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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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