Factors associated with change in the need for recovery and subjective listening effort in employees with hearing loss receiving aural rehabilitation.

OBJECTIVE: Compared to normally-hearing employees, those with hearing loss suffer from higher Need For Recovery (NFR) after work. The aims of this study are to assess the NFR of employees with hearing loss before and after aural rehabilitation and to examine to what extent change in the NFR can be explained by changes in subjective listening effort, personal adjustments, communication strategies, auditory work demands, and self-reported hearing ability. METHODS: We included patients who received aural rehabilitation in two audiological centers in the Netherlands because of hearing complaints in their work situation. Outcomes were measured by questionnaires at baseline and 3 month follow-up. The NFR before and after the rehabilitation was compared with a t test. Hierarchical multiple analyses were performed. RESULTS: In total, 60 patients (aged 22-63, working hours ≥8 per week) participated in the study, of which 50 completed the follow-up questionnaires. The NFR was significantly lower after the aural rehabilitation (M = 45.03) compared to before the aural rehabilitation (M = 51.89), t = -3.43, p < 0.01). Change in NFR could best be explained by the change in personal adjustments (R2 = 0.45, B = -1.23, p < 0.01). CONCLUSION: The NFR of employees with hearing loss can be improved by aural rehabilitation, but this study shows that current practices reduce the NFR only in part of the employees. Therefore, improving current practices should be considered and evaluated, for example by applying a different combination of rehabilitation components. Especially, interventions that affect personal adjustments may be promising to further reduce the NFR in employees with hearing loss.

The relationship between hearing status, listening effort, and the need for recovery in employees of a manufacturing company.

OBJECTIVE: Hearing screening can be used to detect hearing loss, but its value for identifying employees with work functioning difficulties is unclear. The objective of this study was to assess the association between the hearing status measured with an occupational hearing-in-noise screening test, Listening Effort (LE), and Need For Recovery (NFR) in employees of a manufacturing company, and to examine whether these associations depend on the perceived noise level at the workplace. METHODS: Employees of coatings and paints manufacturing company were included. Their hearing status was assessed with an occupational hearing-in-noise screening test. An online survey was used to assess their LE, NFR, and the perceived noise level at the workplace. Responses from 143 employees were analyzed (mean age = 53 years) using hierarchical multiple regression analysis with the outcomes LE and NFR. RESULTS: Regression analysis-with adjustments for gender, age, educational level, health status, pace/amount of work, job variety, and work pleasure-revealed that hearing status was significantly associated with LE, but the interaction between hearing status and the perceived noise level was not. Hearing status nor the interaction between hearing status and the perceived noise level was significantly associated with NFR. CONCLUSION: The results confirm that poorer hearing is associated with higher LE, but not with higher NFR. These associations were unrelated to the perceived noise level at the workplace. Therefore, the value of occupational hearing screening appears to be early identification of hearing loss in employees, but not identification of work functioning difficulties.

Measuring Auditory Fitness in Locomotive Engineers: Development and Validation of a Signal Detection Test.

OBJECTIVES: To perform their job safely and effectively, locomotive engineers are required to detect auditory warning signals in the noisy work setting of a train cabin. Based on audio recordings of Dutch train cabins, we have developed a task and job-specific test for assessing the engineer's ability to detect the two acoustic warning signals for the Dutch situation. The aim of this study was to evaluate the reliability, agreement, and construct validity of this test. DESIGN: Two experiments were performed. In the first experiment, reliability and agreement of the signal detection test were assessed. Normally hearing individuals (N = 12) completed a signal detection test twice in 12 driving conditions. In the second experiment, construct validity was assessed. We retrospectively identified locomotive engineers, suspected of being hearing impaired, who were referred to the Amsterdam UMC for an auditory fitness for job assessment. All included engineers (N = 83) performed the signal detection test in four driving conditions, underwent tone audiometry and two speech perception in noise tests, and rated the effort and concentration it takes to detect the auditory signals. Seven a priori formulated hypotheses were tested. RESULTS: In the first experiment, sufficient reliability and agreement were found in nine driving conditions (ICC = 0.54-0.81; standard error of measurement = 1.15-1.92), poor reliability in two driving conditions (ICC < 0.50), and poor agreement in one driving condition (standard error of measurement = 2.67 dBA). In the second experiment, the results of the signal detection test correlated moderately with the pure-tone thresholds, speech reception threshold in fluctuating noise, and engineer's subjective rating of effort and concentration, but not with the speech reception threshold in continuous noise. According to the hypotheses, poorer test scores were obtained by hearing aid users compared with nonhearing aid users. CONCLUSIONS: The signal detection test has sufficient reliability and agreement in all but three driving conditions. This study provides evidence supporting the construct validity of the signal detection test in locomotive engineers. The moderate associations with conventional hearing tests show that the conventional hearing tests did not cover the whole construct measured with the signal detection test. The results, therefore, underpin the importance of evaluating the ability to detect auditory warning signals separately from other hearing-critical job tasks.

Detectability of auditory warning signals in the ambient noise of Dutch train cabins.

Locomotive engineers need to detect auditory warning signals for safe and effective job performance. We measured the levels and spectra of the warning signals and noises present in Dutch train cabins to evaluate the effectiveness of these signals. Audio-recordings were made in six train types during normal operation. Signal detectability was estimated using the Detectsound software and compared against ISO 7731. Signal detectability was also measured in six normally-hearing individuals in a laboratory setting. Signal levels ranged between 68 and 84 dBA. Noise levels ranged between 53 and 77 dBA. The acoustical requirements for signal detectability were not met in multiple driving conditions, especially at higher speed. Sufficient signal-to-noise ratio's were achieved in the laboratory measurements, but difficulties can be expected in unfavourable driving situations or when the engineer suffers from hearing loss. Acoustical, environmental, or work modifications might be required to prevent situations with insufficient audibility in hearing-impaired engineers. Practitioner summary: The audibility of the warning signals in Dutch trains was evaluated by comparing signal and noise spectra. The results showed that sufficient audibility is not always guaranteed. Under laboratory conditions, normally-hearing individuals could compensate for the suboptimal acoustic circumstances, but acoustical, environmental, or work modifications might be required to prevent situations with insufficient audibility in hearing-impaired engineers.

Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children's Verbal Repetition Accuracy.

OBJECTIVES: Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children. DESIGN: For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed. RESULTS: Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32). CONCLUSIONS: The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children.

Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis.

This systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (reference test) in fetuses at risk for orofacial clefts. Methodological quality was assessed using the QUADAS-2. A meta-analysis was performed with a random-effects model, calculating the pooled sensitivity, specificity, and area under the curve. The search resulted in eight studies (334 fetuses) to be included: four prospective and four retrospective studies. The applicability concern was low. There was, however, a risk of selection and information bias. All studies showed that MRI well predicted the chance of cleft palate. The sensitivity results were homogeneous, but heterogeneity was assumed regarding the specificity estimate (Cochrane's Q test: p = 0.00). The pooled sensitivity was 0.97 (95% CI 0.93-0.99); the pooled specificity was 0.94 (0.89-0.97). The area under the curve was 0.98 (95% CI 0.98-0.99).Conclusion: This meta-analysis shows that MRI has an excellent sensitivity and good to excellent specificity for diagnosing cleft palate in fetuses at risk for orofacial clefts. Future research should assess applicability for clinical care.What is Known:• Using ultrasound for prenatal detection of cleft palate leads to misdiagnosis frequently.• MRI could potentially improve the prenatal detection rate of cleft palate.What is New:• Eight studies describe the diagnostic accuracy of MRI for detecting cleft palate.• Combined results show excellent sensitivity and good to excellent specificity.

Correction to: Factors influencing the need for recovery in employees with hearing loss: a cross-sectional study of health administrative data.

The original publication of this article contains typographical error in Table 5, Row 2.

Factors influencing the need for recovery in employees with hearing loss: a cross-sectional study of health administrative data.

OBJECTIVE: Need for recovery is a predictor of work stress and health problems, but its underlying factors are not yet well understood. We aimed to identify hearing-related, work-related, and personal factors influencing need for recovery in hearing-impaired employees. METHODS: We retrospectively identified hearing-impaired employees (N = 294) that were referred to the Amsterdam University Medical Center between 2004 and 2019. Routinely obtained healthcare data were used, including a survey and hearing assessments. A directed acyclic graph was constructed, revealing the hypothesized structure of factors influencing need for recovery as well as the minimal set of factors needed for multiple regression analysis. RESULTS: Four variables were included in the regression analysis. In total, 46.1% of the variance in need for recovery was explained by the factors feeling that something should change at work (B = 19.01, p < 0.001), self-perceived listening effort (B = 1.84, p < 0.001), personal adaptations scale score (B = - 0.34, p < .001), and having a moderate/poor general health condition (B = 20.06, p < 0.001). Although degree of hearing loss was associated with self-perceived listening effort, the direct association between degree of hearing loss and need for recovery was not significant. CONCLUSIONS: The results suggest that the way employees perceive their hearing loss and how they cope with it directly influence need for recovery, rather than their measured degree of hearing loss. Additionally, general health condition was found to be an independent factor for need for recovery. The results should be confirmed by future, longitudinal research.

Exploring the Sentence Length and Age of Acquisition of Speech Recognition Test Sentences in Dutch, American English, and Canadian French.

PURPOSE: The purpose of this study was to examine the differences between the age of acquisition (AoA) and sentence length of sentences of the speech recognition (SR) tests for adults and children in Dutch, American English, and Canadian French. METHOD: The AoA and sentence length of the sentences of four SR tests for adults and children were determined. One-way analyses of variance were performed to assess differences between the tests. RESULTS: The AoA and sentence length of the sentences significantly differed between the SR tests for adults. These differences were also found between the SR tests for children. CONCLUSIONS: The AoA and the sentence length differ across the SR tests in Dutch, American English, and Canadian French. The Dutch sentences have higher AoA and are longer than the sentences in American English and Canadian French. The effect of the linguistic complexity on sentence repetition accuracy should be investigated during the development and validation of a Dutch SR test for children.