Variability in audiometric recording

Abstract

. Variability in audiometric recording. A study of initial and repeat audiograms by two operators on 143 young male new entrants to industry (free of previous occupational exposure) has shown that mean values (mean of both ears, readings at 3 and 4 kHz) differed significantly between operators, and that this difference was not attributable to transient medical conditions such as wax in the ears or temporary infection.For nearly half the employees, the difference between the results obtained by the two operators amounted to 5 dB or more, with differences up to and including 21 dB. Of the two operators' lists of men in the lowest decile of hearing threshold levels, only half the names were common to both operators; there was clearly wide variation between the operators.With such variability in audiometric recording, some of which may be attributable to variation in the patients' responses, it seems unlikely that small changes in recorded hearing levels will give confident early indication of deterioration in a susceptible ear.It is suggested that further studies be carried out under industrial conditions to ascertain the advantages, if any, of two or more readings taken at one session (or within a short space of time) over single observations. Similar studies are needed using self-recording audiometry.Consideration should be given to the basic training and potential of operators, to the need for monitoring their performance, and to periodic refresher training where appropriate.The present investigation was undertaken to discover whether those subjects who had the poorest hearing at first examination would show the greatest deterioration at subsequent examination within a short period of time.All figures in this paper are based on the mean pure tone audiometric readings for both ears at 3 and 4 kHz; the intention of the present investigation was also to see whether, in practice, small changes in measured hearing levels in the lowest decile were likely to be prognostic of ultimate occupationally related hearing damage, and to look at the variations in audiograms obtained by different operators. Present investigation and resultsA preliminary examination of the pre-employment records of male school-leavers at a number of British Steel Corporation works showed that in practice the 10% of entrants with the greatest deterioration in recorded hearing levels had mean decreases, at all establishments, which were considerably greater than expected from theoretical calculations by Adam (1970, personal communication) on the basis of the work of Burns and Robinson (1970). The exclusion of those subjects with recognized medical impairment or noisy hobbies such as shooting or musical bands had little effect (and certainly no significant effect) on the mean values at any works.Further examination of these audiograms showed that approximately two-thirds of the worst 10% on entry had a second audiogram which showed an increase of hearing levels, whereas in those with an initial reduced hearing level of not more than 8j dB (more no...

A seven-year review of measured hearing levels in male manual steelworkers with high initial thresholds

“…The remaining 449 subjects were each classified into one of three noise exposure groups: less than 90 dbB(A), 90-99 db(A), or 100 dB(A) or over. All audiograms were made by the same operator, thus obviating one major potential source of error (Howell and Hartley, 1972). Men were between 15 and 54 years of age at the initial audiometric examination, and where age is mentioned it is that at the time of first examination.…”

Longitudinal Study of Human Hearings: Its Relationship to Noise and Other Factors. 3. Results from the First Five Years

“…These findings were not confirmed by Karlovich (1975) who used the same noise exposure but a pulsed tone at 1.414 kHz; this choice maximizes the possibility of demonstrating fatigue but excludes the possibility of showing adaptation (Thwing, 1955). Howell and Hartley (1972), in testing young adults, reported a mean interobserver difference of 5 dB with differences up to 21.2 dB. There was a significant systematic difference between the two observers.…”

Estudo do efeito aprendizagem em exames audiométricos sequenciais de trabalhadores de indústria metalúrgica e suas implicações nos programas de conservação auditiva

“…A variabilidade dos registros audiométricos pode ser atribuída tanto à variação das respostas dos trabalhadores, quanto ao treinamento, desempenho, experiência e o potencial do aplicador do exame. Portanto, devem-se considerar a variabilidade e a inconstância do aplicador e do sujeito 5 . Ao se submeter a repetidos exames audiométricos, o trabalhador toma conhecimento de como ele é realizado, torna-se mais atento, menos ansioso e, assim, mais sensível ao mesmo, aprendendo a responder com mais precisão à proposta do teste.…”