Neurobehavioral Alterations in Occupational Noise Exposure: A Systematic Review

Round 1

Reviewer 1 Report

This article mainly focuses on the possibility of occupational noise exposure for employees in neurobehavioral alteration to conduct a review of the relevant literature. A total of 4 review articles and 37 original articles were included in this article to review the relevant literature. This article believes that employees mainly produce psychological distress, annoyance, sleep disturbances, and cognitive performance under occupational noise exposure. In addition, the most influential types of occupations are mainly school staff, employees of industrial sectors, and office workers. The following questions should be explained by authors:

1. How to determine that the noise exposure of all the reviewed documents is the noise exposure of the occupational site? Are all noise exposure assessments performed in the occupational site?
2. How to determine that all health hazards in the reviewed literature are caused by occupational noise exposure, rather than the result of noise during non-occupational periods?
3. The results of the noise exposure assessment show that the sound pressure level exposed by most documents is less than 90db, so it may be wrong to determine that the occupational site is noise exposure.
4. Are there any personal noise exposure dose measurements in these documents? Does the noise exposure dose exceed legal standards?

Author Response

Dear Reviewer,

thank you very much for your work and comments. They were very useful and really helped in improving our manuscript, because they addressed some points that weren’t very clear in the first draft.

Below you will find the comments and answers to your remarks.

1. How to determine that the noise exposure of all the reviewed documents is the noise exposure of the occupational site? Are all noise exposure assessments performed in the occupational site?

The studies selected refer all to occupational noise exposure, as the “working population” was the target population in our PICO. Analyzing the noise exposure in the workplace was one of the main inclusion criteria for our review and we excluded a priori studies not referring to this setting. All the noise exposures were performed in the workplace, thus allowing to define them as “professional exposure”. We added this clarification at the beginning of the discussion (line 408)

2. How to determine that all health hazards in the reviewed literature are caused by occupational noise exposure, rather than the result of noise during non-occupational periods?

This is good point which is frequent when assessing the noise exposure and its detrimental effects in the workplace. In fact, several extraprofessional sources of noise are relevant in human life and it is impossible to completely exclude them when performing a study. This is a limitation of our review and we addressed it in the Discussion, adding some comments (line 505 and following).

3. The results of the noise exposure assessment show that the sound pressure level exposed by most documents is less than 90db, so it may be wrong to determine that the occupational site is noise exposure.

Intensity can’t be considered the only parameter to determine if the noise exposure can be detrimental to human wellbeing, especially when we refer to neurobehavioral alterations. Frequency of the noise, duration of exposure, frequency and duration of the interruption can determine the annoyance of the exposure to a noise. Moreover, noise can cause its effects also in an indirect way. We addressed this issue in the Introduction (line 81-87), justifying the choice in our selection of articles to include also studies in which noise exposure was below 90dB.

4.  Are there any personal noise exposure dose measurements in these documents? Does the noise exposure dose exceed legal standards?

Some studies analyzed the noise exposure quantitatively, and we reported the level of noise measured in the summary tables. In some cases, it exceeds the 85-87 dB which is the higher threshold in Europe for occupational noise exposure. However, the studies selected come from all over the world, also from low- and middle-income countries in which laws regarding Occupation Safety and Health can be different and less strict from those of western countries. We included also studies in which only a qualitative assessment through questionnaires was performed, exploring thus the perception of the noise of workers: this aspect is addressed in line 499 and following.

 

We hope that we have clarified and explained all the points that you brought to our attention.

We really appreciate all your attention and commitment in this review process.

Kind regards,

The Authors.

Reviewer 2 Report

The paper reviews an important issue, that is the harmful
effects of noise to humans during daily activity in closed rooms.
The authors address the question of the working place as the
guiding line for their study. The summary of the several papers
collected from the web is impressive and to a large extent
very useful to both practitioners and newcomers to the field.
It is an excellent guide to look at for getting a broad view on this complex problem. The paper is very written and I can recommend its publication in the journal. I only found some minor points which can be solved easily.

Presentation issues:

(1) Line 45: ad -> as

(2) Question of meaning: Line 56. Should it be
    'From these evidences,...'. Please check.

(3) Table 3: Some items start with lower cases letters,
    and others with capital letters. Please unify.

(4) Tables 4, 5 and 6: same as in (3).

(5) Line 115: 'hand' -> 'manual'. Please check.

(6) Table 5,6: 'Lenght' -> 'Length'

(7) Ref [64] not quoted in text.

 

Author Response

Dear reviewer,

Thank you very much for your work and comments. We correct all the points that you brought to our attention, and we really appreciated the attention that you put in reading and evaluating our manuscript.

We are truly grateful for your nice comments.

Kind regards,

The Authors.

Round 2

Reviewer 1 Report

I have no other comment.