Korean J Occup Environ Med KJOEM Korean Journal of Occupational and Environmental Medicine 1225-3618 The Korean Society of Occupational and Environmental Medicine 10.0000/kjoem.2012.24.4.431 Original Article The Characteristics of Tinnitus and Hearing Threshold - In Workers with Noise Induced Hearing Loss from a Hospital Setting - Kim Nam-Jeong 1 Park Hyoung-Ouk 2 Sim Chang-Sun Lee Choong-Ryeol Kwon Young-Joo 1 Lee Ji-Ho Department of Occupational & Environmental Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Korea. Center for Occupational & Environmental Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Korea. Department of Occupational & Environmental Medicine, Samsung Changwon Hospital, College of Medicine, Sungkyunkwan University, Korea. Corresponding author (oemdoc@naver.com) 12 2012 31 12 2012 24 4 431 440 04 09 2012 20 11 2012 20 11 2012 Copyright © 2012 The Korean Society of Occupational and Environmental Medicine 2012 Objectives

This study was carried out to define the relationship between the characteristics of tinnitus and hearing threshold (puretone and speech) in workers with noise induced hearing loss (NIHL).

 Methods

A total of 189 cases(378 ears) from workers with compensation claims for NIHL during 2004-2009 were investigated. Various factors, including age, work carriers, body mass index (BMI), blood pressure, noise exposure level of worksite hearing threshold, speech discrimination score, pitch match, and loudness of tinnitus were analyzed.

 Results

The average hearing threshold of all subject was 44.2 dBHL, puretone audiometry thresholds in subjects with tinnitus were lower than the non-tinnitus group (except at 8000 Hz). Using speech audiometry, the tinnitus group showed a lower speech recognition threshold and speech discrimination score. The tinnitus group also had an average tinnitus frequency of 4195.2 Hz, loudness of 73.6 dB, and tinnitus sensation average of 6.0 dBSL. These frequencies of tinnitus were in the lowest puretone audiometry frequencies. Tinnitus loudness had a strong relationship with puretone and speech audiometry thresholds.

 Conclusions

In cases beyond moderate hearing loss, the tinnitus group had a better puretone (except 8000 Hz) and speech hearing status, and most comfortable loudness (MCL) level. In addition, puretone and speech audiometry thresholds increase with tinnitus loudness.

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Tinnitus loudness and sensation levels according to tinnitus pitch.

Numbers in bar chart: mean values of the tinnitus loudness and sensation levels.

Abbreviation: T_loud, tinnitus loudness; T_SL, tinnitus sensation levels.

*p<0.05, according to post hoc(Duncan), sensation levels of tinnitus in 250 and 500 Hz were higher than the level over 1000 Hz.

†p<0.05, according to post hoc(Duncan), level of tinnitus loudness over 2000 Hz were higher than the level below 1000 Hz.

Results of weight from partial least square regression analysis.

Abbreviation: PTA512, average of dBHL for (500+1000+2000 Hz)/3; PTA346, average of dBHL for (3000+4000+6000 Hz)/3; SRT, speech reception threshold(dB); MCL, maximum comfortable level(dB); SDS, speech discrimination score(%).

General characteristics of subjects

Abbreviation: SD, standard deviation; PTA 512, average of dBHL for (500+1000+2000 Hz)/3; PTA 346, average of dBHL for (3000+4000+6000 Hz)/3.

*p-value was calculated by t-test between tinnitus(+) and tinnitus(-) group.

Comparison of characteristics among groups classified by tinnitus frequency

Abbreviation: SD, standard deviation; SBP, systolic blood pressure; DBP, diastolic blood pressure; PTA512, average of dBHL for (500+1000+2000 Hz)/3; PTA346, average of dBHL for (3000+4000+6000 Hz)/3; SRT, speech reception threshold; MCL, maximum comfortable level; SDS, speech discrimination score (%).

*p<0.05, tested by ANOVA.

†p<0.05, post hoc(Duncan), hearing threshold of tinnitus pitch 4000 Hz group was significantly higher than other groups. at 4000 Hz,6000 Hz, and PTA 346 in PTA.

Partial correlation coefficient between tinnitus loudness and thresholds of puretone and speech audiometry on each tinnitus frequency

*p<0.05.

Abbreviation: SRT, speech reception threshold(dB); MCL, maximum comfortable level(dB); SDS, speech discrimination score(%).

Results of regression coefficients from partial least square regression analysis for tinnitus patients

Abbreviation: PTA512, average of dBHL for (500+1000+2000 Hz)/3; PTA346, average of dBHL for (3000+4000+6000 Hz)/3; SRT, speech reception threshold(dB); MCL, maximum comfortable level(dB); SDS, speech discrimination score(%); VIP, variance importance in the projection.

Model R2=0.236.