Validation of the auditory hazard assessment algorithm for the human with impulse noise data

Frequency dependence and harmonic distortion of stapes displacement and intracochlear pressure in response to very high level sounds

Previous reports have suggested that intracochlear pressures (PIC) measured at the base of the cochlea increase directly proportionally with stapes displacement (DStap) in response to moderately high (<130 dB SPL) level sounds. Consistent with this assumption, we have reported that for low frequency sounds (<1 kHz), stapes displacement and intracochlear pressures increase linearly with sound pressure level (SPL) for moderately high levels (<130 dB SPL), but saturate at higher exposure levels (>130 dB SPL). However, the magnitudes of each response were found to be frequency dependent, thus the relationship between DStap and PIC may vary at higher frequencies or higher levels. In order to further examine this frequency and level dependence, measurements of DStap and PIC were made in cadaveric human temporal bones prepared with a mastoidectomy and extended facial recess to expose the ossicular chain. PIC was measured in scala vestibuli (PSV) and scala tympani (PST) simultaneously with SPL in the external auditory canal (PEAC) and laser Doppler vibrometry (LDV) measurements of stapes velocity (VStap). Consistent with prior reports, DStap and PSV increased proportionally with sound pressure level in the ear canal up to a frequency-dependent saturation point, above which both DStap and PSV showed a distinct deviation from proportionality with PEAC, suggesting that their relationship may remain constant at these high frequencies. Likewise, while the asymptotic value, and SPL at which saturation occurred were frequency dependent in both DStap and PSV, the reduction in gain with increasing SPL above this level was constant above this level at all frequencies, and the magnitude of responses at harmonics of the driving frequency increased with increasing level, consistent with harmonic distortion via peak clipping. Importantly, this nonlinear distortion shifts the energy arriving at the inner ear to higher frequencies than are present in incident stimulus, thus exposing the high frequency sensitive components of the auditory system to more noise than would be expected from measurement of that stimulus on its own. Overall, responses suggest that the cochlear representation of very high-level air conducted stimuli is limited by nonlinearities in the middle ear, and that this peak limiting leads to increased high frequency cochlear exposures than are present in the driving stimulus.

3D Finite Element Model of Human Ear with 3-Chamber Spiral Cochlea for Blast Wave Transmission from the Ear Canal to Cochlea

Blast-induced auditory trauma is a common injury in military service members and veterans that leads to hearing loss. While the inner ear response to blast exposure is difficult to characterize experimentally, computational models have advanced to predict blast wave transmission from the ear canal to the cochlea; however, published models have either straight or spiral cochlea with fluid-filled two chambers. In this paper, we report the recently developed 3D finite element (FE) model of the human ear mimicking the anatomical structure of the 3-chambered cochlea. The model consists of the ear canal, middle ear, and two and a half turns of the cochlea with three chambers separated by the Reissner's membrane (RM) and the basilar membrane (BM). The blast overpressure measured from human temporal bone experiments was applied at the ear canal entrance and the Fluent/Mechanical coupled fluid-structure interaction analysis was conducted in ANSYS software. The FE model-derived results include the pressure in the canal near the tympanic membrane (TM) and the intracochlear pressure at scala vestibuli, the TM displacement, and the stapes footplate (SFP) displacement, which were compared with experimentally measured data in human temporal bones. The validated model was used to predict the biomechanical response of the ear to blast overpressure: distributions of the maximum strain and stress within the TM, the BM displacement variation from the base to apex, and the energy flux or total energy entering the cochlea. The comparison of intracochlear pressure and BM displacement with those from the FE model of 2-chambered cochlea indicated that the 3-chamber cochlea model with the RM and scala media chamber improved our understanding of cochlea mechanics. This most comprehensive FE model of the human ear has shown its capability to predict the middle ear and cochlea responses to blast overpressure which will advance our understanding of auditory blast injury.

Real-time measurement of stapes motion and intracochlear pressure during blast exposure

Blast-induced auditory injury is primarily caused by exposure to an overwhelming amount of energy transmitted into the external auditory canal, the middle ear, and then the cochlea. Quantification of this energy requires real-time measurement of stapes footplate (SFP) motion and intracochlear pressure in the scala vestibuli (Psv). To date, SFP and Psv have not been measured simultaneously during blast exposure, but a dual-laser experimental approach for detecting the movement of the SFP was reported by Jiang et al. (2021). In this study, we have incorporated the measurement of Psv with SFP motion and developed a novel approach to quantitatively measure the energy flux entering the cochlea during blast exposure. Five fresh human cadaveric temporal bones (TBs) were used in this study. A mastoidectomy and facial recess approach were performed to identify the SFP, followed by a cochleostomy into the scala vestibuli (SV). The TB was mounted to the "head block", a fixture to simulate a real human skull, with two pressure sensors - one inserted into the SV (Psv) and another in the ear canal near the tympanic membrane (P1). The TB was exposed to the blast overpressure (P0) around 4 psi or 28 kPa. Two laser Doppler vibrometers (LDVs) were used to measure the movements of the SFP and TB (as a reference). The LDVs, P1, and Psv signals were triggered by P0 and recorded simultaneously. The results include peak values for Psv of 100.8 ± 51.6 kPa (mean ± SD) and for SFP displacement of 72.6 ± 56.4 μm, which are consistent with published experimental results and finite element modeling data. Most of the P0 input energy flux into the cochlea occurred within 2 ms and resulted in 10-70 μJ total energy entering the cochlea. Although the middle ear pressure gain was close to that measured under acoustic stimulus conditions, the nonlinear behavior of the middle ear was observed from the elevated cochlear input impedance. For the first time, SFP movement and intracochlear pressure Psv have been successfully measured simultaneously during blast exposure. This study provides a new methodology and experimental data for determining the energy flux entering the cochlea during a blast, which serves as an injury index for quantifying blast-induced auditory damage.

Evaluation of kurtosis-corrected sound exposure level as a metric for predicting onset of hearing threshold shifts in harbor porpoises (Phocoena phocoena)

Application of a kurtosis correction to frequency-weighted sound exposure level (SEL) improved predictions of risk of hearing damage in humans and terrestrial mammals for sound exposures with different degrees of impulsiveness. To assess whether kurtosis corrections may lead to improved predictions for marine mammals, corrections were applied to temporary threshold shift (TTS) growth measurements for harbor porpoises (Phocoena phocoena) exposed to different sounds. Kurtosis-corrected frequency-weighted SEL predicted accurately the growth of low levels of TTS (TTS_1-4 < 10 dB) for intermittent sounds with short (1-13 s) silence intervals but was not consistent with frequency-weighted SEL data for continuous sound exposures.

Three-Dimensional Finite Element Modeling of Blast Wave Transmission From the External Ear to a Spiral Cochlea

Blast-induced injuries affect the health of veterans, in which the auditory system is often damaged, and blast-induced auditory damage to the cochlea is difficult to quantify. A recent study modeled blast overpressure (BOP) transmission throughout the ear utilizing a straight, two-chambered cochlea, but the spiral cochlea's response to blast exposure has yet to be investigated. In this study, we utilized a human ear finite element (FE) model with a spiraled, two-chambered cochlea to simulate the response of the anatomical structural cochlea to BOP exposure. The FE model included an ear canal, middle ear, and two and half turns of two-chambered cochlea and simulated a BOP from the ear canal entrance to the spiral cochlea in a transient analysis utilizing fluid-structure interfaces. The model's middle ear was validated with experimental pressure measurements from the outer and middle ear of human temporal bones. The results showed high stapes footplate (SFP) displacements up to 28.5 μm resulting in high intracochlear pressures and basilar membrane (BM) displacements up to 43.2 μm from a BOP input of 30.7 kPa. The cochlea's spiral shape caused asymmetric pressure distributions as high as 4 kPa across the cochlea's width and higher BM transverse motion than that observed in a similar straight cochlea model. The developed spiral cochlea model provides an advancement from the straight cochlea model to increase the understanding of cochlear mechanics during blast and progresses toward a model able to predict potential hearing loss after blast.

The onset of nonlinear growth of middle-ear responses to high intensity sounds

The human tympanic membrane (TM) and ossicles are generally considered to act as a linear system as they conduct low and moderate level environmental sounds to the cochlea. At intense stimulus levels (> 120 dB SPL) there is evidence that the TM and ossicles no longer act linearly. The anatomical structures that contribute to the nonlinear responses and their level and frequency dependences are not well defined. We used cadaveric human ears to characterize middle-ear responses to continuous tones between 200 and 20,000 Hz with levels between 60 and 150 dB SPL. The responses of the TM and ossicles are essentially sinusoidal, even at the highest stimulus level, but grow nonlinearly with increased stimulus level. The umbo and the stapes show different nonlinear behaviors: The umbo displacement grows faster than the stimulus level (expansive growth) at frequencies below 2000 Hz, while the stapes exhibits mostly compressive growth (grows slower than the stimulus level) over a wide frequency range. The sound pressure level where the nonlinearity first becomes obvious and the displacement at that level are lower at the stapes than at the umbo. These observations suggest the presence of multiple nonlinear processes within the middle ear. The existence of an expansive growth of umbo displacement that has limited effect on the stapes compressive growth suggests that the ossicular joints reduce the coupling between multiple nonlinear mechanisms within the middle ear. This study provides new data to test and refine middle-ear nonlinear models.

Noise of underwater explosions in the North Sea. A comparison of experimental data and model predictions

An analysis is presented of sound measurements performed near two detonations of unexploded ordnance (UXO) in the North Sea, at distances ranging from 1.5 to 12 km. The charge masses of the detonations were 325 and 140 kg TNT equivalent. The objective of the measurements was to improve the accuracy of model predictions of the area where UXO detonations affect harbour porpoises in the North Sea. For the predictions, an explosion emission model is combined with a shallow-water propagation model. The prediction model was previously validated for distances up to 2 km. The measurements reported here allowed validation up to a distance of 12 km. The measured levels and spectra are well explained by the model calculations. The model results depend strongly on the sea sediment layering. The propagation of high-frequency components appears to be affected primarily by the silty top layer, while low-frequency components are affected also by deeper sandy layers. Measured and calculated noise levels are used to determine permanent-threshold-shift effect distances for harbour porpoises (Phocoena phocoena). Values ranging from 2 to 6 km are found for the two detonations.

Dual-laser measurement of human stapes footplate motion under blast exposure

Hearing damage is one of the most frequently observed injuries in Service members and Veterans even though hearing protection devices (HPDs, e.g. earplugs) have been implemented to prevent blast-induced hearing loss. However, the formation and prevention mechanism of the blast-induced hearing damage remains unclear due to the difficulty for conducting biomechanical measurements in ears during blast exposure. Recently, an approach reported by Jiang et al. (2019) used two laser Doppler vibrometers (LDVs) to measure the motion of the tympanic membrane (TM) in human temporal bones during blast exposure. Using the dual laser setup, we further developed the technology to detect the movement of the stapes footplate (SFP) in ears with and without HPDs while under blast exposure. Eight fresh human cadaveric temporal bones (TBs) were involved in this study. The TB was mounted in a "head block" after performing a facial recess surgery to access the SFP, and a pressure sensor was inserted near the TM in the ear canal to measure the pressure reaching the TM (P1). The TB was exposed to a blast overpressure measuring around 7 psi or 48 kPa at the entrance of the ear canal (P0). Two LDVs were used to measure the vibrations of the SFP and TB (as a reference). The exact motion of the SFP was determined by subtracting the TB motion from the SFP data. Results included a measured peak-to-peak SFP displacement of 68.7 ± 31.6 μm (mean ± SD) from all eight TBs without HPDs. In five of the TBs, the insertion of a foam earplug reduced the SFP displacement from 48.3 ± 6.3 μm to 21.8 ± 10.4 μm. The time-frequency analysis of the SFP velocity signals indicated that most of the energy spectrum was concentrated at frequencies below 4 kHz within the first 2 ms after blast and the energy was reduced after the insertion of HPDs. This study describes a new methodology to quantitatively characterize the response of the middle ear and the energy entering the cochlea during blast exposure. The experimental data are critical for determining the injury of the peripheral auditory system and elucidating the damage formation and prevention mechanism in an ear exposed to blast.

3D Finite Element Modeling of Blast Wave Transmission from the External Ear to Cochlea

As an organ that is sensitive to pressure changes, the ear is often damaged when a person is subjected to blast exposures resulting in hearing loss due to tissue damage in the middle ear and cochlea. While observation of middle ear damage is non-invasive, examining the damage to the cochlea is difficult to quantify. Previous works have modeled the cochlear response often when subjected to an acoustic pressure input, but the inner ear mechanics have rarely been studied when the ear is exposed to a blast wave. In this study we aim to develop a finite element (FE) model of the entire ear, particularly the cochlea, for predicting the blast wave transmission from the ear canal to cochlea. We utilized a FE model of the ear, which includes the ear canal, middle ear, and uncoiled two-chambered cochlea, to simulate the cochlear response to blast overpressure (BOP) at the entrance of the ear canal with ANSYS Mechanical and Fluent in a fluid-structure interface coupled analysis in the time domain. This model was developed based on previous middle and inner ear models, and the cochlea was remeshed to improve BOP simulation performance. The FE model was validated using experimentally measured blast pressure transduction from the ear canal to the middle ear and cochlea in human cadaveric temporal bones. Results from the FE model showed significant displacements of the tympanic membrane, middle ear ossicles, and basilar membrane (BM). The stapes footplate displacement was observed to be as high as 60 µm, far exceeding the displacement during normal acoustic stimulation, when the 30 kPa (4.35 psi, 183 dB (SPL), Sound Pressure Level) of BOP was applied at the ear canal entrance. The large stapes movement caused pressures in the cochlea to exceed the physiological pressure level [< 10 Pa, 120 dB (SPL)] at a peak of 49.9 kPa, and the BM displacement was on the order of microns with a maximum displacement of 26.4 µm. The FE model of the entire human ear developed in this study provides a computational tool for prediction of blast wave transmission from the ear canal to cochlea and the future applications for assisting the prevention, diagnosis, and treatment of blast-induced hearing loss.

Diagnosis and quantification of military noise-induced hearing loss

The diagnosis and quantification of noise-induced hearing loss (NIHL) in a medico-legal context are usually based on the pattern of hearing loss that is typically associated with long-term exposure to steady broadband noises, such as occur in noisy factories. Evidence is reviewed showing that this pattern is not typical for hearing loss produced by intense impulsive sounds of the type that military personnel are exposed to. The audiometric characteristics of noise-exposed military personnel are reviewed. A set of audiograms from a sample of 58 hearing-impaired noise-exposed military veterans was analyzed and used to develop methods for the diagnosis and quantification of military NIHL. Three requirements are specified for diagnosing military NIHL. Quantification of any loss is done by comparison with audiometric thresholds for non-noise exposed individuals, as specified in ISO7029 [International Organization for Standardization, 2017].

Noise of military weapons, ground vehicles, planes and ships

Noisy equipment and processes are found throughout military operations, exposing service members to risks of hearing damage due to hazardous noise levels. This article provides an overview of the military noise environment for the non-expert and provides a general characterization of the noise by source type and operational category. The focus of the article is primarily related to the Army, but the same, or similar, equipment is used by the Navy, Marine Corps, and Air Force. Damage risk criteria used by the Army Public Health Command are discussed. In addition, the important role of hearing protection to mitigate the hazards of noise exposure is provided.

Limitations of present models of blast-induced sound power conduction through the external and middle ear

The use of models to predict the effect of blast-like impulses on hearing function is an ongoing topic of investigation relevant to hearing protection and hearing-loss prevention in the modern military. The first steps in the hearing process are the collection of sound power from the environment and its conduction through the external and middle ear into the inner ear. Present efforts to quantify the conduction of high-intensity sound power through the auditory periphery depend heavily on modeling. This paper reviews and elaborates on several existing models of the conduction of high-level sound from the environment into the inner ear and discusses the shortcomings of these models. A case is made that any attempt to more accurately define the workings of the middle ear during high-level sound stimulation needs to be based on additional data, some of which has been recently gathered.

Generalizability of clinically measured acoustic reflexes to brief sounds

Middle ear muscle contractions (MEMC) can be elicited in response to high-level sounds, and have been used clinically as acoustic reflexes (ARs) during evaluations of auditory system integrity. The results of clinical AR evaluations do not necessarily generalize to different signal types or durations. The purpose of this study was to evaluate the likelihood of observing MEMC in response to brief sound stimuli (tones, recorded gunshots, noise) in adult participants (N = 190) exhibiting clinical ARs and excellent hearing sensitivity. Results revealed that the presence of clinical ARs was not a sufficient indication that listeners will also exhibit MEMC for brief sounds. Detection rates varied across stimulus types between approximately 20% and 80%. Probabilities of observing MEMC also differed by clinical AR magnitude and latency, and declined over the period of minutes during the course of the MEMC measurement series. These results provide no support for the inclusion of MEMC as a protective factor in damage-risk criteria for impulsive noises, and the limited predictability of whether a given individual will exhibit MEMC in response to a brief sound indicates a need to measure and control for MEMC in studies evaluating pharmaceutical interventions for hearing loss.

Risks of Ear Complaints of Passengers and Drivers While Trains Are Passing Through Tunnels at High Speed: A Numerical Simulation and Experimental Study

Ear complaints induced by interior pressure transients are common experiences for passengers and crew members when high-speed trains are passing through tunnels. However, approaches to assessing the risks of the pressure-related aural discomfort have not been reported until recently. The objective of this study was to evaluate the hazards of interior pressure transients of high-speed train on human ears combining the effects of operation speed and seal index. Moving model tests were conducted to obtain the pressure transients when the model train runs in the tunnel. The recorded data were transformed into the interior pressures by empirical formula. Furthermore, the aural sensations were divided into four levels hierarchically and the range for each level was derived by logistic regression analysis method and represented by three biomechanical metrics. Furthermore, a human middle ear finite element (FE) model was used to simulate its dynamics under the interior pressures. The results indicate that lifting operation speed from 250 km/h to 350 km/h in tunnel will prolong the duration of ear complaints by more than two times whereas improving the seal index from 4 s to 12 s will reduce the incidences of the onset of tinnitus and hearing loss by more than ten times. In addition, the duration of aural comfort shortens from the head car to the tail car against the running direction. It is desirable that enhancing the seal index improve the aural sensations of the passengers and crew members considering the lifting operation speed of high-speed train.

Human middle-ear muscles rarely contract in anticipation of acoustic impulses: Implications for hearing risk assessments

The current study addressed the existence of an anticipatory middle-ear muscle contraction (MEMC) as a protective mechanism found in recent damage-risk criteria for impulse noise exposure. Specifically, the experiments reported here tested instances when an exposed individual was aware of and could anticipate the arrival of an acoustic impulse. In order to detect MEMCs in human subjects, a laser-Doppler vibrometer (LDV) was used to measure tympanic membrane (TM) motion in response to a probe tone. Here we directly measured the time course and relative magnitude changes of TM velocity in response to an acoustic reflex-eliciting (i.e. MEMC eliciting) impulse in 59 subjects with clinically assessable MEMCs. After verifying the presence of the MEMC, we used a classical conditioning paradigm pairing reflex-eliciting acoustic impulses (unconditioned stimulus, UCS) with various preceding stimuli (conditioned stimulus, CS). Changes in the time-course of the MEMC following conditioning were considered evidence of MEMC conditioning, and any indication of an MEMC prior to the onset of the acoustic elicitor was considered an anticipatory response. Nine subjects did not produce a MEMC measurable via LDV. For those subjects with an observable MEMC (n = 50), 48 subjects (96%) did not show evidence of an anticipatory response after conditioning, whereas only 2 subjects (4%) did. These findings reveal that MEMCs are not readily conditioned in most individuals, suggesting that anticipatory MEMCs are not prevalent within the general population. The prevalence of anticipatory MEMCs does not appear to be sufficient to justify inclusion as a protective mechanism in auditory injury risk assessments.

Human ossicular-joint flexibility transforms the peak amplitude and width of impulsive acoustic stimuli

The role of the ossicular joints in the mammalian middle ear is still debated. This work tests the hypothesis that the two synovial joints filter potentially damaging impulsive stimuli by transforming both the peak amplitude and width of these impulses before they reach the cochlea. The three-dimensional (3D) velocity along the ossicular chain in unaltered cadaveric human temporal bones (N = 9), stimulated with acoustic impulses, is measured in the time domain using a Polytec (Waldbronn, Germany) CLV-3D laser Doppler vibrometer. The measurements are repeated after fusing one or both of the ossicular joints with dental cement. Sound transmission is characterized by measuring the amplitude, width, and delay of the impulsive velocity profile as it travels from the eardrum to the cochlea. On average, fusing both ossicular joints causes the stapes velocity amplitude and width to change by a factor of 1.77 (p = 0.0057) and 0.78 (p = 0.011), respectively. Fusing just the incudomalleolar joint has a larger effect on amplitude (a factor of 2.37), while fusing just the incudostapedial joint decreases the stapes velocity on average. The 3D motion of the ossicles is altered by fusing the joints. Finally, the ability of current computational models to predict this behavior is also evaluated.

Intracochlear pressure measurements during acoustic shock wave exposure

INTRODUCTION

Injuries to the peripheral auditory system are among the most common results of high intensity impulsive acoustic exposure. Prior studies of high intensity sound transmission by the ossicular chain have relied upon measurements in animal models, measurements at more moderate sound levels (i.e. < 130 dB SPL), and/or measured responses to steady-state noise. Here, we directly measure intracochlear pressure in human cadaveric temporal bones, with fiber optic pressure sensors placed in scala vestibuli (SV) and tympani (ST), during exposure to shock waves with peak positive pressures between ∼7 and 83 kPa.

METHODS

Eight full-cephalic human cadaver heads were exposed, face-on, to acoustic shock waves in a 45 cm diameter shock tube. Specimens were exposed to impulses with nominal peak overpressures of 7, 28, 55, & 83 kPa (171, 183, 189, & 192 dB pSPL), measured in the free field adjacent to the forehead. Specimens were prepared bilaterally by mastoidectomy and extended facial recess to expose the ossicular chain. Ear canal (EAC), middle ear, and intracochlear sound pressure levels were measured with fiber-optic pressure sensors. Surface-mounted sensors measured SPL and skull strain near the opening of each EAC and at the forehead.

RESULTS

Measurements on the forehead showed incident peak pressures approximately twice that measured by adjacent free-field and EAC entrance sensors, as expected based on the sensor orientation (normal vs tangential to the shock wave propagation). At 7 kPa, EAC pressure showed gain, calculated from the frequency spectra, consistent with the ear canal resonance, and gain in the intracochlear pressures (normalized to the EAC pressure) were consistent with (though somewhat lower than) previously reported middle ear transfer functions. Responses to higher intensity impulses tended to show lower intracochlear gain relative to EAC, suggesting sound transmission efficiency along the ossicular chain is reduced at high intensities. Tympanic membrane (TM) rupture was observed following nearly every exposure 55 kPa or higher.

CONCLUSIONS

Intracochlear pressures reveal lower middle-ear transfer function magnitudes (i.e. reduced gain relative to the ear canal) for high sound pressure levels, thus revealing lower than expected cochlear exposure based on extrapolation from cochlear pressures measured at more moderate sound levels. These results are consistent with lowered transmissivity of the ossicular chain at high intensities, and are consistent with our prior report measuring middle ear transfer functions in human cadaveric temporal bones with high intensity tone pips.

Occupational Hearing Loss from Non-Gaussian Noise

Noise levels are truly continuous in relatively few occupations, with some degree of intermittency the most common condition. The sound levels of intermittent noise are often referred to as non-Gaussian in that they are not normally distributed in the time domain. In some conditions, intermittent noise affects the ear differently from continuous noise, and it is this assumption that underlies the selection of the 5-dB exchange rate (ER). The scientific and professional communities have debated this assumption over recent decades. This monograph explores the effect of non-Gaussian noise on the auditory system. It begins by summarizing an earlier report by the same author concentrating on the subject of the ER. The conclusions of the earlier report supported the more conservative 3-dB ER with possible adjustments to the permissible exposure limit for certain working conditions. The current document has expanded on the earlier report in light of the relevant research accomplished in the intervening decades. Although some of the animal research has supported the mitigating effect of intermittency, a closer look at many of these studies reveals certain weaknesses, along with the fact that these noise exposures were not usually representative of the conditions under which people actually work. The more recent animal research on complex noise shows that intermittencies do not protect the cochlea and that many of the previous assumptions about the ameliorative effect of intermittencies are no longer valid, lending further support to the 3-dB ER. The neurologic effects of noise on hearing have gained increasing attention in recent years because of improvements in microscopy and immunostaining techniques. Animal experiments showing damage to auditory synapses from noise exposures previously considered harmless may signify the need for a more conservative approach to the assessment of noise-induced hearing loss and consequently the practice of hearing conservation programs.

Impulse Noise: Theoretical Solutions to the Quandary of Cochlear Protection

Workers in industries with impact noise, as well as soldiers exposed to supersonic blasts from armament and explosive devices, appear to be more at risk for hearing loss than are their counterparts exposed to continuous noise. Alternative considerations for hearing protection are dictated because of a disproportionately increased biophysical response in comparison to continuous noise. Impulse noise is a significant and distinct problem that requires a new strategy for hearing protection. A review of current clinical and occupational literature suggests that impulse noise may be more damaging than continuous sound. Statistical measurements such as kurtosis hold promise for the quantitative prediction of hearing loss. As sound energy to the cell increases, the mechanism of cochlear damage shifts from biochemical injury to mechanical injury. Outer hair cells appear to be more sensitive than inner hair cells to impulse noise because of their energy requirements, which lead to increased production of reactive oxygen and nitrogen species and self-destruction by apoptosis. Hearing protective devices currently in use for impulse noise include hunters' hearing devices, active noise-reduction headsets, and various in-ear plugs, including nonlinear reacting inserts. Existing equipment is hampered by the materials used and by present-day electronic technology. Antioxidants administered before sound exposure show promise in mitigating hearing loss in industrial and combat situations. New materials with improved damping, reflective, and absorption characteristics are required. Hearing protective devices that allow passage of ambient sound while blocking harmful noise might improve the compliance and safety of those exposed. Sensing devices that instantaneously and selectively hyperpolarize outer hair cells are discussed as alternate protection.

Analytical and numerical modeling of the hearing system: Advances towards the assessment of hearing damage

Hearing is an extremely complex phenomenon, involving a large number of interrelated variables that are difficult to measure in vivo. In order to investigate such process under simplified and well-controlled conditions, models of sound transmission have been developed through many decades of research. The value of modeling the hearing system is not only to explain the normal function of the hearing system and account for experimental and clinical observations, but to simulate a variety of pathological conditions that lead to hearing damage and hearing loss, as well as for development of auditory implants, effective ear protections and auditory hazard countermeasures. In this paper, we provide a review of the strategies used to model the auditory function of the external, middle, inner ear, and the micromechanics of the organ of Corti, along with some of the key results obtained from such modeling efforts. Recent analytical and numerical approaches have incorporated the nonlinear behavior of some parameters and structures into their models. Few models of the integrated hearing system exist; in particular, we describe the evolution of the Auditory Hazard Assessment Algorithm for Human (AHAAH) model, used for prediction of hearing damage due to high intensity sound pressure. Unlike the AHAAH model, 3D finite element models of the entire hearing system are not able yet to predict auditory risk and threshold shifts. It is expected that both AHAAH and FE models will evolve towards a more accurate assessment of threshold shifts and hearing loss under a variety of stimuli conditions and pathologies.

Auditory risk of air rifles

OBJECTIVE

To characterize the impulse noise exposure and auditory risk for air rifle users for both youth and adults.

DESIGN

Acoustic characteristics were examined and the auditory risk estimates were evaluated using contemporary damage-risk criteria for unprotected adult listeners and the 120-dB peak limit and LAeq75 exposure limit suggested by the World Health Organization (1999) for children.

STUDY SAMPLE

Impulses were generated by nine pellet air rifles and one BB air rifle.

RESULTS

None of the air rifles generated peak levels that exceeded the 140 dB peak limit for adults, and eight (80%) exceeded the 120 dB peak SPL limit for youth. In general, for both adults and youth, there is minimal auditory risk when shooting fewer than 100 unprotected shots with pellet air rifles. Air rifles with suppressors were less hazardous than those without suppressors, and the pellet air rifles with higher velocities were generally more hazardous than those with lower velocities.

CONCLUSION

To minimize auditory risk, youth should utilize air rifles with an integrated suppressor and lower velocity ratings. Air rifle shooters are advised to wear hearing protection whenever engaging in shooting activities in order to gain self-efficacy and model appropriate hearing health behaviors necessary for recreational firearm use.

Impulse noise injury prediction based on the cochlear energy

The current impulse noise criteria for the protection against impulse noise injury do not incorporate an objective measure of hearing protection. A new biomechanically-based model has been developed based on improvement of the Auditory Hazard Assessment Algorithm for the Human (AHAAH) using the integrated cochlear energy (ICE) as the damage risk correlate (DRC). The model parameters have been corrected using the latest literature data. The anomalous dose-response inversion behavior of the AHAAH model was eliminated. The modeling results show that the annular ligament (AL) parameters are the dominant cause of the non-monotonic dose-response behavior of AHAAH. Based on parametric optimization analysis, a 40% reduction of the AL compliance from the AHAAH default value removed the dose-response inversion problem, and this value was found to be within the physiological range when compared with experimental data. The transfer functions from the new model are in good agreement with those of the human ear. A dose-response curve based on ICE was developed using the human walk-up temporary threshold shift (TTS) data. Furthermore, the ICE values calculated for the German rifle noise tests show excellent comparison with the injury outcomes, hence providing a significant independent validation of the improved model. The ICE was found to be the best DRC to both large weapons and small arms noise injury data, covering both protected and unprotected exposures, respectively. The new AHAAH model with ICE as the dose metric is adequate for use as a medical standard against impulse noise injury.

Noise-induced hearing loss: a military perspective

PURPOSE OF REVIEW

To summarize relevant literature occurring over the past 12-18 months forwarding understanding of noise-induced hearing loss in relation to military service.

RECENT FINDINGS

Hearing loss prior to entry into military service is highly predictive of subsequent hearing loss and hearing loss disability. Tightly controlled organic solvent exposure may not be a significant risk factor for noise-induced hearing loss. Increasingly detailed analysis of high intensity noise, impulse and blast noise exposures, and the methods used to mitigate these exposures are leading to breakthroughs in understanding and predicting hearing loss in military service.

SUMMARY

Prevention, mitigation, treatment, and prediction of the effects of hazardous noise exposure in military service continue to require a multidisciplinary team of individuals from around the world fully aware of the detrimental effect to service members and their societies of hearing loss disability.

Temporary threshold shift after impulse-noise during video game play: laboratory data

OBJECTIVE

Prevention of temporary threshold shift (TTS) after laboratory-based exposure to pure-tones, broadband noise, and narrowband noise signals has been achieved, but prevention of TTS under these experimental conditions may not accurately reflect protection against hearing loss following impulse noise. This study used a controlled laboratory-based TTS paradigm that incorporated impulsive stimuli into the exposure protocol; development of this model could provide a novel platform for assessing proposed therapeutics.

DESIGN

Participants played a video game that delivered gunfire-like sound through headphones as part of a target practice game. Effects were measured using audiometric threshold evaluations and distortion product otoacoustic emissions (DPOAEs). The sound level and number of impulses presented were sequentially increased throughout the study.

STUDY SAMPLE

Participants were normal-hearing students at the University of Florida who provided written informed consent prior to participation.

RESULTS

TTS was not reliably induced by any of the exposure conditions assessed here. However, there was significant individual variability, and a subset of subjects showed TTS under some exposure conditions.

CONCLUSIONS

A subset of participants demonstrated reliable threshold shifts under some conditions. Additional experiments are needed to better understand and optimize stimulus parameters that influence TTS after simulated impulse noise.

FVB/NJ mice demonstrate a youthful sensitivity to noise-induced hearing loss and provide a useful genetic model for the study of neural hearing loss

The hybrid mouse diversity panel (HMDP), a panel of 100 strains, has been employed in genome wide association studies (GWAS) to study complex traits in mice. Hearing is a complex trait and the CBA/CaJ mouse strain is a widely used model for age-related hearing loss (ARHI) and noise induced hearing loss (NIHL). The CBA/CaJ strain's youthful sensitivity to noise and limited age-related loss led us to attempt to identify additional strains segregating a similar phenotype for our panel. FVB/NJ is part of the HMDP and has been previously described as having a similar ARHI phenotype to CBA/CaJ. For these reasons, we have studied the FVB/NJ mouse for ARHI and NIHL phenotypes in hopes of incorporating its phenotype into HMDP studies. We demonstrate that FVB/NJ exhibits ARHI at an earlier age than CBA/CaJ and young FVB/NJ mice are vulnerable to NIHL up until 10 to 12 weeks. This suggests that FVB/NJ may be used as an additional genetic model for neural forms of progressive hearing loss and for the study of youthful sensitivity to noise.

Soldiers and marksmen under fire: monitoring performance with neural correlates of small arms fire localization

Important decisions in the heat of battle occur rapidly and a key aptitude of a good combat soldier is the ability to determine whether he is under fire. This rapid decision requires the soldier to make a judgment in a fraction of a second, based on a barrage of multisensory cues coming from multiple modalities. The present study uses an oddball paradigm to examine listener ability to differentiate shooter locations from audio recordings of small arms fire. More importantly, we address the neural correlates involved in this rapid decision process by employing single-trial analysis of electroencephalography (EEG). In particular, we examine small arms expert listeners as they differentiate the sounds of small arms firing events recorded at different observer positions relative to a shooter. Using signal detection theory, we find clear neural signatures related to shooter firing angle by identifying the times of neural discrimination on a trial-to-trial basis. Similar to previous results in oddball experiments, we find common windows relative to the response and the stimulus when neural activity discriminates between target stimuli (forward fire: observer 0° to firing angle) vs. standards (off-axis fire: observer 90° to firing angle). We also find, using windows of maximum discrimination, that auditory target vs. standard discrimination yields neural sources in Brodmann Area 19 (BA 19), i.e., in the visual cortex. In summary, we show that single-trial analysis of EEG yields informative scalp distributions and source current localization of discriminating activity when the small arms experts discriminate between forward and off-axis fire observer positions. Furthermore, this perceptual decision implicates brain regions involved in visual processing, even though the task is purely auditory. Finally, we utilize these techniques to quantify the level of expertise in these subjects for the chosen task, having implications for human performance monitoring in combat.

Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions

Audiometric thresholds and otoacoustic emissions (OAEs) were measured in 285 U.S. Marine Corps recruits before and three weeks after exposure to impulse-noise sources from weapons' fire and simulated artillery, and in 32 non-noise-exposed controls. At pre-test, audiometric thresholds for all ears were <or=25 dB HL from 0.5 to 3 kHz and <or=30 dB HL at 4 kHz. Ears with low-level or absent OAEs at pre-test were more likely to be classified with significant threshold shifts (STSs) at post-test. A subgroup of 60 noise-exposed volunteers with complete data sets for both ears showed significant decreases in OAE amplitude but no change in audiometric thresholds. STSs and significant emission shifts (SESs) between 2 and 4 kHz in individual ears were identified using criteria based on the standard error of measurement from the control group. There was essentially no association between the occurrence of STS and SES. There were more SESs than STSs, and the group of SES ears had more STS ears than the group of no-SES ears. The increased sensitivity of OAEs in comparison to audiometric thresholds was shown in all analyses, and low-level OAEs indicate an increased risk of future hearing loss by as much as ninefold.