Classification of audiograms in the prevention of noise-induced hearing loss: A clinical perspective.
Zumbi Musiba
PMID 32129662WHAT IT FOUND
The UKHSE audiogram scheme sums hearing levels at 1, 2, 3, 4 and 6 kHz, compares them with age and sex tables, and assigns warning or referral actions.
It may help workplaces act on noise-induced hearing loss, but the paper does not report effectiveness data.
Key findings
01The UKHSE method sums hearing thresholds at 1 kHz, 2 kHz, 3 kHz, 4 kHz and 6 kHz, compares them with age and sex reference tables, and categorises audiograms as acceptable hearing, mild hearing impairment, poor hearing or rapid hearing loss.
02The UKHSE scheme assigns warning, training and counselling for mild hearing impairment within the 20th percentile, referral for poor hearing within the 5th percentile, and referral for rapid hearing loss defined as a reduction of 30 dB or more within 3 years or less.
03The paper describes a Tanzanian mining company applying the UKHSE scheme to historical audiograms, determining 47% NIHL prevalence, then requiring immediate classification, counselling for warning levels, referral for referral levels, return-to-work risk management and possible reassignment.
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What it does not show
This is a narrative clinical review, not an original study, so it does not test whether the UKHSE scheme prevents noise-induced hearing loss. The UKHSE scheme has been criticised for not using the 4 kHz notch, for relying on a predominantly urban Caucasian reference population, and for gender-based thresholds without a scientific basis. No specificity or sensitivity tests have been conducted to compare the UKHSE scheme against other available methods in a predominantly ethnic group relevant to low- and middle-income settings. Referral to an ENT specialist may be less effective in settings with few occupational physicians. The Tanzanian mining company description is a single workplace case and cannot show that the scheme works. Many cited prevalence figures come from different industries, countries and definitions, so they are not directly comparable.
The easy way to misread this
Do not read the Tanzanian case or the prevalence figures as proof that the UKHSE scheme prevents hearing loss. The paper is a clinical review and does not report a controlled effectiveness study.