The applicability of a speech-in-noise screening test in occupational hearing conservation

Objective: Noise-induced hearing loss (NIHL) is the most reported occupational health disease in the Netherlands. The internet-based speech-in-noise test Earcheck (Albrecht et al, 2005; Leensen et al, 2011b) is designed to detect beginning NIHL and can be a valuable tool in occupational hearing health surveillance. The aim of this study is to investigate the validity of Earcheck compared to regular screening audiometry. Design: Subjects performed online Earcheck tests at home. The results are compared to a pure-tone screening audiogram obtained during regular occupational health examination. A subgroup performed the measurements twice to assess test-retest reliability. Study sample: Two hundred and forty-nine male construction employees who recently had a periodic occupational health examination participated. Results: An average learning effect of -1.6 dB was found, that reduced with increasing test number. The test-retest variability was 1.6 dB. Sensitivity to detect beginning NIHL was 68%, with a specificity of 71%. Conclusions: Although sensitivity and specificity values are only moderate, the broad internet application still promises a valuable addition to current practice. The relatively high learning effect indicates that more reliable results can be obtained after a longer test session. When this is put into practice some improvement in sensitivity and specificity may be expected as well.