In both NIHL and ARHL, difficulties understanding speech in noisy environments are common due to permanently elevated audiometric thresholds, worse temporal resolution, and poorer frequency selectivity ( Findlay, 1976 Gates & Mills, 2005 Scheidt et al., 2010 Schorn & Zwicker, 1990).Įvidence from several animal species suggests that noise exposure and aging may damage the cochlear synapses that connect the inner hair cells with the auditory nerve well before cochlear hair cells are damaged ( Kujawa & Liberman, 2009, 2015 Lin et al., 2011 Shehabi, Prendergast, & Plack, 2022 Valero et al., 2017). At a physiologic level, both NIHL and ARHL manifest as sensorineural hearing loss due to permanent damage to the cochlear outer hair cells (OHCs) inner hair cells (IHCs), and spiral ganglion cells ( Gates & Mills, 2005 Huang & Tang, 2010 E. Alongside other etiologies such as metabolic cochlear changes lifestyle-related factors such as smoking, alcohol intake, low socioeconomic status, dietary aspects, and general health (e.g., cardiovascular disease and diabetes) and genetic susceptibility, these factors may contribute to age-related hearing loss (ARHL Gates & Mills, 2005 Tas, 2022 Toppila et al., 2001). Noise and ototoxic exposures are health and safety hazards in some workplaces ( Lie et al., 2016). A recent study found that about 32% of industrial workers in Palestine had occupational injuries, and thus, the authors concluded that occupational health and safety measures are poorly regulated in Palestine compared to other countries ( Tuhul et al., 2021). The International Labor Organization investigated occupational health and safety measures in the Palestinian territories and highlighted the lack of strict implementation of occupational health and safety laws and the noncompliance with such regulations in Palestinian industries ( International Labour Office, 2017, 2018). This could be explained by the fact that regulations on the maximum permissible levels of occupational noise and the use of protective hearing equipment at the workplace are more strictly implemented in industrialized and developed countries ( Tikka et al., 2012). (2016) estimated that about 7%–21% of hearing loss is attributable to occupational noise exposure among workers, with a significantly higher prevalence in developing than industrialized countries. Similarly, a systematic review by Lie et al. According to the World Health Organization (WHO), occupational noise exposure accounts for about 16% of adult disabling hearing impairment (DHI) cases worldwide, with up to 21% in some developing world subregions ( Concha-Barrientos et al., 2004 D. Permanent hearing impairment secondary to noise exposure is widely known as NIHL ( D. In developing countries, since many workers are present in the workplace for 6 days a week and 8 hr a day (i.e., 48 hr per week), a maximum permissible limit of occupational noise of 88 dB(A) L eq for 8 hr per day has been proposed as a feasible and cost-effective criterion (i.e., realistic to implement) that yet meets the upper ISO limit of maximum occupational noise permissible level ( Shaikh, 1999). Different developed countries have adopted different maximum permissible occupational noise exposure limits within this range ( Shaikh, 1999). The International Standards Organization (ISO) defined maximum permissible levels of occupational noise exposure as 85–90 dB(A) L eq for 8 hr per day (40 hr per week ISO/R 1999:1971 ISO, 1971). Occupational noise exposure is associated with auditory and nonauditory symptoms such as noise-induced hearing loss (NIHL), temporary threshold shifts, tinnitus, hyperacusis, increased stress, cardiovascular disease, and hypertension ( Basner et al., 2014 Sheppard et al., 2020).
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