Non-Auditory Effects of Noise Exposure LTC Lorraine A. Babeu, Ph.D. US Army Research Laboratory,...
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Transcript of Non-Auditory Effects of Noise Exposure LTC Lorraine A. Babeu, Ph.D. US Army Research Laboratory,...
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Non-Auditory Effects of Noise Exposure
LTC Lorraine A. Babeu, Ph.D.US Army Research Laboratory, APG, MD
MAJ Cheryl Cameron, M.S.AMEDD Center & School, Fort Sam Houston, TX
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Non-Auditory Effects Of Noise
Physiological •Stress Arousal
•Sleep Disturbance Psychological
•Annoyance
•Behavioral Communication Cognition Intervention strategies
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Physiological: Stress
Noise is biological stressor•Sympathetic nervous system
•Activated at 65-70dBA
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Physiological:Stress
What is it?•Body’s reaction to any stressor requires
an adjustment or response•The reaction to stress can be physical,
mental or emotional
•Causes of stress can come from your body, your thoughts, or the environment
•Whatever the cause of stress, real or imagined, the body’s response is real
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Autonomic Nervous System (ANS)
Autonomic Nervous System (ANS)•Sympathetic – “Fight or Flight”
•Parasympathetic – reverts system back from “Fight or Flight” to more relaxed
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Sympathetic Nervous System
Fight or Flight (More Energy & Oxygen)•Heart beats faster and pumps more blood per beat
•Constrict blood vessels in organs not essential to fight or flight (e.g. gastrointestinal tract)
•Waste elimination process decreased
•Breathing becomes deeper, faster & more efficient
•Pupils enlarge improving visual sensitivity
•Secretion of adrenalin reinforces and sustains the sympathetic effect
•Liver releases glucose to fuel action
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Parasympathetic Nervous System
Normalize functions of organs after Fight or Flight•Heart rate slows
•Blood vessels expand
•Gastrointestinal function increase
•Bronchial constrict
•Pupils constrict
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Physiological: Stress
Physical Basis
•Homeostasis•Metabolic equilibrium between SNS & PNS
•Over stimulating or tranquilizing leads to imbalance
•Release of powerful hormones intended for short term duty
•Chronic stimulation leads to illness
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Physiological: Stress Stress to some of the leading causes
of death•Heart disease, cancer and lung ailments
•75-90% of all doctor’s office visit stress related ailments and complaints
Per OSHA the cost of stress in the work place •300 billion annually (lost work hours due
to absenteeism, reduced productivity, workers’ compensation)
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Health Effects Associated with Stress
•Cardiovascular problems•Hypertension
•Increased risk of heart attack
•Weakened immune system
•Gastrointestinal problems•Ulcers
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Physiological: Sleep Disturbance Disrupts Normal Sleep
cycle• Longer to fall asleep
• Shortens deep and REM sleep stages
• Arousal reaction & Awakening
Vegetative disturbances persist after subjective adaptation
Decreased psychomotor function
Non REMSleep
REMSleep
Stage V
NormalSleepCycle
Awake
Non REMSleep
StagesI-IV
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Physiological: Sleep Disturbance
60dB(A) Awakening 45dB-55(A) Vegetative arousal
(refrigerator) Sleep disturbance is influenced by
•Characteristics of the noise
•Individual differences
•Age
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Psychological: Annoyance Annoyance
• A response to noise rather than an auditory perception of it •Closing a window when noise outside is too loud
Threshold of annoyance• 50-55dB(A)
Noise is more likely to be annoying if • Random
• Higher pitched
• Combined with warmer climate
• Occurs at night
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Psychological: Annoyance
Annoyance is subjective•Noise is likely to be an annoyance if one
perceives:•Not necessary
•People causing the noise do not care about its effects on those exposed to it
•The noise is not important to the economic and social success of the community
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Psychological: Social Behavior
Increased aggressiveness•Especially in those pre-disposed to
aggressive behavior Decrease helping behavior Problems with interpersonal
relationships
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Cognition
Functions most affected•Reading comprehension
•Attention span
•Problem solving
•Memorization
•Job performance
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Communication Above 55-60dB(A) background noise
interferes with communication Armor Crew Performance (Garinther & Peters, 1990)
•Mission time completion increased from 40-90 seconds
•Crew killed by enemy increased from 7% to 28%
•Targets correctly identified decreased from 98% to 68%
More taxing for children, elderly & hearing impaired
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Do we get used to it?
Habituation•Dissipation of response from repeated
exposure Adaptation
•Voluntary effort to adjust (e.g. sound proofing)
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Non-Auditory Effects of Noise
Job dissatisfaction Somatic complaints (e.g. headaches) Anxiety and post work irritability Post work irritability
• Impatience
•Nervousness
•Generally inability to unwind
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What Can We Do?
Release stress hormones•Exercise
Reduce tension•Relaxation
•Breathing exercises
•Muscle relaxation exercises
•Yoga
•Tai- Chi
•Autogenic exercises• Images of relaxed state
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Conclusion
Noise is a •biological stressor
•Annoys, awakens, angers and frustrates
•Effects performance
•Leads long term health effects Auditory system most important
sensory warning system•On duty 24/7
Include non-auditory effects of noise hearing conservation message
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Questions?????
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Website
Stress Intervention Strategies•http://www.chclibrary.org/micromed/
00066670.html
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Blast WaveA duration – time from the first increase in pressure over ambient (overpressure) reaching a maximum (peak) pressure until its return to baseline
B duration – time from first overpressure until reaching ±10% of peak pressure at a steady state
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Primary Blast Injury•Damage to internal organs without visible
external signs of injury that occurs as a direct result of the pressure wave contacting the body
Secondary Blast Injury•Damage to the body with visible external signs
of injury that occurs as a result of contact with objects that are propelled by the blast wave
Tertiary Blast Injury•Blast wave displacing the body and the body
contacting some object in the environment
Types of Blast Injury
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Noise•The “auditory” component
•Target Organ(s): inner ear
•Outcome: temporary to permanent hearing loss
Blast Injuries
Blast Overpressure•The “non-auditory” component
•Target Organ(s): gas-containing organs (lungs*, trachea, GI tract, ear)
•Outcome: performance problems, mild to severe hemorrhage
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Non-Auditory Noise Effects
Steady State Noise•120 dBA Discomfort
•140 dBA Pain
•160 dBA Ear drum rupture Impulse
•185 dBP Ear drum rupture
•200 dBP Lung rupture & embolism
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Blast Injuries
Signs of lung injury•Present early after exposure
•Dyspnoea•Difficulty breathing
•Cough•Dry to productive with frothy sputum
•Haemoptysis•Coughing up blood
•Chest pain or discomfort
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Blast Injuries
Signs of gastro-intestinal tract injury•Manifest later usually when
complications are advanced
•Abdominal pain, nausea, vomiting
•Rectal & testicular pain
•Tenesmus•Constant feeling of the need to empty bowel
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Blast Injury
Threshold of unsafe levels in humans•12 blasts, 182 dBP, 8-9ms no
abnormalities
•With higher peak pressures, large hemorrhages not only in tracheae but also in the lungs due contusions
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Blast Injury
Mechanism primary blast injuries•Stress waves
•Pressure waves like sound
•Travel slightly faster than speed of sound (340.29 m/s, 1100 feet/second)
•Height amplitude
•Responsible for the lung & small bowel injury
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Blast Injury
Mechanism primary blast injuries•Shear waves
•Long duration, low velocity, transverse waves
•Deformation of body wall and compression of structures
•Different inertias causes tearing of structures from attachments
•Responsible for large bowel injuries
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Blast Injury
Threshold of unsafe levels•Sheep studies
•Indicator of lung damage•Bleeding from very small lesions of
capillaries, harmless, self healing
•5 exposures at 188 dBP for durations of 5ms
•Or higher pressures with shorter duration with 100 exposures threshold value was at 184 dBP
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Non-Auditory Injuries
The presence & extent of pulmonary fat embolism in surviving blast victims seems to be related to mortality
Blast Energy
Lung Surface Damage
Deep Lung DamageDiffuse Aleveolar Over distension
Pulmonary Hemorrhages
Venous Air Embolism
Bone Marrow Embolism
Pulmonary Fat Embolism*
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Mechanical agitation of blast wave can:•Dislodge fat droplets within tissues
•Produce an embolus in a vessel
•Obstruct the vessel, if large enough•May cause heart attack or stroke
Significance of Emboli
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Blast Impulse
The product of the overpressure from the blast wave of an explosion and the time during which it acts at a given point (that is, the area under the positive phase of the overpressure versus time curve.)
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Picture of a damaged sheep lung
Non-Auditory Injuries
Healthy
Damaged