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Biomedical subjects

R Hétu

Publications and source records attributed to R Hétu.

At least 19 recordsLinked to original sources
PubMed1996

The stigma attached to hearing impairment.

Detailed analyses of the experience of impaired hearing demonstrate the ways in which it represents a threat to social identity. The reluctance to acknowledge impairment stems from the negative consequences of disclosing that status. The stigma attaching to hearing loss can be understood in the broader conceptual framework of 'shaming'. Generating stigma also needs to be understood at the micro-(interpersonal) and macro-(social) levels. The significance of stigmatizing in relation to rehabilitative strategies allows a reorientation to the issue of "normalisation' of identity, alongside treatment of disability.

Attitude to Health↗
PubMed1995

Potential risk of hearing damage associated with exposure to highly amplified music.

The experience of highly amplified music listening is described from a psychoacoustic and phenomenologic standpoint in order to characterize both the estimated risk of hearing damage and the perception of such a risk. Exposure as attenders and as the result of a professional activity are examined separately. Data collected in discotheques are analyzed, showing that this type of music is characterized by (a) strong pulsations, the rate of which is approximately 2 Hz; (b) a narrow dynamic range; and (c) a sloping spectrum with maximum energy in the 1/3-octave centered at 63 Hz. This spectrum is almost parallel to the free-field hearing threshold curve raised by 80 dB. Although temporary threshold shift is predictable for different durations of exposure to this type of sound, the long-term risk of permanent threshold shift appears to be very slight for those who are regularly exposed to loud music. An anthropologic approach is proposed with a health education approach to the prevention of hearing loss resulting from amplified music listening.

Amplifiers, Electronic↗
PubMed1994

Attitudes towards co-workers affected by occupational hearing loss. I: Questionnaire development and inquiry.

Previous studies have shown that attitudes of workers towards their hearing impaired colleagues strongly contribute to the psychosocial disadvantages associated with occupational hearing loss (OHL). A questionnaire has been designed to characterize such attitudes. In phase I, a preliminary version consisting of 45 items was divided equally into scales of knowledge, attitudes and reported behaviour towards co-workers affected by OHL. Answers from 176 workers from a metal products plant enabled us to identify discriminative items that belonged to an appropriate factorial structure. In phase II, the response of 125 miners to a second version of the questionnaire, comprising 32 items, permitted further refinement. The final version was tested with 250 workers from three plants. Answers on the scale measuring knowledge showed that noise-exposed workers were not aware of the major consequences of OHL. Attitudes towards hearing impaired co-workers were generally favourable, but this finding appeared to reflect a strong social desirability bias. Reported behaviour indicated that a majority of workers are not inclined to adopt types of conduct that favour communication with people having OHL. Those workers who perceive themselves to be moderately to severely hearing impaired had a more negative image of hearing impaired workers, while reporting more facilitating and helping types of behaviour towards them, they also reported much more frequent contact with them. The findings provide strong indications that hearing impairment in noisy industrial settings frequently goes unnoticed and that many workers who are at risk of developing OHL are often unaware that some of their co-workers are already affected. These findings offer useful leads for the development of an awareness programme on the consequences of OHL.

Adult↗
PubMed1994

Attitudes towards co-workers affected by occupational hearing loss. II: Focus groups interviews.

This study was undertaken as a complement to a questionnaire inquiry on attitudes towards co-workers affected by occupational hearing loss (OHL). Four groups of 7 to 11 volunteer participants were recruited among respondents to the questionnaire inquiry. They were interviewed using a focus group technique. Scenarios were prepared to serve as a basis for asking questions aimed at three major objectives: (a) to characterize workers' perception of a co-worker who has an impairment involving no visible signs; (b) to identify the conditions that trigger social withdrawal and isolation behaviour among people affected by OHL, and the conditions that might make the latter decide to seek help; and (c) to define the type and methods of help that might minimize social withdrawal and isolation among hearing impaired workers. The interviews were taped and transcribed verbatim for content analysis using a phenomenological-interpretative framework. The findings can be summarized by the following description of the perception of the problem of OHL among industrial workers. The strong fear of being stigmatized leads those affected by OHL to conceal its manifestations and consequences in their everyday life. As a result, significant others, co-workers, employers and the general population are not aware of such manifestations. Within the workplace, the problem of OHL is generally seen as being inconsequential. In daily interactions among co-workers, its effects are ignored. Within the family, hearing difficulties are often not interpreted as such but they nevertheless affect the workers' significant others. People do not know how to facilitate communication with a person affected by OHL. A large scale multi-target awareness programme is proposed to demarginalize workers affected by OHL. Implications of the findings are drawn in such areas as characterization of attitudes toward workers with hearing impairment, rehabilitation for those affected by OHL, and prevention of OHL.

Adult↗
PubMed1993

Audibility and identification of auditory alarms in the operating room and intensive care unit.

The audibility and the identification of 23 auditory alarms in the intensive care unit (ICU) and 26 auditory alarms in the operating rooms (ORs) of a 214-bed Canadian teaching hospital were investigated. Digital tape recordings of the alarms were made and analysed using masked-threshold software developed at the Université de Montréal. The digital recordings were also presented to the hospital personnel responsible for monitoring these alarms on an individual basis in order to determine how many of the alarms they would be able to identify when they heard them. Several of the alarms in both areas of the hospital could mask other alarms in the same area, and many of the alarms in the operating rooms could be masked by the sound of a surgical saw or a surgical drill. The staff in the OR (anaesthetists, anaesthesia residents, and OR technologists) were able to identify a mean of between 10 and 15 of the 26 alarms found in their operating theatres. The ICU nurses were able to identify a mean of between 9 and 14 of the 23 alarms found in their ICU. Alarm importance was positively correlated with the frequency of alarm identification in the case of the OR, rho = 0.411, but was not significantly correlated in the case of the ICU, rho = 0.155. This study demonstrates the poor design of auditory warning signals in hospitals and the need for standardization of alarms on medical equipment.

Adult↗
PubMed1992

Frequency selectivity in workers with noise-induced hearing loss.

This study was undertaken in order to document, in a group of subjects affected by a noise-induced hearing loss, the relation between the loss of auditory sensitivity and the loss of frequency selectivity at mid-frequencies, namely 1000 and 3000 Hz. Auditory filter shapes were estimated using the notched noise method. Twelve notch widths were tested, six symmetrical and six asymmetrical with respect to the signal frequency; the spectral level of the noise was set at 50 dB SPL. Data were collected with 22 noise-exposed workers having different degrees of hearing loss. The findings indicate that above a certain degree of hearing loss, which seems to be around 30 dB HL, frequency selectivity tends to decrease linearly with increase in loss of sensitivity. Even when the degree of hearing loss is similar in origin and in magnitude, there is a wide variation among subjects in auditory filter bandwidth. Based on the data collected in this study, it is not possible to adequately predict the auditory filter bandwidth of an individual from hearing threshold levels.

Acoustic Stimulation↗
PubMed1991

Impairment, disability and handicap in audiology: towards a consensus.

Within this paper, we argue that the WHO definitions of impairment, disability and handicap have a useful role in understanding the processes of audiological rehabilitation. We have endeavoured to clarify some of the confusions arising from the various uses of the terms in the audiological literature and propose further classifications of the three. In particular we discuss the complexities of handicap together with the interactions between hearing-impaired individuals and their significant others in its production.

Activities of Daily Living↗
PubMed1991

Development of a rehabilitation program for people affected with occupational hearing loss. 1. A new paradigm.

The highly insidious character of the development of occupational hearing loss (OHL) bears several implications in terms of the nature of the resulting handicap. It calls for rehabilitative services that are adapted to the specific needs of those suffering from OHL. A paradigm for a rehabilitation program was defined using a public health model bringing about social changes. The health problem is defined in terms of reduced listening and communication abilities. Its consequences are examined for the workplace, leisure activities, social involvement, family relationship and individual well-being and self-esteem. The precursors of the problem are hierarchically determined according to their potential influences, and appropriate interventions are identified accordingly to act upon each of them. These interventions include: (a) psychosocial support to the affected workers and their families through group intervention; (b) information to the victims of OHL, their families, to workplaces, public services and the general population, and (c) skill development to facilitate listening and communication for and with the hearing-impaired person. This paradigm was used in the development of a rehabilitation program.

Health Education↗
PubMed1991

Development of a rehabilitation program for people affected with occupational hearing loss. 2. Results from group intervention with 48 workers and their spouses.

A group intervention program was designed to initiate an active search for solutions to listening and communication problems among hearing-impaired workers. Six groups of 8 workers were recruited from different areas of the Province of Québec. The workers were males; they had hearing threshold levels equal to or higher than 30 dB averaged over 0.5, 1, 2 and 4 kHz in at least one ear. The recruitment was conducted by occupational health nurses of local community health centers. The workers were invited to a group meeting with their spouses by means of a home interview. Three groups met during 2-hour weekly evening sessions, and three groups during a 1.5-day weekend session. A follow-up was conducted over a period of 3 months ending with an evaluation meeting. Results based on responses to a handicap questionnaire showed that the workers judged their hearing problem as being significantly less severe after their participation in the session. Group interviews showed that, although they were more conscious of their hearing difficulties, they agreed on being much more confident in dealing with them. Different steps were taken towards improving their situation, including disclosure of their hearing impairment to others, making requests to conversational partners to facilitate communication, and acquiring instrumental aids.

Communication Methods, Total↗
PubMed1990

The likelihood of detecting a significant hearing threshold shift among noise-exposed workers subjected to annual audiometric testing.

The ability of annual audiometric surveillance to detect significant deteriorations in hearing sensitivity is examined considering the time pattern of the growth of noise-induced hearing loss. The yearly rate of change in hearing level due to the effects of noise exposure and age is computed from a mathematical model put forward in the International Standard ISO 1999 (1989). The first-order derivative of hearing level associated with noise and age was compared with different criteria of significant threshold shift (STS). The results show that the potential annual variation in hearing level at 4 kHz, the audiometric frequency most affected by noise, is always less than the minimum margin of error of audiometry under exposure to 90 dBA-8 h. At 100 dBA it nearly equals the margin of error only for the very first year of exposure and for the most sensitive individuals. The rate of change in hearing threshold at 4 kHz is less than or equal to 1 dB per year for a major portion of a population exposed to an average noise level of 90 dBA-8 h (+/- 5 dB SD). For other audiometric frequencies, or for combinations of frequencies, this rate is even lower. It is also demonstrated that, using annual hearing tests, the likelihood of measuring an STS in a noise-exposed population is very small. It would be nearly equal to the likelihood of some workers being exposed to 100 dBA-8 h or more for a first year. Such results throw doubt on the validity of audiometric surveillance as a procedure for early detection of noise-induced hearing loss. They also imply that the detection by audiometric tests of true cases of significant threshold shift due to noise is excessively expensive.

Adult↗
PubMed1990

The reluctance to acknowledge hearing difficulties among hearing-impaired workers.

The reluctance to acknowledge hearing difficulties was studied with two groups of hearing-impaired workers and their spouses. One investigation involved a group interview with workers who participated in a pilot rehabilitation programme and who experienced the disclosure of their hearing difficulties to others by being the subject of a newspaper story on occupational deafness. Analysis of the transcript showed that they were strongly stigmatized as being deaf especially by co-workers. In a second investigation, interviews conducted with hearing-impaired workers who have had no previous contact with hearing specialists were analysed. A selection was made of the interviews containing several examples of contradiction in the worker's discourse or between the worker and his wife about the experience of hearing difficulties. The reluctance to acknowledge hearing difficulties was expressed through various forms of denial, minimization of the problem, uneasiness in talking about the problem and in attempts to normalize oneself. All these expressions can be found in the same individual's discourse. It is concluded that reluctance to acknowledge hearing difficulties is part of an adaptive process that should be taken into account in rehabilitative interventions. It also calls for interventions that would prevent hearing people from stigmatizing hearing-impaired people.

Attitude↗
PubMed1990

An epidemiological perspective of the causes of hearing loss among industrial workers.

An etiologic paradigm of hearing loss for industrial workers is introduced as having two major components, one being occupational and the other extra-occupational. The extra-occupational factors include age, noise exposure outside the work place, trauma, ear disease and ototoxic drugs. The work-related factors include occupational noise, whole body vibration, work-related diseases and toxic exposures. Within this framework, a review of the epidemiology of hearing loss examines the possible relationships between hearing loss and these factors.

Adult↗
PubMed1989

The growth of and recovery from TTS in human subjects exposed to impact noise.

It is now recognized that temporary threshold shift (TTS) grows to an asymptotic level (ATS) after a prolonged exposure to steady-state and intermittent noise. Few studies have been conducted to verify this process of acquisition for impact noise. However, results obtained on animals have demonstrated that an asymptote is reached after 1-2 h of exposure. These results have been confirmed in the present study on four human subjects using a 470-ms (B duration) impact noise at a rate of 1 pps. The above pattern of acquisition has been retested on two subjects exposed to the same impact for periods of 15-150 min. An ATS of 15-20 dB was measured (Lp = 102-104 dBA) after 30-60 min of exposure. Recovery curves were determined for each exposure duration. They appeared to follow a logarithmic function of post-exposure time. It took from 30-50 min for one subject and from 4-5 h for the other to completely recover. The time for total recovery did not seem to vary as a function of exposure time. Implications are drawn for damage risk criteria and for the study of the effects of impact noise on hearing.

Auditory Fatigue↗
PubMed1988

Qualitative analysis of the handicap associated with occupational hearing loss.

Hearing difficulties among noise-exposed workers were investigated by means of an interview. A group of 61 workers from a metal product plant had their hearing tested; 66% had abnormal hearing according to their age. Interviews on hearing problems and on their consequences were conducted at home with the spouses. The interviews were recorded and transcribed, and then treated according to a procedure that combines phenomenological and content analysis. The results were classified into hearing disabilities, disadvantages and adjustments. Listening and communication problems result in extra efforts, anxiety and stress, changes in social activities, isolation in groups and a negative self-image. These problems also affect others, especially the spouse, who take an active part in the spontaneous adjustment to disabilities. A model of the structure of the handicap has been outlined illustrating how spontaneous adjustments can be in themselves sources of disadvantages. Implications for rehabilitation services are discussed in terms of the means to facilitate optimal adjustment to disabilities.

Adult↗
PubMed1987

Psychosocial disadvantages associated with occupational hearing loss as experienced in the family.

A questionnaire has been developed to investigate the psychosocial disadvantages resulting from occupational hearing loss (OHL). It was designed to measure the awareness of the hearing disability, the coping strategies and the family response to the consequences of OHL. Answers to the questionnaire were obtained from 54 workers with various degrees of presumed OHL and from 44 normal-hearing workers employed in the same noisy plant. The results show that the family bears several consequences of the noise exposure and of the hearing loss of the worker and that its spontaneous reaction to OHL appears as one source of the psychosocial disadvantages experienced by the worker. The implications of these results for rehabilitative intervention are discussed.

Family↗
PubMed1986

Is occupational noise exposure during pregnancy a risk factor of damage to the auditory system of the fetus?

In the Province of Quebec, the regulated daily noise exposure limit is 90 dBA-8h. This limit value also applies to pregnant women. Experimental studies suggest however, that this standard is not sufficiently stringent to protect the auditory system of the fetus, particularly in cases of low-frequency noise exposure. An exploratory study was undertaken to assess this possibility. A total of 131 children were examined. Their mothers had worked, while pregnant with that child, in noise conditions ranging from 65 to 95 dBA-8h. Results show a three-fold increase in the risk of having a high-frequency hearing loss in the children whose mothers were exposed to noise in the range between a LAeq,9 m of 85 to 95 dB, and a significant increase in the risk of hearing loss at a frequency of 4000 Hz when these exposures involved a strong component of low-frequency noise.

Female↗
PubMed1985

A Bayesian approach for predicting judged hearing disability.

A method of determining the cutoff point for an administrative decision to award compensation is proposed. To construct the predictive system a Bayesian approach and discriminant analysis were employed. Judged hearing disability was used as the criterion with audiometric scores as the determining variables. The common law doctrine of the balance of probability was used as the criterion, namely the 50th centile, on which to propose a cutoff point. The highest precision in predicting judged hearing disability was obtained with an average audiometric score at 1,000, 2,000, 3,000, 4,000 Hz in the worse ear. Assuming that judged hearing disability is a valid predictor of handicap, the cutoff point based on the balance of probability (50th centile) was obtained at 25 dB. The study also confirmed results from previous studies: hearing sensitivity in frequencies higher than 2,000 Hz is required to predict hearing disability and handicap, judged hearing disability is better correlated with hearing sensitivity in the worst ear, and the audiometric cutoff point for a medical legal definition of impairment should be lower than what certain technical groups have proposed in the past.

Audiometry↗