Improved hearing protection regulations in the prevention of military nihl and tinnitus
This presentation is the property of its rightful owner.
Sponsored Links
1 / 25

Improved Hearing Protection Regulations in the Prevention of Military NIHL and Tinnitus PowerPoint PPT Presentation


  • 51 Views
  • Uploaded on
  • Presentation posted in: General

Improved Hearing Protection Regulations in the Prevention of Military NIHL and Tinnitus. Roderik Mrena, MD University of Helsinki, Finland February 26, 2010 Rosen Plaza Hotel, Orlando, FL. Occupational NIHL in Finland. Occupational NIHL severity.

Download Presentation

Improved Hearing Protection Regulations in the Prevention of Military NIHL and Tinnitus

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Improved Hearing Protection Regulations in the Prevention of Military NIHL and Tinnitus

Roderik Mrena, MD

University of Helsinki, Finland

February 26, 2010

Rosen Plaza Hotel, Orlando, FL


Occupational nihl in finland

Occupational NIHL in Finland


Occupational nihl severity

Occupational NIHL severity

  • occupational NIHL cases are reported to the National Insurance Board

  • mostly mild


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Occupational NIHLMrena, Ylikoski M, Mäkitie A, Pirvola, Ylikoski J. Occupational NIHL reports and tinnitus in Finland. Acta Otolaryngol 2007, Vol. 127, No. 7, p.729-735.

  • hearing loss = compensation

  • tinnitus ≠ compensation


Background

Background

  • military proffessional are at risk of NIHL

  • awareness ↑

  • EU Directive 2003/10/EC (effective 2006)

    • lower exposure action value: 80 dB(A), 135 dB(C)

      • protectors available, possibility for AG

    • upper exposure action value: 85 dB(A), 137 dB(C)

      • protectors mandatory, noise cancellation program

    • exposure limit value: 87 dB(A), 140 dB(C)

      • exposure may not exceed


Regulations in the fdf

Regulations in the FDF

  • 1968

    • hard ammunition

  • 1979

    • muffs in firing range, plugs in combat training

  • 1985

    • also with blanks

  • 1989, 1991

    • supervisor must order usage (but own responsibility)

    • education

  • still, annually 1-2% of conscripts suffer AAT

    • consequences

  • effective in preventing hearing loss / tinnitus?


Subjects

Subjects

  • 246 military personnel ending active duty

  • Period 1 (1984-1986): n=123

  • Period 2 (2003-2005): n=129

  • retrospective review of medical records

    • AG

    • exposure time

    • ear symptoms


Subjects1

Subjects


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Results – Hearing LossMrena R, Ylikoski J, Kiukaanniemi H, Mäkitie A, Savolainen S. The effect of improved hearing protection regulations in the prevention of military NIHL. Acta Oto-Laryngol 2008;128:997-1003.

  • hearing generally worse in the left ear

  • NCOs

    • improvement in both ears

    • statistically significant

  • Officers

    • improvement, but statistically insignificant


Ncos right ear

NCOs – Right Ear


Ncos left ear

NCOs – Left Ear


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Regulations & TinnitusMrena R, Savolainen S, Kiukaanniemi H, Ylikoski J, Mäkitie A. The effect of tightened hearing protection regulations on military noise-induced tinnitus. Int J Audiol 2009;48:394-400.


Results tinnitus prevalence

Results – Tinnitus Prevalence

  • Total Tinnitus Prevalence

    • Period I (1984-1986): 71%

    • Period II (2003-2005): 68%

  • Officers

    • Period I: 68%

    • Period II: 63%

  • NCOs

    • Period I: 76%

    • Period II: 72%

  • significance


Results severe tinnitus

Results – Severe Tinnitus

  • division:

    • no tinnitus / mild / constant or disturbing

    • constant or disturbing tinnitus Period II vs. I:

      • Cox regression analysis:

      • HR 0.6, 95% CI 0.37-0.96, p=0.032


Results tinnitus questionnaire

Results – Tinnitus Questionnaire

  • available only during Period II (2003-2005)

  • localization: left 46% right 30% both 23%

  • high-pitched 90%


Tinnitus related problems

Tinnitus – Related Problems


Conclusions

Conclusions

  • regulations are effective in reducing hearing loss

  • regulations are effective in reducing serious tinnitus

  • tinnitus prevalence did not improve in direct relation to hearing loss improvement

  • retiring military professionals are young

    • NIHL & tinnitus are a serious threat to the quality of life - preventable !


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Significance of Long-Term TinnitusMrena R, Savolainen S, Kuokkanen J, Ylikoski J. Characteristics of tinnitus induced by acute acoustic trauma: a long-term follow-up. Audiol Neurotool 2002;7:122-130.

  • 418 conscripts with AAT: 100% tinnitus

  • 15 years later: 65% tinnitus


Results possible factors

Results – Possible Factors

  • actual use of protectors

    • reasons?

  • leisure activities?


Always wear hearing protection

Always Wear Hearing Protection!


Improved hearing protection regulations in the prevention of military nihl and tinnitus

Thank you !


  • Login