Audiometric referral criteria for industrial hearing conservation programs

Area of Science:

• Occupational Health
• Audiology
• Industrial Hygiene

Background:

• Occupational hearing conservation programs (HCPs) aim to prevent noise-induced hearing loss.
• Standard audiometric referral criteria are used to identify individuals needing further audiological evaluation.
• The effectiveness of these criteria, particularly in large industrial populations, requires ongoing assessment.

Purpose of the Study:

• To evaluate referral rates from American Academy of Otolaryngology-Head and Neck Surgery criteria in industrial HCPs.
• To assess the impact of audiometric retesting on identifying false-positive referrals.

Main Methods:

• A retrospective analysis of 45,055 baseline and 27,047 second audiograms from US and Canadian HCPs.
• Comparison of referral rates between control and noncontrol HCPs.
• Analysis of a subset of 3958 employees with multiple audiograms to confirm findings.

Main Results:

• Noncontrol HCPs exhibited 2-3 times higher referral rates than control HCPs.
• Retesting confirmed initial results, reducing audiometric referral flags by approximately 50% in both control and noncontrol HCPs.
• Mature industrial populations showed higher baseline referral rates.

Conclusions:

• Audiometric retesting is crucial for identifying and reducing false-positive referrals in HCPs.
• Implementing retesting can significantly decrease overreferrals and associated costs.
• Achievable annual referral rates of 1-2% are possible in well-managed HCPs with retesting protocols.