Korean J Occup Environ Med.  2012 Dec;24(4):431-440.

The Characteristics of Tinnitus and Hearing Threshold: In Workers with Noise Induced Hearing Loss from a Hospital Setting

• Kim NJ
• Park HO
• Sim CS
• Lee CR
• Kwon YJ
• Lee JH

Abstract

OBJECTIVES
This study was carried out to define the relationship between the characteristics of tinnitus and hearing threshold (puretone and speech) in workers with noise induced hearing loss (NIHL).
METHODS
A total of 189 cases(378 ears) from workers with compensation claims for NIHL during 2004-2009 were investigated. Various factors, including age, work carriers, body mass index (BMI), blood pressure, noise exposure level of worksite hearing threshold, speech discrimination score, pitch match, and loudness of tinnitus were analyzed.
RESULTS
The average hearing threshold of all subject was 44.2 dBHL, puretone audiometry thresholds in subjects with tinnitus were lower than the non-tinnitus group (except at 8000 Hz). Using speech audiometry, the tinnitus group showed a lower speech recognition threshold and speech discrimination score. The tinnitus group also had an average tinnitus frequency of 4195.2 Hz, loudness of 73.6 dB, and tinnitus sensation average of 6.0 dBSL. These frequencies of tinnitus were in the lowest puretone audiometry frequencies. Tinnitus loudness had a strong relationship with puretone and speech audiometry thresholds.
CONCLUSIONS
In cases beyond moderate hearing loss, the tinnitus group had a better puretone (except 8000 Hz) and speech hearing status, and most comfortable loudness (MCL) level. In addition, puretone and speech audiometry thresholds increase with tinnitus loudness.

Keyword

Tinnitus; Noise induced hearing loss; Worker's compensation

MeSH Terms

Audiometry
Audiometry, Speech
Blood Pressure
Body Mass Index
Compensation and Redress
Hearing
Hearing Loss
Noise
Sensation
Speech Perception
Tinnitus
Workers' Compensation
Workplace

Figure

• 

  Fig. 1 Tinnitus loudness and sensation levels according to tinnitus pitch. Numbers in bar chart: mean values of the tinnitus loudness and sensation levels. Abbreviation: T_loud, tinnitus loudness; T_SL, tinnitus sensation levels. *p<0.05, according to post hoc(Duncan), sensation levels of tinnitus in 250 and 500 Hz were higher than the level over 1000 Hz. †p<0.05, according to post hoc(Duncan), level of tinnitus loudness over 2000 Hz were higher than the level below 1000 Hz.

• 

  Fig. 2 Results of weight from partial least square regression analysis. Abbreviation: PTA512, average of dBHL for (500+1000+2000 Hz)/3; PTA346, average of dBHL for (3000+4000+6000 Hz)/3; SRT, speech reception threshold(dB); MCL, maximum comfortable level(dB); SDS, speech discrimination score(%).

Reference

1. Koo JW, Lee WC, Kim HW, Choi BC, Oh MH, Park CY. Prevalence of tinnitus and hearing thresholds of a non-noise-exposed population with and without tinnitus. Korean J Occup Environ Med. 1999. 11(3):323–331. (Korean).

2. Jung SJ, Woo KH, Park WD, Yu JY, Choi TS, Kim SW, Kim JS. Related factors of high frequency hearing loss in the noise-exposed male workers. Korean J Occup Environ Med. 2000. 12(2):187–197. (Korean).

3. Ministry of Employment Labor. The results of Korean worker's health examination in 2008. cited28 October 2011. Avaliable: cate=3&sec=2&smenu=2&mode=view&seq=1332309807478&page=1&state=A&bbs_cd=103,104,105,106,107,108,113,114,115,116(Korean).

4. Kim NJ, Kwon JK, Lee JH. The impact of noise expose on the hearing threshold extended high frequency. Korean J Occup Environ Med. 2008. 20(2):81–92. (Korean).

5. Adams PF, Hendershot GE, Marano MA. Current estimates neurectomy (CVN), translabyrinthine CVN and from the National Health Interview Survey, 1996. Hyattsville (MD): National Center for Health Statistics. 1999.

6. Kim KS, Chung HG. Characteristics and Affecting Factors of Tinnitus in Noise Exposed Workers. Korean J Occup Environ Med. 2002. 14(4):436–447. (Korean).

7. Ministry of Employment Labor. JH Lee . Concrete admittance standards for work related diseases: enforcement regulations article 5 noise induced hearing loss, Workers compensation law. 2008.

8. Ministry of Employment Labor. JH Lee . Detailed standard for the criterions of disability grades, article 48: noise induced hearing loss. 2008.

9. Song JB, Kim JI, Kim BG, Kim JY. Study on DPOAE audiogram of noise-induced hearing loss with tinnitus. Korean J Occup Health. 2003. 42(2):57–66. (Korean).

10. Reyes SA, Salvi RJ, Burkard RF, Coad ML, Wack DS, Galantowicaz PJ. Brain imaging of the effects of lidocaine on tinnitus. Hear Res. 2002. 171(1-2):43–50.

11. Ahmad N, Siedman M. Tinnitus in the older adult: epidemiology, pathophysiogy,and treatment options. Drugs Aging. 2004. 21(5):297–305.

12. Lee SJ, Lee SK. Relationships of tinnitus to frequency and hearing loss in elderly patients. Korean J Otolaryngol-Head Neck Surg. 2007. 50:869–875. (Korean).

13. Eggermont JJ, Roberts LE. The neuroscience of tinnitus. Trends Neurosci. 2004. 27(11):676–682.

14. Jeong SW, Shin KS, Ryu R, Kim TH, Kim YM, Lee SH, Park CW. Audiologic findings in tinnitus patients. Korean J Otolaryngol-Head Neck Surg. 2008. 12(2):81–85. (Korean).

15. McShane DP, Hyde ML, Alberti PW. Tinnitus prevalence in industrial hearing loss compensation claimants. Clin Otolaryngol. 1988. 13:323–330.

16. Daniell WE, Fulton-Kehoe D, Smith-Weller T, Franklin GM. Occupational hearing loss in Washington state 1984-1991 II. Morbidity and associated costs. Am J Ind Med. 1998. 33:529–536.

17. Alberti PW. Tinnitus in occupational hearing loss: nosological aspects. J Otolaryngol. 1987. 16(1):34–35.

18. Phoon WH, Lee HS, Chia SE. Tinnitus in noise-exposed workers. Occup Med (Lond). 1993. 02. 43(1):35–38.

19. Park JL. An audiometric study of the tinnitus. Korean J Otolaryngol-Head Neck Surg. 1968. 11(4):257–265. (Korean).

20. Coles RRA. Epidemiology of tinnitus: (1)Prevalence. J Laryngol Otol Suppl. 1984. 9:7–15.

21. Kim SY, Lee KS, Yoo SJ, Chu KC. A clinical study of tinnitus. Korean J Otolaryngol-Head Neck Surg. 1995. 38(7):1011–1015. (Korean).

22. Vernon J, Schleuning A. Tinnitus: A new management. Laryngoscope. 1978. 88:413–419.

23. Kim SY, Lee KS, Yoo SJ, Chu KC. A clinical study of tinnitus. Korean J Otolaryngol-Head Neck Surg. 1995. 38(7):1011–1015. (Korean).

24. Axelsson A, Prasher D. Tinnitus induced occupational and leisure noise. Noise & Health. 2000. 8:47–54.

25. Jeon J, Chon KM, Goh EK, Lee IW, Cho KS, Ahn JH. Frequencies of tinnitus and noise of the factory in noise-induced hearing loss. Korean J Otolaryngol-Head Neck Surg. 2005. 48:142–145. (Korean).

26. Auo HJ, Park KH, Yeo SW, Chang KH, Choi HG, Choi BJ, Han MA, Park SN. Treatment. response of modified tinnitus retraining therapy with medical therapy in the patients with tinnitus. Korean J Otorhinolaryngol Head Neck Surg. 2009. 52:648–654. (Korean).

27. Chon KM. Dignosis and treatment of tinnitus. Korean J Otolaryngol-Head Neck Surg. 1996. 7:326–339. (Korean).

28. Jastreboff PJ, Hazell JWP. innitus retraining therapy: implementing the neurophysiological model. 2004. New York: Cambridge University Press;16–62.

29. Wold S, Sjöström M, Eriksson L. PLS-regression: a basic tool of chemometrics. Chemometrics and Intelligent Laboratory Systems. 2001. 58:109–130.