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10-Year prospective study of noise exposure and hearing damage among construction workers
  1. Noah S Seixas1,
  2. Rick Neitzel2,
  3. Bert Stover1,
  4. Lianne Sheppard3,
  5. Patrick Feeney4,
  6. David Mills5,
  7. Sharon Kujawa6
  1. 1Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
  2. 2Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
  3. 3Department of Biostatistics, University of Washington, School of Public Health, Seattle, Washington, USA
  4. 4VA National Center for Rehabilitative Auditory Research, Portland, Oregon, USA
  5. 5Bloedel Hearing Research Center, University of Washington, Seattle, Washington, USA
  6. 6Department of Otology and Laryngology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  1. Correspondence to Dr Noah S Seixas, Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98115, USA; nseixas{at}


Objectives To characterise the effects of noise exposure, including intermittent and peaky exposure, on hearing damage as assessed by standard pure-tone thresholds and otoacoustic emissions, a longitudinal study was conducted on newly hired construction apprentices and controls over a 10-year period.

Methods Among the 456 subjects recruited at baseline, 316 had at least two (mean 4.6) examinations and were included in this analysis. Annual examinations included hearing threshold levels (HTLs) for air conducted pure tones and distortion product otoacoustic emission (DPOAE) amplitudes. Task-based occupational noise exposure levels and recreational exposures were estimated. Linear mixed models were fit for HTLs and DPOAEs at 3, 4 and 6 kHz in relation to time since baseline and average noise level since baseline, while controlling for hearing level at baseline and other risk factors.

Results Estimated LEQ noise exposures were 87±3.6 dBA among the construction workers. Linear mixed modelling demonstrated significant exposure-related elevations in HTL of about 2–3 dB over a projected 10-year period at 3, 4 or 6 kHz for a 10 dB increase in exposure. The DPOAE models (using L1=40) predicted about 1 dB decrease in emission amplitude over 10 years for a 10 dB increase in exposure.

Conclusions The study provides evidence of noise-induced damage at an average exposure level around the 85 dBA level. The predicted change in HTLs was somewhat higher than would be predicted by standard hearing loss models, after accounting for hearing loss at baseline. Limited evidence for an enhanced effect of high peak component noise was observed, and DPOAEs, although similarly affected, showed no advantage over standard hearing threshold evaluation in detecting effects of noise on the ear and hearing.

  • Noise exposure
  • hearing loss
  • otoacoustic emissions
  • longitudinal studies
  • ENT
  • injury
  • pneumoconioses
  • accidents
  • aluminium
  • hearing

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  • The contents of this article do not represent the views of the Department of Veterans Affairs or of the United States Government.

  • Funding This work was supported by US CDC (NIOSH), grant number 5R01 OH003912.

  • Competing interests None declared.

  • Patient consent Observational study among normal adults, with informed consent for participation.

  • Ethics approval Ethics approval was provided by the University of Washington Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Anonymised data sets are available from the author with a specific request and allowing for sufficient time for the data to be extracted.