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Predictors of hearing threshold levels and distortion product otoacoustic emissions among noise exposed young adults
  1. N S Seixas1,
  2. S G Kujawa2,
  3. S Norton3,
  4. L Sheppard4,
  5. R Neitzel1,
  6. A Slee4
  1. 1Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
  2. 2Department of Otology and Laryngology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, USA
  3. 3Children’s Hospital and Regional Medical Center, Seattle, WA, USA
  4. 4Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
  1. Correspondence to:
 Dr N S Seixas
 Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA;


Aim: To examine the relations between noise exposure and other risk factors with hearing function as measured by audiometric thresholds and distortion product otoacoustic emissions.

Methods: A total of 456 subjects were studied (393 apprentices in construction trades and 63 graduate students). Hearing and peripheral auditory function were quantified using standard, automated threshold audiometry, tympanometry, and distortion product otoacoustic emissions (DPOAEs). The analysis addressed relations of noise exposure history and other risk factors with hearing threshold levels (HTLs) and DPOAEs at the baseline test for the cohort.

Results: The cohort had a mean age of 27 (7) years. The construction apprentices reported more noise exposure than students in both their occupational and non-occupational exposure histories. A strong effect of age and years of work in construction was observed at 4, 6, and 8 kHz for both HTLs and DPOAEs. Each year of construction work reported prior to baseline was associated with a 0.7 dB increase in HTL or 0.2 dB decrease DPOAE amplitude. Overall, there was a very similar pattern of effects between the HTLs and DPOAEs.

Conclusions: This analysis shows a relatively good correspondence between the associations of noise exposures and other risk factors with DPOAEs and the associations observed with pure-tone audiometric thresholds in a young adult working population. The results provide further evidence that DPOAEs can be used to assess damage to hearing from a variety of exposures including noise. Clarifying advantages of DPOAEs or HTLs in terms of sensitivity to early manifestations of noise insults, or their utility in predicting future loss in hearing will require longitudinal follow up.

  • ANSI, American National Standards Institute
  • DPOAE, distortion product otoacoustic emission
  • HPD, hearing protection device
  • HTL, hearing threshold level
  • NIHL, noise induced hearing loss
  • OAE, otoacoustic emission
  • OHC, outer hair cells
  • hearing thresholds
  • otoacoustic emissions
  • noise exposure
  • construction workers

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  • Funding: This project was supported by Grant Number 5 RO1 OH03912 from the National Institute for Occupational Safety and Health of the US Centers for Disease Control and Prevention