Occupational noise-induced hearing loss (NIHL) remains a leading occupational disorder worldwide and continues to impose substantial burdens on workers, employers, compensation systems, and health systems. ISO 1999 remains the principal framework for estimating population-level hearing loss associated with occupational noise exposure, while ISO 9612 provides the corresponding methodology for exposure determination. However, the context in which these models are applied has changed substantially. Hearing conservation programs, surveillance systems, and retrospective industrial cohorts now generate large audiometric and exposure datasets that allow direct comparisons between predicted and observed outcomes in real worker populations. This narrative review examines how such data can strengthen occupational NIHL risk assessment through validation, characterization of prediction gaps, population-specific calibration, harmonized reporting of early high-frequency indicators, and prevention-oriented interpretation. It also considers the continued value of energy-based approaches and the limits of L Aeq -only modeling in complex-noise environments characterized by impulsiveness, intermittency, or non-Gaussian temporal structure. The argument is not that established standards should be discarded, but that their implementation should become more transparent, data-informed, and adaptive. A staged pathway is proposed in which established frameworks are retained while their use is strengthened through structured validation procedures, calibration strategies, explicit applicability statements, and data infrastructures that support future model refinement. The proposed framework also treats real-world data heterogeneity, healthy-worker selection, co-exposures, baseline-rule inconsistency, and the field operability of complex-noise metrics as explicit determinants of model transportability. For prediction applications, it emphasizes prespecified endpoints, transparent calibration, external validation, and avoidance of overinterpretation by machine learning or other high-dimensional methods.
OBJECTIVE:To examine intensive care unit (ICU) staff-perceived alarm-noise burden and related health, communication, workload, and alarm-response outcomes, contextualized by usual-care night-time acoustic monitoring. METHODS:We conducted a single-center observational study combining an electronic survey of ICU healthcare professionals with contextual bed-level night-time acoustic monitoring. The survey assessed perceived unit noise, alarm-related health and performance effects, communication interference, alarm-response behavior, alarm-governance perceptions, modified workload, and noise sensitivity. Acoustic outcomes included the equivalent continuous sound level, the maximum sound level, and the time above 80 dBA. Acoustic data were not linked to individual staff responses. Descriptive statistics, Cronbach's alpha, Spearman correlations, and exploratory multivariable regression were used. RESULTS:Among 124 respondents, 83 were nurses, 20 were respiratory therapists, 18 were physicians, and 3 were allied health/other staff. Median perceived unit noise was 7/10 (interquartile range, 5-8), and 67 respondents (54.0%) rated noise as high. Excessive alarms triggered physical symptoms in 70 (56.5%), reduced work performance or motivation in 63 (50.8%), affected concentration or attention in 60 (48.4%), and interfered with communication in 48 (38.7%). Twenty-eight respondents (22.6%) reported missed alarms due to sensory overload. CONCLUSION:ICU alarm noise was perceived as an occupational health and workflow burden. Contextual acoustic monitoring showed measurable night-time sound exposure. Quiet ICU interventions should combine alarm hygiene, escalation governance, workflow redesign, central alarm visibility, and objective acoustic surveillance while preserving patient safety.
OBJECTIVE:To investigate the association of rhythmic auditory stimulation (RAS) combined with body weight support treadmill training (BWSTT) with gait symmetry and balance function in patients with post-stroke hemiplegia. METHODS:This retrospective study included 110 patients with post-stroke hemiplegia admitted between January 2023 and January 2025. According to the treatment received under non-randomized allocation, patients were divided into the BWSTT-alone group ( n = 55) and the RAS + BWSTT group ( n = 55). Gait symmetry, balance function (Berg balance scale [BBS] and Fugl-Meyer assessment [FMA-LE]), and walking ability (10-m walk test [10MWT] and 6-min walk test [6MWT]) were compared between the two groups before and after treatment. Adverse events were recorded. RESULTS:After 8 weeks of treatment, the RAS + BWSTT group showed significantly higher step length symmetry index, cadence symmetry index, and double support phase time symmetry index compared with the BWSTT-alone group ( P < 0.05). BBS scores, FMA-LE scores, 10MWT speed, and 6MWT distance improved significantly in both groups, with the RAS + BWSTT group showing significantly greater improvement ( P < 0.05). However, the between-group differences for BBS (2.26 points) and FMA-LE (2.83 points) did not reach the established minimal clinically important difference (MCID) thresholds. No significant difference in adverse event incidence was observed between the groups ( P > 0.05). CONCLUSION:RAS combined with BWSTT was associated with significant improvements in gait symmetry and walking ability compared with BWSTT alone. For balance and lower limb motor function, although between-group differences were statistically significant, they did not meet MCID thresholds; therefore, their clinical significance requires further investigation. This combined approach may provide a reference for developing walking rehabilitation programs for patients with post-stroke hemiplegia.
OBJECTIVE:To investigate the correlation between environmental noise in the intensive care unit (ICU) and the occurrence of delirium and heart rate variability (HRV) in patients after percutaneous coronary intervention (PCI), thereby providing a clinical basis for optimizing the ICU environment, reducing delirium incidence, and improving patient prognosis. METHODS:We enrolled 132 patients admitted to the ICU after PCI between January 2023 and January 2024. Environmental noise was continuously monitored for 72 h. We assessed delirium using the Nursing Delirium Screening Scale, and HRV parameters, including the standard deviation of normal-to-normal RR intervals (SDNN), the root mean square of successive differences between adjacent RR intervals (rMSSD), low-frequency power (LF), and high-frequency power (HF), were recorded via dynamic electrocardiography. We evaluated data using Pearson correlation analysis and logistic regression analysis. RESULTS:The mean ICU noise level was 51.74 ± 4.82 dB, and the incidence of delirium was 35.61%. Noise levels were significantly higher in the delirium group than in the non-delirium group ( P < 0.05). Pearson analysis revealed that noise levels were negatively correlated with SDNN, rMSSD, and HF ( r = -0.429 to -0.356, P < 0.01), and positively correlated with LF ( r = 0.398, P = 0.001). Multivariate logistic regression analysis identified ICU environmental noise [odds ratio (OR) = 1.171], age (OR = 1.060), and postoperative pain score (OR = 1.288) as independent risk factors for delirium ( P < 0.05). CONCLUSION:Environmental noise levels in the ICU after PCI generally exceed recommendations. High noise levels are associated with abnormal HRV parameters and an increased risk of delirium. Optimizing the ICU acoustic environment may help reduce the incidence of delirium and improve patient outcomes.
INTRODUCTION:Aircraft noise is an occupational and environmental stressor associated with auditory injury and adverse mental health outcomes, but prospective evidence in newly enlisted personnel remains limited. This pilot study examined early changes in hearing thresholds and psychological well-being among Republic of Korea Air Force soldiers. METHODS:Newly enlisted soldiers were enrolled at baseline ( n = 96); 52 completed 8-month follow-up. Air-conduction thresholds were measured at 250 to 8000 Hz. Psychological and sleep outcomes were assessed using the Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index, and Insomnia Severity Index. Regression models adjusted for noise exposure and shift work evaluated associations between threshold shifts and psychological changes. RESULTS:Subclinical threshold shifts of 2 to 3 dB occurred at 4000 Hz in the right ear [False Discovery Rate-adjusted P -values ( PFDR ) = 0.007] and left ear ( PFDR = 0.047), and at 250 Hz in the right ear ( PFDR = 0.038). PHQ-9, CESD-R, and BAI scores increased over follow-up (all Praw < 0.05), although these changes were not significant after FDR adjustment (all PFDR > 0.05). No incident tinnitus was reported. In adjusted models, 4000 Hz threshold shifts showed borderline associations with increased BDI ( β = 0.350, PFDR = 0.057) and CESD-R scores ( β = 0.384, PFDR = 0.057). CONCLUSION:Short-term aircraft noise exposure was associated with early subclinical auditory shifts and numerical worsening of psychological measures. The 4000 Hz shift may represent a preliminary marker of depressive symptom emergence, supporting further investigation of sensory-psychological interactions in high-noise military environments.
OBJECTIVE:To explore the efficacy of home-based white noise therapy combined with positive reinforcement-based nursing on sleep quality, negative emotions, hope level, and postoperative complications in patients after painless endoscopic gastrointestinal polypectomy. METHODS:A retrospective cohort study was conducted on 130 patients who underwent painless endoscopic gastrointestinal polypectomy at Nantong First People's Hospital between November 2023 and November 2024. Patients were categorized into a combination group ( n = 65, routine care, home-based white noise therapy, and positive reinforcement-based nursing) and a routine group ( n = 65, routine home care) based on the nursing regimen they received. Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Herth Hope Index (HHI) scores, and postoperative complication rates were compared between the two groups after nursing. RESULTS:After care, the combination group had significantly lower PSQI, SAS, and SDS scores (all P < 0.05) and significantly higher HHI scores in all dimensions and total score than the routine group (all P < 0.05). The total complication rate was numerically lower in the combination group than in the routine group (1.54% versus 10.76%), but the difference was not statistically significant (Fisher's exact test, P = 0.062). CONCLUSION:Home-based white noise therapy combined with positive reinforcement-based nursing was associated with improved sleep quality, reduced negative emotions, increased hope level, and lower postoperative complication rates in patients after painless endoscopic gastrointestinal polypectomy, suggesting its potential value for clinical application.
OBJECTIVE:To investigate the effects of comprehensive noise reduction nursing on pain management and quality of life in patients with T-tube drainage after choledocholithiasis surgery. METHODS:We retrospectively analysed 170 patients who underwent choledocholithiasis surgery with T-tube drainage between January 2023 and June 2025. Patients received either conventional nursing ( n = 73) or comprehensive noise reduction nursing ( n = 97). Outcomes included postoperative pain assessed using the Visual Analogue Scale (VAS), sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI), stress indicators (cortisol [COR] and norepinephrine [NE]), T-tube-related complications, quality of life assessed using the 36-Item Short Form Health Survey (SF-36) and readiness for hospital discharge assessed using the Readiness for Hospital Discharge Scale (RHDS). RESULTS:The noise reduction group showed significantly lower VAS scores on postoperative days 1, 3 and 7 (all P < 0.05). On postoperative day 7, the noise reduction group had better PSQI scores (except sleep medication use, P = 0.307) and lower serum COR and NE levels than the conventional nursing group (all P < 0.05). T-tube-related complications were fewer in the noise reduction group (9.28% vs. 21.92%, P < 0.05). Before discharge, the noise reduction group exhibited higher SF-36 scores in most dimensions (all P < 0.05), though differences in social functioning and role-emotional were not significant. RHDS scores were also significantly higher in the noise reduction group (all P < 0.05). Sensitivity analyses confirmed the robustness of the main findings, with no significant differences in baseline characteristics or perioperative management between the two study periods. In addition, a contemporaneous subgroup analysis (patients admitted after June 2024) demonstrated consistent results across most study endpoints. CONCLUSION:Comprehensive noise reduction nursing was associated with reduced postoperative pain, improved sleep quality, fewer T-tube-related complications and stress responses and better quality of life and discharge readiness in patients after choledocholithiasis surgery with T-tube drainage.
OBJECTIVE:Transportation noise is a pervasive environmental pollutant that has significant implications for physical and mental health, particularly in urban areas. This scoping review summarizes the long-term health effects of transport noise from road, rail, and aircraft sources and evaluates available mitigation strategies in Europe. METHODS:Using the Reporting Standards for Systematic Evidence Syntheses (ROSES), we identified 74 peer-reviewed articles from Scopus, Web of Science, and Google Scholar in order to assess health impacts of noise and the available strategies for mitigating them. RESULTS:Most studies encompassed European regions via multicountry datasets. The findings support the well-known impacts of noise on human health, including cardiovascular disease, increased blood pressure, annoyance, sleep disturbance, and evidence of adverse mental performance and cognitive impairment outcomes related to noise. Vulnerable populations, such as children and the elderly, are disproportionately affected. Mitigation strategies are subdivided into categories of source, propagation, and exposure. Propagation strategies, such as acoustic barriers and vegetation belts report 8-12 A-weighted decibel (dB(A)) and 2.5-8.5 dB(A) reduction, while source reductions of traffic optimization (1-3.5 dB(A)) and calming (1-5 dB(A)) are lower. Mitigation strategies addressing physical effects primarily focus on source, propagation, and planning measures, whereas strategies targeting mental effects emphasize exposure reduction, such as soundproofing and improvements to the immediate environment through greenery. CONCLUSIONS:Gaps remain in understanding the cumulative effects of multimodal noise exposure, gender-specific responses, and the integration of objective health measures. The scoping review highlights the potential and urgent need for integrated, proactive noise mitigation strategies in spatial and urban planning.
BACKGROUND:Environmental noise exposure, tinnitus and hearing loss (HL) are hypothesised to influence trouble sleeping, but their integrated effects and mediating pathways remain unclear. This study evaluates associations amongst noise exposure, auditory health and sleep outcomes and explores mediation by tinnitus and HL. METHODS:A total of 8539 participants were enrolled using data from the National Health and Nutrition Examination Survey (NHANES, 2006-2020). Logistic regression and mediation analysis examined associations amongst noise exposure, auditory health and sleep outcomes. RESULTS:Noise exposure (workplace: adjusted odds ratio [OR] = 1.145, 95% confidence interval [CI]: 1.015-1.292, P = 0.027; off-work: adjusted OR = 1.165, 95% CI: 1.005-1.348, P = 0.042) and tinnitus (adjusted OR = 1.648, 95% CI: 1.442-1.882, P < 0.001) were positively associated with trouble sleeping, and speech-frequency HL (SFHL) showed a protective effect (adjusted OR = 0.767, 95% CI: 0.660-0.891, P = 0.001). The association between noise exposure and trouble sleeping was significantly mediated by tinnitus and depression (accounting for 12.76%-37.80% of total effects) but not by SFHL. Subgroup analyses showed that SFHL was only significantly associated with trouble sleeping in the subgroups of those unexposed to a noise environment, whereas tinnitus was significant in each subgroup. Restricted cubic spline analyses showed that hearing thresholds ≥20 dB were linked to reduced risk of trouble sleeping, with nonlinear (inverted U-shaped) trends in the subgroups of noise-exposed workplace and noise-unexposed off-work. CONCLUSIONS:> Workplace and off-work noise exposures are closely associated with trouble sleeping, with tinnitus mediating this association and SFHL exerting a protective effect. The findings highlight the importance of controlling noise exposure and implementing preventive interventions for tinnitus to alleviate noise-related sleep issues.
OBJECTIVE:To examine whether sleep disturbance mediates associations between self-reported nighttime noise annoyance and depression, anxiety, and suicide risk in Taiwanese adults. METHODS:We analyzed cross-sectional online survey data from 776 Taiwanese adults collected between December 2024 and May 2025. Self-reported nighttime noise annoyance from road traffic, railways, aircraft, and residential building vibrations was assessed on a 5-point verbal scale. Sleep disturbance was assessed with the Pittsburgh Sleep Quality Index (PSQI), and depression, anxiety, and suicide risk were assessed with validated self-report scales. Mediation analyses estimated total, natural direct, and natural indirect effects using 5000 bootstrap resamples. RESULTS:Self-reported nighttime noise annoyance from road traffic, aircraft, and residential building vibrations was associated with poorer subjective sleep quality. Self-reported nighttime noise annoyance from all four sources was associated with longer sleep latency, more sleep disturbances, greater use of sleeping medication, worse daytime dysfunction, and higher global PSQI scores ( B = 0.652-0.788; all P < 0.001), but not with sleep duration or habitual sleep efficiency. Significant natural indirect effects through sleep disturbance were observed for anxiety, depression, and suicide risk for road traffic annoyance ( B = 0.076-0.463) and residential building vibration annoyance ( B = 0.082-0.503); 95% confidence intervals excluded 0. For residential building vibration annoyance, 40.1%-63.6% of total associations were mediated. CONCLUSION:Sleep disturbance may mediate associations between self-reported nighttime noise annoyance and depression, anxiety, and suicide risk. Populations reporting nighttime noise annoyance may benefit from sleep assessment and source-specific noise mitigation.
OBJECTIVE:The aim of this work is two-fold: to characterize air-source heat pump (ASHP) noise emissions and to systematically evaluate the scientific evidence regarding non-auditory health effects, thereby assessing the technology's current and future public health impact. METHODS:The primary component is a PRISMA-guided systematic review on noise impact. Utilizing a population-exposure-outcome framework, eight bibliographic databases were searched for English and German records. Of 501 identified records, 26 reports (covering 25 unique studies) met eligibility criteria. Risk of bias (RoB) was evaluated across four domains-sampling, measurement validity, confounding, and reporting-while overall evidence certainty was assessed using established frameworks. A secondary, non-systematic scoping overview was conducted to characterize ASHP noise emissions based on technical databases and literature. RESULTS:ASHP sound emissions are highly variable, contingent upon specific components (fan and compressor), radiation angles, and operating conditions. The systematic review identified 10 laboratory studies, 14 observational surveys, and one prognosis study, predominantly published since 2011. While results indicate a non-negligible potential for annoyance, concentration impairment, and self-reported sleep disturbance, the overall certainty is low. This is attributed to small samples, methodological heterogeneity, and high RoB in critical domains. Preliminary data provide tentative indications that ASHP noise may exhibit higher annoyance potential than road traffic noise at equivalent sound pressure levels. CONCLUSION:Despite increasing research interest, the evidence base for long-term health impacts of heat pump noise remains limited and of low certainty. Future research should prioritize large-scale longitudinal studies and comparative investigations with other environmental noise sources to inform evidence-based noise control.
OBJECTIVE:This study aimed to evaluate the protective efficacy and molecular mechanisms of hydrogen (H 2 ) against noise-induced damage across the peripheral and central auditory systems. MATERIALS AND METHODS:Mice were exposed to noise with or without H 2 treatment. Auditory function was assessed using the auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE). Cochlear morphological changes were examined using a scanning electron microscope. Central effects in the inferior colliculus (IC) were evaluated using hematoxylin and eosin staining, transmission electron microscopy, and proteomic analysis. Behavioral changes were measured by using prepulse inhibition (PPI) and shuttle-box tasks. RESULTS:H 2 significantly attenuated noise-induced ABR threshold shifts ( P < 0.05) and preserved wave I amplitudes at 80 dB (2.69 ± 0.40 vs. 3.57 ± 0.15 μV, P < 0.05). H 2 attenuated noise-induced reduction of DPOAE (16 kHz: 34.40 ± 2.70 vs. 24.67 ± 4.35, P < 0.05) and mitigated outer hair cell (OHC) loss (survival: 89.92% ± 1.23% vs. 82.10% ± 1.6%, all P < 0.05). In the IC, H 2 reduced neuronal pyknosis by 12.6% ( P < 0.05) and preserved the synaptic ultrastructure. Behaviorally, H 2 suppressed the noise-induced elevation of PPI at 75 and 80 dB (75 dB: 40.87% ± 6.32% vs. 58.04% ± 2.47%; 80 dB: 50.01% ± 3.14% vs. 58.04% ± 2.47%, all P < 0.05) and improved performance on the shuttle-box test. Proteomic analysis revealed that H 2 upregulated nicotinamide adenine dinucleotide phosphate hydrogen regeneration-related proteins (e.g., Tigar) and GABAergic synaptic proteins (e.g., Gad1) in the IC. CONCLUSION:H 2 exerts a comprehensive neuroprotective effect against noise-induced damage, spanning from OHCs to central synaptic remodeling. This cognitive protection may be mediated by enhancing the antioxidant capacity and restoring the excitation - inhibition balance in the IC.
Occupational noise is a well-recognized hazard in industrial workplaces, yet its implications for metallurgical research laboratories have received comparatively limited attention despite the widespread use of high-noise equipment. Although systematic personal dosimetry studies of laboratory researchers are currently unavailable, evidence from industrial and equipment-engineering studies indicates that common metallurgical processes, including ball milling, mechanical alloying, grinding, polishing, powder processing, and high-temperature operations, can generate sound pressure levels approaching or exceeding recommended occupational exposure limits. Laboratory-scale high-energy mills, in particular, have been reported to produce substantially higher noise levels than conventional industrial rotary mills, suggesting the potential for significant occupational exposure. This review critically examines the principal sources of occupational noise in metallurgical research laboratories and the factors influencing exposure, including equipment characteristics, operating conditions, processing duration, and laboratory design. It synthesizes current knowledge on both auditory effects, such as noise-induced hearing loss and tinnitus, and non-auditory impacts, including stress, fatigue, impaired concentration, and reduced work efficiency. The review also evaluates existing occupational noise exposure standards, measurement and monitoring approaches, and engineering, administrative, and personal protective strategies for noise control. The available evidence demonstrates that current understanding of noise exposure in metallurgical research laboratories is largely derived from industrial studies rather than direct laboratory measurements, highlighting a critical knowledge gap. The review emphasizes the need for systematic exposure assessment, personal noise dosimetry, and interdisciplinary research to characterize occupational noise risks better and support the development of effective noise management strategies for safer and healthier metallurgical research environments.
Hospital noise is a pervasive environmental stressor that may adversely affect sleep quality and neurological recovery of post-stroke patients. Although the World Health Organization has established recommended limits for hospital noise levels, real-world conditions frequently exceed these limits, with the issue being particularly pronounced in stroke wards due to noise generated by medical equipment and staff activity. The incidence of post-stroke sleep disorders is notably high. Noise disrupts sleep architecture through pathophysiological mechanisms, including activation of the auditory pathway and cortical arousal, induction of stress responses and neuroendocrine dysregulation, and increased cardiovascular burden. These detrimental effects are further amplified by the heightened vulnerability resulting from post-stroke brain injury. Clinical evidence indicates a dose-response relationship between hospital noise levels and impaired subjective sleep quality and sleep efficiency. Furthermore, noise has been associated with delayed motor and cognitive functions and exacerbates mood disorders. Effective management strategies require systematic, multifaceted interventions, encompassing engineering and administrative modifications at the noise source, along with patient-centered protective measures and sound-masking therapies. However, challenges such as the complexity of hospital noise, individual patient differences, and implementation compliance persist, and high-quality research in this area remains insufficient. Future efforts should focus on developing intelligent monitoring systems, conducting research on personalized clinical pathways, and integrating noise management throughout the stroke rehabilitation process to establish an optimal acoustic environment conducive to neurological recovery.
Childhood asthma is a heterogeneous prevalent chronic airway disease in paediatrics worldwide. It not only directly impairs the cardiopulmonary development, sleep rhythms and social skills of school-aged children, but also significantly increases the burden of medical care on families and the pressure on public health prevention and control. Environmental noise is a significant risk factor for allergic diseases, but its pathogenicity is not solely due to physical stimulation. Rather, it acts as a systemic stressor, reshaping the body's pathological microenvironment through potential indirect pathways. Given the current lack of direct clinical evidence, this article conducts a hypothesis-generating review of the potential neuro-immune mechanisms by which noise may induce or exacerbate childhood asthma. At the immune-inflammatory level, noise disrupts immune homeostasis, facilitates T-helper type 2 (Th2) inflammation, disrupts the airway epithelial barrier through systemic oxidative stress, activates chemokine networks to mediate immune cell recruitment and drives non-Th2 inflammation. At the neuroendocrine level, noise leads to autonomic imbalance and receptor remodelling, triggering vagal rebound; simultaneously, it induces central sensitisation through the 'lung-brain axis', triggering substance P-mediated neurogenic inflammation; and it disrupts sleep rhythms, triggering airway hyperresponsiveness during the nocturnal vagal hypertonic period. Elucidating these two potential mechanisms provides a new theoretical basis for neuro-immune-targeted interventions, psychosomatic treatment and acoustic environment optimisation for childhood asthma.
OBJECTIVE:This study aims to analyze the impact of perioperative music therapy (including intraoperative playback and postoperative guided listening) on procedural comfort in patients undergoing cerebral digital subtraction angiography (DSA). METHODS:A retrospective cohort study was conducted. The clinical data of 145 patients who underwent DSA at the Second Affiliated Hospital of Bengbu Medical University between January 2024 and October 2025 were reviewed and categorized based on the administration of perioperative music therapy. Seventy-three patients receiving standard DSA were assigned to the conventional group, while 72 patients receiving DSA plus immediate music therapy were assigned to the music group. The primary outcome measure was comfort level assessed by the Kolcaba General Comfort Questionnaire (GCQ). Secondary outcomes included procedure-related metrics, hemodynamic parameters, anxiety and depression status [State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory-II (BDI-II)], as well as complication rates. RESULTS:No significant differences were found between the groups in terms of either procedure duration or hospital stay ( P > 0.05). A significant group × time interaction was observed for postoperative Visual Analogue Scale scores ( P < 0.05), with the music group reporting lower pain at all time points ( P < 0.05). Post-procedure GCQ scores increased in both groups, with significantly higher scores observed in the music group ( P < 0.05). Hemodynamic analysis revealed a significant group × time interaction ( P < 0.05); at 30 min, the music group exhibited smaller increases (Δ 1 ) in heart rate, respiratory rate, and mean arterial pressure ( P < 0.05), and at the end of the procedure, all parameters were closer to baseline (smaller absolute Δ 2 , P < 0.05). At discharge, STAI and BDI-II scores were significantly lower in the music group ( P < 0.05). No significant difference was found in complication rates (6.85% versus 2.78%, P > 0.05). CONCLUSION:Perioperative music therapy for patients undergoing DSA is associated with more stable hemodynamics, greater comfort, lower pain levels, and reduced anxiety and depression, without an increased complication risk.
OBJECTIVE:To investigate the effect of a multidimensional comprehensive management plan with noise control as the core, based on the Software, Hardware, Environment, Liveware (SHEL) risk assessment model, on rehabilitation exercise compliance, balance ability, and sleep quality in patients after knee arthroplasty (KA). METHODS:This retrospective observational study was conducted on 90 patients who underwent KA at Daqing People's Hospital between January 2022 and December 2024. Patients were categorized into an observation group and a control group (45 cases each) based on the ward management and nursing protocols received during hospitalization. The control group received routine nursing care and ward management, whereas the observation group received a comprehensive ward management plan with noise control as the core, based on the SHEL model, in addition to the routine care. Rehabilitation exercise compliance, balance ability (Berg Balance Scale [BBS]), and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were compared between the two groups at 5 and 10 days postoperatively. Postoperative complications were also recorded. RESULTS:Compared with the control group, the observation group showed significantly lower mean daytime and nighttime noise levels in the ward during hospitalization, lower PSQI scores, and higher functional exercise compliance and BBS scores at 5 and 10 days postoperatively (all P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P > 0.05). CONCLUSION:The comprehensive noise management scheme based on the SHEL model was associated with improved sleep quality, rehabilitation exercise compliance, and balance function in patients after KA. This model may have good clinical application value in environmental management following orthopedic surgery.
BACKGROUND:Occupational noise exposure may impair female reproductive health, but evidence on its association with menstrual disorders remains limited. OBJECTIVE:This systematic review and meta-analysis evaluated the association between occupational noise exposure and menstrual disorders among female workers, providing evidence for future research and occupational health policy. METHODS:Peer-reviewed studies published from January 1, 1995, to December 31, 2024, were searched in PubMed, Web of Science, CNKI, Wanfang, and VIP. Eligible studies examined occupational noise exposure and menstrual disorders in female workers. Data on study characteristics, exposure assessment, diagnostic criteria, menstrual outcomes, and effect estimates were extracted. Study quality was assessed using tools for cross-sectional and cohort studies. Meta-analyses were performed using odds ratios (ORs) or risk ratios (RRs), as appropriate, with 95% confidence intervals (CIs) and subgroup analyses were conducted by study design, noise level, diagnostic criteria, and industry type. RESULTS:Twenty-two studies were included in the review, and 18 studies were included in the meta-analysis. All were conducted in China, mostly in textile-related settings. Occupational noise exposure was significantly associated with menstrual disorders among female workers (OR = 3.27, 95% CI: 2.50-4.29, P < 0.01), including dysmenorrhea (RR = 1.76, 95% CI: 1.58-1.95), menstrual cycle irregularities (OR = 3.54, 95% CI: 2.54-4.94), abnormal menstrual duration (OR = 3.29, 95% CI: 1.65-6.59), and abnormal menstrual flow (OR = 2.52, 95% CI: 1.74-3.66). Higher noise levels, especially ≥90 dB(A), longer exposure duration, and nonsteady or impulsive noise may further increase risk. Substantial heterogeneity was observed. CONCLUSION:Occupational noise exposure may increase the risk of menstrual disorders among female workers. However, evidence is limited by observational designs, heterogeneous exposure and diagnostic methods, inadequate control for confounders, and a concentration in Chinese textile-related settings. Prospective multicenter studies with standardized criteria, objective noise assessment, and rigorous adjustment for confounders are needed.
BACKGROUND:Gestational diabetes mellitus (GDM) may exacerbate hyperbilirubinemia-induced auditory neurotoxicity via oxidative stress, whereas genetic susceptibility (e.g., GJB2 variants) heightens cochlear vulnerability. However, the tripartite interplay among maternal metabolic dysregulation, neonatal hyperbilirubinemia and genetic predisposition remains poorly characterized. OBJECTIVE:This study aimed to investigate the synergistic interaction between GDM and neonatal hyperbilirubinemia in auditory dysfunction, focusing on the modifying role of deafness-associated genetic variants (GJB2, SLC26A4, and mtDNA). METHODS:In this prospective cohort study (our hospital, 2023-2025), 350 neonates were classified by an exposure-based 2 × 2 factorial design into four groups: GDM-exposed hyperbilirubinemia ( n = 98), non-GDM hyperbilirubinemia ( n = 185), GDM-only ( n = 42) and healthy controls ( n = 25). Genetic screening was performed via Sanger sequencing. Serial audiological assessments (automated auditory brainstem response) and brainstem auditory evoked potential [BAEP]) and biochemical monitoring (bilirubin-to-albumin [B/A]), malondialdehyde [MDA] and superoxide dismutase) were conducted at birth, 72 h, 1 month, and 3 months. Cox proportional hazards models, multivariable logistic regression and bootstrapped causal mediation analysis were used to evaluate risk factors and oxidative stress-mediated pathways. RESULTS:GDM-exposed hyperbilirubinemia neonates exhibited a 2.3-fold higher incidence of severe hearing loss compared with those with hyperbilirubinemia alone (34.7% vs. 15.1%, P < 0.001). GJB2 variant carriers showed significantly greater BAEP threshold elevation (Δ = 9.2 ± 3.1 dB vs. 3.1 ± 1.8 dB, P = 0.002) than their counterparts. The B/A ratio was a GDM-dependent prognostic marker, with B/A > 5.5 predicting hearing loss only in the GDM subgroup (odds ratio = 4.17, 95% confidence interval [CI]: 2.33-7.45). MDA accounted for 38% of the total effect of GDM-hyperbilirubinemia on auditory impairment (indirect effect β = 0.28, 95% CI: 0.19-0.39). CONCLUSION:GDM significantly modifies hyperbilirubinemia-induced auditory toxicity through oxidative stress and genetic interaction, particularly in GJB2 carriers. Integrated screening of maternal glycemic status, neonatal bilirubin dynamics, and deafness-associated genes is warranted.
