Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes

Coles, R. R. A.; Lutman, Mark E.; Buffin, Jez

doi:10.1046/j.1365-2273.2000.00368.x

Cited by 171 publications

(214 citation statements)

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“…Coles et al 2000). There have been several attempts to identify audiometric notches according to objective criteria (Coles et al 2000;Rabinowitz et al 2006;Niskar et al 2001).…”

Section: Evects In the Pure-tone Audiogrammentioning

confidence: 99%

Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras

Jansen

Helleman

Dreschler

et al. 2008

Int Arch Occup Environ Health

156

117

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Objectives An investigation of the hearing status of musicians of professional symphony orchestras. Main questions are: (1) Should musicians be treated as a special group with regard to hearing, noise, and noise related hearing problems (2) Do patterns of hearing damage diVer for diVerent instrument types (3) Do OAE have an added value in the diagnosis of noise induced hearing loss (NIHL) in musicians. Methods 241 professional musicians, aged between 23-64 participated. A brief medical history and the subjective judgment of their hearing and hearing problems were assessed. Musicians were subjected to an extensive audiological test battery, which contained testing of audiometric thresholds, loudness perception, diplacusis, tinnitus, speech perception in noise, and otoacoustic emissions. Results Most musicians could be categorized as normal hearing, but their audiograms show notches at 6 kHz, a frequency that is associated with NIHL. Musicians often complained about tinnitus and hyperacusis, while diplacusis was generally not reported as a problem. Tinnitus was most often localized utmost left and this could not be related to the instrument. It was usually perceived in high frequency areas, associated with NIHL. In general, musicians scored very well on the speech-in-noise test. The results of the loudness perception test were within normal limits. Otoacoustic emissions were more intense with better pure-tone thresholds, but due to large individual diVerences it can still not be used as an objective test for early detection of NIHL.Conclusions Musicians show more noise induced hearing loss than could be expected on the basis of age and gender. Other indicators, such as complaints and prevalence of tinnitus, complaints about hyperacusis and prevalence of diplacusis suggest that musicians' ears are at risk. Continuing education about the risks of intensive sound exposure to musicians, with the emphasis on the possible development of tinnitus and hyperacusis and the need for good hearing protection is warranted.

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“…Coles et al 2000). There have been several attempts to identify audiometric notches according to objective criteria (Coles et al 2000;Rabinowitz et al 2006;Niskar et al 2001).…”

Section: Evects In the Pure-tone Audiogrammentioning

confidence: 99%

Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras

Jansen

Helleman

Dreschler

et al. 2008

Int Arch Occup Environ Health

156

117

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“…In a considerable proportion of the NIHL cases, especially after the age of about 50 years, the characteristic high-frequency notch is missing. Additional presence of a high-frequency hearing impairment due to other reasons has the effect of converting a noise-induced audiometric notch into a bulge (Coles et al, 2000). The NIHL and age-related hearing loss often coexist in the same ear, however, the conditions under which these forms of hearing loss interact remain poorly understood (Kujawa, Liberman, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…The normal hearing was defined as thresholds of ≤ 20 dB hearing level (HL) at the audiometric frequencies from 250 to 8000 Hz, and the pathologic audiogram was defined as an audiogram with the hearing thresholds of > 20 dB HL at any of the frequencies (Adjamian et al, 2012). A high-frequency "notch" was defined as a hearing threshold level at 3000 and/or 4000 and/or 6000 Hz; at least 10 dB greater than at 1000 or 2000 Hz and at 6000 or 8000 Hz (Coles et al, 2000). For the statistical data analysis we have used the Chi-square test and Fisher exact test with the level of significance at p < 0.05.…”

Section: Methodsmentioning

confidence: 99%

Frequency of the Audiometric Notch Following Excessive Noise Exposure

Ristovska¹,

Jachova²,

Atanasova³

2015

Archives of Acoustics

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The aim of the study was to determine the configuration of pathologic audiograms in patients with excessive noise exposure, and to calculate the frequency of notches in the audiogram in patients with and without excessive noise exposure by avoiding the effect of age-related hearing loss. We have analyzed 514 audiograms of 257 patients aged between 20 to 50 years: 240 patients (mean age of 38.7 years) with excessive noise exposure and 17 patients (mean age of 41.2 years) with notches in the audiogram, but without a history of excessive noise exposure. For statistical data analysis we have used the Chi-square test and Fisher exact test with the level of significance p < 0.05. Pathologic audiograms were classified into five different types: Slope at 4000 Hz (0.8%), Slope at 2000 Hz (15.1%), Notch at 4000 Hz (67.4%), Notch at 2000 Hz (0.8%), Flat (8.9%), and 7% were out of this classification. A total of 190 (79.2%) patients with excessive noise exposure had a notch in the audiogram. Left ear notches were the most common. Among the patients with notched audiograms, 91.8% had a history of excessive noise exposure, either occupational or nonoccupational, and 8.2% did not report any excessive noise exposure.

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“…In the UK this is usually done by using the audiometric thresholds at 1 and 8 kHz as anchor points, and selecting appropriate values from tables of hearing loss as a function of age and gender for non-noise-exposed individuals (Coles et al, 2000), although this approach has been criticized (Ali et al, 2014). An alternative 'two-pass' method has recently been proposed by Lutman et al (2016).…”

Section: Effects On Speech Intelligibility Expected From the Speech Imentioning

confidence: 99%

“…The thresholds are within the normal range for frequencies up to 3 kHz, but are elevated at higher frequencies. Row 4 shows the HTLs at the anchor points of 1 and 8 kHz, and row 5 shows the age-associated hearing loss (AAHL) for a man aged 55 at the 50th percentile, taken from Table 2 of Coles et al (2000). The actual audiometric threshold is 3 dB worse than for the AAHL at the 1-kHz anchor point and 3 dB better than for the AAHL at the 8-kHz anchor point.…”

Section: Effects On Speech Intelligibility Expected From the Speech Imentioning

confidence: 99%

A review of the perceptual effects of hearing loss for frequencies above 3 kHz

Moore

2016

International Journal of Audiology

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Background: Hearing loss caused by exposure to intense sounds usually has its greatest effects on audiometric thresholds at 4 and 6 kHz. However, in several countries compensation for occupational noise-induced hearing loss is calculated using the average of audiometric thresholds for selected frequencies up to 3 kHz, based on the implicit assumption that hearing loss for frequencies above 3 kHz has no material adverse consequences. This paper assesses whether this assumption is correct. Design: Studies are reviewed that evaluate the role of hearing for frequencies above 3 kHz. Results: Several studies show that frequencies above 3 kHz are important for the perception of speech, especially when background sounds are present. Hearing at high frequencies is also important for sound localization, especially for resolving front-back confusions. Conclusions: Hearing for frequencies above 3 kHz is important for the ability to understand speech in background sounds and for the ability to localize sounds. The audiometric threshold at 4 kHz and perhaps 6 kHz should be taken into account when assessing hearing in a medico-legal context.

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Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes

Cited by 171 publications

References 1 publication

Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras

Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras

Frequency of the Audiometric Notch Following Excessive Noise Exposure

A review of the perceptual effects of hearing loss for frequencies above 3 kHz

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