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Am J Audiol. 2007 Dec;16(2):S190-202.

Comparison of audiometric screening criteria for the identification of noise-induced hearing loss in adolescents.

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University of Northern Colorado, Audiology & Speech-Language Sciences, Campus Box 140, Greeley, CO 80639, USA.



To ascertain whether current pure-tone school hearing screening criteria used across the United States are adequate for the early identification of noise-induced hearing loss (NIHL) in adolescents.


School-based pure-tone hearing screening protocols were collected, reviewed, and consolidated from 46 state agencies. A retrospective categorical analysis of air-conduction audiometric thresholds from a computerized database of 9th-grade (n = 376) and 12th-grade (n = 265) students from a suburban high school was conducted. The database analysis was designed to determine whether each screening protocol would identify high-frequency notched audiometric configurations suggestive of NIHL when using the noise notch criteria described by A. S. Niskar et al. (2001).


All of the school-based hearing screening criteria identified significantly (p <or= .05) fewer students with a high-frequency notch (HFN) than the noise notch protocol regardless of screening decibel level specified. Over half of the school-based hearing screening protocols used in the United States will identify only 22% of the students with an HFN and consequently would fail to detect a potential NIHL.


Currently implemented school-based hearing screening guidelines are nonstandardized and inadequate for the early identification of NIHL. This denies the majority of students the opportunity to receive early intervention and to prevent further progression of NIHL. It is necessary to identify, standardize, and implement effective and efficient screening or monitoring programs for the early detection and prevention of NIHL in adolescents.

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