Audiogram notches in noise-exposed workers

Ear Hear. 2006 Dec;27(6):742-50. doi: 10.1097/01.aud.0000240544.79254.bc.

Abstract

Objectives: Diagnostic criteria for noise-induced hearing loss include the audiometric notch, yet no standardized definition exists. This study tested whether objective notch metrics could match the clinical judgments of an expert panel.

Design: A panel of occupational physicians, otolaryngologists, and audiologists reviewed audiograms of noise-exposed workers. In a two-sample process, the panel judged whether a notch was present and whether hearing loss had progressed in a notch pattern. Quantitative notch metrics were compared against expert decisions.

Results: At least five of six experts agreed about notch identification in 71 and 72% of the cases in the two samples, and agreement about notch progression was 61 and 67%. Notch depth and professional specialty appeared to affect notch judgments. Despite this variability, a notch metric showed excellent agreement with expert notch consensus in each sample (94.7 and 96.6%; kappa = 0.88 and 0.92).

Conclusions: Audiogram notch metrics can agree with expert clinical consensus and assist in the surveillance of noise-exposed workers.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Auditory Threshold / physiology*
  • Chi-Square Distribution
  • Hearing Loss, Noise-Induced / diagnosis*
  • Hearing Loss, Noise-Induced / physiopathology
  • Humans
  • Middle Aged
  • Noise, Occupational / adverse effects*
  • Observer Variation
  • Occupational Diseases / diagnosis*
  • Occupational Diseases / physiopathology
  • Retrospective Studies
  • Time Factors