title: Acoustic reflexes are common but not pervasive: evidence from the National Health and Nutrition Examination Survey, 1999-2012.
abstract: To determine whether acoustic reflexes are pervasive (i.e. sufficiently prevalent to provide 95% confidence of at least 95% prevalence) and might be invoked in damage-risk criteria (DRC) and health hazard assessments (HHA) for impulsive noise.
  
  
  
  Cross-sectional analyses of a nationally-representative study.
  
  
  
  National Health and Nutrition Examination Survey (NHANES) data collected between 1999 and 2012 were used. Over 60 thousand reflex traces obtained from 15,106 NHANES participants were used in the study, along with demographic, audiometric, health and exposure variables obtained in that study.
  
  
  
  Acoustic reflexes were not sufficiently prevalent to be deemed pervasive by any detection method or in any subgroup defined by age or audiometric characteristics. The odds of observing acoustic reflexes were greater for women, young adults, and people with better hearing sensitivity. Abnormally high tympanometric admittance and "Other" race/ethnicity (i.e. people who do not self-identify as exclusively Non-Hispanic White, Non-Hispanic Black, Mexican-American, or Hispanic) were associated with lower odds.
  
  
  
  Acoustic reflexes are not sufficiently prevalent to be included in DRC and HHA for impulsive noise.
authors.affiliation: a Department of Speech Pathology and Audiology , Western Michigan University , Kalamazoo , MI , USA and.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Flamme
authors.affiliation: a Department of Speech Pathology and Audiology , Western Michigan University , Kalamazoo , MI , USA and.
authors.forename: Kristy K
authors.initials: KK
authors.lastname: Deiters
authors.affiliation: a Department of Speech Pathology and Audiology , Western Michigan University , Kalamazoo , MI , USA and.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Tasko
authors.affiliation: b Auditory Protection and Performance Division , U.S. Army Aeromedical Research Laboratory , Fort Rucker , AL , USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Ahroon
mesh_terms: D000158:Acoustic Impedance Tests; D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D001309:Auditory Threshold; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006309:Hearing; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D009749:Nutrition Surveys; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D044469:Racial Groups; D012022:Reflex, Acoustic; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Noise; demographics/epidemiology; hearing conservation; middle ear