Interaction of noise-induced permanent threshold shift and age-related threshold shift.

Current medical-legal practices as well as an international standard (ISO 1999) assume the permanent threshold shifts produced by exposure to noise add (in dB) to the threshold shifts caused by increased chronological age (presbyacusis). This assumption, known as the additivity rule, was tested in an animal model. Mongolian gerbils, born and raised in a quiet vivarium, were exposed at age 18 months to a 3.5-kHz pure tone for 1 h at 113 dB SPL. At 6-weeks post-exposure, permanent threshold shifts in the exposed ear were approximately 20 dB in the 4- to 8-kHz region. Thresholds in the nonexposed, control ear were unaffected by the exposure. Animals were then allowed to age in the quiet vivarium until age 36 months and then were retested. Thus in a given animal, aging-only effects were assessed in one ear (internal control) and noise-plus-aging effects were assessed in the other (test) ear. A second control was mean age-related threshold shift measured in 48 gerbils who were born and raised in the quiet vivarium. This group is referred to as a non-noise-exposed population (population control). Using the additivity rule, predictions with either the internal or population control significantly overestimated noise-plus-aging effects. Use of the ISO 1999 compression factor reduced the overestimations by 0-5 dB. The intensity rule produced the most accurate predictions. These results suggest that the interaction of noise-induced permanent threshold shift and age-related threshold shift is not straightforward and that current medical-legal methods using the additivity rule overestimate the contribution of "noise effects".