Army recruits of Indian origin: early detection and further prevention of noise induced hearing loss by otoacoustic emission

Himanshu Joshi, Avinash Das


Background: There has been no study on Indian population which has tested ears prone for “noise induced hearing loss”. Also, no study on recruits of Indian origin could be found in the literature, so an attempt has been made to screen the individuals to prevent noise induced hearing loss.

Methods: Otoacoustic emission (OAE) screening is done over recruits before and after first exposure to loud noise of rifle firing in our study. Recruits were followed up at 04 hours, 24 hours, 01 month and 06 months after exposure. Individuals showing variation in OAE at 24 hours were also subjected to pure tone audiometry (PTA) at 01 month and 06 months.  

Results: 98 recruits developed ‘refer’ in OAE at initial 4 hours out of which 67 recruits recovered in 24 hours. Remaining 31 recruits (45 ears) when followed up and screened at 01 month shows ‘refer’ in OAE in 22 recruits (37 ears) and high frequency loss on PTA in 17 recruits (31 ears). At 06 months 16 recruits (28 ears) shows ‘refer’ in OAE and 12 recruits (22 ears) shows dip in high frequency in PTA.

Conclusions: OAE is more sensitive tool for early detection of noise induced hearing loss. This study also correlates time and frequency involved in OAE in detecting early hearing loss as the individuals who show refer in OAE at both 04 hours and 24 hours with both 3 kHz and 4 kHz involved are more prone for noise induced hearing loss in future.


NIHL, Indian origin, Screening, Otoacoustic emission

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Collee A, Legrand C, Govaerts B, Veken PV, Boodt DF, Degrave E. Occupational exposure to noise and the prevalence of hearing loss in a Belgian military population: A cross-sectional study. Noise Health. 2011;13:64-70.

National Institute for Occupational Safety and Health, USA. Criteria for a Recommended Standard: Occupational Noise Exposure − Revised Criteria DHHS (NIOSH) Publication No. Cincinnati, Ohio: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health; 1998:98-126.

Saunders GH, Griest SE. Hearing loss in veterans and the need for hearing loss prevention programs. Noise Health. 2009;11:14-21.

Abel S. Hearing loss in military aviation and other trades: Investigation of prevalence and risk factors. Aviat Space Environ Med. 2005;76:1128-35.

Barney R, Bohnker B. Hearing thresholds for U.S. Marines: Comparison of aviation, combat arms, and other personnel. Aviat Space Environ Med. 2006;77:53-62.

Marshall L, Lapsley Miller JA, Heller LM, Wolgemuth KS, Hughes LM, Smith SD, et al. Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions. J Acoust Soc Am. 2009;125:995-1013.

Miller LJA, Marshall L, Heller LM, Hughes LM. Low-level otoacoustic emissions may predict susceptibility to noise-induced hearing loss. J Acoust Soc Am. 2006;120:280-96.

Job A, Nottet JB. DPOAEs in young normal-hearing subjects with histories of otitis media: Evidence of sub-clinical impairments. Hear Res. 2002;16:28-32.

Shupak A, Tal D, Sharoni Z, Oren M, Ravid A, Pratt H. Otoacoustic emissions in early noise-induced hearing loss. Otol Neurotol. 2007;28:745-52.

Attias J, Horovitz G, Hatib EN, Nageris B. Detection and clinical diagnosis of noise induced hearing loss by otoacoustic emission. Noise Health. 2001;3(12):19-31.

Ward WD. Temporary threshold shift in males and females. J Acoust Soc Am. 1966;40:478-85.

Bhattacharyya TK, Dayal VS. Age related cochlear toxicity from noise and antibiotics: a review. J Otolaryngol. 1986;15:15-20.

Barone JA, Peters JM, Garabrant DH, Bernstein L, Krebsbach R. Smoking as a risk factor in noise-induced hearing loss. J Occup Med. 1987;29:741-5.

Jerger JF, Jerger S, Pepe P, Miller R. Race difference in susceptibility to noise induced hearing loss. Am J Otol. 1986;7:425-9.

Pawelczyk M, Laer VL, Fransen E, Rajkowska E, Konings A, Carlsson PI, et al. Analysis of gene polymorphisms associated with K+ ion circulation in the inner ear of patients susceptible and resistant to noise-induced hearing loss. Ann Hum Genet. 2009;73:411-21.

Konings A, Laer VL, Michel S, Pawelczyk M, Carlsson PI, Bondeson ML, et al. Variations in HSP70 genes associated with noise-induced hearing loss in two independent populations. Eur J Hum Genet. 2009;17:329-35.

Konings A, Laer VL, Michel S, Pawelczyk M, Carlsson PI, Bondeson ML, et al. Candidate gene association study for noise-induced hearing loss in two independent noise-exposed populations. Ann Hum Genet. 2009;73:215-24.

Rosen S, Plester D, Mofty EA, Rosen HV. Relation of hearing loss to cardiovascular disease. Trans Am Acad Ophthalmol Otolaryngol. 1964;68:433-44.

Hodgson MJ, Talbott E, Helmkamp JC, Kuller LH. Diabetes, noise exposure, and hearing loss. J Occup Med. 1987;29:576-9.

Axelsson A, Lindgren F. Is there a relationship between hypercholesterolemia and noise-induced hearing loss? Acta Otolaryngol (Stockh). 1985;100:379-86.

Carhart R. Updating special hearing tests in otological diagnosis. Arch Otolaryngol. 1973;97:88-91.

Humes LE, Schwartz DM, Bess FH. The threshold of octave masking (TOM) test as a predictor of susceptibility to noise-induced hearing loss. J Audit Res. 1977;17:5-12.

Bienvenue GR, Singer VJR, Michael PL. Loudness discrimination index (LDI): A test for the early detection of noise susceptible individuals. Am Ind Hyg Assoc J. 1977;38:333-7.

Konopka W, Zalewski P, Pietkiewicz P. Evaluation of transient and distortion product otoacoustic emissions before and after shooting practice. Noise Health. 2001;3:29-37.

Luebke AE, Stagner BB, Martin GK, Martin LBL. Adaptation of distortion product otoacoustic emissions predicts susceptibility to acoustic over-exposure in alert rabbits. J Acoust Soc Am. 2014;135:1941-9.

Müller J, Janssen T. Impact of occupational noise on pure-tone threshold and distortion product otacoustic emissions after one workday. Hear Res. 2008;246:9-22.

Muller J, Dietrich S, Janssen T. Impact of three hours of discotheque music on pure-tone thresholds and distortion product otoacoustic emissions. J Acoust Soc Am. 2010;128:1853-69.

Hannah K, Ingeborg D, Leen M, Annelies B, Birgit P, Freya S, et al. Evaluation of the olivocochlear efferent reflex strength in the susceptibility to temporary hearing deterioration after music exposure in young adults. Noise Health. 2010;16:108-15.

Lobarinas E, Spankovich C, Prell LCG. Evidence of “hidden hearing loss” following noise exposures that produce robust TTS and ABR wave-I amplitude reductions. Hear Res. 2017;349:155-63.

Bliskas S, Tsalighopoulos M, Psillas G, Markouk. Utility of otoacoustic emissions and olivocochlear reflex in predicting vulnerability to noise-induced inner ear damage. Noise Health. 2018;20(94)101-11.