Noise-induced hearing loss.
Occup Airways 2000 Aug; 6(2):1-4
A forty-five year old longshoreman came to Yale for evaluation with a complaint of tinnitus. He has a 20 year work history of loading and unloading ships, being around loud engines, truck and forklifts, "impulse" noise from the clanking of steel loads against the steel holds, and loud fans in the refrigeratoed warehouses. He admits to wearing hearing protetction very intermittently. His problem began with sensations of ringing in his ears and decreased hearing at the end of a work shift. He would turn the radio up on his way home after work and the next morning he would find that is was much too loud. Now, he reports constant ringing in his ears. He has difficulty understanding conversations in crowded rooms and has been arguing with his wife about turning up the volume of the TV. His audiogram (Figure 1) reveals a "notch" of decreased hearing in the higher frequencies. This case is typical for noise-induced hearing loss with a history of chronic exposure to loud noise, initial temporary losses of hearing acuity ("temporary threshold shifts (TTS)"), and more gradual onset of permanent loss. The hearing deficit typically begins with a "notch", around 4000 Hz, and with time increases to involve other frequencies.
Occupational-health; Noise-induced-hearing-loss; Noise-protection; Hearing-protection; Hearing-loss; Hearing-disorders; Health-care-personnel
Yale University, Occupational and Environmental Medicine Program, New Haven, CT 06510