The quest for a damage risk criterion for hazardous noise exposure.

The Reflections series takes a look back on historical articles from The Journal of the Acoustical Society of America that have had a significant impact on the science and practice of acoustics.

Population-based age adjustment tables for use in occupational hearing conservation programs.

Objective: In occupational hearing conservation programmes, age adjustments may be used to subtract expected age effects. Adjustments used in the U.S. came from a small dataset and overlooked important demographic factors, ages, and stimulus frequencies. The present study derived a set of population-based age adjustment tables and validated them using a database of exposed workers.Design: Cross-sectional population-based study and retrospective longitudinal cohort study for validation.Study sample: Data from the U.S. National Health and Nutrition Examination Survey (unweighted n = 9937) were used to produce these tables. Male firefighters and emergency medical service workers (76,195 audiograms) were used for validation.Results: Cross-sectional trends implied less change with age than assumed in current U.S. regulations. Different trends were observed among people identifying with non-Hispanic Black race/ethnicity. Four age adjustment tables (age range: 18-85) were developed (women or men; non-Hispanic Black or other race/ethnicity). Validation outcomes showed that the population-based tables matched median longitudinal changes in hearing sensitivity well.Conclusions: These population-based tables provide a suitable replacement for those implemented in current U.S. regulations. These tables address a broader range of worker ages, account for differences in hearing sensitivity across race/ethnicity categories, and have been validated for men using longitudinal data.

Generalizability of clinically measured acoustic reflexes to brief sounds.

Middle ear muscle contractions (MEMC) can be elicited in response to high-level sounds, and have been used clinically as acoustic reflexes (ARs) during evaluations of auditory system integrity. The results of clinical AR evaluations do not necessarily generalize to different signal types or durations. The purpose of this study was to evaluate the likelihood of observing MEMC in response to brief sound stimuli (tones, recorded gunshots, noise) in adult participants (N = 190) exhibiting clinical ARs and excellent hearing sensitivity. Results revealed that the presence of clinical ARs was not a sufficient indication that listeners will also exhibit MEMC for brief sounds. Detection rates varied across stimulus types between approximately 20% and 80%. Probabilities of observing MEMC also differed by clinical AR magnitude and latency, and declined over the period of minutes during the course of the MEMC measurement series. These results provide no support for the inclusion of MEMC as a protective factor in damage-risk criteria for impulsive noises, and the limited predictability of whether a given individual will exhibit MEMC in response to a brief sound indicates a need to measure and control for MEMC in studies evaluating pharmaceutical interventions for hearing loss.

Auditory risk of exposure to ballistic N-waves from bullets.

OBJECTIVE: Assessment of the auditory risk associated with sound from ballistic N-waves produced by a rifle bullet. DESIGN: Acoustical recordings of ballistic N-waves passing through a microphone array at 6.4 metres down range were analysed to determine (a) the trajectory of the bullet, (b) the distance between the trajectory and each microphone (less than 1.3 m), and (c) the numbers of permissible exposures according to both damage-risk criteria for impulsive noise in the current U.S. military standard (MIL-STD-1474E). STUDY SAMPLE: The gun was an AR-15 style semiautomatic rifle configured to fire a 0.50 calibre Beowulf00AE cartridge. Four sample shots were recorded for each of four microphone spacing conditions and five kinds of ammunition (80 shots in total). RESULTS: The ballistic N-waves recorded in this study would constitute a significant auditory risk to unprotected listeners at all distances sampled. The numbers of permissible exposures decreased as the distance to the bullet trajectory decreased, decreased with increased bullet length, and departed from linear increases as the bullet velocity increased. CONCLUSIONS: Unprotected exposure to a ballistic N-wave from a supersonic 0.50 calibre bullet presents a significant risk to hearing at distances of 6.4 metres down range and through trajectories within 1.2 metres of an ear.

Acoustic reflexes are common but not pervasive: evidence using a diagnostic middle ear analyser.

OBJECTIVE: The objective of this study is to determine whether acoustic reflexes are pervasive (i.e. known with 95% confidence to be observed in at least 95% of people) by examining the frequency of occurrence using a friction-fit diagnostic middle ear analyser. DESIGN: Adult participants with very good hearing sensitivity underwent audiometric and middle ear testing. Acoustic reflexes were tested ipsilaterally and contralaterally in both ears across a range of elicitor frequencies. Reflex elicitors were 700 ms tones presented at maximum level of 100 dB HL. Two automated methods were used to detect the presence of an acoustic reflex. STUDY SAMPLE: A group of 285 adult volunteers with normal hearing. RESULTS: There were no conditions in which the proportion of participants exhibiting acoustic reflexes was high enough to be deemed pervasive. Ipsilateral reflexes were more likely to be observed than contralateral reflexes and reflexes were more common at 0.5 and 1 kHz elicitor frequencies as compared with 2 and 4 kHz elicitor frequencies. CONCLUSIONS: Acoustic reflexes are common among individuals with good hearing. However, acoustic reflexes are not pervasive and should not be included in damage risk criteria and health hazard assessments for impulsive noise.

The reduction of gunshot noise and auditory risk through the use of firearm suppressors and low-velocity ammunition.

OBJECTIVE: This research assessed the reduction of peak levels, equivalent energy and sound power of firearm suppressors. DESIGN: The first study evaluated the effect of three suppressors at four microphone positions around four firearms. The second study assessed the suppressor-related reduction of sound power with a 3 m hemispherical microphone array for two firearms. RESULTS: The suppressors reduced exposures at the ear between 17 and 24 dB peak sound pressure level and reduced the 8 h equivalent A-weighted energy between 9 and 21 dB depending upon the firearm and ammunition. Noise reductions observed for the instructor's position about a metre behind the shooter were between 20 and 28 dB peak sound pressure level and between 11 and 26 dB LAeq,8h. Firearm suppressors reduced the measured sound power levels between 2 and 23 dB. Sound power reductions were greater for the low-velocity ammunition than for the same firearms fired with high-velocity ammunition due to the effect of N-waves produced by a supersonic bullet. CONCLUSIONS: Firearm suppressors may reduce noise exposure, and the cumulative exposures of suppressed firearms can still present a significant hearing risk. Therefore, firearm users should always wear hearing protection whenever target shooting or hunting.

Acoustic reflexes are common but not pervasive: evidence from the National Health and Nutrition Examination Survey, 1999-2012.

OBJECTIVE: 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. DESIGN: Cross-sectional analyses of a nationally-representative study. STUDY SAMPLE: 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. RESULTS: 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. CONCLUSIONS: Acoustic reflexes are not sufficiently prevalent to be included in DRC and HHA for impulsive noise.

Auditory risk of air rifles.

OBJECTIVE: To characterize the impulse noise exposure and auditory risk for air rifle users for both youth and adults. DESIGN: Acoustic characteristics were examined and the auditory risk estimates were evaluated using contemporary damage-risk criteria for unprotected adult listeners and the 120-dB peak limit and LAeq75 exposure limit suggested by the World Health Organization (1999) for children. STUDY SAMPLE: Impulses were generated by nine pellet air rifles and one BB air rifle. RESULTS: None of the air rifles generated peak levels that exceeded the 140 dB peak limit for adults, and eight (80%) exceeded the 120 dB peak SPL limit for youth. In general, for both adults and youth, there is minimal auditory risk when shooting fewer than 100 unprotected shots with pellet air rifles. Air rifles with suppressors were less hazardous than those without suppressors, and the pellet air rifles with higher velocities were generally more hazardous than those with lower velocities. CONCLUSION: To minimize auditory risk, youth should utilize air rifles with an integrated suppressor and lower velocity ratings. Air rifle shooters are advised to wear hearing protection whenever engaging in shooting activities in order to gain self-efficacy and model appropriate hearing health behaviors necessary for recreational firearm use.

Stimulus and transducer effects on threshold.

OBJECTIVE: This study examined differences in thresholds obtained under Sennheiser HDA200 circumaural earphones using pure tone, equivalent rectangular noise bands, and 1/3 octave noise bands relative to thresholds obtained using Telephonics TDH-39P supra-aural earphones. DESIGN: Thresholds were obtained via each transducer and stimulus condition six times within a 10-day period. STUDY SAMPLE: Forty-nine adults were selected from a prior study to represent low, moderate, and high threshold reliability. RESULTS: The results suggested that (1) only small adjustments were needed to reach equivalent TDH-39P thresholds, (2) pure-tone thresholds obtained with HDA200 circumaural earphones had reliability equal to or better than those obtained using TDH-39P earphones, (3) the reliability of noise-band thresholds improved with broader stimulus bandwidth and was either equal to or better than pure-tone thresholds, and (4) frequency-specificity declined with stimulus bandwidths greater than one equivalent rectangular band, which could complicate early detection of hearing changes that occur within a narrow frequency range. CONCLUSIONS: These data suggest that circumaural earphones such as the HDA200 headphones provide better reliability for audiometric testing as compared to the TDH-39P earphones. These data support the use of noise bands, preferably ERB noises, as stimuli for audiometric monitoring.

Auditory risk estimates for youth target shooting.

OBJECTIVE: To characterize the impulse noise exposure and auditory risk for youth recreational firearm users engaged in outdoor target shooting events. The youth shooting positions are typically standing or sitting at a table, which places the firearm closer to the ground or reflective surface when compared to adult shooters. DESIGN: Acoustic characteristics were examined and the auditory risk estimates were evaluated using contemporary damage-risk criteria for unprotected adult listeners and the 120-dB peak limit suggested by the World Health Organization (1999) for children. STUDY SAMPLE: Impulses were generated by 26 firearm/ammunition configurations representing rifles, shotguns, and pistols used by youth. Measurements were obtained relative to a youth shooter's left ear. RESULTS: All firearms generated peak levels that exceeded the 120 dB peak limit suggested by the WHO for children. In general, shooting from the seated position over a tabletop increases the peak levels, LAeq8 and reduces the unprotected maximum permissible exposures (MPEs) for both rifles and pistols. Pistols pose the greatest auditory risk when fired over a tabletop. CONCLUSION: Youth should utilize smaller caliber weapons, preferably from the standing position, and always wear hearing protection whenever engaging in shooting activities to reduce the risk for auditory damage.

Short-term variability of pure-tone thresholds obtained with TDH-39P earphones.

OBJECTIVE: To estimate the short-term variability and correlates of variability in pure-tone thresholds obtained using audiometric equipment designed for occupational use, and to examine the justification for excluding 8 kHz as a mandatory threshold in occupational hearing conservation programs. METHOD: Pure-tone thresholds and other hearing-related tests (e.g. noise dosimetry, otoscopy, middle-ear assessment) were conducted with a group of 527 adults between 20 and 69 years of age. Five measurement visits were completed by participants within 14 days. RESULTS: The 50% critical difference boundaries were - 5 and 0 dB at 4 kHz and below and - 5 and 5 dB at 6 and 8 kHz. The likelihood of spurious notches due to test-retest variability was substantially lower than the likelihood of failing to detect a notched configuration when present. Correlates of variability included stimulus frequency, baseline threshold, acoustic reflectance of the ear, average noise exposure during the previous eight hours, age, and the tester's level of education in audiology. CONCLUSION: The short-term variability in 8-kHz pure-tone thresholds obtained with the TDH-39P earphone was slightly greater than at other frequencies, but this difference was not large enough to justify the disadvantages stemming from the inability to detect a 6-kHz notch.

Impulse noise generated by starter pistols.

OBJECTIVE: This study describes signals generated by .22 and .32 caliber starter pistols in the context of noise-induced hearing loss risk for sports officials and athletes. DESIGN: Acoustic comparison of impulses generated from typical .22 and .32 caliber starter pistols firing blanks were made to impulses generated from comparable firearms firing both blanks and live rounds. Acoustic characteristics are described in terms of directionality and distance from the shooter in a simulated outdoor running track. Metrics include peak sound pressure levels (SPL), A-weighted equivalent 8-hour level (L(eqA8)), and maximum permissible number of individual shots, or maximum permissible exposures (MPE) for the unprotected ear. RESULTS: Starter pistols produce peak SPLs above 140 dB. The numbers of MPEs are as few as five for the .22-caliber starter pistol, and somewhat higher (≤ 25) for the .32-caliber pistol. CONCLUSION: The impulsive sounds produced by starter pistols correspond to MPE numbers that are unacceptably small for unprotected officials and others in the immediate vicinity of the shooter. At the distances included in this study, the risk to athletes appears to be low (when referencing exposure criteria for adults), but the sound associated with the starter pistol will contribute to the athlete's overall noise exposure.

Sports officials' hearing status: whistle use as a factor contributing to hearing trouble.

The objectives of this study were to examine the prevalence of hearing loss in a sample of sports officials and estimate the duration of whistle use required to reach a permissible 8-hr 100% noise dose. We conducted an online survey of 321 sports officials regarding their exposure to whistle noise and symptoms of hearing loss and tinnitus, and we assessed the acoustic characteristics of commercially available whistles. Male sports officials registered in Michigan had a greater prevalence of self-reported hearing trouble and tinnitus than observed in the general population of the midwestern United States. Sound levels produced by whistles range between 104 and 116 dBA, which corresponds to maximum unprotected exposure times of 90 to 5 sec, respectively. These findings suggest that whistle use may contribute to hearing loss among sports officials.

Measurement of impulse peak insertion loss for four hearing protection devices in field conditions.

OBJECTIVE: In 2009, the U.S. Environmental Protection Agency (EPA) proposed an impulse noise reduction rating (NRR) for hearing protection devices based upon the impulse peak insertion loss (IPIL) methods in the ANSI S12.42-2010 standard. This study tests the ANSI S12.42 methods with a range of hearing protection devices measured in field conditions. DESIGN: The method utilizes an acoustic test fixture and three ranges for impulse levels: 130-134, 148-152, and 166-170 dB peak SPL. For this study, four different models of hearing protectors were tested: Bilsom 707 Impact II electronic earmuff, E·A·R Pod Express, E·A·R Combat Arms version 4, and the Etymotic Research, Inc. Electronic BlastPLG™ EB1. STUDY SAMPLE: Five samples of each protector were fitted on the fixture or inserted in the fixture's ear canal five times for each impulse level. Impulses were generated by a 0.223 caliber rifle. RESULTS: The average IPILs increased with peak pressure and ranged between 20 and 38 dB. For some protectors, significant differences were observed across protector examples of the same model, and across insertions. CONCLUSIONS: The EPA's proposed methods provide consistent and reproducible results. The proposed impulse NRR rating should utilize the minimum and maximum protection percentiles as determined by the ANSI S12.42-2010 methods.

Typical noise exposure in daily life.

OBJECTIVE: Identify the distribution of typical noise levels present in daily life and identify factors associated with average sound levels. DESIGN: This was an observational study. STUDY SAMPLE: Participants (N = 286) were 20 to 68 year old men and women, drawn from the general population of Kalamazoo County, Michigan. A total of 73 000 person-hours of noise monitoring were conducted. RESULTS: Median overall daily average levels were 79 and 77 dBLeq(A,8,equiv), with average levels exceeding EPA recommended levels for 70% of participants. Median levels were similar between the hours of 9 a.m. and 9 p.m., and varied little across days of the week. Gender, occupational classification, and history of occupational noise exposure were related to average noise levels, but age, educational attainment, and non-occupational noise exposures were not. CONCLUSIONS: A large portion of the general population is exposed to noise levels that could result in long-term adverse effects on hearing. Gender and occupation were most strongly related to exposure, though most participants in this study had occupations that are not conventionally considered noisy.

Effects of unilateral eye closure on middle ear muscle contractions.

Middle ear muscle contractions (MEMCs) are most commonly considered a response to high-level acoustic stimuli. However, MEMCs have also been observed in the absence of sound, either as a response to somatosensory stimulation or in concert with other motor activity. The relationship between MEMCs and non-acoustic sources is unclear. This study examined associations between measures of voluntary unilateral eye closure and impedance-based measures indicative of middle ear muscle activity while controlling for demographic and clinical factors in a large group of participants (N=190) with present clinical acoustic reflexes and no evidence of auditory dysfunction. Participants were instructed to voluntarily close the eye ipsilateral to the ear canal containing a detection probe at three levels of effort. Orbicularis oculi muscle activity was measured using surface electromyography. Middle ear muscle activity was inferred from changes in total energy reflected in the ear canal using a filtered (0.2 to 8 kHz) click train. Results revealed that middle ear muscle activity was positively associated with eye muscle activity. MEMC occurrence rates for eye closure observed in this study were generally higher than previously published rates for high-level brief acoustic stimuli in the same participant pool suggesting that motor activity may be a more reliable elicitor of MEMCs than acoustic stimuli. These results suggest motor activity can serve as a confounding factor for auditory exposure studies as well as complicate the interpretation of any impulsive noise damage risk criteria that assume MEMCs serve as a consistent, uniform protective factor. The mechanism linking eye and middle ear muscle activity is not understood and is an avenue for future research.

Distributions of pure-tone hearing threshold levels among adolescents and adults in the United States by gender, ethnicity, and age: Results from the US National Health and Nutrition Examination Survey.

Cumulative distributions of audiometric pure-tone thresholds for a non-occupationally noise-exposed population vary with demographic characteristics (e.g. gender, ethnicity, age), tested ear, and stimulus frequency. However, commonly-used audiometric databases either do not take these differences into account, or account for them using data not easily generalized to the US population. The objective of this study was to obtain distributions that are generalizable to the US population without significant history of exposure to occupational noise. Cumulative pure tone threshold distributions from the National Health and Nutrition Examination Survey (NHANES) III and the 1999-2004 data from the continuous NHANES were fitted with an asymmetric sigmoid function with reverse asymmetry, by gender, ethnicity, age, ear, and the stimulus frequency. Results indicated that conditional distributions based on these factors are warranted. Percentiles on the cumulative distribution functions can be transformed into standard normal variates (i.e. z-scores) to facilitate combination of results over time or across individuals with different demographic characteristics. However, combinations across frequency could obscure meaningful differences between the reference group and the hearing test results under analysis.

Auditory risk to unprotected bystanders exposed to firearm noise.

BACKGROUND: What is the risk of hearing loss for someone standing next to a shooter? Friends, spouses, children, and other shooters are often present during hunting and recreational shooting activities, and these bystanders seem likely to underestimate the hazard posed by noise from someone else's firearm. Hunters use hearing protection inconsistently, and there is little reason to expect higher use rates among bystanders. Acoustic characteristics and estimates of auditory risk from gunfire noise next to the shooter were assessed in this study. RESEARCH DESIGN: This was a descriptive study of auditory risk at the position of a bystander near a recreational firearm shooter. DATA COLLECTION AND ANALYSIS: Recordings of impulses from 15 recreational firearms were obtained 1 m to the left of the shooter outdoors away from reflective surfaces. Recordings were made using a pressure-calibrated 1/4 inch measurement microphone and digitally sampled at 195 kHz (24 bit depth). The acoustic characteristics of these impulses were examined, and auditory risk estimates were obtained using three contemporary damage-risk criteria (DRCs) for unprotected listeners. RESULTS: Instantaneous peak levels at the bystander location ranged between 149 and 167 dB SPL, and 8 hr equivalent continuous levels (LeqA8) ranged between 64 and 83 dB SPL. Poor agreement was obtained across the three DRCs, and the DRC that was most conservative varied with the firearm. The most conservative DRC for each firearm permitted no unprotected exposures to most rifle impulses and fewer than 10 exposures to impulses from most shotguns and the single handgun included in this study. More unprotected exposures were permitted for the guns with smaller cartridges and longer barrel length. CONCLUSIONS: None of the recreational firearms included in this study produced sound levels that would be considered safe for all unprotected listeners. The DRCs revealed that only a few of the small-caliber rifles and the smaller-gauge shotguns permitted more than a few shots for the average unprotected listener. This finding is important for professionals involved in hearing health care and the shooting sports because laypersons are likely to consider the bystander location to be inherently less risky because it is farther from the gun than the shooter.

Estimates of the auditory risk from outdoor impulse noise. I: Firecrackers.

Firecrackers are common impulse noise exposures in the United States. In this study, impulses produced outdoors by consumer firecrackers were recorded, described, and analyzed with respect to the amount of the auditory risk they pose to the unprotected listener under various listening conditions. Risk estimates were obtained using three contemporary damage risk criteria (DRC), including a waveform parameter-based approach (peak SPL and B duration), an energy-based criterion (A-weighted sound exposure level and equivalent continuous level), and a physiological model (the AHAAH model developed by Price and Kalb). Results from these DRC were converted into numbers of maximum permissible unprotected exposures to facilitate comparison. Acoustic characteristics of firecracker impulses varied with the distance, but only subtle differences were observed across firecrackers. Typical peak levels ranged between 171 dB SPL at 0.5 m and 142 dB SPL at 8 m. Estimates of the auditory risk did not differ significantly across firecrackers, but varied with the distance. Vast differences in maximum permissible exposures were observed, and the directions of the differences varied with the level of the impulse. Typical estimates of maximum permissible exposures ranged between 0 and 2 at 0.5 m and between 31 and 227,000 at 8 m. Unprotected exposures to firecracker impulses should be limited or avoided entirely if the firecrackers are ignited in batches within 8 m of the listener. Differences across DRC are inconsequential at 0.5 m, but have substantial implications at distances of 1 m and more.

Estimates of auditory risk from outdoor impulse noise. II: Civilian firearms.

Firearm impulses are common noise exposures in the United States. This study records, describes and analyzes impulses produced outdoors by civilian firearms with respect to the amount of auditory risk they pose to the unprotected listener under various listening conditions. Risk estimates were obtained using three contemporary damage risk criteria (DRC) including a waveform parameter-based approach (peak SPL and B-duration), an energy-based criterion (A-weighted SEL and equivalent continuous level) and a physiological model (AHAAH). Results from these DRC were converted into a number of maximum permissible unprotected exposures to facilitate interpretation. Acoustic characteristics of firearm impulses differed substantially across guns, ammunition, and microphone location. The type of gun, ammunition and the microphone location all significantly affected estimates of auditory risk from firearms. Vast differences in maximum permissible exposures were observed; the rank order of the differences varied with the source of the impulse. Unprotected exposure to firearm noise is not recommended, but people electing to fire a gun without hearing protection should be advised to minimize auditory risk through careful selection of ammunition and shooting environment. Small-caliber guns with long barrels and guns loaded with the least powerful ammunition tend to be associated with the least auditory risk.