Appendix D
Summary Tables on Epidemiological Studies



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Noise and Military Service: Implications for Hearing Loss and Tinnitus Appendix D Summary Tables on Epidemiological Studies

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Noise and Military Service: Implications for Hearing Loss and Tinnitus TABLE D-1 Toluene Exposure as a Risk Factor for Noise-Induced Hearing Loss Citation Design Population Exposures and Source of Exposure Data a. Human Studies Schaper et al. (2003) Longitudinal study, 1996–2001 192 employees from 14 German rotogravure printing plants with 4 examinations Subjects at each examination: Exam 1:333 Exam 2:278 Exam 3:241 Exam 4:216 Stratification Toluene exposure: low vs high (based on worksite) Job tenure: short vs long Noise exposure: low (< 82 dBA) vs high (≥82 dBA) Medical, psychological examinations Toluene and noise exposure measured 2 times per yr for each subject Historical records for past exposure estimates Toluene: Mean study exposure: High: 26 ppm Low: 3 ppm Lifetime weighted average daily exposure (for current exposure groups) High: 45 ppm Low: 10 ppm Biomarkers of exposure: hippuric acid, o-cresol Noise: lifetime average daily exposure Current high noise: 82 dBA Current low noise: 81 dBA Morata et al. (1997) Cross-sectional 124 male rotogravure printing workers, Sao Paulo, Brazil Mean age: 34 yrs (range 21–58 yrs) Employed at least 1 yr Mean tenure: 7 yrs (range 1–25 yrs) Solvent exposure: TWA exposure evaluation for toluene, ethanol, and ethyl acetate Toluene levels (air): 0.14 to 919 mg/m 3 109 workers monitored for hippuric acid and creatinine in their urine Noise exposure: Continuous noise, 71 to 93 dBA; dosimetry for individual workers

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Outcome Measure Results Comments Hearing thresholds Hearing loss: thresholds > 25 dB Tested at 0.125–12 kHz Age adjustment based on ISO 7029 (1984) before repeated measures analysis No sig effect on auditory thresholds for toluene intensity, exposure duration, or interactions Sig effect of current noise intensity (F = 4.5, p = .04) Subjects were volunteers; some loss to follow-up No unexposed control group Little difference in noise exposure for high and low toluene exposure High-freq hearing loss: notch in a freq b/t 3 and 6 kHz or thresholds poorest in this freq range Normal hearing: no single threshold > 25 dB Pure-tone audiometry: 0.5–8 kHz No statistical interactions between noise and toluene Concentration of toluene in air was not sig associated w/ hearing loss Level of biological marker for toluene exposure (urinary hippuric acid) sig associated w/ hearing loss (OR = 1.76, 95% CI 1.00–2.98) 93% of subjects reported no exposure to major sources of nonoccupational noise (e.g., firearms, motorcycles, etc.) 11% of those exposed to noise > 85 dBA used hearing protection

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Citation Design Population Exposures and Source of Exposure Data Morata et al. (1993) Cross-sectional 190 male printing and paint manufacturing workers, Brazil Employed at least 1 yr Mean employment: Printing: 8 to 13 yrs Paint mfg: 6 yrs Exposure groups Noise only (printing): 50 Noise and toluene (printing): 51 Mixed solvents, no excess noise (paint mfg): 39 Unexposed (printing): 50 Noise only group: 88–97 dBA (continuous); dose 209–335% (5-dB exchange rate) Noise and toluene group: 88–98 dBA; dose 140–350% (5-dB exchange rate); toluene TWA 75–600 ppm Mixed solvents group: no dose data; toluene concentration 10–70 ppm (11 samples) Interviewed for work, exposure, and medical histories b. Animal Studies Davis et al. (2002) Experimental 33 chinchillas, in 6 exposure groups 6 adult rats as control group 10-day exposures Toluene: 2000 ppm Noise: 500 Hz octave band noise, 97.5 dB SPL Background noise < 60 dBA 22 chinchillas (monaural) Group 1:8 h toluene, background noise only Group 2: no toluene, 8 h noise Group 3:8 h toluene, 8 h noise Group 4: control group

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Outcome Measure Results Comments Normal hearing Worst threshold at 3–8 kHz (avg left and right ears): 0–25 dB; average of 0.5, 1, 2 kHz ≤ 25 dB High-freq hearing loss Categories based on worst threshold at 3–8 kHz (avg left and right ears) and average of 0.5, 1, 2 kHz ≤ 25 dB: (I) 30–40 dB, (II) 45–55 dB, (III) ≥ 60 dB (IV) average of 0.5, 1, 2 kHz > 25 dB Other hearing loss Unilateral, conductive Pure-tone audiometry: 0.5–8 kHz Otoscopy, immittance audiometry Prevalence of high-freq hearing loss: 8% unexposed 26% noise 53% noise and toluene 18% mixture of solvents Relative risk of high-freq hearing loss: Noise only: 4.1 (95% CI 1.4–12.2) Noise and toluene: 10.9 (95% CI 4.1–28.9) Solvents only: 5.0 (95% CI 1.5–17.5) Noise and solvent exposures in the different groups were not equivalent Without a group exposed to only toluene, could not assess whether effect of combined exposure was additive or multiplicative     Differences in liver metabolism of toluene suggest that rats and mice are better models for human ototoxicity than chinchillas Chinchillas ABR threshold shifts (pre- vs postexposure) Tested at 0.5, 1, 2, 4, 8, 16 kHz Postexposure testing on days 1, 3, 7, 14, and 30 Chinchillas Noise effects, but no ototoxicity Noise: 12 dB permanent threshold shift at 2 and 4 kHz Analysis of variance: no sig main effect for toluene alone or interaction of toluene w/ noise  

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Citation Design Population Exposures and Source of Exposure Data       11 chinchillas (binaural) Group 5:12 h toluene, 8 h noise; noise from 2 h after start to 2 h before end of toluene exposure Group 6:12 h toluene, background noise only Rat comparison group 6 adult rats exposed to toluene at 2000 ppm, 8 h / day for 5 days Only background noise Johnson et al. (1990) Experimental 49 young male rats Exposure groups: Controls: 10 Noise: 10 Toluene: 10 Noise followed by toluene: 10 Noise, rest, toluene: 9 Toluene: 1000 ppm, 16 h/d, 7 d/w (11:00 am to 3:00 am) Noise: 10 h/d, 7 d/w Continuously varying signal: 2 kHz wide noise band, sweeping from 3 to 30 kHz at freq of 0.5 Hz Equivalent to sound level of 100 dB Controls: no noise or toluene Noise: 4 wks Toluene: 2 wks Noise followed by toluene: 4 wks noise, 2 wks toluene Noise, rest, toluene: 4 wks noise, 4 wks rest, 2 wks toluene

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Outcome Measure Results Comments Rats ABR threshold shifts (pre- vs postexposure) Tested at 8, 16, 32 kHz Postexposure testing on day 30 Rats Sig permanent threshold shift w/ shorter toluene exposure Threshold shifts of 20 and 15 dB at 16 and 32 kHz, respectively   ABR thresholds at 1.6, 3.15, 6.3, 12.5, 20.0 kHz Measured at 1–5 wks after termination of exposure Effect of noise followed by toluene, w/ or w/o rest, was larger than exposure to noise or toluene alone at 6.3, 12.5, and 20.0 kHz Noise: higher thresholds than controls at 6.3 (9 dB, p < .05), 12.5 (26 dB, p < .001), and 20.0 kHz (18 dB, p < .001) Toluene: higher thresholds than controls at all freq (1.6 to 12.5 kHz, 15–32 dB, p < .001; 20.0 kHz, 15 dB, p < .01) Noise followed by toluene: higher thresholds than controls at all freq (1.6 kHz, 8 dB, p < .05; 3.15 to 20.0 kHz, 34–45 dB, p < .001) Additive effects from noise and toluene Exposure to toluene after noise may produce smaller losses than exposure to noise after toluene

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Citation Design Population Exposures and Source of Exposure Data Johnson et al. (1988) Experimental 39 male rats Exposure groups: Controls: 10 Group T (toluene only) 12 Group N (noise only): 8 Group T+N (toluene followed by noise): 9 Toluene: 1000 ppm, 16 h/d, 5 d/wk (3 pm to 7 am) Noise: 10 h/d, 7 d/wk Continuously varying signal: 2 kHz wide noise band, sweeping from 3 to 30 kHz at a freq of 0.5 Hz Equivalent sound level 100 dB Controls: no toluene or noise Group T: 2 wks toluene Group N: 4 wks noise Group T+N: 2 wks toluene; 4 wks noise NOTES: ABR, auditory brainstem response; CI, confidence interval; OR, odds ratio; TWA, time-weighted average.

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Outcome Measure Results Comments ABR threshold shifts at 1.6, 3.15, 6.3, 12.5, 20.0 kHz Controls: at age 5 mos Group T: 2–5 days after termination of exposure; repeated 1 and 6 mos later Group N: 2–5 days after termination of exposure Group T+N: 2–5 days after termination of noise exposure, repeated 6 mos later Group T: Higher thresholds than controls at all freq (p < .001); greatest difference (40 dB) at 12.5 kHz; improvement at most frequencies at 1 mo (5–10 dB) and 6 mo (5 dB) Group N: Higher thresholds than controls; greatest difference at highest freqs (6.3, 12.5, and 20.0 kHz; p < .001); maximum difference (50 dB) at 12.5 kHz Group T+N: Higher thresholds than controls at all freq (p < .001); for most animals, threshold exceeded maximum stimulus intensity at 12.5 and 20.0 kHz For any exposure, threshold shift greatest at 6.3 and 12.5 kHz; after 6 mos, greatest at 12.5 kHz Combined exposure (toluene followed by noise) produced greater shifts at 3.15 (p < .01) and 6.3 kHz (p < .0001) than summed losses for single exposures  

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Noise and Military Service: Implications for Hearing Loss and Tinnitus TABLE D-2 Carbon Monoxide as a Risk Factor for Noise-Induced Hearing Loss in Animals Citation Design Population Exposures Rao and Fechter (2000) Experimental Rats   A: Combined exposure 8 exposure groups: in each, n = 6 Random assignment CO: 1200 ppm Octave band noise w/ center frequency of 13.6 kHz (9.6–19.2 kHz) Background noise: ~ 50 dBA CO only Noise only: 95 dB for 4 h 100 dB for 2 h 105 dB for 1 hr Noise plus CO: 95 dB for 4 h, 100 dB for 2 h 105 dB for 1 hr Control: Air only   B: Increased duration of exposure 2 exposure groups: in each, n = 6 CO: 1200 ppm Noise: 105 dB Noise only: 4 h Noise plus CO: 4 h

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Outcome Measure Results Comments CAP thresholds for 11 pure tones between 2 and 40 kHz 4-wk recovery period Exposure groups significantly different from each other (F(8, 45) = 13.04, p < .05) Sig interaction b/t freq and exposure (F(80, 450) = 4.35, p < .05) Potentiation of threshold elevation for combined exposure does not increase beyond 100 dB for 2h 95 dB for 4h Combined exposure: 6 dB threshold elevation above noise only; difference not sig at any frequency 100 dB for 2h Combined exposure: sig elevation over noise only at all frequencies (p < .05) 105 dB for 1h Combined exposure: sig elevation over noise only at all frequencies (p < .05); greater dysfunction at lower freq than w/ other exposures Noise only: sig elevation over thresholds for 95 dB (4h), 100 dB (2h) (p < .05) CO only No sig difference from exposure to air only F(1,10) = 1.72, p > .05 Rats more resistant to CO than humans (30 min LD50 = 5000 ppm for rats; 1500 ppm immediately dangerous for humans) CAP thresholds for 11 pure tones between 2 and 40 kHz 4-wk recovery period Combined exposure: threshold elevations not sig diff from noise only Combined exposure: threshold elevations 15 dB greater than for 105 dB + CO for 1h  

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Study Design, Population Definition of Tinnitus Definition of Hearing Level or Hearing Loss d. Acoustic Trauma Mrena et al. (2002) Finland, 1999 Longitudinal Former conscripts, Finnish Defense Forces 418 soldiers treated for acoustic trauma July 1984–April 1989, all w/ tinnitus 122 w/ persistent tinnitus at discharge, 1984–1989 101 reached in 1999 (83%), 66 still w/ tinnitus Mean age at exposure: 21 yrs (18.8–30.4) Age at follow-up 30–41 yrs Duration of tinnitus: 12 yrs (9.8–14.3) No prior tinnitus Tinnitus Handicap Questionnaire Rating scales for intensity, level of annoyance (0–100, least to most) Hearing loss: threshold > 20 dB HL at any frequency at discharge 6 cases w/ hearing loss on entering military service No indication of audiometric testing at follow-up Temmel et al. (1999) Austrian military service, Jan 1995–June 1996 Cross-sectional 81 male acoustic trauma patients Mean age: 22 yrs Treated 3 days after exposure Exclusions: hearing threshold > 20 dB HL at any frequency at start of service; illnesses, conditions that might affect auditory system No questions/ definition provided Acute acoustic trauma: acute acoustic exposure producing temporary or permanent pure-tone threshold shift Hearing loss: threshold > 20 dB HL Hearing thresholds at 0.125–8 kHz

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Noise Exposure and Source of Exposure Data Prevalence of Tinnitus Prevalence of Hearing Level Tinnitus, by Comments Assault rifle: 42 cases Bazooka: 3 cases Single cases: handguns, cannons, grenades 73% had fired the weapon 2 cases wore hearing protection (ear plugs) Other exposure history from medical records At discharge 29% (122 of 418) w/ tinnitus At follow-up (10–15 yrs) 66% (66 of 101) w/ tinnitus Normal hearing 4 cases (at time of discharge) Greater hearing impairment associated w/ greater tinnitus disturbance Perceived problems 33% tinnitus worse than hearing loss 33% hearing loss worse than tinnitus 79% response (52 of 66) 80% not wearing hearing protection (accidental discharges, loss of protectors, etc.) 84% w/ tinnitus Hearing loss 83% w/ tinnitus No hearing loss 100% w/ tinnitus 75% had hearing loss at frequencies above 2 kHz No significant differences for: a. blank/live ammunition b. number of shots c. use of hearing protection

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Study Design, Population Definition of Tinnitus Definition of Hearing Level or Hearing Loss Man and Naggan (1981) Israel Cross-sectional 102 patients w/ acoustic trauma; 81 w/ tinnitus Age: 18–35 Selected for evidence of “cochlear trauma” (high-frequency hearing loss?) Exclusions: head injury, history of ear disease   Audiometric testing, ISO calibration Worst threshold: 6 kHz for 76% Ears pooled Melinek et al. (1976) Israel, 1967–1970 Cross-sectional and longitudinal 433 soldiers treated for acute acoustic trauma 313 transferred to noncombat unit 120 continued in field units Inclusion criteria: Age 18 to 25 yrs; abrupt onset of tinnitus or hearing loss w/in 2 mos; audiometric grade of 2+ in at least one ear; diagnostic audiometry 1 wk or more after exposure; no history of prior industrial noise exposure; no history of ear disease; audiometric follow-up w/in 1 to 24 mos No definition provided Acute acoustic trauma: abrupt onset of symptoms (tinnitus or hearing loss) generally associated w/ unusually loud impact noise Severity grouping Normal: all thresholds except 8 kHz ≤ 15 dB Mild: thresholds 20–25 dB at 4 kHz and up to 30 dB or more at 6 kHz Moderate: thresholds ≥ 20 dB at 4 kHz w/ or w/out elevated thresholds at 3 kHz Severe: thresholds of ≥ 45 dB at 4 kHz w/ thresholds ≥ 35 dB at 2 kHz or thresholds of ≥ 25 dB at 1 kHz

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Noise Exposure and Source of Exposure Data Prevalence of Tinnitus Prevalence of Tinnitus, by Hearing Level Comments Questionnaire on noise exposure and complaints about hearing, tinnitus 79% of subjects Always present: 70% (of ears) Sometimes present: 30% (of ears) Tinnitus matched at frequencies between 4 and 8 kHz (37% at 6; 23% at 4; 24% at 8) Higher intensity tinnitus associated w/ greater hearing loss (r = 0.71, p < 0.001) No statistical association between tinnitus level and disturbed sleep or concentration Potential selection effect from use of clinic population No ear protection used 61% (of ears) w/ tinnitus Change in subjective symptoms (including tinnitus) at follow-up: Transferred Deterioration: 2% Improvement: 34% Continued field unit Deterioration: 15% Improvement: 22% Normal 42% Mild AT 60% Moderate AT 66% Severe 66% Some hearing loss may have existed before acoustic trauma Lower initial severity rating for group continuing in field units Statistical significance of differences not reported

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Study Design, Population Definition of Tinnitus Definition of Hearing Loss Hearing Level or   Analysis based on ears because of differences in severity   Pure-tone audiometric testing at 0.5, 1, 2, 4, 8 kHz; at 3 and 6 kHz for some subjects Salmivalli (1967) Cross-sectional No questions or definitions provided Severity grades I: narrow dip, thresholds ≤ 30 dB HL II: thresholds 30–60 dB HL only at frequencies above 2 kcps III: thresholds > 60 dB HL above 2 kcps or elevated at 0.5 to 2 kcps IV: thresholds elevated at 0.5 to 1 kcps Finland, 1963 197 male infantry and artillery soldiers (officers and enlisted) exposed to gunfire or blast basis for selection not specified       Pure-tone testing at 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, kc/ sec NOTE: AT, acoustic trauma; CI, confidence interval; NIHL, noise-induced hearing loss; OR, odds ratio; PTA, pure-tone average; TWA, time-weighted average.

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Noise Exposure and Source of Exposure Data Prevalence of Tinnitus Prevalence of Tinnitus, by Hearing Level Comments Noise levels measured under field conditions No overall prevalence reported Prevalence of tinnitus Normal: 15.7% I: 33% II: 25% III: 35% IV: 56%   No estimate of rounds fired by individuals     Prevalence of tinnitus after firing Normal: 41% I: 49% II: 49% III: 57% IV: 64%

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Noise and Military Service: Implications for Hearing Loss and Tinnitus REFERENCES Table D-1 Davis RR, Murphy WJ, Snawder JE, Striley CA, Henderson D, Khan A, Krieg EF. 2002. Susceptibility to the ototoxic properties of toluene is species specific. Hearing Research 166(1–2): 24–32. ISO (International Organization for Standardization). 1984. ISO 7029: Acoustics—Threshold of Hearing by Air Conduction as a Function of Age and Sex for Otologically Normal Persons. Geneva, Switzerland: ISO. Johnson AC, Juntunen L, Nylen P, Borg E, Hoglund G. 1988. Effect of interaction between noise and toluene on auditory function in the rat. Acta Oto-Laryngologica 105(1–2): 56–63. Johnson AC, Nylen P, Borg E, Hoglund G. 1990. Sequence of exposure to noise and toluene can determine loss of auditory sensitivity in the rat. Acta Oto-Laryngologica 109(1–2): 34–40. Morata TC, Dunn DE, Kretschmer LW, Lemasters GK, Keith RW. 1993. Effects of occupational exposure to organic solvents and noise on hearing. Scandinavian Journal of Work, Environment & Health 19(4):245–254. Morata TC, Fiorini AC, Fischer FM, Colacioppo S, Wallingford KM, Krieg EF, Dunn DE, Gozzoli L, Padrao MA, Cesar CL. 1997. Toluene-induced hearing loss among rotogravure printing workers. Scandinavian Journal of Work, Environment & Health 23(4):289–298. Schaper M, Demes P, Zupanic M, Blaszkewicz M, Seeber A. 2003. Occupational toluene exposure and auditory function: Results from a follow-up study. Annals of Occupational Hygiene 47(6):493–502. Table D-2 Chen GD, Fechter LD. 1999. Potentiation of octave-band noise induced auditory impairment by carbon monoxide. Hearing Research 132(1–2):149–159. Fechter LD, Chen GD, Rao D, Larabee J. 2000. Predicting exposure conditions that facilitate the potentiation of noise-induced hearing loss by carbon monoxide. Toxicological Sciences 58(2):315–323. Rao DB, Fechter LD. 2000. Increased noise severity limits potentiation of noise induced hearing loss by carbon monoxide. Hearing Research 150(1–2):206–214. Young JS, Upchurch MB, Kaufman MJ, Fechter LD. 1987. Carbon monoxide exposure potentiates high-frequency auditory threshold shifts induced by noise. Hearing Research 26(1):37–43. Table D-3 Cruickshanks KJ, Klein R, Klein BEK, Wiley TL, Nondahl DM, Tweed TS. 1998. Cigarette smoking and hearing loss: The Epidemiology of Hearing Loss Study. Journal of the American Medical Association 279(21):1715–1719. Ferrite S, Santana V. 2005. Joint effects of smoking, noise exposure and age on hearing loss. Occupational Medicine (London) 55(1):48–53. ISO (International Organization for Standardization). 1964. ISO/R 389: Standard Reference Zero for the Calibration of Pure Tone Audiometers. Geneva, Switzerland: ISO.

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Noise and Military Service: Implications for Hearing Loss and Tinnitus ISO. 1990. ISO 1999: Acoustics—Determination of Occupational Noise Exposure and Estimation of Noise-Induced Hearing Impairment. Geneva, Switzerland: ISO. Mizoue T, Miyamoto T, Shimizu T. 2003. Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers. Occupational and Environmental Medicine 60:56–59. Palmer KT, Griffin MJ, Syddall HE, Coggon D. 2004. Cigarette smoking, occupational exposure to noise, and self reported hearing difficulties. Occupational and Environmental Medicine 61:340–344. Pyykko I, Koskimies K, Starck J, Pekkarinen J, Inaba R. 1988. Evaluation of factors affecting sensory neural hearing loss. Acta Oto-Laryngologica (Suppl 449):155–158. Starck J, Toppila E, Pyykko I. 1999. Smoking as a risk factor in sensory neural hearing loss among workers exposed to occupational noise. Acta Oto-Laryngologica 119(3):302–305. Virokannas H, Anttonen H. 1995. Dose-response relationship between smoking and impairment of hearing acuity in workers exposed to noise. Scandinavian Audiology 24(4):211–216. Table D-4 Cruickshanks KJ, Tweed TS, Wiley TL, Klein BEK, Klein R, Chappell R, Nondahl DM, Dalton DS. 2003. The 5-year incidence and progression of hearing loss: The Epidemiology of Hearing Loss Study. Archives of Otolaryngology–Head and Neck Surgery 129:1041–1046. Gates GA, Schmid P, Kujawa SG, Nam B, D’Agostino R. 2000. Longitudinal threshold changes in older men with audiometric notches. Hearing Research 141(1–2):220–228. Lee FS, Matthews LJ, Dubno JR, Mills JH. 2005. Longitudinal study of pure-tone thresholds in older persons. Ear and Hearing 26:1–11. Rosenhall U. 2003. The influence of ageing on noise-induced hearing loss. Noise Health 5(20):47–53. Table D-5 ANSI (American National Standards Institute). 1969. ANSI S3.6: Specification for Audiometers. New York: American National Standards Institute. ASA (American Standards Association). 1951. American Standard Specification for Audiometers for General Diagnostic Purposes. Pub. No. Z24.5-1951. New York: ASA. Bohnker BK, Page JC, Rovig G, Betts LS, Muller JG, Sack DM. 2002. U.S. Navy and Marine Corps hearing conservation program, 1995–1999: Mean hearing thresholds for enlisted personnel by gender and age groups. Military Medicine 167(2):132–135. Chandler DW, Fletcher JL. 1983. Hearing levels in U.S. Army engineers. Journal of Audiology Research 23(1):23–32. Glorig A, Roberts J. 1965. Hearing levels of adults by age and sex, United States, 1960–1962. Vital and Health Statistics. Series 11, No. 11. Washington, DC: Department of Health, Education, and Welfare. Goldenberg RA. 1977. Hearing loss in the Marine Corps. Transactions—American Academy of Ophthalmology and Otolaryngology 84(6):991–996. Henselman LW, Henderson D, Shadoan J, Subramaniam M, Saunders S, Ohlin D. 1995. Effects of noise exposure, race, and years of service on hearing in U.S. Army soldiers. Ear and Hearing 16(4):382–391.

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Noise and Military Service: Implications for Hearing Loss and Tinnitus ISO (International Organization for Standardization). 1964. ISO/R 389: Standard Reference Zero for the Calibration of Pure Tone Audiometers. Geneva, Switzerland: ISO. ISO. 1990. ISO 1999: Acoustics—Determination of Occupational Noise Exposure and Estimation of Noise-Induced Hearing Impairment. Geneva, Switzerland: ISO. Ohlin D. 1992. 15 Years Revisited: The Prevalence of Hearing Loss Among Selected U.S. Army Branches. Hearing Conservation Special Study No. 51-01-PM82-93. Aberdeen Proving Ground, MD: U.S. Army Environmental Hygiene Agency. Peters LJ, Ford H. 1983. Extent of Hearing Loss Among Army Aviators at Fort Rucker, Alabama. USAARL Rept. No. 83-12. Fort Rucker, AL: U.S. Army Aeormedical Research Laboratory. Robertson RM, Page JC, Williams CE. 1978. The Prevalence of Hearing Loss Among Selected Navy Enlisted Personnel. NAMRL-1251. Pensacola, FL: Naval Aerospace Medical Research Laboratory, Naval Medical Research and Development Command. Sutherland HC, Gasaway DC. 1976. Hearing Levels of Noise-Exposed U.S. Air Force Personnel Compared to Those in the Total U.S. Population. Report SAM-TR-76-27. Brooks Air Force Base, TX: United States Air Force School of Aerospace Medicine. Sutherland HC, Gasaway DC. 1978. Current Hearing Threshold Levels for Noise-Exposed U.S. Air Force Personnel. One Year’s Reportings. Report SAM-TR-78-39. Brooks Air Force Base, TX: United States Air Force School of Aerospace Medicine. Thomas JW. 1995. The Application of Audiometric Data Base Analysis to Selected Air Force Bases. Master’s thesis, University of North Carolina, Chapel Hill. Walden BE, Worthington DW, McCurdy HW. 1971. The Extent of Hearing Loss in the Army: A Survey Report. Washington, DC: Walter Reed Army Medical Center. Walden BE, Prosek RA, Worthington DW. 1975. The Prevalence of Hearing Loss within Selected U.S. Army Branches. Washington, DC: Walter Reed Army Medical Center. Table D-6 Adams PF, Benson V. 1991. Current estimates from the National Health Interview Survey, 1990. Vital and Health Statistics. Series 10, No. 181. Hyattsville, MD: National Center for Health Statistics. Adams PF, Marano MA. 1995. Current estimates from the National Health Interview Survey, 1994. Vital and Health Statistics. Series 10, No. 193. Hyattsville, MD: National Center for Health Statistics. Adams PF, Hendershot GE, Marano MA. 1999. Current estimates from the National Health Interview Survey, 1996. Vital and Health Statistics. Series 10, No. 200. Hyattsville, MD: National Center for Health Statistics. ASA (American Standards Association). 1951. American Standard Specification for Audiometers for General Diagnostic Purposes. Pub. No. Z24.5-1951. New York: ASA. Attias J, Reshef I, Shemesh Z, Salomon G. 2002. Support for the central theory of tinnitus generation: A military epidemiological study. International Journal of Audiology 41(5):301–307. Axelsson A, Ringdahl A. 1989. Tinnitus—a study of its prevalence and characteristics. British Journal of Audiology 23(1):53–62. Christiansson BA, Wintzell KA. 1993. An audiological survey of officers at an infantry regiment. Scandinavian Audiology 22(3):147–152. Chung DY, Gannon RP, Mason K. 1984. Factors affecting the prevalence of tinnitus. Audiology 23(5):441–452. Coles RR. 1996. Epidemiology, aetiology, and classification. In: Reich GE, Vernon JA, eds. Proceedings of the Fifth International Tinnitus Seminar 1995. Portland, OR: American Tinnitus Association. Pp. 25–29.

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Noise and Military Service: Implications for Hearing Loss and Tinnitus Coles RR. 1984. Epidemiology of tinnitus: (1) Prevalence. Journal of Laryngology and Otology Supplement 9:7–15. Gabriels P, Monley P, Guzeleva D. 1996. Noise-exposed workers: Is tinnitus being ignored? In: Reich GE, Vernon JA, eds. Proceedings of the Fifth International Tinnitus Seminar 1995. Portland, OR: American Tinnitus Association. Pp. 373–380. Griest SE, Bishop PM. 1996. Evaluation of tinnitus and occupational hearing loss based on 20-year longitudinal data. In: Reich GE, Vernon JA, eds. Proceedings of the Fifth International Tinnitus Seminar 1995. Portland, OR: American Tinnitus Association. Pp. 381–394. Hoffman HJ, Reed GW. 2004. Epidemiology of tinnitus. In: Snow JB, ed. Tinnitus: Theory and Management. Hamilton, Ontario, Canada: B.C. Decker. Pp. 16–41. Kamal AA, Mikael RA, Faris R. 1989. Follow-up of hearing thresholds among forge hammering workers. American Journal of Industrial Medicine 16(6):645–658. Man A, Naggan L. 1981. Characteristics of tinnitus in acoustic trauma. Audiology 20(1): 72–78. Medical Research Council’s Institute of Hearing Research. 1981. Epidemiology of tinnitus. In: Evered D, Lawrenson G, eds. Tinnitus. Ciba Foundation Symposium 85. London, England: Pitman Books Ltd. Pp. 16–34. Melinek M, Naggan L, Altman M. 1976. Acute acoustic trauma—a clinical investigation and prognosis in 433 symptomatic soldiers. Israel Journal of Medical Sciences 12(6):560–569. Mrena R, Savolainen S, Kuokkanen JT, Ylikoski J. 2002. Characteristics of tinnitus induced by acute acoustic trauma: A long-term follow-up. Audiology and Neuro-Otology 7(2):122–130. Neuberger M, Korpert K, Raber A, Schwetz F, Bauer P. 1992. Hearing loss from industrial noise, head injury and ear disease. A multivariate analysis on audiometric examinations of 110,647 workers. Audiology 31(1):45–57. Nondahl DM, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. 2002. Prevalence and 5-year incidence of tinnitus among older adults: The Epidemiology of Hearing Loss Study. Journal of the American Academy of Audiology 13(6):323–331. Palmer KT, Griffin MJ, Syddall HE, Davis A, Pannett B, Coggon D. 2002. Occupational exposure to noise and the attributable burden of hearing difficulties in Great Britain. Occupational and Environmental Medicine 59(9):634–639. Parving A, Hein HO, Suadicani P, Ostri B, Gyntelberg F. 1993. Epidemiology of hearing disorders. Some factors affecting hearing. The Copenhagen Male Study. Scandinavian Audiology 22(2):101–107. Phoon WH, Lee HS, Chia SE. 1993. Tinnitus in noise-exposed workers. Occupational Medicine (London) 43(1):35–38. Roberts J. 1968. Hearing status and ear examination: Findings among adults, United States, 1960–1962. Vital and Health Statistics. Series 11, No. 32. Washington, DC: Department of Health, Education, and Welfare. Rosenhall U, Karlsson AK. 1991. Tinnitus in old age. Scandinavian Audiology 20(3):165–171. Salmivalli A. 1967. Acoustic trauma in regular army personnel. Clinical audiologic study. Acta Oto-Laryngologica (Suppl 222):1–85. Sindhusake D, Mitchell P, Newall P, Golding M, Rochtchina E, Rubin G. 2003a. Prevalence and characteristics of tinnitus in older adults: The Blue Mountains Hearing Study. International Journal of Audiology 42(5):289–294. Sindhusake D, Golding M, Newall P, Rubin G, Jakobsen K, Mitchell P. 2003b. Risk factors for tinnitus in a population of older adults: The Blue Mountains Hearing Study. Ear and Hearing 24(6):501–507.

OCR for page 223
Noise and Military Service: Implications for Hearing Loss and Tinnitus Sindhusake D, Golding M, Wigney D, Newall P, Jakobsen K, Mitchell P. 2004. Factors predicting severity of tinnitus: A population-based assessment. Journal of the American Academy of Audiology 15(4):269–280. Sulkowski W, Kowalska S, Lipowczan A, Prasher D, Raglan E. 1999. Tinnitus and impulse noise-induced hearing loss in drop-forge operators. International Journal of Occupational Medicine and Environmental Health 12(2):177–182. Tambs K, Hoffman HJ, Borchgrevink HM, Holmen J, Samuelsen SO. 2003. Hearing loss induced by noise, ear infections, and head injuries: Results from the Nord-Trøndelag Hearing Loss Study. International Journal of Audiology 42(2):89–105. Temmel AF, Kierner AC, Steurer M, Riedl S, Innitzer J. 1999. Hearing loss and tinnitus in acute acoustic trauma. Wiener Klinische Wochenschrift 111(21):891–893. Ylikoski ME, Ylikoski JS. 1994. Hearing loss and handicap of professional soldiers exposed to gunfire noise. Scandinavian Journal of Work, Environment & Health 20(2):93–100.