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New evidence on soccer noise risk to hearing


CAPE TOWN, SOUTH AFRICA Apr 22 2010 06:58

Researchers have produced evidence -- based on tests at a soccer match with blaring vuvuzelas -- that the
sound level inside a 2010 Soccer World Cup stadium could lead to permanent hearing damage.

"The findings of this study demonstrate a real risk of noise-induced hearing loss," they say in an article in the
latest edition of the South African Medical Journal.

The study was authored by Dr De Wet Swanepoel of the University of Pretoria's department of communication
pathology, and Dr James Hall of a sister department at the University of Florida.

They said they tested the hearing of 11 spectators before and after they attended a Premier Soccer League
match at a Fifa-approved training stadium with 30 000 seats.

During the match, ten of the 11 wore personal sound exposure meters fixed to their shoulders, and four of them
blew vuvuzelas.

The researchers said the average sound exposure experienced by the participants during the almost two hours
they spent in the stadium was 100,5 decibels.

The peak exposure exceeded 140 decibels for eight of the ten participants, with the maximum peak reaching
144,2.

The four who blew vuvuzelas had the most exposure to noise.

Swanepoel and Hall said South African standards for occupational noise required hearing protection for
workers exposed to levels of 85 decibels and above.

The decibel scale was logarithmic, implying a doubling of hearing loss risk with every three decibel increase.

This meant participants in the stadium study were "exposed to high-intensity sound far exceeding the current
legislated average exposure and peak exposure levels for occupational noise".

Tests on the 11 after the match showed a "significant" decrease in hearing sensitivity.

Though the decrease was probably temporary, the changes usually preceded permanent hearing damage.

Swanepoel and Hall said their findings supported a recommendation for hearing protection for soccer
spectators.

"Official match stadiums for the 2010 Fifa World Cup will house 90 000 spectators, three times more than the
stadium used in this study.

"It is reasonable to suspect that sound intensity will be even higher in the larger official venues."

Though they could not pinpoint the vuvuzela's contribution to the overall sound level, the instrument was
certainly "a major factor".

http://www.mg.co.za/printformat/single/2010-04-22-new-evidence-on-soccer-noise-risk-to-hea... 04/05/2010
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In a previous study, also published in the South African Medical Journal, they reported on tests conducted at
the university that showed exposure to vuvuzela noise for more than a few minutes put people at risk of hearing
loss.

A South African company is marketing foam earplugs specially designed for the World Cup. -- Sapa

Source: Mail & Guardian Online


Web Address: http://www.mg.co.za/article/2010-04-22-new-evidence-on-soccer-noise-risk-to-
hearing

http://www.mg.co.za/printformat/single/2010-04-22-new-evidence-on-soccer-noise-risk-to-hea... 04/05/2010
SCIENTIFIC LETTERS

Vuvuzela – good for your team, bad for your ears


De Wet Swanepoel, James W Hall III, Dirk Koekemoer

To the Editor: Excitement surrounding the 2010 Soccer World 1- and 2-metre distances from the bell. A person without prior
Cup is mounting, with less than a year to go before the first experience with a vuvuzela blew it while two recordings were
kick-off. Half a million soccer fans from all over the world made at each of the four sound recording sites. To ensure an
are expected to converge in South Africa to enjoy this major equivalent environment to a typical open stadium game, the
sporting event, which will make history as the first to be recordings were made outside on a large open lawn area.
hosted on the continent of Africa. Spectators can look forward The maximum sound output, averaged between the two
to the beautiful African landscapes, the rich cultural heritage, recordings at each recording site, varied between 113 and
the diversity of the rainbow nation, and the lively rhythm 131 dBA (Fig. 1). The intensities between repeated measures
of Africa. They will also experience the unique sound of the for separate instances of blowing the vuvuzela varied by less
African horn, called a vuvuzela, which is blown by most avid than 1.4 dB for all recording sites except the 2-metre distance
South African soccer supporters. It is a proud symbol of South condition, where it varied by 4.6 dB between the first (114.9
African soccer, having evolved over the past 15 years into a dBA) and second (110.3 dBA) recording. The frequency
symbol of hope and unity for many people in the country.1 spectrum of the sound was broad and flat with largely
Traditionally made from a kudu horn, the vuvuzela was equivalent energy across the frequency spectrum from 250
used to call together meetings and could be heard by distant to 8 000 Hz. Fig. 1 illustrates the permissible noise exposure
peoples summoned to attend. Today soccer stadiums in time without hearing protection in relation to the intensities
South Africa are invariably filled with its loud and raucous produced by the vuvuzela at the various distances from it.
sound, which reverberates with energy to the exhilaration of According to the South African National Standard regulating
supporters. The intensity of the sound caught the attention of occupational noise exposure in South Africa,2 no one within
the global soccer community during the 2009 Confederation a 2-metre radius of a vuvuzela, including the person blowing
Cup recently concluded in South Africa and in anticipation it, should be exposed to it continually for more than a minute.
of the forthcoming World Cup in 2010. Despite complaints by At an intensity of 100 dBA a person should be exposed to less
international commentators, players and audiences, FIFA has than 15 minutes of such noise per day, and the permissible time
approved the Vuvuzela as part of the signature South African is halved with every 3 dB increase in intensity.2,3 According to
World Cup.1 It is not surprising, however, that the international South African occupational noise exposure legislation,2,4 at the
soccer community would be astounded at the loudness of the lowest recorded intensity of 113 dBA subjects should not be
vuvuzela and its non-stop chorus throughout the duration of a
soccer match.
To determine exactly what intensity of sound the vuvuzela
produces, and the possible related hearing risks, a calibrated
type 1 sound level meter was used to measure the sound
intensity and spectrum produced by an official vuvuzela at
four distinct distances from the bell of the instrument where
the sound exits. The measurements included a recording at
the ear of the person blowing the vuvuzela, at the bell, and at

Department of Communication Pathology, University of Pretoria, and Callier Center


for Communication Disorders, School of Behavioral and Brain Sciences, University of
Texas at Dallas, USA
De Wet Swanepoel, PhD

Department of Communication Pathology, University of Pretoria, and Department of


Communicative Disorders, University of Florida, Gainesville, Fla, USA 99
James W Hall III, PhD

Research and Development Department, GeoAxon, South Africa



Dirk Koekemoer, MB ChB
2
Fig. 1. Average sound level
Fig. el measurements
measurements(dBA)
me (dBA) of
ofaavuvuzela
vuvuzela with
with the
he SANS
S
the SANS2 recommendations
recommendations tion for
for duration duration
of sound of sound
exposure exposure
allowed allowedinten
at specific at
ntensities (every 3
specific
dB intensities
increase halves(every 3owed
the alloweddB increase
exposurehalves
time,the allowed
starting at 8exposure
hours fortime,
85 dBA).
d Two
starting at were
recordings 8 hours
madefor 85 dBA).
at eachach ofTwo
the recordings werefrom
four distances made
theatbell
each
ofof thevuvuzela.
the vu
Correponding author: D W Swanepoel (dewet.swanepoel@up.ac.za) four distances from the bell of the vuvuzela.

February 2010, Vol. 100, No. 2 SAMJ


SCIENTIFIC LETTERS

exposed for more than 1 minute without hearing protection. with significant social consequences in addition to its limiting
This places all bystanders within a 2-metre radius in the effect on educational and vocational prospects.
severe risk category for permanent hearing loss. Intensities Although more investigations are required, initial findings
at each of the recording sites far exceeded the legislated certainly demonstrate that the vuvuzela exceeds the
levels of occupational noise exposure allowed without permissible occupational noise exposure levels in South Africa
hearing protection. Even with hearing protection the intensity and poses a significant recreational risk of noise-induced
produced at the bell of the vuvuzela is still unacceptably high hearing loss. Preventive measures such as public awareness
(≥130 dBA).2,4 and hearing protection should be prioritised as an important
These measurements are an important indication of health care approach in sporting events where the vuvuzela
the recreational risk vuvuzelas pose to spectators. Until is used, especially in view of the upcoming World Cup. The
investigated further, it can only be assumed that if a single vuvuzela has reached iconic status and should be kept as
vuvuzela emits a sound that is dangerously loud to those in part of the South African soccer culture, but measures to
at least a 2-metre radius, the cumulative effect of numerous protect spectators’ hearing must be considered of paramount
vuvuzelas, typically blown together for the duration of a soccer importance.
match, may have an additive effect, putting spectators at a
significant risk of noise-induced hearing loss. Exceeding the
recommended exposure time for the intensities produced by References

the vuvuzela can irreversibly damage the delicate hair cells of 1. Fédération Internationale de Football Association (FIFA). Vuvuzela: a symbol of South
Africa. 19 June 2009. http://www.fifa.com/confederationscup/news/newsid=1073689.html
the cochlea.3 Although initial threshold shifts in hearing may (accessed 28 July 2009).
not be noticed by exposed persons, the effects over time result 2. SANS10083:2004. The Measurement and Assessment of Occupational Noise for Hearing Conservation
Purposes. Pretoria: South African National Standards, 2004.
in progressive and permanent sensory hearing loss. Although 3. Franz RM, Phillips JI. Noise and vibration. In: Guild R, Ehrlich RI, Johnston JR, Ross MH, eds.
there is significant individual variability in susceptibility Handbook of Occupational Health Practice in the South African Mining Industry. Braamfontein:
Safety in Mines Research Advisory Committee (SIMRAC), 2001: 193-230.
to noise-induced hearing loss, no one is immune to the 4. Department of Labour. The determination of permanent disablement resulting from hearing
devastating effects of loud sound over a prolonged period loss caused by exposure to excessive noise and trauma. Circular Instruction No. 171.
Compensation for Occupational Injuries and Diseases Act, No.130 of 1993. Republic of South
of time, especially at the intensity levels produced by the Africa. Government Gazette 2001; 16 May.

vuvuzela. Noise-induced hearing loss is a disabling condition


Accepted 23 October 2009.

100

February 2010, Vol. 100, No. 2 SAMJ


CORRESPONDENCE
Vuvuzela sound measurements their technique and the pressure exerted. Also, the sound level
produced by multiple individuals simultaneously blowing
To the Editor: Our recent paper in the SAMJ1 reported the vuvuzelas within a limited space cannot be predicted from
maximum output levels of a vuvuzela at various distances these data.
from the horn. In response to enquiries, we provide additional
information on the method and results reported in the earlier De Wet Swanepoel
paper. Department of Communication Pathology
University of Pretoria, and
One commercial vuvuzela was used in the recording of Callier Center for Communication Disorders
sound levels at 4 different positions: (i) at the ear of the person University of Texas
Dallas, USA
blowing the vuvuzela; (ii) at the bell end; (iii) 1 m from the
dewet.swanepoel@up.ac.za
bell end; and (iv) 2 m from the bell end. All measurements
were made approximately 1.6 m from the ground, in an open- James W Hall III
air setting. Sound levels were measured twice at a single Department of Communication Pathology
University of Pretoria, and
instance while the vuvuzela was being blown by one of the Department of Communicative Disorders
investigators. Measurements were made using a calibrated University of Florida
Type 1 Larson Davis SLM 824 sound level meter with a 2559 Gainesville, Fla, USA

normal sensitivity microphone fitted with a manufacturer-


Dirk Koekemoer
supplied windscreen (WS001). Measurements were made using
Research and Development Department
the fast response time option, which corresponds to a time GeoAxon
constant of 0.125 s that is intended to approximate the time Pretoria
constant of human hearing.2
1. Swanepoel D, Hall JW III, Koekemoer D. Vuvuzela – good for your team, bad for your ears. S
The initial report1 provided the maximum instantaneous Afr Med J 2010; 100: 99-100.
A-weighted sound pressure level (Lmax Fast [dBA]) averaged 2. Berglund B, Lindvall T, Schwela DH, Goh KT, eds. Guidelines for Community Noise. Technical
Report. Geneva: World Health Organization, 1999.
for 2 recordings during single vuvuzela blasts at 4 distances
from the bell of the vuvuzela. This method is in agreement
with the recommendation by the World Health Organization2 Pandemic flu (H1N1) 2009 and pregnancy
for measuring individual sound events. A-weighting was
used for all measurements to compensate for the non-linear To the Editor: We welcome the recommendations by Schoub
sensitivity of the human ear, which is differentially sensitive et al.1 and advertisements in local newspapers highlighting the
to sound across the frequency spectrum (least sensitive at importance of influenza vaccination (Cape Times 17 February
very high and very low frequencies). A breakdown of the 2010), but are concerned that there is no unified strategy to
average intensities at individual frequencies across the ensure that all pregnant women are offered influenza vaccine
frequency spectrum is provided in Table I. A characteristically and have access to antivirals should they develop symptoms of
flat frequency spectrum was evident between 250 and 8 000 infection.
Hz. The average intensity difference between the individual A striking feature of the pandemic H1N1 infection has been
frequency measurements (Table I) of the 2 recordings at each of the predilection of severe disease in pregnant women. This
the 4 respective distances from the bell of the vuvuzela was 0.6 is not surprising as pregnancy causes immunological and
dB (±3.2 dB standard deviation). physiological changes which are likely to contribute to an
These measures provide an indication of the sound levels increased susceptibility to influenza infection and an excessive
and frequency spectrum of a typical vuvuzela. There are now risk of influenza-related morbidity and mortality.2 We have
numerous types of vuvuzela made by several manufacturers, previously highlighted the problem of H1N1 in South Africa in
which may all produce varying intensity and frequency pregnant women.3
outputs. In addition to these variables, individuals blowing Antivirals oseltamivir and zanamivir are effective against
a vuvuzela will produce varying intensities depending on H1N1, and both may be used in pregnancy.2 Despite a lack of
formal trials in pregnancy, both have been widely used in the
Table I. Average vuvuzela intensity measurements across second and third trimester without proven adverse effects on
frequencies at 4 distinct distances from the bell end of the the mother or teratogenic effects on the unborn child. Their
vuvuzela (dBA)
use is justified on the basis that the potential benefit to the
Intensity (dBA) mother outweighs any potential risk to the fetus.4 However,
Frequency
(Hz) At ear Bell opening 1m 2m antiviral therapy must be initiated early to be effective, posing
a considerable logistical challenge.5 Vaccination is the most
125 36 62 38 35
important weapon in preventing influenza infection and its
250 92 106 82 85
500 103 121 102 101 sequelae in pregnant women. Pregnant women have been
1 000 106 122 108 100 prioritised for vaccination in industrialised countries during
2 000 101 122 110 101 the 2009/2010 season. The inactivated influenza vaccine
4 000 97 109 110 102 is void of harmful effects on maternal or neonatal health.6
5 000 93 111 109 100
Since pandemic H1N1 vaccines are produced using the same
8 000 87 110 107 98
manufacturing and licensing process as seasonal influenza

192 April 2010, Vol. 100, No. 4 SAMJ

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