title: Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions.
abstract: Audiometric thresholds and otoacoustic emissions (OAEs) were measured in 285 U.S. Marine Corps recruits before and three weeks after exposure to impulse-noise sources from weapons' fire and simulated artillery, and in 32 non-noise-exposed controls. At pre-test, audiometric thresholds for all ears were <or=25 dB HL from 0.5 to 3 kHz and <or=30 dB HL at 4 kHz. Ears with low-level or absent OAEs at pre-test were more likely to be classified with significant threshold shifts (STSs) at post-test. A subgroup of 60 noise-exposed volunteers with complete data sets for both ears showed significant decreases in OAE amplitude but no change in audiometric thresholds. STSs and significant emission shifts (SESs) between 2 and 4 kHz in individual ears were identified using criteria based on the standard error of measurement from the control group. There was essentially no association between the occurrence of STS and SES. There were more SESs than STSs, and the group of SES ears had more STS ears than the group of no-SES ears. The increased sensitivity of OAEs in comparison to audiometric thresholds was shown in all analyses, and low-level OAEs indicate an increased risk of future hearing loss by as much as ninefold.
authors.affiliation: Naval Submarine Medical Research Laboratory, Groton, Connecticut 06349-5900, USA. lynne.marshall@med.navy.mil
authors.forename: Lynne
authors.initials: L
authors.lastname: Marshall
authors.forename: Judi A
authors.initials: JA
authors.lastname: Lapsley Miller
authors.forename: Laurie M
authors.initials: LM
authors.lastname: Heller
authors.forename: Keith S
authors.initials: KS
authors.lastname: Wolgemuth
authors.forename: Linda M
authors.initials: LM
authors.lastname: Hughes
authors.forename: Shelley D
authors.initials: SD
authors.lastname: Smith
authors.forename: Richard D
authors.initials: RD
authors.lastname: Kopke
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D007758:Ear, Inner / Q000293:injuries*; D005389:Firearms; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008889:Military Personnel; D009623:Noise, Occupational / Q000009:adverse effects*; D017084:Otoacoustic Emissions, Spontaneous; D011237:Predictive Value of Tests; D018570:Risk Assessment; D055815:Young Adult