Acoustic reflexes are common but not pervasive: evidence from the National Health and Nutrition Examination Survey, 1999–2012

Abstract

Objective: To determine whether acoustic reflexes are pervasive (i.e. sufficiently prevalent to provide 95% confidence of at least 95% prevalence) and might be invoked in damage-risk criteria (DRC) and health hazard assessments (HHA) for impulsive noise.

Design: Cross-sectional analyses of a nationally-representative study.

Study sample: National Health and Nutrition Examination Survey (NHANES) data collected between 1999 and 2012 were used. Over 60 thousand reflex traces obtained from 15,106 NHANES participants were used in the study, along with demographic, audiometric, health and exposure variables obtained in that study.

Results: Acoustic reflexes were not sufficiently prevalent to be deemed pervasive by any detection method or in any subgroup defined by age or audiometric characteristics. The odds of observing acoustic reflexes were greater for women, young adults, and people with better hearing sensitivity. Abnormally high tympanometric admittance and “Other” race/ethnicity (i.e. people who do not self-identify as exclusively Non-Hispanic White, Non-Hispanic Black, Mexican–American, or Hispanic) were associated with lower odds.

Conclusions: Acoustic reflexes are not sufficiently prevalent to be included in DRC and HHA for impulsive noise.

Keywords:

• Noise
• middle ear
• demographics/epidemiology
• hearing conservation

Acknowledgements

The authors thank Howard Hoffman (U.S. National Institute on Deafness and Other Communication Disorders, NIDCD), Christa Themann (U.S. National Institute for Occupational Safety and Health, NIOSH), William Murphy (U.S. National Institute for Occupational Safety and Health, NIOSH), and Mark Stephenson (Stephenson and Stephenson Research and Consulting, SASRAC) for supporting audiometric testing in NHANES and for their advice and assistance in executing this study. They also thank Nate Greene and Heath Jones (U.S. Army Aeromedical Research Laboratory) for their contributions to this work.

Declaration of interest

This work was supported by the U.S. Army Medical Research and Materiel Command Award number W81XWH-14-2-0140. The views, opinions and/or findings contained in this report are those of the authors and are not an official Department of the Army position, policy, or decision. Citation of trade names in this report does not constitute an endorsement or approval of the use of such commercial items.