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Article
April 1995

Audiometric Referral Criteria for Industrial Hearing Conservation Programs

Author Affiliations

From the Department of Audiology, Wayne State University School of Medicine, Detroit, Mich (Drs Simpson and Blakley); and Department of Communication Disorders, Central Michigan University, Mount Pleasant (Dr Stewart).

Arch Otolaryngol Head Neck Surg. 1995;121(4):407-411. doi:10.1001/archotol.1995.01890040031005
Abstract

Objectives:  To determine referral rates resulting from application of American Academy of Otolaryngology—Head and Neck Surgery audiometric referral criteria for occupational hearing conservation programs (HCPs) in a large industrial population and to estimate the efficacy of audiometric retesting in identifying false-positive referral flags.

Design:  Retrospective, comparing referral rates between control and noncontrol HCPs from public domain data in the American National Standards Institute Draft American National Standard: Evaluating the Effectiveness of Hearing Conservation Programs.

Setting:  Occupational HCPs from the United States and Canada.

Patients:  A total of 45 055 baseline and 27 047 second chronologic audiograms were analyzed. A subset of 3958 employees who had baseline and seven subsequent tests were examined to confirm results.

Interventions:  None.

Main Outcome Measures:  Percent of employees meeting referral criteria was calculated for unconfirmed (ie, single test) and confirmed (two consecutive tests) audiometric findings. No a priori hypotheses were formulated for referral rates for control or noncontrol HCPs.

Results:  Noncontrol HCP referral rates were typically two to three times that of control HCPs. Control and non-control HCPs had about half as many audiometric referral flags when retests were used to confirm initial results.

Conclusions:  Mature industrial populations are likely to yield higher baseline referral rates than younger populations. Retesting may identify up to 50% of audiometric referral flags as false-positive and significantly reduce costly overreferrals. Annual referral rates of 1% to 2% seem to be achievable in well-run HCPs in which retesting is performed to identify false-positive audiometric outcomes.(Arch Otolaryngol Head Neck Surg. 1995;121:407-411)

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