JSLHR Papers in Press
Published online September 15, 2010
Journal of Speech, Language, and Hearing Research 2010; doi:10.1044/1092-4388(2010/09-0132)

Journal of Speech, Language, and Hearing Research 2011;54:679.

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Article

Are False Positive Rates Leading to an Overestimation of Noise-Induced Hearing Loss?

Robert S. Schlauch
Edward Carney
University of Minnesota

Address all correspondence to: Robert S. Schlauch, Ph.D., Dept of Speech-Language-Hearing Sciences, 115 Shevlin Hall, University of Minnesota, Minneapolis, MN 55455.

Purpose: To estimate false positive rates for rules proposed to identify early noise-induced hearing loss (NIHL) using the presence of notches in audiograms.

Methods: Audiograms collected from school-aged children in a national survey of health and nutrition (NHANES III) were examined using published rules for identifying noise notches at various pass-fail criteria. These results were compared with computer-simulated "flat" audiograms. The proportion of these identified as having a noise notch is an estimate of the false-positive rate for a particular rule.

Results: Audiograms from the NHANES III survey for children aged 6–11 yield notched audiograms at rates consistent with simulations, suggesting that this group does not have significant NIHL. Further, pass-fail criteria for rules suggested by expert clinicians, applied to NHANES III audiometric data, yielded unacceptably high false-positive rates.

Conclusions: Computer simulations provide an effective method for estimating false positive rates for protocols used to identify notched audiograms. Audiometric precision could possibly be improved by 1) eliminating systematic calibration errors, including a possible problem with reference levels for TDH-style earphones; 2) repeating and averaging threshold measurements; and 3) using earphones that yield lower variability for 6.0 and 8.0 kHz—two frequencies critical for identifying noise notches.

KEY WORDS: pure-tone air conduction thresholds, OSHA, noise-induced hearing loss, audiograms


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