Noise-induced extra-aural pathology: a review and commentary.

The focus of this review paper will be the effects of acoustic phenomenon (noise), characterized by large pressure amplitude (> or =90 dB) and low frequency (< or =500 Hz) (LPALF) on humans and animal models. Current concepts imply the assumption that such LPALF noise impinges only on, or through, the somatic medium of the auditory system. As a consequence of this assumption, the effect of noise on humans is only regulated for purposes of hearing conservation. Guidelines and regulations governing occupational noise assessments are biased toward the subjective human perception of sound. The author will not make the assumption that airborne acoustic phenomena impacts only on the auditory system, and will present a literature review providing evidence for such position. The purpose of this review paper is to defend the existence of extra-aural, noise-induced pathology, particularly the vibroacoustic disease; and to advance the recognition that the respiratory tract could very well be a target organ of this environmental stressor.