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Understanding the Consequences of Recreational Noise Exposure

了解娱乐噪音暴露的后果

基本信息

批准号：
MR/V01272X/1
负责人：
Chris Plack
金额：
$ 235.08万
依托单位：
University of Manchester
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2021
资助国家：
英国
起止时间：
2021 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FV01272X%2F1
关键词：
Understanding Consequences Recreational Noise Exposure

项目摘要

Hearing loss is the most common sensory deficit and the third leading cause of long-term disability, higher than diabetes and dementia. Yet just 0.6% of UK health research spending is on hearing health. Noise exposure is the main cause of preventable hearing loss worldwide. In particular, there is much concern in the academic and clinical communities, and in the popular media, that young people are damaging their hearing by exposure to intense recreational noise, through the use of personal music players and attendance at nightclubs and live music events. In the clinic, hearing loss is diagnosed using pure tone audiometry, which measures the sensitivity of the ear by determining the softest tones that can be heard at several test frequencies, plotted as an audiogram. However, pure tone audiometry is relatively insensitive to the earliest effects of noise damage: damage to the hair cells in the inner ear can occur without affecting the audiogram; hearing loss may occur at high frequencies, beyond the standard range that is tested in the clinic; and evidence from experiments in rodents and monkeys suggest that noise exposure can disconnect the nerve fibres that carry information from the ear to the brain, again without affecting sensitivity to quiet sounds. It is important that we understand the full effects of recreational noise exposure, beyond the pure tone audiogram, because:1. "Sub-clinical" deficits may contribute to listening difficulties, such as understanding speech in noisy environments, and may be a cause of tinnitus ("ringing in the ear"). 2. These deficits will likely be exacerbated by the effects of age, which is also associated with hair cell and nerve deficits. Hence, noise damage in early life, even if it doesn't cause listening difficulties at the time, may contribute to listening difficulties in later years, affecting employability, reducing quality of life, and possibly increasing the risk of dementia. 3. The presence of sub-clinical deficits may be an early warning that continued exposure will lead to future, more substantial, clinical hearing loss and chronic tinnitus.In this five-year grant we aim to determine the true impact of recreational noise exposure on hearing health. We will test a large cohort of teenagers before and after their first years of exposure to potentially harmful recreational noise, using advanced tests sensitive to subtle hair cell and neural deficits. We will also investigate listening habits and relation to hearing ability and tinnitus in a large number of young adults using an internet survey, and we will investigate the factors affecting temporary hearing loss in a laboratory-based study, in particular whether ears can be "toughened" by prior noise exposure. We will use these results to determine the early signs of noise damage and the risk factors involved. Finally, we will use advanced brain imaging and electrophysiological techniques to help detect sub-clinical damage to the auditory nervous system in younger and older adults. We will determine the relative contributions of the sub-clinical and clinical deficits to listening ability.Our research has a number of potential benefits. Being able to detect the early signs of noise damage, and characterise the circumstances and individual characteristics that are associated with damage, will help identify young people who are at risk, and provide targeted healthcare advice to prevent further hearing loss. Understanding the true impact of noise exposure will also inform noise exposure regulations, particularly in recreational situations for which current regulations are weak. For people experiencing listening difficulties, our results may lead to more sensitive clinical tests that will improve management options, such as fitting characteristics for hearing aids and behavioural changes. Overall, our findings will help to reduce the huge societal burden of hearing loss and tinnitus.

听力损失是最常见的感觉缺陷，也是导致长期残疾的第三大原因，高于糖尿病和痴呆症。然而，英国健康研究支出中只有0.6%用于听力健康。噪声暴露是全球可预防听力损失的主要原因。特别是，学术界和临床界以及大众媒体都非常关注年轻人因使用个人音乐播放器和参加夜总会和现场音乐活动而暴露于强烈的娱乐噪音而损害他们的听力。在临床上，听力损失是使用纯音测听来诊断的，纯音测听通过确定在几个测试频率下可以听到的最柔和的音调来测量耳朵的灵敏度，绘制成听力图。然而，纯音测听对噪声损伤的早期影响相对不敏感：内耳毛细胞的损伤可能发生而不影响听力图;听力损失可能发生在高频，超出临床测试的标准范围;在啮齿动物和猴子身上的实验证据表明，噪音暴露会切断从耳朵到大脑传递信息的神经纤维，同样不影响对安静声音的敏感性。重要的是，我们要了解娱乐性噪声暴露的全部影响，超越纯音听力图，因为：1。“亚临床”缺陷可能导致听力困难，例如在嘈杂环境中理解语音，并且可能是耳鸣（“耳鸣”）的原因。2.这些缺陷可能会因年龄的影响而加剧，这也与毛细胞和神经缺陷有关。因此，早期生活中的噪音损伤，即使当时不会导致听力困难，也可能导致晚年的听力困难，影响就业能力，降低生活质量，并可能增加痴呆症的风险。3.亚临床缺陷的存在可能是一个早期警告，持续暴露将导致未来更严重的临床听力损失和慢性耳鸣。在这个为期五年的资助中，我们的目标是确定娱乐性噪音暴露对听力健康的真正影响。我们将使用对细微的毛细胞和神经缺陷敏感的先进测试，在青少年暴露于可能有害的娱乐噪音的前几年和后几年对他们进行测试。我们还将使用互联网调查研究大量年轻人的听力习惯及其与听力和耳鸣的关系，我们将在实验室研究中调查影响暂时性听力损失的因素，特别是耳朵是否可以通过先前的噪音暴露而变得“坚韧”。我们将使用这些结果来确定噪音损害的早期迹象和所涉及的风险因素。最后，我们将使用先进的脑成像和电生理技术来帮助检测年轻人和老年人听觉神经系统的亚临床损伤。我们将确定亚临床和临床缺陷对听力的相对贡献。我们的研究有许多潜在的好处。能够检测到噪音损害的早期迹象，并识别与损害相关的环境和个人特征，将有助于识别处于风险中的年轻人，并提供有针对性的医疗建议，以防止进一步的听力损失。了解噪声暴露的真实影响也将为噪声暴露法规提供信息，特别是在当前法规薄弱的娱乐场所。对于有听力困难的人，我们的研究结果可能会导致更敏感的临床测试，这将改善管理选项，例如助听器的适配特性和行为变化。总的来说，我们的研究结果将有助于减轻听力损失和耳鸣的巨大社会负担。