|Year : 2016 | Volume
| Issue : 3 | Page : 162-167
Self-assessment of noise-induced hearing impairment in traffic police and bus drivers: Questionnaire-based study
Himanshu Kumar Sanju, Prawin Kumar
Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
|Date of Web Publication||8-Aug-2016|
Himanshu Kumar Sanju
All India Institute of Speech and Hearing, Mysore - 570 006, Karnataka
Source of Support: None, Conflict of Interest: None
Background and Objectives: Noise-induced hearing loss is a major preventable occupational hazard. The ill effect of noise exposure is well evidenced by researchers. This study was done to study the self-assessment of hearing quality, annoyance evaluation, noise-related attitude and knowledge in traffic police, and bus drivers on Indian population in a growing city. Subjects and Methods: The study was done on 60 nonsmokers, male traffic police, and 80 long route bus drivers in the age range of 30–50 years. There were 15 questions related to self-assessment administered on these individuals. Results: The results revealed that in spite of regular noise exposure, around 60% individuals rated excellent hearing. Further, surprisingly all individuals rated no knowledge of any ear protection devices available. Nearly, 30–50% individuals related to poor quality of sleep due to noise exposure in both groups. The result also revealed strong association between the responses of most of the questions asked from bus drivers and traffic police. Conclusion: The negative consequences of noise exposure are well reflected as an outcome of this questionnaire-based study which shows these individuals are having signs of hearing-related problems. Hence, there is a need to educate these professionals about hazardous effect of noise exposure.
Keywords: Annoyance, Bus drivers, Occupational hazard, Traffic police
|How to cite this article:|
Sanju HK, Kumar P. Self-assessment of noise-induced hearing impairment in traffic police and bus drivers: Questionnaire-based study. Indian J Otol 2016;22:162-7
|How to cite this URL:|
Sanju HK, Kumar P. Self-assessment of noise-induced hearing impairment in traffic police and bus drivers: Questionnaire-based study. Indian J Otol [serial online] 2016 [cited 2020 Sep 30];22:162-7. Available from: http://www.indianjotol.org/text.asp?2016/22/3/162/187971
| Introduction|| |
It is a well-known fact that noise exposure for long duration on daily basis could result in noise-induced hearing loss (NIHL). However, if any individual is exposed to short duration of noise exposure due to blast or impulse which could result in hearing impairment, then it is referred as acoustic trauma. Acoustic trauma is a condition where there is an evidence of mixed or sensorineural hearing impairment, whereas NIHL mainly leads to sensorineural hearing loss. The ill effect of noise exposure is well evidenced by researchers which include both auditory and nonauditory effects such as fatigue, depression, impulsive behavior, and inability to concentrate on tasks., Further, it could lead to either temporary or permanent shift in the threshold of hearing due to unwanted exposure of noise on daily basis. The rapid growth of many cities in developing countries like India increases the use and ownership of motor vehicles. Further, lack of awareness among general public in connection with when and where to use horns during driving vehicles leads to noise pollution. This could be the reason, the traffic police who are engaged in controlling heavy traffic are more susceptible to NIHL as they are continuously exposed to the high level of noise. In India, occupational permissible noise levels limit for 8 h time-weighted average is 90 dB. According to a survey done at Hyderabad city in 2010, the effects of noise pollution on traffic police were estimated as 76% who were exposed to high level of noise. In addition, those traffic police who had worked for 5-years continuously during their service period reported to be having 100% incidence of hearing loss. In a similar way, long route bus drivers were exposed to noise level more than 82 dB (A) affected by noise pollution while driving for longer duration as noted by several researchers., Hence, there is a need to explore how well these individuals (traffic police and bus drivers) are aware of health-related issues which can be aggravated due to the exposure of high-level noise on day-to-day life.
A study done by Mishra  on traffic police in Indian population revealed high level of noise exposure in these individuals. They are exposed to noise level ranging from 75 to 80 dB at various traffic points and it reaches to the maximum sound level of 103 dB. According to a study done by Shrestha et al., 2011, in Nepal, they reported traffic police personal are in constant risk of NIHL. Similarly a study done by Corrêa Filho et al. observed that risk of NIHL is even greater for long route bus drivers if they are in service for more than 6 years. Further, the study done by Gupta et al. showed that a majority of traffic police were oblivious to the harmful effects of noise and did not consider it as an occupational hazard. Kumar et al. in 2005 showed high prevalence of hearing loss in tractor drivers. Santos and Castro Júnior in 2009 reported changes in brainstem auditory-evoked potential latencies an early functional injury of the first auditory pathway afferent neuron. A study by Andrea et al. in 2012 on drivers showed that the occurrence of hearing loss in the absence of complaints. Public transport drivers were exposed to excess noise on roads and 65% of them were suffering from NIHL as reported by Muhammad et al., 2007. Abdelmoneim in 2003 reported that more hearing impairment and higher prevalence of hypertension among long route bus drivers than their counterparts operating in the city. From the above literature, it is well evident that though there are sporadic studies carried out in growing cities of India still there is a dearth of information among workers affected by traffic noise such as traffic police and bus drivers exposed to occupation health hazards. Hence, there is a need to study the self-assessment of hearing quality, annoyance evaluation, noise-related attitude, and knowledge in traffic police and bus drivers in an Indian population in a growing city.
The objective of this study was to carry out self-assessment of hearing quality, noise-related attitudes, knowledge about ear protection device (EPD), and annoyance among traffic police and bus drivers. In addition, this study also aimed to compare the outcome in terms of noise exposure between traffic police and bus drivers.
| Methods|| |
The study was done on two groups of population. Group I consisted of 60 male nonsmokers traffic police, in the age range of 30–50 years (mean age 40.50) working for 8 h daily from more than 8 years at heavy traffic points in a growing city of India. Group II consisted of 80 male nonsmokers, long route bus drivers, in the age range of 30–50 years (mean age 39.31) working for 8–15 h daily from more than 8 years. All the participants were randomly selected based on their willingness to participate in the study. They were explained in detail about the purpose of the study. They were belonging from low-to-medium socioeconomic status and had education up to 12th classes (pre-university college). Primarily, the mother tongue of all the participants was Hindi with a little knowledge of English.
There were 15 questions related to self-assessment of hearing quality, annoyance evaluation, noise-related attitudes, and knowledge adopted from similar studies.,, The questions administered were in accordance with ISO/TS 15666 (2003), an international standard of acoustics-assessment of noise annoyance using social and socio-acoustic surveys. These questionnaires were translated into Hindi, and reverse translation was carried out make sure that the meaning of the content remains the same. These translated questions in Hindi were proofread by a native speaker of Hindi as well as having knowledge of English too. Later, the same questionnaire was used for the participants under close supervision of audiologists.
There were six questions related to self-assessment of hearing quality, four questions related to attitude and knowledge about NIHL, and five questions related to annoyance. These questions were closed-set tasks either in 2-point, 3-point, and 4-point rating scale, depending upon the nature of the questions. All the participants were asked to answer these questions in writing while selecting the most appropriate single answer. Those participants who were having the presence of a positive family history of ear disease and exposure to loud noise other than traffic-related noise were excluded from the study, based on the structured case history. Oral informed consent was taken from all participants. The data were analyzed using SPSS (version 17, IBM Corporation, Bengaluru, India), along with descriptive statistics, percentages and proportions of the study subjects, in context to a particular response. Chi-square test was used to compare between two groups. Pearson's correlation test was done to assess the correlation between different questions within group.
| Results|| |
The percentages and proportions of different categories of questionnaires described under different headings are based on the rating scale through graphical representation. In addition, Chi-square test was carried out to check the association between two groups for each question. The results of the study described based on the nature of questions such as self-assessment of hearing, awareness of EPDs, and annoyance due to noise exposure.
The response of question asked about “quality of hearing” (χ2  = 135.42, P < 0.001), “tinnitus” (χ2  = 174.28, P < 0.001), “uncomfortable on loud sound” (χ2  = 23.02, P < 0.001) shows strong association between two groups. [Figure 1], [Figure 2], [Figure 3] display responses obtained from each individuals in both groups for question related to the quality of hearing tinnitus and uncomfortable on loud sound, respectively. Responses of the question asked about hearing over phone, hearing in crowd, sounds of TV/radio, and talking too loudly are shown in [Table 1].
|Table 1: Responses of the question asked about self-assessment of hearing|
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|Figure 1: Responses obtained for the question asked about quality of hearing|
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|Figure 3: Response of the question asked about uncomfortable on loud sounds|
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The response of question asked about, hearing over phone (χ2  = 82.12, P < 0.001), hearing in crowd (χ2  = 114.05, P < 0.001), increasing the volume of television or radio (χ2  = 15.11, P < 0.001), complaint that they are talking too loudly (χ2  = 15.11, P < 0.001) showed strong association between both groups (traffic police and bus drivers).
The responses of question asked about knowledge about NIHL and health problem caused by noise (χ2  = 77.25, P < 0.001) also revealed strong association between both groups (traffic police and bus drivers) [Figure 4]. Responses of the questions asked about the effectiveness of EPDs, use of other personal protective equipment, and ever used EPDs is shown in [Table 2].
|Figure 4: Response of the question asked about awareness of noise-induced hearing loss|
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|Table 2: Responses of the questions asked about use of protective devices|
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Effectiveness of EPDs if used (χ2  = 53.15, P < 0.001) shows strong association between two groups. Chi-square test did not show any outcome for questions related “other personal protective equipment” and “ever used EPDs” scored 100% for both the groups (traffic police and bus drivers).
Questions related to annoyance due to noise exposure at work showed strong association between two groups for headache (χ2  = 41.25, P < 0.001), annoyance (χ2  = 8.25, P < 0.001) as well as for irritation after work (χ2  = 33.02, P < 0.001) [Table 3]. Overall, the result of this study revealed strong association between two groups (traffic police and bus drivers) except one parameter in which question was asked about quality of sleep (χ2  = 2.31, P > 0.05) which revealed poor association between two groups. Although the exposure to noise was similar in two groups, probably the nature of work was different which could have an impact on quality of sleep in both the groups.
|Table 3: Responses of the questions asked about annoyance due to noise exposure|
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Association between different questionnaires was done using Pearson's correlation test separately for traffic police as well as for bus drivers. The result showed significant correlation only between few questions such as “quality of hearing” and “talking too loudly;” “hearing over phone” and “hearing in crowd;” “effectiveness of EPDs”, and “awareness about NIHL.” Similarly, significant correlation (association) was observed in bus drivers between a few questions such as “hearing in crowd” and “talking too loudly;” “sounds of TV/Radio louder” and “quality of sleep;” “talking too loudly” and “annoyance due to occupational noise;” and “tinnitus” and “on loud sounds, do you feel uncomfortable.”
| Discussion|| |
This study illustrates that even though only 10% of the bus drivers and none of the traffic police rated hearing quality below average, but 43.33% of traffic police and 25% of the bus drivers reported to have difficulty in hearing over phone. Similarly, 19.96% of traffic police and 22.5% of the bus drivers reported to have tinnitus. It also noted that 33.2% of the traffic police and 20% of the bus drivers have difficulty of hearing in crowd. Similar findings noticed in a study done by Gupta et al. 2014 revealed that even though only 5.5% of the traffic police rated their hearing ability as below average, a larger percentage of subjects reported having trouble during normal (40%), and telephonic conversation (16.7%). Tripathi and Tiwari in 2006 too confirmed that only 2.3% of traffic police felt that their hearing ability was below average, and 11.6% of traffic police complained of regular tinnitus, whereas only 6.1% is the prevalence of tinnitus in normal population. Similarly, Venkatappa et al. reported only 3.33% of traffic police rated their hearing ability below average, whereas 25% of the participants were missed some conversation over telephone. They also reported that 16.6% of their participants were having feeling tinnitus. According to Majumder et al. 2010, only 11.8% of the subjects showed below average rating to their hearing ability. Gaganija et al. 2011 reported that 3.75% of bus drivers and 3.8% of the taxi drivers rated their hearing below average, but 58.8% of bus drivers and 32.6% of taxi drivers reported to have difficulty in hearing over phone. In the same study, similar proportion of subject also reported difficulty in hearing during crowd situation. They reported that 27.5% of the bus drivers and 23.8% of the taxi drivers talks too loudly with other people. It is also observed that 30% of the traffic police and 37.5% of the bus drivers got complained of talking too loudly from others. This could be because they become habituated talking loudly and do not realize the same. The auditory system too gets adapted to the louder input due to constant stimulation to loud noise. A common finding between this study and all of the above studies was that although the self-assessed prevalence of hearing loss was found in a lower percentage of subjects, a closer scrutiny of the supplementary questions to assess the hearing status showed that the number of participants with hearing impairment is in large proportion, though hearing impairment may not be significant to disturb day-to-day conversation.
Questionnaire related to attitude and knowledge toward noise revealed 100% of individuals (bus drivers and traffic police) were not aware of any EPD and had never used the same. Further, 100% of bus drivers and traffic police reported no use of any other personal protective equipment to prevent NIHL. It reflects toward the lack of awareness among these individuals who are exposed to noise at workplace and unaware of consequences of it. The above finding is similar to earlier reported literature.,, According to a study done by Venkatappa et al. in 2012 on traffic police also revealed that 100% of the subjects had never used any EPDs. They explained nonavailability of EPDs was the reason for 100% of scores. Similar findings are also reported by Gupta et al. where 100% of the traffic police had never used any EPDs, and 64.4% of the traffic police were unaware of the harmful effects of noise. Contrary to the above finding, Tripathi and Tiwari in 2006 reported that only 4.6% of the traffic police used EPDs and 67.4% subjects did not use any method to reduce exposure to noise while remaining used either fingers, hands, and cotton to avoid noise exposure. A study done by Gaganija et al. in 2011 on bus and taxi drivers also showed 83.8% of bus drivers, and 81.3% of taxi drivers never used any EPDs. In the same study, they also reported that 85% of bus drivers and 96.3% of taxi drivers never used any personal protective devices to prevent noise exposure. Overall, the above finding point toward lack of awareness toward the use of ear protective devices among these individuals (traffic police and bus drivers).
Questionnaire related to annoyance evaluation reflects that bus drivers and traffic police are vulnerable to noise during their duties as well as off the duties. This study showed 16.66% of the traffic police and 27.5% of the bus drivers reported headache. This study also showed that 36.66% of the traffic police and 40% of the bus drivers reported annoyance from occupational noise. In addition, 23.33% of the traffic police and 27.5% of the bus drivers showed irritation even after work. Similar study done by Bruno et al. in 2013 in bus drivers reported considerable level of noise annoyance in these individuals. They also reported that most annoyed drivers were younger in age with less working time. Omidvari and Nouri in 2009 reported that noise pollution has damaging effects on their behavioral condition as per their personal assessment. Agarwal and Swami in 2011 reported that 60–85% people opined that vehicular road traffic was a major source of noise pollution and creates annoyance among people. About 52% of sample population reported frequent irritation while 67% people were suffering by common noise-related problems such as headache or loss of sleep. This study also showed that 33.33% of the traffic police and 51.25% of the bus drivers reported poor quality of sleep after work, because of exposure to occupational noise during work.
The result of this study revealed strong association between the responses obtained for most of the questions asked from bus drivers and traffic police. The overall finding showed that irrespective of differences in nature of work, the effects of noise on the individuals are same. Therefore, equal concern and attention should be given by professionals dealing with prevention of NIHL in these populations. Further, effective measures should be taken by the government and nongovernment agencies dealing with such individuals. The little variations in the results of this study and the previous ones may be due to the differences in the sample size of the studies.,,,,, It is further advised that, to know the exact number of traffic police and bus drivers with hearing impairment, their further audiological evaluation needs to be done. In this study, the amount of noise level was not measured, and audiological txsesting was not carried out on all participants as there were limitations of the facilities available during the data collection. In addition, this study only includes male participants that were a chance factor or could be because of nature of work where in Northern India hardly females are trained as traffic police or bus drivers. Similar study can be replicated on other professionals who are exposed to noisy environment. Along with audiological evaluation of the subjects which could help in correlation between questionnaires-based outcome with audiological findings.
This study also revealed a significant correlation between few questions in traffic police as well as in bus drivers. The association between these questions showed impacts of self-assessment of hearing with their consequences positively. Further, it also reflects there is a significant impact of noise on their daily activities such as affecting quality of sleep. Even symptoms such as tinnitus show association with uncomfortable loud sounds. Overall, it shows one question is associated with other aspects such as hearing protection as well as annoyance only for a few components. However, the majority of questions did not reflect association between self-assessment of hearing, awareness about hearing devices, and annoyance due to occupational noise exposure in both traffic police and bus drivers.
| Summary and Conclusion|| |
The present preliminary study showed that most of the participants rated good quality of hearing in spite of excessive noise exposure during their duty unwillingly. The negative consequences of noise exposure are well reflected as an outcome of this questionnaire-based study which shows at different levels these individuals are having signs of hearing-related problems. Further, this study also highlights lack of awareness and poor knowledge about EPDs and hazardous effect of occupational noise. Hence, there is a need to educate these professionals about hazardous effect of noise exposure and importance of hearing protection devices. Further identified person should be referred for detailed audiological evaluation to rule out the involvement of peripheral and central auditory system. This study also showed the noise-related annoyance and hazard among bus drivers and traffic police are same irrespective of the difference in nature of work culture. Hence, they must be educated to minimize the health-related hazard due to noise exposure as prevention is better than cure.
The authors would like to acknowledge all the participants of this study and also acknowledge Geeta Kumari Singh and J. Nirmala for their valuable support, motivation, and help during data collection and preparation of the manuscript.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3]