The use of the kurtosis metric in the evaluation of occupational hearing loss in workers in China: Implications for hearing risk assessment

Davis, Robert I.; Qiu, Wei; Heyer, Nicholas J.; Zhao, Yiming; Yang, Min; Li, Nan; Tao, Liyuan; Zhu, Liangliang; Zeng, Lin; Yao, D H

doi:10.4103/1463-1741.104903

Cited by 40 publications

(24 citation statements)

References 29 publications

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“…The noise type in the automotive industry was the non‐Gaussian noise judged from the waveforms of noise. Workers exposed to a non‐Gaussian noise (complex noise) consisting of a Gaussian background noise that was punctuated by a temporally complex series of randomly occurring high‐level noise transients might suffer from considerably greater hearing loss than those exposed to the Gaussian noise . The prevalence of AHFNIHL in the specific population exposed to complex noise at 94 ≤ CNE < 100 dB(A)·year was 37.75%, which was relatively higher than that in the Gaussian noise group (11.10%) at 95 ≤ CNE < 100 dB(A)·year in Xie's study .…”

Section: Discussionmentioning

confidence: 95%

Prevalence and determinants of noise-induced hearing loss among workers in the automotive industry in China: A pilot study

Chen

Zhang

Qiu

et al. 2019

Journal of Occupational Health

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Objective Data on noise‐induced hearing loss (NIHL) in the automotive industry are rare. This pilot study aimed to investigate the prevalence and determinants of NIHL among workers in the automotive industry in China. Methods A cross‐sectional survey was conducted with 6557 participants from the automotive industry. The questionnaire survey was administered, and individual noise exposure level (LAeq.8h) and hearing loss level were measured. Results Of participants, 96.43% were male; the median age was 27.0 years and 28.82% had NIHL defined as adjusted high‐frequency noise‐induced hearing loss (AHFNIHL). Concerning individual noise levels (LAeq.8h), 62.53% exceeded 85 dB(A), which were mainly concentrated in various jobs, including metal cutting, surface treatment, stamping, welding, grinding, assembly, plastic molding, and forging. Each typical noise source generated its own unique temporal waveform shape with the type of non‐Gaussian noise. Of workers, 53.15% regularly used hearing protector devices (HPD), and the proportion of regular HPD use increased with LAeq.8h. The trend test showed that the prevalence of AHFNIHL in male workers significantly increased with an increase in LAeq.8h at <94 dB(A) and cumulative noise exposure (CNE) in each age group (P < 0.05 or P < 0.01). A logistic regression analysis showed that CNE and HPD usage frequency were important factors contributing to AHFNIHL. Conclusions CNE and HPD usage frequency were the determinants for NIHL. Much more human surveys are needed to understand the prevalence and determinants of NIHL in the automotive industry in China.

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Section: Discussionmentioning

confidence: 95%

Prevalence and determinants of noise-induced hearing loss among workers in the automotive industry in China: A pilot study

Chen

Zhang

Qiu

et al. 2019

Journal of Occupational Health

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“…With that assumption, the ISO model predicts that 10 yr of additional exposure at 87 dBA will yield an additional 3 dB or more of NIPTS (median, not mean). With these points taken into consideration, the threshold shifts experienced by these apprentices were either consistent with or less than those predicted by ISO-1999. We disagree with Suter's interpretation of the data reported by Davis et al (2012). These authors compared hearing thresholds predicted by ISO-1999 (based on a subject's age, sex, and noise exposure) to their actual thresholds.…”

Section: Response To Suter and Nioshmentioning

confidence: 46%

“…In combination, these errors would make the differences between their subjects' hearing and ISO-1999 predictions seem about 7 dB worse than they really were. Figure 2 in Davis et al (2012) summarizes data for all their subjects; median thresholds appeared to be 1 to 8 dB worse than predicted. With appropriate corrections as indicated earlier, these differences would disappear.…”

Section: Response To Suter and Nioshmentioning

confidence: 89%

“…First, Davis et al compared subjects' binaural average thresholds to the better-ear thresholds in Annex B of ISO-1999ISO- (1990. The underlying data in Annex B (Glorig & Roberts 1965) show that binaural average thresholds were 4 to 5 dB higher than better-ear thresholds, for the frequencies and age groups represented in Davis et al (2012). Second, it appears that Davis et al presented subject group median thresholds without making the 2.5-dB correction that is necessary before comparison with these Annex B medians, assuming that the medians had been calculated in the conventional way (Hoffman et al 2010).…”

Section: Response To Suter and Nioshmentioning

confidence: 95%

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Response to Suter and NIOSH

Dobie

Clark

2015

Ear &Amp; Hearing

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492We thank Suter and Morata et al. for their letters. The authors of Morata et al. are all employees of the National Institute for Occupational Safety and Health (NIOSH); it is our understanding that their letter, lacking the disclaimer usually attached to public comments of federal employees, represents the official position of that agency, and thus, we will refer to it as the NIOSH letter. We will address each of the comments in the Suter and NIOSH letters, followed by a brief discussion on important issues that they omitted. Although we would have preferred a brief response, the extent, nature, and scientific foundation of the arguments brought forward require a thorough rebuttal.Suter and NIOSH are longtime collaborators and proponents of the 3-dB exchange rate (ER), so their disagreement with our article is not unexpected. What was unexpected was NIOSH's assertion that a "re-examination of the exchange rate" requires adherence to a long list of criteria, including the use of two raters of study quality, with a third to adjudicate conflicts; a formal assessment of quality across multiple domains; attempting to contact authors; presenting study findings grouped by "certainty of exposure level estimates"; an evaluation of the risk of bias; and others. We disagree and note that neither NIOSH (1998) nor Suter's (1992) report to NIOSH considered any of these elements when they re-examined the 5-dB ER, which NIOSH (1972) had previously recommended, and decided to instead advocate for the 3-dB ER.For those who have not read our article, we reviewed all the literature we could find that could shed light on the issue of the appropriate ER, based on human noise-induced permanent threshold shift (NIPTS). We included every study that had been cited by Suter (1992) and NIOSH (1998), as well as other studies from the reference lists of those articles, and additional studies discovered by a literature search. We applied clear inclusion criteria, analyzed included studies in comparison with the predictions of an international standard (International Organization for Standardization [ISO]-1999[ISO]- , 1990) using fully transparent methodology that others can replicate, and submitted our work to a peer-reviewed journal. We believe that our contribution was unique in this literature. We could not replicate the findings of a frequently cited previous review (Passchier-Vermeer 1973) that despite its unclear methodology and lack of peer review has been very influential (as we note later). Although we reviewed 19 studies in detail and included nine in our summary table, it is notable that neither Suter nor NIOSH question any of our exclusions, nor do they suggest alternative interpretations for any of the included studies. Suter notes that we "excluded most of the studies used by Passchier-Vermeer from their analysis." That is misleading: we read, analyzed, and commented on all the studies Passchier-Vermeer relied on and explained why most of them had to be excluded from our final summary table.Some studies that NIOSH now conside...

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“…Recently, a carefully controlled study of Chinese workers by Davis and his colleagues (both Chinese and American) has made significant progress in the development of a more sophisticated metric to evaluate hearing loss (Davis et al 2012). The population they studied had never worn hearing protectors or only used them in the past 1 to 2 years of employment but had worked in the same exposure environment for many years.…”

Section: Letter To the Editor: An Alternative Interpretation Of Issuementioning

confidence: 99%

Letter to the Editor

Suter¹

2015

Ear &Amp; Hearing

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Dobie and Clark (2014) have reviewed certain studies to determine whether the 3-dB or the 5-dB exchange rate (ER) more accurately predicts noiseinduced hearing loss. The authors have gone to considerable trouble and expense, including translations from German, Dutch, and Czech, to reanalyze data from studies, several of them more than 40 years old. In their discussion of the ER, the authors concentrate on the hearing loss studies analyzed by the Dutch scientist Wilhelmina Passchier-Vermeer in the early 1970s.From their results, Dobie and Clark have made recommendations that most of the rest of the world has already chosen not to implement. The 5-dB ER is used by Occupational Safety and Health Administration (OSHA) and two other U.S. agencies concerned with noise-exposed workers, the Mine Safety and Health Administration also in the U.S. Department of Labor, and the Federal Railroad Administration in the U.S. Department of Transportation. However, the origin of the 5-dB rule is characterized by oversimplification and economic/political considerations (Suter 1992).The original Department of Labor "Walsh-Healey" noise standard required a permissible exposure limit (PEL) of 85 dBA for continuous noise and a method for assessing noncontinuous noise that varied according to noise level and degree of intermittency. This standard was officially promulgated early in 1969 (Department of Labor 1969a). It was subsequently withdrawn after a change in administration, and later that year, a noise standard was issued with a 90-dBA PEL and a 5-dB ER, which regulation is still in effect today (Department of Labor 1969b). In the meantime, several U.S. Agencies and most other nations, including all the nations of the European Union, have adopted the 3-dB ER for all types of noise-continuous, varying, and intermittent.In her analysis on the effects of varying and intermittent noise, Passchier-Vermeer did not test whether the median data from the studies she selected supported either the 5-dB or the 3-dB ER. (The 5-dB rule had just been implemented by the Department of Labor and was not well known internationally.) Instead, she examined the extent to which the hearing loss data from varying and intermittent noise followed the hearing threshold levels resulting from exposure to continuous noise, either from the continuous noise data she had collected (Passchier-Vermeer 1973) or those collected by Burns and Robinson (1970). When compared with Passchier-Vermeer's continuous noise data, the hearing threshold levels from varying and intermittent noise generally followed the continuous noise curve, supporting the use of the 3-dB ER for noncontinuous noise. When Passchier-Vermeer compared the hearing threshold levels from varying and intermittent noise with the equal energy (3-dB) curve developed by Burns and Robinson, most of the data points fell above the curve, indicating that intermittent and varying exposures were at least as harmful as the continuous exposures. She attributes the difference between the two comparisons to the increased...

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The use of the kurtosis metric in the evaluation of occupational hearing loss in workers in China: Implications for hearing risk assessment

Cited by 40 publications

References 29 publications

Prevalence and determinants of noise-induced hearing loss among workers in the automotive industry in China: A pilot study

Prevalence and determinants of noise-induced hearing loss among workers in the automotive industry in China: A pilot study

Response to Suter and NIOSH

Letter to the Editor

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