Assessment of Occupational Hearing Loss Associated With Non-Gaussian Noise Using the Kurtosis-Adjusted Cumulative Noise Exposure Metric: A Cross-Sectional Survey

OBJECTIVE: There is little literature on the validity of kurtosis-adjusted noise energy metrics in human studies. Therefore, this study aimed to validate the application of cumulative noise exposure (CNE) adjusted by kurtosis in evaluating occupational hearing loss associated with non-Gaussian noise among manufacturing workers. METHODS: A cross-sectional survey was conducted on 1,558 manufacturing workers exposed to noise from five industries to collect noise exposure and hearing loss data. Both CNE and kurtosis-adjusted CNE (CNE′) were collapsed into 2-dB(A)∙year bins, and the mean noise-induced permanent threshold shifts at 3, 4, and 6 kHz (NIPTS(346)) in each bin were calculated. The contributions of CNE and CNE′ to noise-induced hearing loss (NIHL) were compared using the multiple linear regression. The degree of overlap of two linear regression equations (i.e., between CNE′ and NIPTS(346) for non-Gaussian noise and between CNE and NIPTS(346) for Gaussian noise) was used to evaluate the validity of the CNE′ using a stratified analysis based on age and sex. RESULTS: Multiple linear regression models showed that after kurtosis adjustment, the standardized regression coefficient of CNE increased from 0.230 to 0.255, and R(2) increased from 0.147 to 0.153. The linear relationship between NIPTS(346) and CNE′ or CNE showed that the regression line of non-Gaussian noise was closer to that of Gaussian noise when using CNE′ than using CNE. The mean difference in NIPTS(346) between the equations of non-Gaussian noise and Gaussian noise was significantly reduced from 4.32 to 1.63 dB HL after kurtosis adjustment (t = 12.00, p < 0.001). Through a stratified analysis, these significant decreases were observed in male and female workers, and workers aged ≥30 years old. CONCLUSION: As a noise exposure metric combining noise energy and temporal characteristics, the kurtosis-adjusted-CNE metric was more effective than CNE alone in assessing occupational hearing loss among manufacturing workers in non-Gaussian noise environment. However, more studies are needed to verify the validity of the kurtosis-adjusted-CNE metric.