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Hearing Disorders: HELP
Articles by Robert A. Dobie
Based on 26 articles published since 2010
(Why 26 articles?)
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Between 2010 and 2020, Robert Dobie wrote the following 26 articles about Hearing Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Occupational Noise-Induced Hearing Loss. 2018

Mirza, Raúl / Kirchner, D Bruce / Dobie, Robert A / Crawford, James / Anonymous5700957. ·American College of Occupational and Environmental Medicine, Elk Grove, Illinois. ·J Occup Environ Med · Pubmed #30095587.

ABSTRACT: : Occupational hearing loss is preventable through a hierarchy of controls, which prioritize the use of engineering controls over administrative controls and personal protective equipment. The occupational and environmental medicine (OEM) physician plays a critical role in the prevention of occupational noise-induced hearing loss (NIHL). This position statement clarifies current best practices in the diagnosis of occupational NIHL.

2 Guideline Occupational noise-induced hearing loss: ACOEM Task Force on Occupational Hearing Loss. 2012

Anonymous4060713 / Kirchner, D Bruce / Evenson, Eric / Dobie, Robert A / Rabinowitz, Peter / Crawford, James / Kopke, Richard / Hudson, T Warner. · ·J Occup Environ Med · Pubmed #22183164.

ABSTRACT: -- No abstract --

3 Editorial Cost-Effective Hearing Conservation: Regulatory and Research Priorities. 2018

Dobie, Robert A. ·Department of Otolaryngology - Head and Neck Surgery University of Texas Health Science Center at San Antonio Texas, USA. ·Ear Hear · Pubmed #29251690.

ABSTRACT: Hearing conservation programs (HCPs) mandated by the US Occupational Safety and Health Administration (OSHA) cost about $350/worker/year. Are they cost-effective? A cross-sectional model of the US adult population with and without HCPs incorporates (1) the American Medical Association's method for estimating binaural hearing impairment and whole-person impairment; (2) the model of the International Organization for Standardization (ISO) for estimating both age-related and noise-induced hearing loss; and (3) an acceptable cost of $50,000 per quality-adjusted life year. The ISO model's outputs were audiometric thresholds for groups of people with different age, sex, and noise exposure history. These thresholds were used to estimate cost per quality-adjusted life year saved for people in HCPs with different noise exposure levels. Model simulations suggest that HCPs may be cost-effective only when time-weighted average (TWA) noise exposures are ≥ 90 dBA. Enforcing existing regulations, requiring engineering noise control at high exposure levels, and using new methods that can document hearing protection device performance could improve cost-effectiveness. If the OSHA action level remains at 85 dBA-TWA, reducing the permissible exposure limit to the same level would simplify management and slightly improve cost-effectiveness. Research should evaluate employer compliance across industries, determine whether workers currently excluded from HCP regulations are at risk of noise-induced hearing loss, and develop cost-effective HCPs for mobile workers in construction, agriculture, and oil and gas drilling and servicing. Research on HCP cost-effectiveness could be extended to incorporate sensitivity analyses of the effects of a wider range of assumptions.

4 Editorial Tinnitus: Research supported by the Tinnitus Research Consortium. 2016

Ryan, Allen F / Dobie, Robert A / Dubno, Judy R / Lonsbury-Martin, Brenda L. ·Otolaryngology and Neurosciences, UCSD School of Medicine and San Diego VA Health System, La Jolla, CA 92093, USA. Electronic address: aryan@ucsd.edu. · Dept. of Otolaryngology - Head and Neck Surgery, University of Texas Health Science Center at San Antonio, USA. · Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550 Charleston, SC 29425-5500, USA. Electronic address: dubnojr@musc.edu. · Department of Otolaryngology - Head & Neck Surgery, Loma Linda University Health, Senior Research Scientist Research Service VA, Loma Linda Healthcare System, Loma Linda, CA, USA. ·Hear Res · Pubmed #26739791.

ABSTRACT: -- No abstract --

5 Review Commentary on the regulatory implications of noise-induced cochlear neuropathy. 2017

Dobie, Robert A / Humes, Larry E. ·a Department of Otolaryngology , Head and Neck Surgery, University of Texas Health Science Center at San Antonio , San Antonio , TX , USA and. · b Department of Speech and Hearing Sciences , Indiana University , Bloomington , IN , USA. ·Int J Audiol · Pubmed #27849127.

ABSTRACT: OBJECTIVE: A discussion on whether recent research on noise-induced cochlear neuropathy in rodents justifies changes in current regulation of occupational noise exposure. DESIGN: Informal literature review and commentary, relying on literature found in the authors' files. No formal literature search was performed. STUDY SAMPLE: Published literature on temporary threshold shift (TTS) and cochlear pathology, in humans and experimental animals, as well as the regulations of the US Occupational Safety and Health Administration (OSHA). RESULTS: Humans are less susceptible to TTS, and probably to cochlear neuropathy, than rodents. After correcting for inter-species audiometric differences (but not for differences in susceptibility), exposures that caused cochlear neuropathy in rodents already exceed OSHA limits. Those exposures also caused "pathological TTS" (requiring more than 24 h to recover), which does not appear to occur with human broadband noise exposure permissible under OSHA. CONCLUSION: It would be premature to conclude that noise exposures permissible under OSHA can cause cochlear neuropathy in humans.

6 Review Exchange rates for intermittent and fluctuating occupational noise: a systematic review of studies of human permanent threshold shift. 2014

Dobie, Robert A / Clark, William W. ·1Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX; and 2Department of Audiology and Communication Sciences, Washington University School of Medicine, St. Louis, MO. ·Ear Hear · Pubmed #24366410.

ABSTRACT: OBJECTIVE: The aim of this study was to review the literature regarding human noise-induced permanent threshold shift and to determine whether the observed data agreed with the predictions of two different exchange rates (ERs). DESIGN: An initial list of possibly relevant studies included those cited by authors who endorsed the 3 dB ER, as well as studies in personal files, studies retrieved by a MEDLINE search, and the reference lists of all of these. Criteria for relevance were designed to ensure that exposures were sufficiently intermittent or fluctuating that effective exposure levels based on the 3 dB (LAeq8h) and 5 dB (time-weighted average [TWA]) ERs would differ by at least 1 dB, that at least one of these metrics could be estimated, and that audiometric data were available for groups of defined age, sex, and exposure. Relevant studies were reviewed in detail, and their audiometric data were compared with the predictions of the ISO-1999/ANSI S3.44 model. RESULTS: Nine relevant studies were identified. For six articles, the reported hearing levels were substantially less than would have been predicted from LAeq8h. In each of these cases, TWA would have predicted lower hearing levels than LAeq8h and would have better fit the observed data. In three cases it was not possible to say which ER would have better fit the observed data. CONCLUSIONS: The 3 dB ER systematically overestimates the risk of noise-induced hearing loss for intermittent or fluctuating noise. The 5 dB ER appears to be more accurate, but also overestimates risk, particularly for exposures above 100 dBA.

7 Article Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010. 2019

Hoffman, Howard J / Dobie, Robert A / Losonczy, Katalin G / Themann, Christa L / Flamme, Gregory A. ·Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland. · Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas. · Hearing Loss Prevention Team, Engineering and Physical Hazards Branch, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio. · Stephenson and Stephenson Research and Consulting, LLC-West, Forest Grove, Oregon, U.S.A. ·Laryngoscope · Pubmed #30289551.

ABSTRACT: OBJECTIVES/HYPOTHESIS: To investigate factors associated with hearing impairment (HI) in adolescent youths during the period 1966-2010. STUDY DESIGN: Cross-sectional analyses of US sociodemographic, health, and audiometric data spanning 5 decades. METHODS: Subjects were youths aged 12 to 17 years who participated in the National Health Examination Survey (NHES Cycle 3, 1966-1970; n = 6,768) and youths aged 12 to 19 years in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994; n = 3,057) and NHANES (2005-2010; n = 4,374). HI prevalence was defined by pure-tone average (PTA) ≥ 20 dB HL for speech frequencies (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Multivariable logistic models were used to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: Overall speech-frequency HI prevalence was 10.6% (95% CI: 9.7%-11.6%) in NHES, 3.9% (95% CI: 2.8%-5.5%) in NHANES III, and 4.5% (95% CI: 3.7%-5.4%) in NHANES 2005 to 2010. The corresponding high-frequency HI prevalences were 32.8% (95% CI: 30.8%-34.9%), 7.3% (95% CI: 5.9%-9.0%), and 7.9% (95% CI: 6.8%-9.2%). After adjusting for sociodemographic factors, overall high-frequency HI was increased twofold for males and cigarette smoking. Other significant risk factors in NHANES 2005 to 2010 included very low birth weight, history of ear infections/otitis media, ear tubes, fair/poor general health, and firearms use. CONCLUSIONS: HI declined considerably between 1966 to 1970 and 1988 to 1994, with no additional decline between 1988 to 1994 and 2005 to 2010. Otitis media history was a significant HI risk factor each period, whereas very low birth weight emerged as an important risk factor after survival chances improved. Reductions in smoking, job-related noise, and firearms use may partially explain the reduction in high-frequency HI. Loud music exposure may have increased, but does not account for HI differences. LEVEL OF EVIDENCE: NA Laryngoscope, 129:1922-1939, 2019.

8 Article The Reduction in the Age-Adjusted Prevalence of Hearing Impairment in the United States-Reply. 2017

Hoffman, Howard J / Dobie, Robert A / Flamme, Gregory A. ·Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland. · Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at San Antonio, San Antonio. · Department of Speech Pathology and Audiology, Western Michigan University, Kalamazoo. ·JAMA Otolaryngol Head Neck Surg · Pubmed #28617915.

ABSTRACT: -- No abstract --

9 Article Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years. 2017

Hoffman, Howard J / Dobie, Robert A / Losonczy, Katalin G / Themann, Christa L / Flamme, Gregory A. ·Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland. · Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at San Antonio3Department of Otolaryngology-Head and Neck Surgery, The University of California at Davis4Dobie Associates, San Antonio, Texas. · Hearing Loss Prevention Team, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio. · Department of Speech Pathology and Audiology, Western Michigan University, Kalamazoo7Stephenson & Stephenson Research & Consulting, Loveland, Ohio. ·JAMA Otolaryngol Head Neck Surg · Pubmed #27978564.

ABSTRACT: Importance: As the US population ages, effective health care planning requires understanding the changes in prevalence of hearing loss. Objective: To determine if age- and sex-specific prevalence of adult hearing loss has changed during the past decade. Design, Setting, and Participants: We analyzed audiometric data from adults aged 20 to 69 years from the 2011-2012 cycle of the US National Health and Nutrition Examination Survey, a cross-sectional, nationally representative interview and examination survey of the civilian, noninstitutionalized population, and compared them with data from the 1999-2004 cycles. Logistic regression was used to examine unadjusted, age- and sex-adjusted, and multivariable-adjusted associations with demographic, noise exposure, and cardiovascular risk factors. Data analysis was performed from April 28 to June 3, 2016. Interventions: Audiometry and questionnaires. Main Outcomes and Measures: Speech-frequency hearing impairment (HI) defined by pure-tone average of thresholds at 4 frequencies (0.5, 1, 2, and 4 kHz) greater than 25 decibels hearing level (HL), and high-frequency HI defined by pure-tone average of thresholds at 3 frequencies (3, 4, and 6 kHz) greater than 25 decibels HL. Results: Based on 3831 participants with complete threshold measurements (1953 men and 1878 women; mean [SD] age, 43.6 [14.4] years), the 2011-2012 nationally weighted adult prevalence of unilateral and bilateral speech-frequency HI was 14.1% (27.7 million) compared with 15.9% (28.0 million) for the 1999-2004 cycles; after adjustment for age and sex, the difference was significant (odds ratio [OR], 0.70; 95% CI, 0.56-0.86). Men had nearly twice the prevalence of speech-frequency HI (18.6% [17.8 million]) as women (9.6% [9.7 million]). For individuals aged 60 to 69 years, speech-frequency HI prevalence was 39.3% (95% CI, 30.7%-48.7%). In adjusted multivariable analyses for bilateral speech-frequency HI, age was the major risk factor (60-69 years: OR, 39.5; 95% CI, 10.5-149.4); however, male sex (OR, 1.8; 95% CI, 1.1-3.0), non-Hispanic white (OR, 2.3; 95% CI, 1.3-3.9) and non-Hispanic Asian race/ethnicity (OR, 2.1; 95% CI, 1.1-4.2), lower educational level (less than high school: OR, 4.2; 95% CI, 2.1-8.5), and heavy use of firearms (≥1000 rounds fired: OR, 1.8; 95% CI, 1.1-3.0) were also significant risk factors. Additional associations for high-frequency HI were Mexican-American (OR, 2.0; 95% CI, 1.3-3.1) and other Hispanic race/ethnicity (OR, 2.4; 95% CI, 1.4-4.0) and the combination of loud and very loud noise exposure occupationally and outside of work (OR, 2.4; 95% CI, 1.4-4.2). Conclusions and Relevance: Adult hearing loss is common and associated with age, other demographic factors (sex, race/ethnicity, and educational level), and noise exposure. Age- and sex-specific prevalence of HI continues to decline. Despite the benefit of delayed onset of HI, hearing health care needs will increase as the US population grows and ages.

10 Article Is this STS work-related? ISO 1999 predictions as an adjunct to clinical judgment. 2015

Dobie, Robert A. ·Department of Otolaryngology, Head and Neck Surgery, University of Texas Health Science Center, San Antonio, Texas. ·Am J Ind Med · Pubmed #26443047.

ABSTRACT: BACKGROUND: Physicians and audiologists are often asked to decide whether standard threshold shifts (STSs) are work-related; epidemiological data can inform these decisions. METHODS: Predictions of ISO (2013) for both age-related and noise-induced threshold shifts, for the 2, 3, and 4 kHz average used in calculating OSHA STSs, are presented, in tables, graphs, and an Excel spreadsheet calculator. Specifically, the ISO 1999 model estimates age-related thresholds based on age and sex; it estimates noise-induced threshold shifts based on noise level and duration. It specifies that to estimate the final hearing thresholds for a person of given percentile, age, sex, and noise exposure, the expected age-related threshold is to be added to the expected noise-induced threshold shift. Examples show how these data can predict the relative contributions of aging and occupational noise to an STS. RESULTS: Early-career STSs, especially with high levels of noise exposure, are more likely to be primarily noise-induced. After the first decade of exposure, most STSs will be primarily age-related. CONCLUSION: Given a worker's age, sex, and occupational noise exposure history, ISO 1999 estimates of the expected contributions of aging and noise can supplement clinical judgment.

11 Article Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers. 2015

Dobie, Robert A / Wojcik, Nancy C. ·The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA. · ExxonMobil Biomedical Sciences, Inc., Annandale, New Jersey, USA. ·BMJ Open · Pubmed #26169804.

ABSTRACT: OBJECTIVES: The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. METHODS: Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. RESULTS: The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. CONCLUSIONS: Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers.

12 Article Does occupational noise cause asymmetric hearing loss? 2014

Dobie, Robert A. ·Department of Otolaryngology-Head & Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. ·Ear Hear · Pubmed #24879031.

ABSTRACT: OBJECTIVE: Determine whether occupational noise exposure increases audiometric asymmetry. DESIGN: Audiograms were performed on 2044 men from the Occupational Noise and Hearing Survey, representing four groups based on preliminary screening (for previous noise exposure, otologic history, and otoscopy) and current occupational noise exposure. The effects of current noise exposure on audiometric asymmetry were tested using ANCOVA, with binaural average thresholds as covariates. RESULTS: There were no significant differences in asymmetry attributable to current occupational noise exposure. RESULTS: Occupational noise exposure does not usually cause or exacerbate audiometric asymmetry.

13 Article A new standardized format for reporting hearing outcome in clinical trials. 2012

Gurgel, Richard K / Jackler, Robert K / Dobie, Robert A / Popelka, Gerald R. ·Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA. ·Otolaryngol Head Neck Surg · Pubmed #22931898.

ABSTRACT: The lack of an adequate standardized method for reporting level of hearing function in clinical trials has hampered the ability of investigators to draw comparisons across studies. Variability in data reported and presentation format inhibits meta-analysis and makes it impossible to accumulate the large patient cohorts needed for statistically significant inference. Recognizing its importance to the field and after a widely inclusive discussion, the Hearing Committee of the American Academy of Otolaryngology-Head and Neck Surgery endorsed a new minimal standard for reporting hearing results in clinical trials, consisting of a scattergram relating average pure-tone threshold to word recognition score. Investigators remain free to publish their hearing data in any format they believe is interesting and informative, as long as they include the minimal data set to facilitate interstudy comparability.

14 Article Hearing threshold levels at age 70 years (65-74 years) in the unscreened older adult population of the United States, 1959-1962 and 1999-2006. 2012

Hoffman, Howard J / Dobie, Robert A / Ko, Chia-Wen / Themann, Christa L / Murphy, William J. ·Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA. hoffmanh@nidcd.nih.gov ·Ear Hear · Pubmed #22080933.

ABSTRACT: OBJECTIVES: To provide hearing threshold percentiles from unscreened older adults for creating new Annex B reference standards. DESIGN: Percentiles are calculated, and 95% confidence intervals for medians from two U.S. surveys are compared graphically. RESULTS: Median thresholds are lower (better) in the 1999-2006 National Health and Nutrition Examination Survey for men across all frequencies except 1 kHz. Results for women are similar; however, there is more overlap in confidence intervals across frequencies. CONCLUSIONS: The prevalence of hearing impairment in older adults, age 70 years (65-74 years), is lower in 1999-2006 compared with 1959-1962, consistent with our earlier findings for younger adults.

15 Article The AMA method of estimation of hearing disability: a validation study. 2011

Dobie, Robert A. ·Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA. dobie@uthscsa.edu ·Ear Hear · Pubmed #21694598.

ABSTRACT: OBJECTIVE: To test the assumptions of the 1979 American Medical Association (AMA) method for estimation of hearing disability. DESIGN: One thousand and one patients attending five regional audiology centers competed conventional audiometric testing and the Communication Profile for the Hearing Impaired. A Communication Performance (CP) score calculated from scales of the Communication Profile for the Hearing Impaired served as the gold standard for self-assessed hearing disability. Pure-tone thresholds and word recognition scores (WRSs), and combinations thereof, were compared with the CP scores using correlation and multiple regression analysis. RESULTS: Several different better-ear pure-tone averages (PTAs) correlated reasonably well with self-assessed CP; none were significantly better than the 0.5, 1, 2, and 3 kHz PTA used in the current AMA method. Better-ear to worse-ear weights ranging from 3:1 to 9:1 performed similarly, but none were better than the AMA better-ear weight of 5:1. The AMA method assumes no disability below 25 dB HL and linear growth of disability above this "low fence"; this study showed a similar relationship between PTA and self-assessed hearing disability. There were too few subjects with severe and profound speech-frequency losses to permit validation of the AMA "high fence" of 92 dB HL. Combining pure-tone thresholds and WRSs improved prediction of hearing disability only very slightly. CONCLUSIONS: This study supports the continued use of the 1979 AMA method. Incorporation of WRSs, as typically measured clinically, into methods of estimating hearing disability is not supported because of negligible improvement in accuracy and inability to control exaggeration for speech tests in medical-legal settings.

16 Article The Annex C fallacy: why unscreened databases are usually preferable for comparison of industrially exposed groups. 2011

Dobie, Robert A / Agrawal, Yuri. ·Department of Otolaryngology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA. dobie@uthscsa.edu ·Audiol Neurootol · Pubmed #20516680.

ABSTRACT: One can study occupational noise exposure by comparing hearing thresholds of exposed people to control data from national or international standards. ANSI S3.44 (1996) offers Annex C--thresholds for people without occupational noise exposure--as appropriate control data for such comparisons. Annex C is based on the false assumption that people who have had occupational noise exposure are similar in all other important ways to those without such exposures. In fact, people with noisy jobs are more likely than others to be smokers, diabetics, poorly educated, white and exposed to non-occupational noise. Taking these other risk factors into account, the appropriate thresholds for comparison to industrial study populations are closer to those of the unscreened population than to an 'Annex C' population that simply excludes occupationally noise-exposed persons.

17 Article Americans hear as well or better today compared with 40 years ago: hearing threshold levels in the unscreened adult population of the United States, 1959-1962 and 1999-2004. 2010

Hoffman, Howard J / Dobie, Robert A / Ko, Chia-Wen / Themann, Christa L / Murphy, William J. ·Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland 20892, USA. hoffmanh@nidcd.nih.gov ·Ear Hear · Pubmed #20683190.

ABSTRACT: OBJECTIVES: (1) To present hearing threshold data from a recent nationally representative survey in the United States (National Health and Nutrition Examination Survey, 1999-2004) in a distributional format that might be appropriate to replace Annex B in international (ISO-1999) and national (ANSI S3.44) standards and (2) to compare these recent data with older survey data (National Health Examination Survey I, 1959-1962) on which the current Annex B is based. DESIGN: Better-ear threshold distributions (selected percentiles and their confidence intervals) were estimated using linear interpolation. The 95% confidence intervals for the medians for the two surveys were compared graphically for each of the four age groups and for both men and women. In addition, we calculated odds ratios comparing the prevalences of better-ear hearing impairment (thresholds > 25 dB HL) between the two surveys, for 500, 1000, 2000, and 4000 Hz, and for their four-frequency average. RESULTS: Across age and sex groups, median thresholds were lower (better) in the 1999-2004 survey at 500, 3000, 4000, and 6000 Hz (8000 Hz was not tested in the 1959-1962 survey). For both men and women, the prevalence of hearing impairment was significantly lower in 1999-2004 at 500, 2000, and 4000 Hz, but not at 1000 Hz. CONCLUSIONS: For men and women of a specific age, high-frequency hearing thresholds were lower (better) in 1999-2004 than in 1959-1962. The prevalences of hearing impairment were also lower in the recent survey. Differences seen at 500 Hz may be attributable at least in part to changes in standards for ambient noise in audiometry. The National Health and Nutrition Examination Survey 1999-2004 distributions are offered as a possible replacement for Annex B in ISO-1999 and ANSI S3.44.

18 Article Estimating the effect of occupational noise exposure on hearing thresholds: the importance of adjusting for confounding variables. 2010

Agrawal, Yuri / Niparko, John K / Dobie, Robert A. ·Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. yagrawa1@jhmi.edu ·Ear Hear · Pubmed #20075736.

ABSTRACT: OBJECTIVES: To evaluate whether valid estimation of the effect of occupational noise exposure on hearing thresholds requires adjustment for factors other than age, sex, and race, which also influence hearing function. DESIGN: Multivariate regression analyses were performed in the 1999-2002 National Health and Nutrition Examination Survey (N = 3527). RESULTS: Occupational noise exposure was significantly associated with educational level, leisure time and firearm noise, and smoking. Incomplete adjustment for these factors leads to an overestimation of the effect of occupational noise exposure. CONCLUSIONS: Current methods of estimating the effect of occupational noise exposure (e.g., Annex C of American National Standards Institute S3.44) require better consideration of these confounding factors.

19 Minor Exchange Rate and Risk of Noise-Induced Hearing Loss in Construction Workers. 2018

Dobie, Robert A / Clark, William W / Kallogjeri, Dorina / Spitznagel, Edward L. ·Department of Otolaryngology - Head and Neck Surgery, University of Texas Health Science Center, San Antonio, TX, USA. · Program in Audiology and Communication Sciences, Washington University, St. Louis, MO, USA. · Department of Otolaryngology, Washington University, St. Louis, MO, USA. · Department of Mathematics and Statistics, Washington University, St. Louis, MO, USA. ·Ann Work Expo Health · Pubmed #30107470.

ABSTRACT: -- No abstract --

20 Minor In reference to To image or not to Image? A cost-effectiveness analysis of MRI for patients with asymmetric sensorineural hearing loss. 2018

Dobie, Robert A. ·Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas. ·Laryngoscope · Pubmed #28699203.

ABSTRACT: -- No abstract --

21 Minor Response to Suter and NIOSH. 2015

Dobie, Robert A / Clark, William W. ·1University of Texas Health Science Center, San Antonio, Texas, USA; and 2Program in Audiology and Communication Sciences, Washington University School of Medicine, St. Louis, Missouri, USA. ·Ear Hear · Pubmed #25866947.

ABSTRACT: -- No abstract --

22 Minor Hearing loss in firefighters. 2014

Dobie, Robert A. ·University of Texas Health Science Center at San Antonio, dobie@uthscsa.edu. ·J Occup Environ Med · Pubmed #25192231.

ABSTRACT: -- No abstract --

23 Minor Comments re Macrae (2013). 2014

Dobie, Robert A. ·University of Texas Health Science Center at San Antonio. ·Int J Audiol · Pubmed #24456180.

ABSTRACT: -- No abstract --

24 Minor Letter to the editor response--Entong Wang. 2013

Jackler, Robert / Gurgel, Richard / Dobie, Robert / Popelka, Gerald. · ·Otolaryngol Head Neck Surg · Pubmed #23884919.

ABSTRACT: -- No abstract --

25 Minor Reply to Dr Carlson's letter: A new standardized format for reporting hearing outcome in clinical trials. 2013

Jackler, Robert / Gurgel, Richard / Dobie, Robert / Popelka, Gerald. · ·Otolaryngol Head Neck Surg · Pubmed #23884917.

ABSTRACT: -- No abstract --

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