Simpson T H, Amos N, Rintelmann W F
Department of Audiology and Speech-Language Pathology, Wayne State University, Detroit, Michigan 48202, USA.
J Am Acad Audiol. 1998 Apr;9(2):112-20.
Draft ANSI S12.13 1991 Standard Evaluating the Effectiveness of Hearing Conservation Programs presents statistical protocols purportedly sensitive to temporary threshold shift (TTS) in occupational hearing conservation program (HCP) audiometric databases. Because it is well established that less TTS is found in humans with hearing loss than in those with essentially normal hearing, one might predict baseline hearing level to be a confounding variable in interpreting ANSI S12.13 outcomes, with better-hearing industrial populations tending to demonstrate greater year-to-year audiometric variability than poorer-hearing groups. However, in a large industrial sample from the public domain audiometric database, poorer-hearing groups systematically demonstrated greater audiometric threshold variability than better-hearing groups, and ANSI S12.13 outcome magnitudes were highly positively correlated to baseline hearing levels. These findings generally do not support notions that ANSI S12.13 outcomes clearly provide indirect measures of TTS. HCP managers should exercise extreme caution in interpreting ANSI S12.13 outcomes to rate overall program performance. In particular, HCP managers should not rely upon these outcomes for decisions regarding hearing protection policies without careful consideration of pre-existing hearing loss in the populations involved.
1991年美国国家标准学会（ANSI）S12.13标准草案《评估听力保护计划的有效性》提出了统计方案，据称该方案对职业听力保护计划（HCP）听力测定数据库中的暂时性阈移（TTS）敏感。众所周知，与听力基本正常的人相比，听力损失者的TTS较少，因此有人可能预测基线听力水平在解释ANSI S12.13结果时是一个混杂变量，听力较好的工业人群往往比听力较差的人群表现出更大的年度听力测定变异性。然而，在一个来自公共领域听力测定数据库的大型工业样本中，听力较差的组系统性地表现出比听力较好的组更大的听力阈值变异性，并且ANSI S12.13结果的大小与基线听力水平高度正相关。这些发现总体上不支持ANSI S12.13结果能清楚地提供TTS间接测量值的观点。HCP管理人员在解释ANSI S12.13结果以评估整体计划绩效时应格外谨慎。特别是，HCP管理人员在未仔细考虑相关人群中已有的听力损失情况之前，不应依赖这些结果来做出有关听力保护政策的决策。
