[2026-01-26] Comparing Diagnostic Criteria for Noise-Induced Hearing Loss in Hospital Personnel: Age Adjustments With ISO 7029-2017

Pitchaya Chevasutho

doi:10.33165/rmj.2026.e273715

Authors

Pitchaya Chevasutho Department of Occupational Medicine, Chonburi Hospital, Chon Buri, Thailand https://orcid.org/0009-0000-0123-5002

DOI:

https://doi.org/10.33165/rmj.2026.e273715

Keywords:

Noise-induced hearing loss, Age-adjustment, Audiogram, ISO 7029-2017

Abstract

Background: Noise-induced hearing loss (NIHL) is a prevalent occupational health concern, especially in high-noise industries. Despite various diagnostic methods, no universally accepted gold standard for diagnosing NIHL exists. Age adjustments, which are an unresolved issue, vary across proposed standards. Comparing diagnostic criteria is vital for improving early detection and prevention strategies.

Objective: To compare different NIHL diagnostic methods, assessing the impact of age adjustments on hearing threshold interpretations in hospital personnel.

Methods: A retrospective study was conducted, analyzing audiometric data from hospital personnel in a hearing conservation program (HCP) using multiple diagnostic criteria, including the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) threshold shift criteria, the Coles, Lutman, and Buffin (CLB) method with OSHA age-adjustment table, and ISO 7029-2017 values. NIHL quantification was performed using various averages and age-associated hearing loss (AAHL) values.

Results: A total of 108 participants (71.30% male; mean age 43.92 years) were included. The mean duration of employment was 12.80 years. Based on OSHA Standard Threshold Shift (OSTS), 9.26% of participants had NIHL, while NIOSH Significant Threshold Shift (NSTS) identified 35.19%. Coles' bulge analysis revealed varied NIHL prevalence of 28.70% using OSHA Table F-1/F-2, and 46.30% with ISO 7029-2017. Mean hearing thresholds (average of 0.5 kHz, 1 kHz, 2 kHz, 3 kHz) were 23.02 dB (OSHA AAHL) and 20.90 dB (ISO 7029-2017), compared to 41.22 dB and 50.56 dB when 4 kHz was included.

Conclusions: NIHL diagnosis remains complex due to the lack of a definitive standard. Diagnostic criteria and age adjustment methods influence prevalence estimates, highlighting the need for further research to enhance NIHL assessment for more effective prevention strategies.

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