title: [Quality control of audiologic results in a university phoniatric/pediatric institution. An example of expert assessment of occupational noise induced hearing loss].
abstract: OBJECTIVE
  An investigation was made to reveal whether suspicion of occupational hearing loss can be satisfactorily determined by an otolaryngologist or workplace audiological measurement. These were compared with a formal audiometrical assessment at a university clinic.
  
  
  RESULTS
  A retrospective study was made of 95 cases of noise induced hearing loss. A total of 78 individuals were investigated by an otolaryngologist and 70 by workplace audiometry. Using workplace audiometry, 27% of the tests showed a reduction in working capacity of at least 20%. In only five of these was a specialist opinion sought within a year. In 50%, this took longer than 5 years. A comparison of audiometric data from expert opinion revealed that there was conformity in only 47% with workplace audiometry and 48% with otolaryngologist testing. In some cases (27% workplace and 33% ENT practice), the measured hearing loss and calculation of disability exceeded that determined by the experts.
  
  
  CONCLUSIONS
  The results of workplace audiometry demonstrated that hearing loss was frequently reported only after the workers had received a disability of at least 20%. Possible reasons for discrepancies in audiological testing might be the exaggeration of hearing loss by the worker, insufficient recovery time after noise exposure, or inexperienced audiologists. Our data show that audiometric testing in workplace audiometry, as well as in ENT practice, often reveal a higher disability rating compared to formal audiological (university) assessment, even if these discrepancies do not reach statistical significance.
authors.affiliation: Bereich Phoniatrie und Pädaudiologie der Klinik für Hals-, Nasen-, Ohrenheilkunde, Universität Tübingen. sibylle.brosch@med.uni-tuebingen.de
authors.forename: S
authors.initials: S
authors.lastname: Brosch
authors.forename: K
authors.initials: K
authors.lastname: Bürner
authors.forename: H S
authors.initials: HS
authors.lastname: Johannsen
authors.forename: H
authors.initials: H
authors.lastname: de Maddalena
authors.forename: P S
authors.initials: PS
authors.lastname: Mauz
mesh_terms: D000328:Adult; D000368:Aged; D001298:Audiology; D001299:Audiometry / Q000379:methods* / Q000706:statistics & numerical data*; D015897:Comorbidity; D005104:Expert Testimony; D005260:Female; D005858:Germany / Q000453:epidemiology; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D011379:Prognosis; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013333:Student Health Services / Q000706:statistics & numerical data; D017132:Workplace / Q000706:statistics & numerical data