Objective: To assess the test–retest variability of hearing thresholds obtained with an innovative, mobile wireless automated hearing-test system (WAHTS) with enhanced sound attenuation to test industrial workers at a worksite as compared to standardised automated hearing thresholds obtained in a mobile trailer sound booth. Design: A within-subject repeated-measures design was used to compare air-conducted threshold tests (500–8000 Hz) measured with the WAHTS in six workplace locations, and a third test using computer-controlled audiometry obtained in a mobile trailer sound booth. Ambient noise levels were measured in all test environments. Study sample: Twenty workers served as listeners and 20 workers served as operators. Results: On average, the WAHTS resulted in equivalent thresholds as the mobile trailer audiometry at 1000, 2000, 3000 and 8000 Hz and thresholds were within ±5 dB at 500, 4000 and 6000 Hz. Conclusions: Comparable performance may be obtained with the WAHTS in occupational audiom...

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Going wireless and booth-less for hearing testing in industry

Objectives Detection thresholds in quiet become adult-like earlier in childhood for high than low frequencies. When adults listen for sounds near threshold, they tend to engage in behaviors that reduce physiologic noise (e.g., quiet breathing), which is predominantly low frequency. Children may not suppress self-generated noise to the same extent as adults, such that low-frequency self-generated noise elevates thresholds in the associated frequency regions. This possibility was evaluated by measuring noise levels in the ear canal simultaneous with adaptive threshold estimation. Design Listeners were normal-hearing children (4.3 to 16.0 years) and adults. Detection thresholds were measured adaptively for 250-, 1000-, and 4000-Hz pure tones using a three-alternative forced-choice procedure. Recordings of noise in the ear canal were made while the listeners performed this task, with the earphone and microphone routed through a single foam insert. Levels of self-generated noise were computed in octave-wide bands. Age effects were evaluated for four groups: 4- to 6-year olds, 7- to 10-year olds, 11- to 16-year olds, and adults. Results Consistent with previous data, the effect of child age on thresholds was robust at 250 Hz and fell off at higher frequencies; thresholds of even the youngest listeners were similar to adults' at 4000 Hz. Self-generated noise had a similar low-pass spectral shape for all age groups, although the magnitude of self-generated noise was higher in younger listeners. If self-generated noise impairs detection, then noise levels should be higher for trials associated with the wrong answer than the right answer. This association was observed for all listener groups at the 250-Hz signal frequency. For adults and older children, this association was limited to the noise band centered on the 250-Hz signal. For the two younger groups of children, this association was strongest at the signal frequency, but extended to bands spectrally remote from the 250-Hz signal. For the 1000-Hz signal frequency, there was a broadly tuned association between noise and response only for the two younger groups of children. For the 4000-Hz signal frequency, only the youngest group of children demonstrated an association between responses and noise levels, and this association was particularly pronounced for bands below the signal frequency. Conclusions These results provide evidence that self-generated noise plays a role in the prolonged development of low-frequency detection thresholds in quiet. Some aspects of the results are consistent with the possibility that self-generated noise elevates thresholds via energetic masking, particularly at 250 Hz. The association between behavioral responses and noise spectrally remote from the signal frequency is also consistent with the idea that self-generated noise may also reflect contributions of more central factors (e.g., inattention to the task). Evaluation of self-generated noise could improve diagnosis of minimal or mild hearing loss.

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Effects of Self-Generated Noise on Estimates of Detection Threshold in Quiet for School-Age Children and Adults.

A comparison of test–retest variability and time efficiency of auditory thresholds measured with pure tone audiometry and new early warning test

School-based hearing screening won't prevent noise-induced hearing loss.

Objetivo: verificar a influencia do tipo de transdutor na audiometria tonal e vocal de idosos em dife rentes decadas de vida. Metodos: 39 individuos de ambos os sexos, com idade entre 60 e 89 anos, selecionados no Ambulatorio de Audiologia Clinica do Departamento de Fonoaudiologia da UNIFESP, foram divididos em tres grupos etarios 60-69 (G1), 70-79 (G2), 80-89 anos (G3). Todos os pacientes foram submetidos a anamnese audiologica, meatoscopia e avaliacao audiologica basica, sendo que a audiometria tonal liminar e a logoaudiometria foram realizadas tanto com os fones supra-aurais TDH-39 quanto com os fones de insercao ER-3A. Os resultados foram analisados estatisticamente com os testes ANOVA e T-Student Pareado. Resultados: a analise estatistica realizada por orelha e por grupo revelou limiares auditivos mais baixos com os fones ER-3A com significância estatistica nas frequencias de 4 e 6KHz. Na comparacao entre os grupos etarios, verificou-se que quanto maior a idade, piores os limiares, independente do transdutor. O Indice Percentual de Reconhecimento de Fala apresentou maiores porcentagens de acertos com o fone ER-3A e houve piora do desempenho com o aumento da idade, com ambos os transdutores. Conclusao: os fones de insercao (ER-3A) possibilitam a obtencao de melhores limiares de audibilidade se comparados aos fones supra-aurais (TDH-39) independente da idade. Em decorrencia do aumento da idade, ha a diminuicao progressiva da audicao refletida tanto nos limiares de audibilidade como no reconhecimento de fala.

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FONES DE INSERÇÃO E FONES SUPRA-AURAIS: AVALIAÇÃO AUDIOLÓGICA EM IDOSOS Insertion and supra-aural earphones: Audiological assessment in the elderly

Clinical audiologists and audiometric equipment manufacturers have embraced the clinical use of insert earphones; however, their use in audiometric testing in occupational hearing loss prevention programs has been limited. This study was undertaken to research whether certified audiometric technicians without practical hands-on training could reliably use insert earphones when compared to a clinically experienced audiologist. Hearing thresholds were obtained on 60 human ears by six certified audiometric technicians using insert earphones for the first time. Technician-acquired audiometric thresholds were compared to thresholds obtained under the same conditions by a clinical audiologist experienced in the use of the insert earphones. Statistical analyses of audiometric thresholds were performed to investigate the relationships between audiometric threshold values at each frequency obtained by certified technicians vs. the audiologist. These relationships were examined for the group as a whole as well as when ear tip size and earphone insertion depth varied between the audiologist and the technicians. No significant differences (p > .01) were found between mean group thresholds at any of the test frequencies (500-8000 Hz). Mean group thresholds differed by .01) even when the audiologist and technicians varied in their selection of ear tip size or in the amount of insertion depth achieved. This study suggests that CAOHC-certified audiometric technicians can reliably use insert earphones without practical training when testing in quiet environments by reading the earphone package directions provided by the manufacturer.

Cassie Tuell

Papers

Reliability of audiometric thresholds obtained with insert earphones when used by certified audiometric technicians.