Follow-up of hearing thresholds among forge hammering workers

Hearing threshold was reexamined in a group of forge hammering workers investigated 8 years ago with consideration of the age effect and of auditory symptoms. Workers were exposed to impact noise that ranged from 112 to 139 dB(A)--at an irregular rate of 20 to 50 drop/minute--and a continuous background noise that ranged from 90 to 94 dB(A). Similar to what was observed 8 years ago, the present permanent threshold shift (PTS) showed a maximum notch at the frequency of 6 kHz and considerable elevations at the frequencies of 0.25-1 kHz. The age-corrected PTS and the postexposure hearing threshold were significantly higher than the corresponding previous values at the frequencies 0.25, 0.5, 1, and 8 kHz only. The rise was more evident at the low than at the high frequencies. Temporary threshold shift (TTS) values were significantly less than those 8 years ago. Contrary to the previous TTS, the present TTS were higher at low than at high frequencies. Although progression of PTS at the frequencies 0.25 and 0.5 kHz was continuous throughout the observed durations of exposure, progression at higher frequencies occurred essentially in the first 10 to 15 years of exposure. Thereafter, it followed a much slower rate. Tinnitus was significantly associated with difficulty in hearing the human voice and with elevation of PTS at all the tested frequencies, while acoustic after-image was significantly associated with increment of PTS at the frequencies 0.25-2 kHz. No relation between PTS and smoking was found. PTS at low frequencies may provide an indication of progression of hearing damage when the sensitivity at 6 and 4 kHz diminishes after prolonged years of exposure. Tinnitus and acoustic after-image are related to the auditory effect of forge hammering noise.