SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background: Literature suggests that risk factors for middle ear pathologies, such as traumatic injuries and human immunodeficiency virus (HIV), exist in mines. However, studies on hearing health in mines seem to focus primarily on occupational noise-induced hearing loss and ignore middle ear pathologies. As a result, there is little documented evidence on the trends of middle ear pathologies in mine workers.

Objectives: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in mine workers.

Method: A systematic literature review of studies that reported middle ear pathologies in mine workers was conducted. Medline, CINAHL, PubMed, PsychInfo and Google Scholar databases were searched for studies in English published between January 1994 and December 2018 and reporting on trends in middle ear pathologies in mine workers.

Results: Two research studies met the selection criteria and were included for analysis. One research study used tympanometry with 226 Hz probe tone, while another study used interviews to determine the presence of middle ear pathologies. While these studies indicate that middle ear pathologies exist in individuals working in mines, the evidence is limited.

Conclusion: While current data indicate that individuals working in mines may present with middle ear pathologies of varying severities, the evidence is too small to provide a clear trend of middle ear pathologies in individuals working in mines. Therefore, the current limited data suggest a need for further studies to examine middle ear pathologies in individuals working in mines.

The aim of this study was to explore the perspectives of occupational health practitioners (OHPs) regarding education and training of mineworkers on occupational noise induced hearing loss (ONIHL) and its impact on mineworkers' health. Qualitative, in-depth telephonic and face-to-face interviews were conducted with 16 OHPs. Purposive and snowball sampling was utilized to recruit participants. Data were analysed using inductive thematic analysis. Three themes emerged from the data: seeing is believing, not my department, barriers and facilitators to raising awareness (with two subthemes -blame it on the language and level of education, and compensation pay-outs). Superficially, OHPs believe that mineworkers are aware of the impact of noise health, however, the OHPs are not knowledgeable on how the mineworkers are educated on ONIHL and its latent consequences. Furthermore, language, low levels of education and literacy, as well as financial constraints are factors found to affect education and training of the mineworkers about the risks of ONIHL. If the mining industry is committed in eliminating ONIHL, they should prioritize health literacy, and mines need to have an effective awareness raising plan in place at every mine. This plan should consider diversity of the workforce, including linguistic as well as educational level diversity.

Background: Occupational health laws must recognise the constitutional requirement of substantive equality, and its role in 'the progressive realisation' of the rights provided by Section 27.

Objectives: Our main aim is to review current South African occupational health law (vis-à-vis workers' constitutional rights) in relation to hearing loss. We focus on gaps in the law regarding occupational hearing loss in South Africa.

Method: Our review of legal texts relies on experience as a methodological device augmented by the use of a critical science. Guided by literature or evidence synthesis methodologies, South African primary and secondary laws were reviewed along with unpublished (non-peer-reviewed) grey literature. An established six-step framework guided our thematic analysis. A semantic approach aided the critical interpretation of data using the Bill of Rights as a core analytical framework.

Results: Four themes are discussed: (1) separate and unequal regulatory frameworks; (2) monologic foregrounding of noise; (3) minimisation of vestibular disorders; and (4) dilution of ototoxic agents. The highly divided legal framework of occupational health and safety in South Africa perpetuates a monologic 'excessive noise-hearing loss' paradigm that has implications for the rights of all workers to equal protections and benefits. There is a need to harmonise occupational health and safety law, and expand the scope of hearing-protection legislation to include the full range of established ototoxic hazards.

Conclusion: Occupational audiology is dominated by efforts to address noise-induced hearing loss. A 'noise' despite the reality of workers' exposures to a range of ototoxic stressors that act synergistically on the ear, resulting in audio-vestibular disorders.

Background: A relationship exists between occupational noise exposure and age, which remains poorly understood.

Objectives: The aim of this study was to establish the relationship between hearing loss and age over time.

Method: Audiological data from 2583 mine workers in South Africa were utilised. Data were received from a non-noise exposed group (NNEG) (n = 951) and a noise exposed group (NEG) (≥85 dBA) (n = 1632). Data comprised a low-frequency average (LFA512) (average of audiological thresholds for 0.5 kHz, 1 kHz and 2 kHz) and high-frequency average (HFA346) (average of audiological thresholds for 3 kHz, 4 kHz and 6 kHz). Data were compared by using mixed-effects regression analysis.

Results: Base threshold values were higher for the NEG than for the NNEG across frequencies. All year-to-year increases in mean hearing thresholds were statistically significant (p 0.01). When correcting for age, increases in mean hearing thresholds were higher for the NEG than for the NNEG for HFA346 (3.5 dB vs. 2.9 dB decline over a 4-year period) but similar for LFA512 (0.6 dB vs. 0.7 dB decline). Uncorrected for age, increases in mean hearing thresholds were higher than when age was corrected for.

Conclusion: Age and occupational noise exposure influence hearing thresholds over time. The continued increase in hearing thresholds of the NEG above that of the NNEG can be related to ineffective noise management programmes and/or the fact that early noise exposure leads to a higher burden of hearing loss over time - even after noise exposure had stopped.

Background: Chemical exposure leading to ototoxicity is a fresh challenge for occupational healthcare in South Africa.

Objectives: The critical question is: 'what is known about occupational ototoxic chemicals with or without noise exposure in South Africa?'

Method: This qualitative, mapping study was completed with published (peer-reviewed) and grey literature from 1979-2019. Data was analysed using the Preferred Reporting Items for Systematic reviews and Meta-Analyses: extension for Scoping Reviews and the Nursing and Allied Health Resources Section subcommittee on Mapping the Literature of Nursing and Allied Health (adapted). Numerical analysis of article type was completed, but the primary focus was on capturing patterns/trends using thematic analysis and ideology critique.

Results: The African Journal of Disability, African Journal of Primary Health Care and Family Medicine, South African Medical Journal, The South African Journal of Communication Disorders [SAJCD] and Health SA Gesondheid) were included with the SAJCD containing one relevant item and seventeen other items were analysed. Research focusses on the mining sector (gold) in Gauteng, and ototoxic medication (tuberculosis and/or human immunodeficiency virus) take precedence. In KwaZulu-Natal, the focus is on commerce and industry across formal and informal sectors. There are no governmental policies that refer to chemical ototoxicity. Occupational hearing loss is configured exclusively on the meme that noise exposure is the only toxin.

Conclusion: Chemical exposures are only just beginning to be recognised as ototoxic in South Africa. Hearing conservation programmes should always serve the workers' interests and never bow down to the econometric interests of employers.

Background: The significance of how occupational noise can influence attitudes towards occupational noise exposure, susceptibility to hearing loss and job performance has generally been neglected in the past studies.

Objectives: The aim of this study was to determine the impact of occupational noise on attitudes towards occupational noise exposure, susceptibility to hearing loss and job performance of manufacturing small and medium enterprises (SMEs) workers in Zimbabwe.

Method: A survey was conducted involving 250 respondents, including manufacturing SME workers, and the hypotheses were analysed by applying structural equation modelling.

Results: Occupational noise had a positive and significant effect on attitudes towards occupational noise exposure and perceived susceptibility to hearing loss amongst manufacturing SME workers. In addition, attitudes towards exposure to occupational noise and the perceived susceptibility of hearing loss have had a positive and significant impact on manufacturing SME workers' job performance.

Conclusion: The novelty of the research is its analysis of occupational noise as an indicator of attitudes towards occupational noise exposure and susceptibility to hearing loss as well as job performance. This study provides practitioners with beneficial implications. Collective knowledge on occupational noise could help manufacturing SME managers in recognising the perceptions of employees on occupational noise and how it ultimately affects job performance. Moreover, this study is intended to add new knowledge to the current body of African occupational noise literature - a context that has not received much research attention in developing countries.

Background: Occupational noise-induced hearing loss (ONIHL) does not occur in isolation from other influencing factors such as health conditions and illnesses like human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS), as well as tuberculosis (TB). How the burden of disease influences the occurrence and/or management of ONIHL becomes a key if the goal of hearing conservation programmes (HCPs) is to be achieved within these contexts.

Objectives: The purpose of this scoping review was to conduct an investigation on how the burden of disease's influence on ONIHL is reported in literature, with a specific focus on the most prevalent diseases in South African mines - HIV and AIDS and TB.

Method: A scoping review was conducted using the Arksey and O'Malley's framework. A search was conducted in five electronic bibliographic databases and the grey literature.

Results: The search procured 10 publications, with two specific to ONIHL within the South African context. In addition to the two publications specific to TB and ONIHL, findings revealed a serious gap in the evidence around the scoping review question globally. This obvious lack of investigations into the influence of these two conditions in the South African mining context raises serious implications about the responsiveness, and proactive nature of HCPs within this population.

Conclusion: Considering the burden of diseases on otology and audiology is critical as certain diseases cause hearing impairment either as a primary effect, as a secondary/opportunistic effect or as a side effect of treatment options for that disease. An employee suffering from any such disease with concomitant exposure to hazardous noise levels presents an even bigger challenge to HCPs if such is not taken into consideration in the conception, implementation and monitoring of HCPs.

Background: Current evidence from low- and middle-income (LAMI) countries, such as South Africa, indicates that occupational noise-induced hearing loss (ONIHL) continues to be a health and safety challenge for the mining industry. There is also evidence of hearing conservation programmes (HCPs) being implemented with limited success.

Objectives: The aim of this study was to explore and document current evidence reflecting recent advances in HCPs in order to identify gaps within the South African HCPs.

Method: A systematic literature review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Electronic databases including Sage, Science Direct, PubMed, Scopus MEDLINE, ProQuest and Google Scholar were searched for potential studies published in English between 2010 and 2019 reporting on recent advances in HCPs within the mining industry.

Results: The study findings revealed a number of important recent advances internationally, which require deliberation for possible implementation within the South African HCPs context. These advances have been presented under seven themes: (1) the use of metrics, (2) pharmacological interventions and hair cell regeneration, (3) artificial neural network, (4) audiology assessment measures, (5) noise monitoring advances, (6) conceptual approaches to HCPs and (7) buying quiet.

Conclusion: The study findings raise important advances that may have significant implications for HCPs in LAMI countries where ONIHL remains a highly prevalent occupational health challenge. Establishing feasibility and efficacy of these advances in these contexts to ensure contextual relevance and responsiveness is one of the recommendations to facilitate the success of HCPs targets.