Effects of noise exposure on auditory brainstem response and speech-in-noise tasks: a review of the literature

Figures & data

Table 1. Relationship between occupational noise exposure and auditory brainstem response (ABR) metrics.

Author	Participants	Noise Exposure/Noise Survey	Hearing Threshold	OAE amplitude	ABR amplitude and latency	Speech in Noise Testing
Attias and Pratt (1984)	31 new employees, ages 18–21	Continuous engine noise of 112–117 dB(A) for 8 h/day; subjects self-reported HPD use	PTS at 4 kHz developed over 14 months	Not included	Forehead and mastoid electrodes; alternating polarity clicks; 10 and 55/sec, 75 dB HL, 1024 repetitions averaged, waveforms replicated Wave-I latencies prolonged after 14 months, at both 10 and 55/sec rates; Waves III and V were delayed only with 55/sec rate	Not included
Almadori et al. (1988)	54M patients ages 25–51 years with presumed NIHL; 15 age matched controls	At least 5-year occupational noise exposure	Bilateral and symmetric hearing loss in the 1–4 kHz range, ranging from less than 20 dB to 50–71 dB	Not included	Alternating polarity clicks; 21 and 51/sec, 70 dB nHL, 2048 repetitions averaged Latency values within normal limits for waves I, III, V Wave I missing in 10 cases, generally observed in ears with more hearing loss	Not included
Chen, Chiang, and Chen (1992)	112 employees (92M, 20F) ranging in age from 20–50 years and working at an airport in Kaohsiung, Taiwan; controls were 13M, 6F ranging in age from 25–45 years	Exposures were distributed across maintenance workers (n = 23), firemen (n = 20), policemen (n = 24), airline ground staff (n = 34) and civil servants (n = 14)	High frequency hearing loss observed in 65% of maintenance workers, 55% of firemen, 42% of policemen, 32% of ground staff, and 0% of civil servants.	Not included	Alternating polarity clicks; 13.3/sec, 70 dB SL, 2048 repetitions averaged Wave V latency values significantly prolonged in maintenance workers and firemen.	Not included
Attias et al. (1996)	13M career military personnel with NIT ages 21–45 years, 11 matched controls without NIT	All subjects were military personnel with well documented history of noise exposure	Notched audiometric configuration in both groups	Not included	Scalp and mastoid electrodes; 100 μsec alternating polarity clicks; 10.3/sec, 120 dB peSPL, 1024 repetitions averaged ABR Wave III amplitude larger in participants with tinnitus; no inclusion of noise-free control – effects of noise cannot be determined	Not included
Donaldson and Ruth (1996)	9M, 1F ages 33–54 years; normative data derived from Donaldson and Ruth (1993)	“significant history of noise exposure”	Slight, mild, or moderate hearing loss consistent with NIHL	Not included	Forehead and mastoid electrodes; 65 dB nHL (99 dB peSPL) rarefaction clicks; 27/s. Maskers presented at 57 dB SPL spectrum level, equivalent to 95 dB SPL in the wideband condition Noisier and less repeatable waveforms in NIHL group in both high-pass and band-pass conditions	Not included
Noorhassim, Kaga, and Nishimura (1996)	22M ranging from <50 years to >70 years old; mean = 62.1±9.9 yrs	Occupational exposure >90 dB(A), <10 years to >20 yrs exposure	All subjects had permanent NIHL	Not included	Forehead and mastoid electrodes; clicks; 10/sec, 90-100 dB HL, two replicated runs Eight ears (18.2%) with prolonged Wave-I latency; eight ears with missing Wave-I Ears with missing Wave-I were more likely to be from participants with severe hearing loss	Not included
Xu et al. (1998)	22M with NIHL ages 37–64 years (mean = 51 years), and 21M controls with an average age of 41 years	Various industries >85 dB(A), 10–40 years	SNHL at 4 kHz, with or without hearing loss at 1, 2 and 3 kHz	TEOAE with click at 85 dB, 260 sweeps; TEOAE disrupted	Alternating polarity clicks; 21.3/sec, 90 dB nHL Wave I/V amplitude ratios decreased with increasing SNHL Presence of Wave I decreased with increasing SNHL	Not included
Fabiani et al. (1998)	130 athletes (104M, 26F) (mean age ∼30 yrs old); 77 had thresholds ≤25  dB HL; 53 had thresholds ≥30 dB HL at one or more frequencies from 2–8 kHz	Athletes belonged to Italian National Teams of trapshooting (FITAV), target shooting, (UITS), modern pentathlon, (FIPM) and triathlon (FISI)	Hearing loss was prevalent in sport shooters, including 35 athletes with severe high frequency hearing loss	Not included	Clicks; 24/sec, 100 dB SPL; 2000 responses averaged Latency of Waves I-V was measured but amplitude was not; ABR was absent in 19 ears and Wave V was delayed in 12 ears. Central and peripheral pathology inferred, and described as “hidden” behind the hearing loss	Not included
Thakur, Anand, and Banerjee (2004)	38M workers at Air India, Mumbai airport; 24 exposed to noise (mean age 48 years) and 14 controls (mean age 43 yrs)	24M with occupational exposure of 95–110 dB(A) for 7–8 hrs/day over 15–30 years; controls not exposed to noise exceeding 80 dB(A)	The majority of noise-exposed workers had mild or moderate hearing loss at 4 or 8 kHz, with no hearing loss in controls	Not included	Vertex and earlobe electrodes; 100-μsec clicks; 15/sec, 70 dB SL, 2000 repetitions averaged with repetition to assure repeatability ABR Wave III latency delayed in participants with noise exposure; ABR Wave V/I ratios not reliably different	Not included
Konrad-Martin et al. (2012)	131 veterans, age 26–71 years; mostly male sample with very few females	Noise index created from questionnaire on noise and HPD use in military, occupational, and recreational settings	Thresholds were <40 dB HL at 2 kHz, and <70 dB HL at 4 kHz	Not included	Mastoid and forehead surface electrodes; 100-μsec alternating polarity clicks; 11, 51, and 71/sec rates, 110 dB SPL, 1024 repetitions collected twice to verify replication then all 2048 runs averaged. Age related decreases in amplitude and increases in latency were detected for waves I, III, and V, with greatest effects of age observed at 11/sec rate; noise included in model but effects of noise not discussed in detail	Not included
Samelli et al. (2012)	32M aged 18–45 years with thresholds no poorer than 40 dBNA from 0.25–8 kHz no poorer; musicians subdivided as normal or hearing loss	16 professional musicians belonging to rock/pop bands for more than 5 years and having at least 2 h/wk exposure to amplified music; 16 controls	Musicians with hearing loss had poorer hearing at 2, 3, 12.5, 14, 16 and 18 kHz, relative to musicians without hearing loss and non-musician controls	TEOAE with clicks presented at 78–83 dB peSPL, 200 sweeps/ear; musicians poorer at 1, 1.5, 2, 3 and 4 kHz.	Mastoid and forehead surface electrodes; 0.1-μsec alternating polarity clicks; 19/sec rates, 80 dB nHL dB SPL, 2000 repetitions. No significant differences in ABR amplitude or latency for Waves I, III, or V.	Not included
Karawani et al. (2015)	82 workers with an average age of 38 years	Exposure was a combination of industrial (continuous noise exposure) and military (impulsive noise exposure); all participants were enrolled in annual audiometric monitoring programme	25 workers had normal hearing (thresholds ≤20 dB HL from 0.25–8 kHz); 57 workers had bilateral symmetrical NIHL including thresholds of 25 dB HL or poorer and notched configuration	Not included	Forehead surface electrode and two earlobe electrodes; 100-μsec rarefaction clicks and 1 and 2 kHz tone bursts; 13.3/sec, 80 dB HL decreasing to threshold, minimum of 2000 repetitions per level with more repetitions near threshold. In 24 ears with profound NIHL, brainstem responses to clicks and tone bursts could not be recorded, although auditory steady-state responses (ASSR) were able to be obtained.	Not included
Pushpalatha and Konadath (2016)	20M individuals ages 20–45 years, exposed to occupational noise; 20 control	Occupational noise exposure >85dB(A) for 0–5 years, 5–10 years, or >10 years	All hearing thresholds within 25 dB HL	Not included	Forehead and mastoid electrodes; clicks and CE-chirps; 11.1/sec, 80 dB HL Clicks: Wave-III amplitude smaller and latency delayed, Wave-V amplitude reduced. Chirps: Waves I, III, V latencies delayed; wave-V amplitude decreased	Not included

Table 2. Relationship between non-occupational noise exposure and auditory brainstem response (ABR) metrics.

Author	Participants	Noise Exposure/Noise Survey	Hearing Threshold	OAE amplitude	ABR amplitude and latency	Speech in Noise Testing
Schaette and McAlpine (2011)	33 young adult females with or without tinnitus (average age within groups was 33 to 36 yrs old); participants had thresholds ≤20 dB HL from 0.125–8 kHz	Noise exposure history was not assessed	Five participants with tinnitus and three controls were unable to hear 16 kHz. Effects of noise on functional metrics could not be determined as noise exposure was not surveyed	Not included	Electrodes placed on both mastoids and on the high forehead. 50-μsec clicks; 11/sec, 90 and 100 dB SPL, minimum of 6000 repetitions averaged. ABR Wave I amplitude was significantly smaller in the tinnitus group; no differences were observed in Wave-V. Effects of noise on evoked potential amplitude could not be determined as noise exposure was not surveyed	Not included
Stamper and Johnson (2015a)	30 young adults (10M, 20F) ages 19 to 28 years (mean = 22.8 yrs) with thresholds ≤20 dB HL from 0.25–8 kHz	LAEQ8760 assessed via NEQ: mean = 74.6, range = 67–83	.25–8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity	DPOAE at 1–4 kHz, 50–80 dB FPL: No statistically significant relationships between DPOAE amplitude and threshold	TM and Mastoid used for noninverting electrode; inverting electrode at forehead and ground at contralateral mastoid. 100-μsec clicks and 4 kHz tones; 11.3/sec, 70–90 dB nHL, two runs of 2000 repetitions, averaged. Statistically significant correlations between LAEQ8760 observed when tests were conducted with mastoid electrodes but not TM electrodes. When reanalysed accounting for sex differences, effects limited to females (Stamper and Johnson2015b).	Not included
Liberman et al. (2016)	34 participants (19M, 15F) ages 18-41 yrs with thresholds <20 dB HL from 0.25 –8 kHz	Subjects divided as high-risk (15M, 7F) or low-risk (4M, 8F) based on self-reported exposure to sound and use of HPDs	High-risk group showed significant threshold elevation at all test-frequencies above 8 kHz	DPOAE at 0.5–12 kHz using F1 = 65/F2 = 55 dB; DPOAEs present in all subjects with no significant group difference in amplitude	Extra-tympanic gold-foil wrapped electrodes with ground on forehead; 100-μsec alternating polarity clicks; 9.1 or 40.1/sec, 94.5 dB nHL. Statistically significant increase in SP in high-risk cohort, no reliable differences in AP; SP/AP ratio increased in high risk group	See Table 3
Bramhall et al. (2017)	100 participants ages 19–35 years with thresholds <20 dB HL from 0.25–8 kHz; 64 participants (37M, 27F) included in final analysis.	Subjects interviewed regarding occupational, military, and recreational lifetime noise history, and use of HPDs, using LENS-Q; subjects divided into four veteran/non-veteran and high-noise/low-noise subgroups	Veterans with high noise exposure had threshold elevations of ∼5 dB for 3, 4 and 6 kHz PTA; statistical comparisons not reported and threshold not included in Bayesian analysis of factors influencing ABR measurements	DPOAEs screened from 1.5–6 kHz; DPOAE amplitude not reliably different across groups	Extra-tympanic gold-foil wrapped electrode with reference on high forehead and ground on low forehead; tonebursts varied in duration and level across frequencies (1, 3, 4 and 6 kHz); 11.1/sec, all tones included 110 dB p-pe SPL condition, some included 60, 70, 80, 90 and 100 dB p-pe SPL. ABR Wave-I amplitude reduced in veteran high noise and non-veteran firearm group at 110 dB p-pe SPL across frequencies with no differences in the amplitude of waves III or V.	Not included
Fulbright et al. (2017); for additional discussion see Fulbright (2016)	60 participants (26M, 34F) from 18-28 yrs old with thresholds ≤25 dB HL from 0.25 – 8 kHz	LAEQ8760 assessed via NEQ: mean = 78.6, range = 64-87 Post-hoc analysis included assignment to high-risk and low-risk groups based on self-report of a previous TTS after a loud event.	.25-8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity	DPOAE screened from .5-8 kHz using F1 = 65/F2 = 55 dB SPL, and F1 = 53/F2 = 35 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	Electrodes placed at high and low forehead and ipsilateral earlobe; 100-μsec rarefaction clicks; 21.1/sec, 70, 80, 90, and 99 dB nHL, minimum of 2000 repetitions. Tones were 4 kHz alternating polarity, 27.1/sec, 90 dB nHL; electrode configurations included earlobe electrode as per clicks, and tiptrode ear canal electrode. Females had larger Wave I amplitudes than males. No relationships between noise exposure history and ABR Wave-I amplitude were detected. No differences between high risk and low risk groups were detected.	See Table 3
Grinn et al. (2017)	32 participants (13M, 19F) from 21-27 yrs old with thresholds ≤25 dB HL from 0.25 – 8 kHz	LAEQ8760 assessed via NEQ: mean =79.3, range =57-87	.25-8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity.	DPOAE screened from 1-8 kHz using F1 = 55/F2 = 45 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	Tiptrode ear canal electrodes placed in both ears and electrodes placed at high and low forehead; alternate polarity clicks and 2, 3, and 4 kHz tone bursts; 11.7/sec, 70, 80, 90, and 99 dB nHL, 500 repetitions with replication. Females had larger Wave I amplitudes than males. No relationships between noise exposure history and ABR Wave-I amplitude were detected.	See Table 3
Prendergast et al. (2017a)	126 participants (51M, 75F) ages 18-36 yrs with thresholds <25 dB HL from 0.25 – 8 kHz	Lifetime noise exposure questionnaire modified from Lutman et al. (2008)	No statistically significant relationships between noise exposure history and threshold sensitivity from 0.25 to 8 kHz; 16 kHz thresholds elevated as a function of noise history in females, but not males	TEOAEs screened from 1.5-4 kHz at 83 dB peSPL; TEOAE amplitude not reliably related to noise exposure history	Electrodes placed at high forehead, seventh cervical vertebra and both mastoids; 100-μsec alternating polarity clicks; 11/sec, 80 and 100 dB peSPL presented dioticly; 7480 repetitions per stimulus condition. Females had larger amplitudes and shorter latencies than males. No relationships between noise and ABR amplitude or latency were detected. No relationships between noise and ABR Wave I:V amplitude ratio were detected	Described in Prendergast et al. (2017b); see Table 3
Spankovich et al. (2017); for additional discussion see Spankovich (2010)	40 participants (18M, 22F) from 18-28 yrs old with thresholds <25 dB HL from 0.25 – 8 kHz; participants with type 1 diabetes mellitus were included as high risk group	LAEQ8760 assessed via NEQ: mean = 74.1, range = 66-83 Noise Exposure History (NEH) (modified from Neitzel et al., 2004a; 2004b; Seixas et al.,2004), General Noise Survey (GNH) (following Jokitulppo et al.,1997; 2006), and Adolescents Habits and Hearing Protection Use (AHH) (see Olsen,2004) also used.	.25-8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity	Click-evoked TEOAEs screened at 80 dB peak SPL; TEOAE amplitude not reliably related to noise exposure history. DPOAE screened from .5-8 kHz using F1 = 65/F2 = 55 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	Four electrode montage including vertex, both ears, and high forehead; 100-μsec clicks; 27.7 and 77.7/sec, 50, 65, and 80 dB nHL, 2048 repetitions, at least two runs averaged. Females had larger amplitudes and shorter latencies than males. No relationships between noise and ABR amplitude or latency were detected; no relationships between noise and wave V/I ratio were detected.	Not included
Grose, Buss, and Hall (2017)	61 participants (32M, 29F) ages 18–35 years with thresholds ≤20 dB HL from 0.25–8 kHz	Self-reported event attendance: High Noise group included 31 participants (21M, 10F) who had attended ≥ 25 loud music events in past year, and ≥ 40 loud music events in past two years. The control group included 30 participants (11M, 19F) with median 2-year event attendance of 4 loud events (range =0–30 loud events)	The only observed relationship was poorer threshold sensitivity at 16 kHz in the High Noise group; no statistically significant differences were observed from 0.25–11.2 kHz.	DPOAE screened from .5–8 kHz using F1 = 65/F2 = 55 dB SPL; additional L1 and L2 levels were: 65:65, 63:60, 61:55, 59:50, 57:45, 55:40, 53:35, 51:30, 49:25 and 47:20: DPOAE amplitude was not reliably different between the two noise exposure groups.	Tiptrode ear canal electrodes placed in both ears and electrodes placed at high and low forehead; 100-μsec alternating polarity clicks; 7.7/sec, 95 and 105 dB nHL, 2048 repetitions with replication were run. ABR Wave-I amplitude had a larger average value in the control group, although the difference was not statistically significant. After normalising as Wave I/V ratio, there was a statistically significant difference with controls having a larger I/V ratio than high noise participants.	See Table 3
Prendergast et al. (2018)	30 female participants ages 19–34 years with thresholds <25 dB HL from 0.25–8 kHz	Lifetime noise exposure questionnaire modified from Lutman, Davis, and Ferguson (2008), and described in Guest et al. (2017); subjects were divided into high noise and low noise groups.	The high-noise group had higher (poorer) thresholds at 16 kHz in the left ear but not the right ear; ABRs were acquired from the right ear.	DPOAEs screened from 1 -8 kHz at 70 dB SPL; DPOAE amplitude was not reliably different as a function of noise exposure history.	Electrode placed at high forehead and contralateral mastoid; reference electrode was either earcanal Tiptrode or ipsilateral mastoid. Stimuli: 100-μsec alternating polarity clicks; 11/sec, 80 dB nHL (115.5 dB peSPL); minimum of 6000 repetitions per stimulus condition. No relationships between noise exposure history and ABR Wave-I amplitude, wave-V amplitude or SP amplitude were detected. No relationships between noise exposure history and SP/AP amplitude were detected. ABR Wave-I amplitude was highly reliable; neither SP nor SP/AP ratio were reliably replicated.	Not included
Skoe and Tufts (2018)	73 participants ages 18–24 years with thresholds ≤25 dB HL from 0.25–8 kHz	Participants wore a dosimeter for one week and were grouped as low noise (10M, 19F; average daily dose ≤ 20%), moderate noise (average daily dose between 20 and 100%), or high noise (4M, 22F; exposures exceeding 100% on two or more days).	There were no statistically significant differences in threshold sensitivity from .125 to 8 kHz for low noise versus high noise groups.	Not included	Electrodes placed at vertex, forehead, and right earlobe; 100-μsec rarefaction clicks; 3.4, 6.9, 10.9, 15.4, 31.25, 46.5, 61.5 and 91.24/sec, 75 dB nHL, at least 2000 repetitions were run. ABR Wave-I could not be resolved in a subset of participants when rates were ≥ 46.5/sec. There were no statistically significant differences in amplitude of ABR Waves I, III, or V for high-noise and low-noise groups, even when controlling for sex. Latency of ABR Waves I, III and V was later in high-noise than low-noise groups, with biggest differences observed at Wave-V.	Not included
Valderrama et al. (2018)	74 participants (37M, 37F) from 29–55 yrs old; 84% had normal thresholds (≤20 dB HL from 0.25–6 kHz) and 12% had near normal thresholds (≤25 dB HL up to 2 kHz, ≤30 dB HL at 3 kHz, _ 35 dB HL at 4 kHz, and ≤ 40 dB HL at 6 kHz. Thresholds were assessed to 12.5 kHz.	Lifetime noise exposure was calculated using online surveys that assess both occupational and leisure noise (following Beach et al., 2013; Yeend et al., 2017)	.25–12.5 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity; Although noise exposure history and high frequency thresholds were not related, poorer high frequency thresholds were related to poorer speech-in-noise performance and greater self-reported listening difficulty.	DPOAE screened from 1–12 kHz using F1 = 65/F2 = 55 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	Electrodes placed at high forehead, middle forehead, ipsilateral mastoid, and ipsilateral gold TIPtrode in ear canal. Stimuli: 113-μsec rarefaction clicks; 39.1/sec, 108.5 dB peSPL (75 dB nHL); 12,500 repetitions per stimulus condition. There were statistically significant associations between lifetime noise exposure and ABR Waves I, III, and V amplitudes and latencies. The authors cautioned that significant individual variability was observed and statistical significance relied on inclusion of a single subject with extremely low noise exposure and very large ABR waveform amplitudes.	See Table 3
Bramhall et al. (2018)	74 participants ages 19–35 yrs; this report describes a subset of participants assessed by Bramhall et al. (2017).	Subjects interviewed regarding occupational, military, and recreational lifetime noise history, and use of HPDs, using LENS-Q; LENS-Q noise score not considered as part of analysis.	All participants had thresholds <20 dB HL from 0.25–8 kHz; thresholds not included in analysis.	All participants had normal DPOAEs. DPOAEs averaged from 3–8 kHz were not correlated with Wave-I amplitude at 4 kHz.	Extra-tympanic gold-foil wrapped electrode with reference on high forehead and ground on low forehead; 4 kHz toneburst; 11.1/sec, 110 dB p-pe SPL. The probability of reporting tinnitus increased as Wave I amplitude decreased.	See Table 3
Ridley et al. (2018)	33 participants. 13 participants (6M, 7F) ages 23-48 years old had normal hearing (≤15 dB HL from 0.25–8 kHz). 20 participants ages 35–64 years old (10M, 10F) had SNHL (thresholds >15 dB at 4 kHz).	LAEQ8760 assessed via NEB: mean =75.2, range =66.8–86.5		DPOAE screened at F2 = 1 kHz and F2 = 4 kHz using F1 = 61 dB SPL and F2 = 55 dB SPL. DPOAE amplitude was correlated with threshold.	Electrodes placed at vertex, forehead, and in the ear canal (Tiptrode); 1 and 4 kHz tonebursts; 27/sec, 80 and 100 dB peSPL, at least 4000 repetitions were run. SP was identified by two waveform reviewers working together as SP was difficult to identify. There were no statistically significant differences in amplitude of ABR Waves I, III, or V for high-noise and low-noise groups, even when controlling for sex. Latency of ABR Waves I, III, and V was later in high-noise than low-noise groups, with biggest differences observed at Wave-V.	See Table 3

Table 3. Relationship between noise exposure history and speech-in-noise test metrics.

Author	Participants	Noise Exposure/Noise Survey	Hearing Threshold	OAE amplitude	ABR amplitude and latency	Speech in Noise Testing
Alvord (1983)	20 participants: 10 Male subjects ages 23–57 years working in high noise occupations; 10 controls (7M, 3F) ages 30–58 years reported no history of intense noise exposure	High noise occupations included jet mechanics, firing range instructors, and helicopter crew members;	Threshold sensitivity was ≤20 dB HL from .25–4 kHz and ≤30 dB HL at 8 kHz; noise-exposed participants had 5–10 dB poorer thresholds across all tested frequencies.	Not Included	Not Included	Monosyllabic words were presented at 60 dB HL with background noise set for 10 dB SNR. There was a statistically significant difference between groups, with the controls achieving ∼80% correct performance whereas the noise-exposed group had ∼70% correct performance.
Kujala et al. (2004)	20 participants ages 20–36, including 10 noise-exposed participants (9M, 1F) and 10 control participants (9M, 1F)	Noise-exposed participants worked in shipyard (n = 8, 95–100 dB(A), HPDs worn) and day-care (n = 2, 67–75 dB(A), no HPD use). Controls worked in quieter jobs.	No statistically significant group difference detected; threshold data were not presented and no enrolment criteria were listed.	Not Included	Not Included	Subjects performed complex visual tracking task while distractor syllable (/pa/) was repeated. Subjects’ responded as quickly as possible when presented with a deviant syllable (/ka/) or novel sound (telephone ringing, door slamming, etc.). The stimulus level was 70 dB SPL; white noise background was delivered at 15 dB SNR. The noise-exposed workers did more poorly on the visual tracking task and had poorer signal in noise identification as shown by fewer correct target detections (69% hit rate versus 42% hit rate).
Stone, Moore, and Greenish (2008)	A subset of 26 participants aged 16–47, including 6 noise-exposed participants (5M, 1F) and 10 control participants (5M, 5F). Thresholds were ≤ 15 dB HL at enrolment	Noise-exposed participants went to concerts and clubs (>105 dB(A) for ≥45 min at least once/week without hearing protection). Controls had only occasional event attendance.	No statistical comparisons reported; threshold data presented in report reveal ∼5 dB better thresholds in noise-exposed participants at 4 kHz.	Not Included	Not Included	Subjects discriminated Gaussian noise from low-noise noise which had same long-term power spectrum but less amplitude (envelope) fluctuation. The noise-exposed participants performed more poorly than controls at sensation levels below 20 dB SL, with no group differences at higher sound levels.
Kumar, Ameenudin, and Sangamanatha (2012)	118 participants: 28 noise exposed workers ages 30–40 (n = 13), 41–50 (n = 9), and 51–60 (n = 6) years; 30 age matched controls per age group	Noise-exposed participants were railway train engine drivers exposed to noise [Leq of 86 dB(A)] for 8–10 h/day for >10 years	Threshold data were not presented; hearing threshold sensitivity was <25 dB HL from .25–8 kHz.	Not Included	Not Included	Speech-in-babble task and gap detection, modulation detection, and duration pattern (temporal processing tasks) were assessed. Noise-induced deficits on temporal processing tasks varied with age and with task; noise-exposed groups had statistically significant deficits on the speech-in-babble task were across age groups.
Hope, Luxon, and Bamiou (2013)	20 participants: 10 Male Royal Air Force aircrew pilots and 10 Male administrators, ages 24–39 years; thresholds ≤ 20 dB HL from .5 to 4 kHz	Noise-exposed Royal Air Force pilots had a minimum of 500 flying hours; Royal Air Force administrator controls had no history of noise exposure	Pure tone average at .5, 1, 2 and 4 kHz was ∼2 dB poorer in noise-exposed pilots but differences were not statistically significant	Click-evoked TEOAEs screened at 80 dB; TEOAE amplitude deemed normal if SNR ≥ 6 dB and reproducibility criteria were met; TEOAE amplitude was ∼4 dB larger in noise-exposed pilots with statistically significant differences for the right ear.	Not Included	Tests were binaural and included temporal processing (backward masking tests), spectral processing (simultaneous masking tests), frequency discrimination, auditory attention, and recognition of speech-in-noise (vowel–consonant–vowel test in International Collegium for Rehabilitative Audiology (ICRA) noise). Noise-exposed pilots had statistically significant deficits in their speech-in-noise test results, with no statistically significant differences on any of the temporal processing tests.
Liberman et al. (2016)	34 participants (19M, 15F) ages 18–41 years with thresholds <20 dB HL from 0.25–8 kHz	Subjects divided as high-risk (15M, 7F) or low-risk (4M, 8F) based on self-reported exposure to sound and use of HPDs	High-risk group showed significant threshold elevation at all test-frequencies above 8 kHz	DPOAE at 0.5–12 kHz using F1 = 65/F2 = 55 dB; DPOAEs present in all subjects with no significant group difference in amplitude	See Table 2	Northwestern University List 6 (NU-6) words presented at 35 dB HL; white noise presented at 35 dB HL (0 dB SNR) and 30 dB HL (5 dB SNR). NU-6 words time compressed (45% or 65%) and reverberation added (0.3 s). Participants in high-risk group had significantly poorer scores than participants in low risk group.
Prendergast, Millman et al et al. (2017b)	138 participants (56M, 82F) ages 18–36 years with thresholds <25 dB HL from 0.25–8 kHz; included all participants described in Prendergast et al. (2017a)	Lifetime noise exposure questionnaire modified from Lutman et al. (2008)	The only observed relationship was between 16 kHz threshold and amplitude modulation detection: at 80 dB SPL, detection thresholds improved with increasing 16-kHz thresholds, with reduced relationships after controlling for lower-frequency thresholds.	TEOAEs screened from 1.5–4 kHz at 83 dB peSPL; TEOAE amplitude not reliably related to noise exposure history.	Participants tested in evoked potential portion of the study are described in Prendergast et al. (2017a); see Table 2	Digit triplet test: three spoken digits with varied sound levels presented sequentially in background noise at 40 or 80 dB SPL. SNRs vary from –24 to –3 in three dB steps. Co-ordinated response measure speech task performed at 40 and 80 dB SPL with maskers in different locations and at different SNRs. Frequency difference limens, intensity difference limens, interaural phase difference discrimination, amplitude modulation detection thresholds, localisation and musical consonance task also assessed. Some weak trends noted, with more noise-exposed participants having better function in some but not all trends.
Fulbright et al. (2017); for additional discussion see Fulbright (2016)	60 participants (26M, 34F) from 18–28 years old with thresholds ≤25 dB HL from 0.25–8 kHz	LAEQ8760 assessed via NEQ: mean =78.6, range =64–87 Post hoc analysis included assignment to high-risk and low-risk groups based on self-report of a previous TTS after a loud event.	.25–8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity	DPOAE screened from .5–8 kHz using F1 = 65/F2 = 55 dB SPL, and F1 = 53/F2 = 35 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	See Table 2	Word in Noise (WIN) test used; Babble fixed at 80 dB SPL and SNR adjusted from 24 to 0 dB in 4 dB steps to determine 50% correct threshold. NU-6 words also presented at 80 dB HL in competing broadband noise presented at 50 or 60 dB HL. Temporal summation assessed using 4-kHz tones with durations of 3, 30 and 300 msec. There were no statistically significant relationships between supra-threshold tasks and noise exposure history, or ABR Wave-I amplitude.
Grinn et al. (2017)	32 participants (13M, 19F) from 21-27 yrs old with thresholds ≤25 dB HL from 0.25–8 kHz	LAEQ8760 assessed via NEQ: mean =79.3, range =57–87	.25–8 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity.	DPOAE screened from 1–8 kHz using F1 = 55/F2 = 45 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	See Table 2	Words in Noise (WIN) test used; Babble is fixed at 80 dB SPL and speech level is adjusted from 24 dB SNR to 0 dB SNR in 4 dB steps to determine 50% correct speech reception threshold. There were no statistically significant relationships between word in noise identification and noise exposure history.
Yeend et al. (2017)	122 participants (59M, 63F) from 30–57 years old; 71% had thresholds ≤20 dB HL from 0.25–6 kHz; 21% had thresholds ≤40 dB HL up to 6 kHz; 8% had one or two thresholds above 40 dB HL. Thresholds were assessed to 12.5 kHz.	Lifetime noise exposure was calculated using online surveys that assess both occupational and leisure noise (following Beach et al.,2013; Williams et al.,2015)	.25–12.5 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity; Although noise exposure history and high frequency thresholds were not related, poorer high frequency thresholds were related to poorer speech-in-noise performance and greater self-reported listening difficulty.	DPOAE screened from 3–12.5 kHz using F1 = 65/F2 = 55 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	Not Included	Listening in Spatialized Noise-Sentences High Cue Condition (LiSN-S), National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT), Temporal Fine Structure task, Threshold-equalising noise test, and amplitude modulation thresholds, were also assessed. There was no evidence that noise exposure history was associated with auditory processing ability or speech in noise identification.
Grose et al. (2017)	61 participants (32M, 29F) ages 18–35 years with thresholds ≤20 dB HL from 0.25–8 kHz	Self-reported event attendance: High Noise group included 31 participants (21M, 10F) who had attended ≥ 25 loud music events in past year, and ≥ 40 loud music events in past two years. The control group included 30 participants (11M, 19F) with median 2-year event attendance of four loud events (range =0–30 loud events)	The only observed relationship was poorer threshold sensitivity at 16 kHz in the High Noise group; no statistically significant differences were observed from 0.25-11.2 kHz.	DPOAE screened from .5-8 kHz using F1 = 65/F2 = 55 dB SPL; additional L1 and L2 levels were: 65:65, 63:60, 61:55, 59:50, 57:45, 55:40, 53:35, 51:30, 49:25, and 47:20: DPOAE amplitude was not reliably different between the two noise exposure groups.	See Table 2	Speech tests included filtered phoneme recognition and speech-in-noise recognition. Psychoacoustic tests included temporal modulation detection, spectral modulation detection, and sensitivity to interaural phase. There were no relationships between noise exposure history and supra-threshold function on any of the above tests.
Guest et al. (2018)	85 participants ages 18–40 years recruited as controls or speech-in-noise (SPiN) impaired; enrolled participants were matched based on age, sex, and threshold. All thresholds ≤20 dB HL from 0.25–8 kHz	Structured lifetime noise exposure questionnaire described in Guest et al. (2017). Noise exposure did not differ between SPiN impaired groups and controls.	There were no statistically significant differences in threshold sensitivity from .125 to 14 kHz for speech-in-noise (SPiN) impaired groups versus controls.	Not included	See Table 2	Of 32 participants self-reporting speech in noise (SPiN) impairment, 16 were verified as impaired-based on Coordinate Response Measure (CRM) test performance at 90^th percentile relative to controls. SPiN impairment was not associated with lifetime noise exposure, nor with any evoked potential measurements.
Le Prell et al. (2018)	74 participants (14M, 60F) ages 18–27 years; Although participants were not required to have “normal” hearing, all but two had thresholds ≤ 25 dB HL from .25 to 8 kHz.	Exposure to loud recreational sound was common, with bars or dance clubs and music players being the two most commonly reported sources of loud sound.	There were no statistically significant relationships between noise exposure history and threshold sensitivity.	DPOAE screened from 2–8 kHz using F1 = 55/F2 = 45 dB SPL and F1 = 45/F2 = 35 dB SPL. There were no statistically significant relationships between noise exposure history and DPOAE amplitude.	Not included	Words in Noise (WIN) test used; Babble is fixed at 80 dB SPL and speech level is adjusted from 24 dB SNR to 0 dB SNR in 4 dB steps to determine 50% correct speech reception threshold. There were no statistically significant relationships between noise exposure history and performance on the WIN.
Valderrama et al. (2018)	74 participants (37M, 37F) from 29-55 yrs old; 84% had normal thresholds (≤20 dB HL from 0.25 – 6 kHz) and 12% had near normal thresholds (≤25 dB HL up to 2 kHz, ≤30 dB HL at 3 kHz, _ 35 dB HL at 4 kHz, and ≤ 40 dB HL at 6 kHz. Thresholds were assessed to 12.5 kHz.	Lifetime noise exposure was calculated using online surveys that assess both occupational and leisure noise (following Beach et al.,2013; Yeend et al.,2017)	.25-12.5 kHz: No statistically significant relationships between noise exposure history and threshold sensitivity; Although noise exposure history and high frequency thresholds were not related, poorer high frequency thresholds were related to poorer speech-in-noise performance and greater self-reported listening difficulty.	DPOAE screened from 1-12 kHz using F1 = 65/F2 = 55 dB SPL: DPOAE amplitude not reliably related to noise exposure history.	See Table 2	High cue condition in Listening in Spatialized Noise-Sentences High Cue Condition (LiSN-S). Masker presented at 61 dB SPL; unamplified sentences presented at 68 dB SPL initially, with levels adjusted for audibility using NAL-RP prescription. There was a statistically significant interaction between central gain (amplitude difference between Waves I and V), conduction speed (latency difference between Waves I and V) and LiSN-S performance.
Bramhall et al. (2018)	74 participants ages 19–35 years; this report describes a subset of participants assessed by Bramhall et al. (2017).	Subjects interviewed regarding occupational, military, and recreational lifetime noise history, and use of HPDs, using LENS-Q; LENS-Q noise score not considered as part of analysis.	All participants had thresholds <20 dB HL from 0.25–8 kHz; thresholds not included in analysis.	All participants had normal DPOAEs. DPOAEs averaged from 3-8 kHz were not correlated with Wave-I amplitude at 4 kHz.	See Table 2	All participants performed at close to 100% on speech perception in quiet tasks at both 60 dB HL and 90 dB HL sound levels, with no relationship with wave I amplitude. ABR wave I amplitude was not correlated with speech perception in noise, as measured by the WIN test.
Ridley et al. (2018)	33 participants. 13 participants (6M, 7F) ages 23-48 yrs old had normal hearing (≤15 dB HL from 0.25 – 8 kHz). 20 participants ages 35-64 yrs old (10M, 10F) had SNHL (thresholds >15 dB at 4 kHz).	LAEQ8760 assessed via NEB: mean =75.2, range =66.8-86.5		DPOAE screened at F2 = 1 kHz and F2 = 4 kHz using F1 = 61 dB SPL and F2 = 55 dB SPL. DPOAE amplitude was correlated with threshold.	See Table 2	Thresholds in noise measured using the Threshold-equalising noise (TEN) (HL) test described by Moore et al. (2004). The TEN masker was set at 70 dB HL

Table 4. Relationship between short-term noise exposure resulting in temporary threshold shift (TTS) and auditory brainstem response (ABR) amplitude changes.

Author	Participants	Noise Exposure/Noise Survey	Hearing Threshold	OAE amplitude	ABR amplitude and latency	Speech in Noise Testing
Mills et al. (1970)	28-yr old male with normal hearing from 0.125–4 kHz, and 25 dB HL threshold at 6 kHz	octave-band noise centred at 0.5 kHz and presented at 81.5 dB SPL for 48 hours (exposure 1) and 92.5 dB SPL for 29.5 hrs (exposure 2)	TTS asymptote reached at approx. 8 hrs; TTS4 at 0.75 kHz was 10.5 dB (exposure 1) and 27.5 dB (exposure 2). Complete recovery required 3-6 days	Not included	Vertex; 0.75 kHz tone, 20 msec or 200 msec; 1 sec inter-stimulus interval; 60 repetitions averaged Threshold shift paralleled behavioural shift but slope of the N1–P2 input-output function did not change	Not included
Sohmer and Pratt (1975)	10 adults with normal hearing	White noise, 117 dB SPL (90 dB SL), 15-min	TTS2 on the order of 15 dB for clicks, with recovery within 30-60 min	Not included	Scalp and ear lobe clip electrodes; clicks; 10/sec, 60 dB SL, 512 repetitions averaged Temporary N1 amplitude decrease, Temporary N1 latency increase; The largest changes were observed immediately post-exposure, with rapid recovery from 3-30 min post noise	Not included
Botte et al. (1976), Botte et al. (1979)	5 young adults with normal hearing	1 kHz tone, at varied level and duration, ranging from 90 dB for 30 min to 95 dB for 85 min, used to induce TTS2=20 dB at 1.5 kHz	TTS2 on the order of 20 dB at 1.5 kHz, with recovery within 80 min	Not included	Vertex and ear lobe electrodes; 1.5 kHz tone Temporary N1–P2 amplitude decrease; the largest changes were observed 2-5 min post-exposure, with rapid recovery from 10-80 min post noise	Not included
Klein and Mills (1981)	5 young adults with thresholds of 7 dB HL or better from 0.25 to 8 kHz	narrow-band noise centred at 2.6 kHz and presented at 86 dB(C) for 4 or 8h; if TTS was <25 dB at 4h, the exposure was 8h	Maximum TTS of 28 dB measured at 3.5 kHz (testing began 20-min post-noise, with tuning curve tests followed by evoked potentials)	Not included	Forehead, ear canal near TM, and mastoid electrodes; 3.6 kHz tone; 21/sec, 61, 76, and 91-dB pe SPL; maximum of 4096 repetitions averaged One subject had decreases in Wave-I amplitude outside of test-retest values	Not included
Fialkowska et al. (1983)	22 young normal hearing persons	octave band noise centred at 2.8 kHz, 108 dB SPL	TTS of 15-35 dB at 4-6 kHz across subjects (Post-noise time not specified)	Not included	ABR: Forehead and mastoid electrodes, ECoG: silver ball electrode close to TM and mastoid electrode; Both ABR and ECoG: 4 kHz tone burst; 10/sec, 10 dB nHL (20 dB SPL) to 100 dB nHL (220 dB SPL); ABR: 2048 repetitions, ECoG: 512 repetitions Wave-I, III, and V latencies prolonged during TTS but only at lower intensities; CAP and Wave-I amplitude decreased	Not included
Attias and Pratt (1986)	All subjects included in Attias and Pratt (1984) (31 new employees, ages 18-21)	TTS induced by 95-dB HL pink noise for 15-min	TTS was 15±7 dB immediately post exposure	Not included	Forehead and mastoid electrodes; alternating polarity clicks; 10 and 55/sec, 75 dB HL, 1024 repetitions averaged, waveforms replicated Wave I, III, and V latencies were prolonged during TTS; amplitude was deemed “too variable to be suitable for further description”	Not included
Nam and Won (2004)	10 healthy adults (8M, 2F) ages 22 to 40 yrs (mean =26.9± 5.7) with no history of hearing loss	3 consecutive hours in computer arcade at 90.3-105.3 dB SPL (mean =91.5±4.5 dB)	TTS at 0.5, 1, 2 and 4 kHz was 5.8±2.8 dB immediately post-exposure; largest TTS (average: 10 dB) observed at 4 kHz	Not included	Extra-tympanic gold-foil wrapped electrodes; alternating polarity clicks; 7/sec, 90 dB; statistically significant increase in SP, no reliable change in AP, thus, SP/AP ratio increased; no reliable correlations between TTS and change in SP or change in SP/AP ratio	Not included
Lichtenhan and Chertoff (2008)	39 normal hearing participants ages 20 to 38 yrs: 25 dB HL or better from 0.25–8 kHz	N = 27 exposed to 115 dB SPL narrow band noise centred at 2 kHz for 15 min; n = 6 unexposed controls	TTS 30-60 sec post-noise ranged from 10-30 dB at 4 kHz in all but one subject; that subject improved by 5 dB post-exposure	Not included	Custom TM electrode, forehead, and ipsilateral ear lobe; alternating polarity clicks; 11.1/sec, 75–125 dB peSPL; CAP at lower SPLs more affected than CAP at higher SPLs; modelling suggests fewer responding neurons and less synchronous response at lower SPLs post-noise	Not included
Grinn et al. (2017)	32 participants (13M, 19F) from 21–27 years old with thresholds ≤25 dB HL from 0.25–8kHz	Prospective monitoring of changes in function the day after a loud event and one-week later. Noise dose was calculated based on SLM app data and duration of exposure.	No statistically significant relationships between noise dose and threshold shift the day after the event from .25 to 8 kHz; most noise-induced TTS had recovered.	DPOAE from 1-8 kHz with F1 = 55/F2 = 45 dB SPL: No statistically significant relationships between noise dose and DPOAE changes the day after the event.	Tiptrode ear canal electrodes placed in both ears and electrodes placed at high and low forehead; alternate polarity clicks and 2, 3, and 4 kHz tone bursts; 11.7/sec, 70, 80, 90 and 99 dB nHL, 500 repetitions with replication. No systematic changes in ABR Wave-I amplitude were observed the day after the recreational noise exposure.	Words in Noise (WIN) test used; Babble is fixed at 80 dB SPL and speech level is adjusted from 24 dB SNR to 0 dB SNR in 4 dB steps to determine 50% correct speech reception threshold. Temporary deficits on the WIN were observed with increasing deficits as noise dose increased. Performance returned to baseline one week post noise.

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