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ICT for Health: Networks, standards and innovation







           the  different  exposure  volume  for  the  8-hour  period,  the   The  app  samples  environmental  noise  exposure  using  an
           percent dosage calculation is multiplied by a factor f, where   external microphone or internal phone microphone and can
           f is the ratio of OSHA’s recommended 8-hour noise level (85   sample  audio  sound  exposure  from  the  mobile  phone’s
           dBA) over the other standard’s recommended 8-hour noise   system audio player. The app leverages the mobile phone’s
           level.                                             short-range  wireless  connection  to  a  PSAP  consisting  of
                                                              digital  signal  processor  (DSP)  packaged  with  a  Bluetooth
           2.4    Mitigation of discrepancies in measuring sound   Low Energy (LE) module to more accurately measure the
           exposure                                           environmental and streamed sound exposure from a closer
                                                              distance  to  the  user’s  eardrum  (Figure  1).  Following  the
           There are a few causes of discrepancy when measuring a   Bluetooth  LE  protocol  will  allow  the  app  to  receive  data
           user’s sound exposure. One such cause is the difference in   points  from  the  PSAP,  subject  to  the  particular  DSP.  For
           distance  between  the  ear  and  microphone  sampling   example, volume settings, battery level and ambient noise
           environmental noise. Because sound attenuation is inversely   levels may be available data points the app can query. When
           proportional  to  the  distance  from  the  source,  squared,  the   possible,  hardware  tests  of  the  PSAP  device  can  be
           perceived sound at a point closer to the source of the sound   performed by ensuring that input and output voltages do not
           can  be  substantially  louder  than  the  perceived  sound  at  a   exceed those as listed in the DSP specification, as well as
           point  farther  away.  Another  such  cause  is  the  type  of   accessing  test  points  from  the  Bluetooth  LE  module  to
           microphone  that  is  sampling.  Different  microphones  have   program  and  debug  the  module.  Note  that  the  PSAP  is
           different  sensitivities,  meaning  that  different  microphones   indicated for users without hearing impairment.
           can possibly register different sound pressure levels from the
           same  sound  signal.  To  mitigate  these  two  causes  of   Privacy  and  security  measures  to  safeguard  personal
           discrepancy, we propose using a microphone from a specific   information  include:  (i)  limiting  data  collection  to  that
           PSAP  product  because  the  distance  between  the  PSAP   required  specifically  for  app  execution,  (ii)  implementing
           microphone and the user’s eardrum is decreased and because   Health  Insurance  Portability  and  Accountability  Act
           the  software  can  be  standardized  to  that  specific  PSAP   (HIPAA) and General Data Protection Regulation (GPDR),
           microphone’s sensitivity.                          and  (iii)  using  Amazon  Web  Services  (AWS)  for  cloud
                                                              security.  To  ensure  data  security,  the  app  only  collects
                             3.  RESULTS                      amplitudes  of  the  sound  in  decibels  and  stores  them  in
                                                              dynamoDB  using  s3  provided  by  AWS,  which  highly
           3.1    App overview                                emphasizes security and strictly meets US and international
                                                              compliance requirements.
           The Hearing Health app (Figure 1) is designed as a software
           tool to serve as a companion for personal hearing health that   3.2   User voice assessment for app personalization
           prompts a user to make informed decisions about personal
           listening  behaviors  based  on  personal  listening  trends.   An  initial  assessment  of  user  awareness  of  NIHL  and
           Throughout  the  day,  the  app  monitors  sound  levels  to   preferences for app personalization features was conducted
           estimate  the  user’s  sound  exposure,  while  also  presenting   in several user segments to represent a wide demographic
           alerts  and  notifications  to  the  user  to  indicate  how  the   and  is  summarized  below.  The  user  segments  included
           personal  listening  behavior  compares  to  sound  doses   military  and  civilian,  young  adults  (age  18-25  years)  and
           prescribed by safe listening standards. The app also provides   adults (age >25 years), with or without perceived hearing
           personalized recommendations to limit or counteract unsafe   impairment.
           noise exposure that is relatable to daily lifestyles.
                                                              CIVILIAN, young adult, not aware of personal impairment:

                                                              •   limited awareness of NIHL;
                                                              •   general perception that NIHL is not a risk for them;
                                                              •   prefer to use personal audio devices throughout the day,
                                                                  even during classes and face-to-face conversations;
                                                              •   some would like to mitigate NIHL risk;
                                                              •   app would be helpful; but need to integrate to daily life.
                                                              CIVILIAN, young adult, with hearing impairment, tinnitus:

                                                              •   some awareness of NIHL;
                   Figure 1 – Hearing Health app overview     •   may or may not wear hearing aids or hearing protection
                                                                  devices as they are inconvenient or not effective;






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