Development of a new standard laboratory protocol for estimating the field attenuation of hearing protection devices. Part III. The validity of using subject-fit data.

The mandate of ASA Working Group S12/WG11 has been to develop "laboratory and/or field procedure(s) that yield useful estimates of field performance" of hearing protection devices (HPDs). A real-ear attenuation at threshold procedure was selected, devised, tested via an interlaboratory study, and incorporated into a draft standard that was approved in 1997 [J. D. Royster et at., "Development of a new standard laboratory protocol for estimating the field attenuation of hearing protection devices. Part I. Research of Working Group 11, Accredited Standards Committee S12, Noise," J. Acoust. Soc. Am. 99, 1506-1526 (1996); ANSI S12.6-1997, "American National Standard Methods for Measuring Real-Ear Attenuation of Hearing Protectors" (American National Standards Institute, New York, 1997)]. The real-world estimation procedure utilizes a subject-fit methodology with listeners who are audiometrically proficient, but inexperienced in the use of HPDs. A key factor in the decision to utilize the subject-fit method was an evaluation of the representativeness of the laboratory data vis-à-vis attenuation values achieved by workers in practice. Twenty-two field studies were reviewed to develop a data base for comparison purposes. Results indicated that laboratory subject-fit attenuation values were typically equivalent to or greater than the field attenuation values, and yielded a better estimate of those values than did experimenter-fit or experimenter-supervised fit types of results. Recent data which are discussed in the paper, but which were not available at the time of the original analyses, confirm the findings.

The effect of fitting procedure on hearing protector attenuation.

Realistically evaluating the effectiveness of hearing protectors continues to be a major problem in hearing conservation. The purpose of this study was to examine a laboratory-based fitting procedure (User Fit) that was designed to yield hearing protector attenuation values similar to that derived from field studies. Ten subjects who were naive to hearing protectors were used in a repeated measures design that measured real ear attenuation at threshold for two types of plugs. Each subject was tested in two fitting conditions that varied based on the type and degree of assistance given to the subjects by the experimenter. The results showed significant differences in attenuation based on the fitting procedure used, with the User Fit best approximating field data. In addition, a generalized learning effect was noted. The results suggest that any experience with earplugs leads to subsequent improvement in attenuation despite the type of earplug used. Further testing is planned with greater numbers of subjects and additional types of hearing protectors.

Hearing loss in the chinchilla from impact and continuous noise exposure.

The relative hazard posed to the peripheral auditory system by impact/impulse and continuous noise of the same power spectrum was determined. Impact noise was generated by striking a nail with a hammer and was digitally recorded. The acoustical power spectrum of the impact was determined and pink noise was filtered to produce a continuous noise stimulus with the same acoustic power spectrum. Pre-exposure auditory evoked response (AER) thresholds were obtained at 1, 2, 4, and 8 kHz on 16 adult chinchillas. The pool of animals was divided into two equal groups based upon pre-exposure AER thresholds. One group was exposed to impact noise and the other group to the filtered pink noise. Exposures were 4 h/day for 5 days. Thirty days following the exposure, auditory evoked response thresholds were remeasured. Changes in auditory sensitivity were determined by subtracting the pre-exposure thresholds from the post-exposure thresholds. Hearing threshold shifts of the impact noise group were significantly greater (p less than 0.0001) than the hearing threshold shifts of the continuous noise group. These data indicate a need to more closely examine the parameters and effects of impact noise. There may be a need to develop expanded damage-risk criteria for occupational exposure to impulse/impact noise.

A one-year series of pediatric prehospital care: I. Ambulance runs; II. Prehospital communication; III. Interhospital transport services.

During a 12-month period ending on November 30, 1988, all ambulance arrivals at a pediatric emergency department (ED), all prehospital communications with this ED, all first-responder ambulance runs on Oahu and the state of Hawaii, and all neonatal/pediatric interhospital transports were examined to evaluate pediatric prehospital care. Handicapped patients were more likely to use an ambulance, and their care was more likely to be perceived as a weakness on the part of ambulance personnel. Poorer communication clarity was associated with longer duration of communication. Common pediatric diagnoses were trauma, respiratory problems, seizures, near drownings, and poisonings. Mean transport times were shorter on Oahu than on the outer islands. Premature newborns and handicapped children commonly required interhospital transport. The care of children can be improved by addressing some of the identified problem areas, eg, improving prehospital communication and improving the training of prehospital personnel in the care of infants and handicapped children.