factor for HFNIHL, with a notably higher prevalence among men compared to women (8). These findings align with existing research, which consistently demonstrates similar trends. For instance, in developed regions of China, most cases of occupational noise-induced deafness were observed in young adults, averaging around 40 years of age. Several other studies have also highlighted that in occupations with high noise exposure, the prevalence of NIHL is significantly higher among men than women, typically affecting young and middle-aged individuals. Although most studies have accounted for age adjustments in their hearing threshold assessments, it remains evident that age can still exert an influence on the occurrence of HFNIHL(9,10).\u003c/p\u003e \u003cp\u003eThe findings of our study shed light on several important parameters that have also been explored in previous research, providing valuable insights into their relationships and implications for occupational NIHL. One key parameter we investigated was job duration, categorized as job durations of 5 years or less (\u0026le;\u0026thinsp;5 years) and those exceeding 5 years (\u0026gt;\u0026thinsp;5 years). Our analysis revealed that 55.6% of participants had job durations of 5 years or less, while 44.4% had job durations exceeding 5 years. This distribution aligns with the duration of noise exposure, a well-established risk factor for NIHL. Previous studies have consistently shown that prolonged exposure to occupational noise increases the risk of hearing loss (10,11). Our findings reinforce this trend, highlighting the importance of monitoring and protecting the hearing health of individuals with longer job durations.\u003c/p\u003e \u003cp\u003eThe assessment of tinnitus prevalence is essential as it is often associated with NIHL. In our study, 51.9% of participants reported experiencing tinnitus. This aligns with previous research, which has consistently shown that noise exposure is a significant risk factor for tinnitus. The high prevalence of tinnitus in our study population underscores the need for comprehensive hearing assessments and interventions. Tinnitus profoundly affects one's quality of life and is a more direct contributor to mental stress than hearing loss alone. In the study conducted by Kang et al., which focused on patients with occupational NIHL, they found a correlation between the severity of hearing loss and the intensity of tinnitus sounds. However, it's important to note that the loudness of tinnitus was not documented in our current study. (12\u0026ndash;15).\u003c/p\u003e \u003cp\u003eOur study examined hearing threshold levels among 160 noise-exposed workers and revealed trends that align with existing research. Hearing thresholds increased progressively with higher audiometry frequencies, with the most substantial hearing thresholds observed at 4000 Hz, 6000 Hz, and 8000 Hz, indicating HFHL, a common consequence of noise exposure. The PTA across all frequencies was 40.09 dB, emphasizing the overall hearing sensitivity impairment in the study population. The SD percentage of 83.15% highlighted the communication challenges faced by these individuals due to their hearing impairment. Related to the literature in the study by E. Henderson et al.the findings revealed no significant increases in noise-induced threshold shifts (NITSs), noise-induced threshold shifts, or low-frequency hearing loss between the survey periods, except for a notable increase in NITS prevalence among female youths. This increase in NITS prevalence among females was attributed to heightened exposure to recreational noise and reduced use of hearing protection, emphasizing the importance of hearing conservation efforts in this demographic. (16\u0026ndash;18).\u003c/p\u003e \u003cp\u003eWe also investigated the impact of job duration on hearing thresholds, categorizing workers based on job tenure. Workers with job durations exceeding 5 years demonstrated significantly higher hearing thresholds at 4000 Hz, 6000 Hz, and 8000 Hz frequencies, reaffirming the link between extended noise exposure and HFHL. Logistic regression analysis identified tinnitus status and longer work durations as predictors of NIHL among noise-exposed workers. A. Nickpour et al. conducted a 15-year historical cohort study involving 6,632 male steelworkers to explore the relationship between shift work and NIHL. The results indicated a higher hazard risk of ear problems related to both low-frequency hearing (LFH) and high-frequency hearing in routinely rotating shift workers (RRS) compared to day workers. Among weekly rotating shift workers, ear problems were primarily associated with LFH. Furthermore, shift workers were more likely to develop hearing problems within a shorter time frame than day workers (19\u0026ndash;21).\u003c/p\u003e \u003cp\u003eOur study's findings underscore the urgency of hearing conservation efforts, particularly for workers with tinnitus symptoms and those with extended job durations. Tinnitus is an early warning sign of potential hearing damage, warranting immediate action to protect workers' hearing. The association between longer work durations and increased NIHL risk emphasizes the importance of regular monitoring, education, and noise control measures in occupational settings. In conclusion, our study reinforces the established relationship between noise exposure and hearing impairment, highlighting the need for comprehensive interventions to prevent and mitigate the risk of HFHL in workplaces. Also, our study's exploration of these parameters contributes to the understanding of NIHL and underscores the multifaceted nature of this public health concern. These findings can inform future interventions and policies to reduce the prevalence of NIHL and improve the overall well-being of individuals exposed to occupational noise.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e\u003cb\u003eLimitations\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003eThe study's sample size of noise-exposed workers may not fully encompass the diversity of occupational settings and noise exposure levels, potentially reducing the generalizability of the findings. Moreover, the research relies solely on retrospective data analysis within a single center, suggesting the need for broader, multicentric studies for a more comprehensive understanding. While the study briefly mentions protective measures like hearing aids and headphones, it lacks an exhaustive evaluation of their effectiveness or an exploration of alternative interventions for preventing NIHL in occupational settings. Furthermore, the study is limited by the absence of data quantifying the intensity of tinnitus, preventing an examination of its potential correlation with the degree of hearing impairment in individuals affected by NIHL.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study underscores the pervasive impact of occupational noise exposure on workers' hearing health, highlighting NIHL as a significant global public health concern. The findings confirm the well-established association between prolonged noise exposure and HFHL, emphasizing the need for vigilant monitoring and comprehensive hearing conservation efforts in workplaces. The study identifies key predictors of NIHL, including tinnitus symptoms and extended job durations, emphasizing their importance in early detection and intervention. Furthermore, the study underscores the multifaceted nature of this public health issue, calling for tailored interventions and policies to mitigate the risk of NIHL and enhance the overall well-being of noise-exposed individuals. Overall, this research contributes valuable insights to the ongoing efforts to combat NIHL and improve workers' hearing health worldwide.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003e \u003cb\u003eEthics Approval and Consent to participate\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003eThis study was designed at the University of Health Sciences, Izmir Bozyaka Education and Research Hospital. The ethics committee approved this study. Ethical full approval number is 1101217/04 (approval N\u0026thinsp;=\u0026thinsp;04 and date 11/01/2017).All the participants provided written informed consent to participate in the study.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eThe authors declared that this study had received no financial support\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConception: ES, AA; Design: ES, AA; Supervision: ES, AA; Fundings: None; Materials: ES, AA; Data Collection and/or Processing: ES, AA; Analysis and/or Interpretation: AA; Literature: ES, AA; Review: ES, AA; Writing: AA, ES; Critical Review: ES, AA\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNatarajan, N., Batts, S., \u0026amp; Stankovic, K. M. (2023). Noise-Induced Hearing Loss. Journal of clinical medicine, 12(6), 2347. https://doi.org/10.3390/jcm12062347\u003c/li\u003e\n\u003cli\u003eTikka, C., Verbeek, J. H., Kateman, E., Morata, T. C., Dreschler, W. A., \u0026amp; Ferrite, S. (2017). Interventions to prevent occupational noise-induced hearing loss. The Cochrane database of systematic reviews, 7(7), CD006396. https://doi.org/10.1002/14651858.CD006396.pub4\u003c/li\u003e\n\u003cli\u003eKurabi, A., Keithley, E. M., Housley, G. D., Ryan, A. F., \u0026amp; Wong, A. C. (2017). Cellular mechanisms of noise-induced hearing loss. Hearing research, 349, 129\u0026ndash;137. https://doi.org/10.1016/j.heares.2016.11.013\u003c/li\u003e\n\u003cli\u003eFairfax R. E. (2020). The Occupational Safety and Health Administration\u0026apos;s Impact on Employers: What Worked and Where to Go From Here. American journal of public health, 110(5), 644\u0026ndash;645. https://doi.org/10.2105/AJPH.2020.305624\u003c/li\u003e\n\u003cli\u003eChen, K. H., Su, S. B., \u0026amp; Chen, K. T. (2020). An overview of occupational noise-induced hearing loss among workers: epidemiology, pathogenesis, and preventive measures. Environmental health and preventive medicine, 25(1), 65. https://doi.org/10.1186/s12199-020-00906-0\u003c/li\u003e\n\u003cli\u003eNational Institute for Occupational Safety and Health (NIOSH) Noise and hearing loss prevention: facts and statistics. Available: http://www.cdc.gov/niosh/topics/noise/stats.html\u003c/li\u003e\n\u003cli\u003eZhou, J., Shi, Z., Zhou, L., Hu, Y., \u0026amp; Zhang, M. (2020). Occupational noise-induced hearing loss in China: a systematic review and meta-analysis. BMJ open, 10(9), e039576. https://doi.org/10.1136/bmjopen-2020-039576\u003c/li\u003e\n\u003cli\u003eZhu W, Ding B, Sheng H, et al.. Occupational noise-induced deafuess diaqnosis analysis in Jiangsu from 2006 to 2009]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2015;33:671\u0026ndash;3. Seixas NS, Neitzel R, Stover B, et al.. 10-year prospective study of noise exposure and hearing damage among construction workers. Occup Environ Med 2012;69:643\u0026ndash;50. 10.1136/oemed-2011-100578\u003c/li\u003e\n\u003cli\u003eLie A, Skogstad M, Johannessen HA, et al. Occupational noise exposure and hearing: a systematic review. Int Arch Occup Environ Health 2016;89:351\u0026ndash;72. 10.1007/s00420-015-1083-5 \u003c/li\u003e\n\u003cli\u003eNelson DI, Concha-Barrientos M, Driscoll T, Steenland K, Fingerhut M, Punnett L, et al. The global burden of selected occupational diseases and injury risks: methodology and summary. Am. J. Ind. Med. 2005;48(6):400\u0026ndash;418. doi: 10.1002/ajim.20211\u003c/li\u003e\n\u003cli\u003eMirza R, Kirchner B, Dobie RA, Crawford J. Occupational noise-induced hearing loss. J. Occup. Environ. Med. 2018;60:e498\u0026ndash;e501. doi: 10.1097/JOM.0000000000001423\u003c/li\u003e\n\u003cli\u003eRalli M, Balla MP, Greco A, Altissimi G, Ricci P, Turchetta R, et al. Workrelated noise exposure in a cohort of patients with chronic tinnitus: analysis of demographic and audiological characteristics. Int J Environ Res Public Health. 2017;14(9):1035. https:// doi. org/ 10. 3390/ ijerp h1409 1035.\u003c/li\u003e\n\u003cli\u003eHong O, Chin DL, Phelps S, Joo Y. Double jeopardy: hearing loss and tinnitus among noise-exposed workers. Workplace Health Saf. 2016;64(6):235\u0026ndash;. https:// doi. org/ 10. 1177/ 21650 79916 629975.\u003c/li\u003e\n\u003cli\u003eKang HJ, Jin Z, Oh TI, Kim SS, Park DY, Kim SH, et al. Audiologic characteristics of earing and tinnitus in occupational noise-induced hearing loss. J Int Adv Otol. 2021;17(4):330\u0026ndash;4. https:// doi. org/ 10. 5152/ iao. 2021. 9259.\u003c/li\u003e\n\u003cli\u003eElsaidy WH, Mahmoud AA. Prevalence of noise induced hearing loss among employees at wood industry in Damietta governorate. IJMA. 2020;2(1):253\u0026ndash;9. https:// doi. org/ 10. 21608/ ijma. 2020. 20970. 1055.\u003c/li\u003e\n\u003cli\u003eBasner M, Babisch W, Davis A, Brink M, Clark C, Janssen S, et al. Auditory and non-auditory effects of noise on health. Lancet. 2014;383:1325\u0026ndash;32.https:// doi. org/ 10. 1016/ S0140- 6736(13) 61613-X.\u003c/li\u003e\n\u003cli\u003eHenderson, E., Testa, M. A., \u0026amp; Hartnick, C. (2011). Prevalence of noise-induced hearing-threshold shifts and hearing loss among US youths. Pediatrics, 127(1), e39\u0026ndash;e46. https://doi.org/10.1542/peds.2010-0926\u003c/li\u003e\n\u003cli\u003eLie A, Engdahl B, Hoffman HJ, Li CM, Tambs K. Occupational noise exposure, hearing loss, and notched audiograms in the HUNT Nord-Tr\u0026oslash;ndelag hearing loss study, 1996-1998. Laryngoscope. 2017;127(6):1442\u0026ndash;1450. doi: 10.1002/lary.26256\u003c/li\u003e\n\u003cli\u003eNikpour, A., Gholami Fesharaki, M. (2022). Time to Noise-Induced Hearing Loss among Different Type of Shift Work among Steel Workers: A Survival Study. Iranian journal of public health, 51(3), 669\u0026ndash;675. https://doi.org/10.18502/ijph.v51i3.8945\u003c/li\u003e\n\u003cli\u003eNelson DI, Concha-Barrientos M, Driscoll T, Steenland K, Fingerhut M, Punnett L, et al. The global burden of selected occupational diseases and injury risks: methodology and summary. Am. J. Ind. Med. 2005;48(6):400\u0026ndash;418. doi: 10.1002/ajim.20211\u003c/li\u003e\n\u003cli\u003ePelegrin AC, Canuet L, Rodr\u0026iacute;guez \u0026Aacute;A, Morales MP. Predictive factors of occupational noise-induced hearing loss in Spanish workers: a prospective study. Noise Health. 2015;17(78):343\u0026ndash;349. doi: 10.4103/1463-1741.165064.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-otolaryngology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Otolaryngology](https://ejo.springeropen.com/)","snPcode":"43163","submissionUrl":"https://submission.springernature.com/new-submission/43163/3","title":"The Egyptian Journal of Otolaryngology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Noise-induced hearing loss, Occupational factor, Tinnitus, Hearing impairment.","lastPublishedDoi":"10.21203/rs.3.rs-5620797/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5620797/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: This research explores the prevalence of occupational noise-induced hearing loss (NIHL) among ENT clinic patients and the related factors. We aim to assess the prevalence of NIHL, examine noise-exposed workers' characteristics, and identify factors causing high-frequency hearing loss (HFHL).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 160 workers were divided into two groups based on noise exposure duration: less than five years and over five years. We compared hearing thresholds, demographics, hearing aid usage, and preventive measures between these groups. Audiometric evaluations gauged hearing levels at various frequencies. Demographic data, including age, gender, education, and smoking habits, were collected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Most participants were male (84.4%) and under 40 (63.1%). 44.4% had worked over 5 years, 29.4% used hearing aids, and 51.9% had tinnitus. Audiometry showed increased hearing thresholds at higher frequencies, especially 4 kHz, 6 kHz, and 8 kHz. Regression showed tinnitus and longer job durations as significant predictors of NIHL.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The study reveals the vulnerability of noise-exposed workers to HFHL. Tinnitus is a primary predictor, and long job durations also affect hearing. The findings underscore the importance of hearing conservation, especially for workers with tinnitus and prolonged noise exposure.\u003c/p\u003e","manuscriptTitle":"Role Of Occupational Factors in Noise-Induced Hearing Loss: A Single-Center Real-World Data Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-30 07:03:09","doi":"10.21203/rs.3.rs-5620797/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-12T18:32:06+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-18T17:50:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-14T07:39:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12126279945152039978498398471902363945","date":"2025-01-12T21:07:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"138130138050212192072359795633896286083","date":"2025-01-07T20:13:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"169882435162796518214111180989468473416","date":"2025-01-07T19:46:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-07T13:42:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-12-27T15:52:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-12-27T15:51:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"The Egyptian Journal of Otolaryngology","date":"2024-12-11T04:12:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-otolaryngology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Otolaryngology](https://ejo.springeropen.com/)","snPcode":"43163","submissionUrl":"https://submission.springernature.com/new-submission/43163/3","title":"The Egyptian Journal of Otolaryngology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"79a57c9a-15e4-4dba-bb2c-9619842c46c4","owner":[],"postedDate":"December 30th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-03-05T18:23:17+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-30 07:03:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5620797","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5620797","identity":"rs-5620797","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}