Download Ace Medicine Rating Noise-induced hearing loss: scientific advances

474 OCCUPATIONAL MEDICINE
doi:10.1093/occmed/kqs107
Noise-induced hearing loss:
scientific advances
Edited by Colleen Le Prell, Donald Henderson, Richard R.
Fay and Arthur N. Popper. Published by Springer, New York,
2012. ISBN: 978-1-4419-9522-3. Price: $110 (hardback),
Amazon: £94.05 (hardback) or £72.15 (Kindle). 376 pp.
If you are a ‘jobbing’ occupational physician looking for
a book on the diagnosis of noise-induced hearing loss
(NIHL), then this is not the one for you. It is from a
series of volumes on auditory research aimed at graduate students, post-doctoral researchers and clinical
investigators; a synthetic rather than a systematic review,
laced with a wealth of conceptual information. Prefaced
in this light, I started the book with some trepidation
but ended it with full blown NIHL ‘anoraksia’. The
editors have brought together a group of international
and expert contributors, primarily US based, who have
written in mostly readable styles where the emphasis is
more public than occupational health. It concentrates
on recent advances in the understanding of mechanisms associated with NIHL. The book is divided into
four sections: scope, dose-response, susceptibility and
protection.
Perennial problems over case definition, the use of the
‘notch’ (not universally present) and its disappearance
with age are covered well. I particularly liked the chapter
on kurtosis (Greek for bulging) to improve the analysis
of noise exposures or for that matter the movement of
stocks and shares; the burden of hearing loss from noise
exposure may not be well served by always relying on
the ‘average’ (Leq) as opposed to intermittent higher levels. They rightly draw attention to the inappropriate use
of age effect tables developed over 40 years ago to estimate the current burden of NIHL that doesn’t reflect
generational differences. The chapter on suprathreshold
auditory processing nicely links temporary threshold
shift to asymptomatic threshold shift, which may last
for weeks or months, and the development of permanent hearing loss and associated auditory processing difficulties. A better understanding of biological aspects of
noise-induced tinnitus is explored with a view to treatments aimed at auditory aspects instead of traditional
attentional and emotional treatments.
Part III on susceptibility probes the areas of genetic
and early life experiences of noise, but as yet no specific
test exists for the susceptibility to noise. Age-related hearing loss is covered but the book draws no definitive conclusions regarding an additive or synergistic effect with
noise other than it being more complex than ISO 1999.
This section also includes interesting aspects on the synergistic effects of some chemicals and noise, which alone
would not cause NIHL, but in combination can result in
a significant and permanent loss.
The last section including hearing protection devices
(HPD) is, however, informative on new applications particularly for very high noise levels and specialized communication settings; HPD if properly selected, fitted and
worn are indeed effective [but so rarely the case in practice]. In conclusion, the book points to the future use of
therapeutic antioxidants and other agents as a potential
protection for the inner ear!
Fascinating stuff, but for an occupational health practitioner, this is one for the reference library. I’ll stick to
my third edition of Sataloff and Sataloff.
Rating
HHII (Reference only)
Ian J. Lawson
doi:10.1093/occmed/kqs108
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