Welleschik B
Wien Klin Wochenschr Suppl. 1980;120:1-13.
The paper discusses the question of which factors that are to be taken into consideration are of relevance to the expert in making his differential diagnosis in cases of occupational hearing loss. On the basis of the medical literature and earlier investigations the discussion is concerned with the proof of recruitment as well as with the effects of the exposure level and the exposure duration. Special reference is made to the "typical" hearing-threshold curve. The result of the examination with factor-analysis of 14,684 pure tone audiograms suggests that a small involvement of low and medium frequencies in the hearing loss is especially typical of occupational hearing losses. Not even this method permits delineating the effects of age on hearing from those of exposure to noise. The varying (pathogenetic) exposure level has a strikingly low influence on the extent of the occupational hearing loss. The entire data resulting from 25.544 pure tone audiograms are furthermore used for the computation of hearing-loss curves of different tail probability (supposing a normal distribution). The expert has thus a means available to estimate the probability of whether or not a concrete case is still a typical example of occupational hearing loss.
本文讨论了在职业性听力损失病例中，专家在进行鉴别诊断时应考虑哪些相关因素的问题。基于医学文献和早期调查，讨论涉及重振的证据以及暴露水平和暴露持续时间的影响。特别提到了“典型”的听力阈值曲线。对14684份纯音听力图进行因子分析的检查结果表明，听力损失中低频和中频的轻度受累是职业性听力损失的特别典型特征。即使这种方法也无法将年龄对听力的影响与噪声暴露的影响区分开来。变化的（致病的）暴露水平对职业性听力损失的程度影响极低。此外，来自25544份纯音听力图的全部数据被用于计算不同尾部概率（假设为正态分布）的听力损失曲线。因此，专家有办法估计一个具体病例是否仍然是职业性听力损失典型例子的概率。
