The accuracy of a smartphone-based hearing assessment compared to conventional audiometry in workers exposed to noise according to sociodemographic, occupational and pre-assessment conditions
Claire Márcia Santana Lima; Luma Cordeiro Rodrigues Fernandes; Ana Paula Corona
Abstract
Purpose: To investigate the sociodemographic and occupational factors, as well as the pre-assessment conditions that influence the accuracy of the hearTest in workers exposed to noise. Methods: Secondary data from an accuracy study conducted with 232 workers were used. A sociodemographic and occupational questionnaire was administered, and an air conduction hearing assessment of 0.5 to 8 kHz was performed using the hearTest and CA. A Youden index (J) ≥ 70% was considered to define good hearTest accuracy. Results: When analyzing the identification of any HL by the hearTest, it was observed that sociodemographic factors (age between 40 and 49 years; white race, low education level, and income above five minimum wages) reduced the accuracy of the assessment. When analyzing the identification of NIHL, sociodemographic factors (age between 40 and 49 years; low level of education; and income above two minimum wages) also reduced the accuracy of the assessment, along with the worker’s pre-assessment condition (irregular sleep the night before the assessment). For both HL criteria, it was found that the hearTest presented worse accuracy with increasing age. Workers with higher educational levels achieved greater accuracy, and the J was higher among women, workers in technical roles, those aged between 18 and 29 years, non-white, those with higher education, those with an income of two to five minimum wages, and those who denied fasting, for both HL classifications. Conclusion: The findings indicate that sociodemographic, occupational, and pre-assessment conditions can impact the accuracy of the hearTest assessment in workers.
Keywords
References
- 1WHO: World Health Organization. World report on hearing. Geneva: Departament of Noncommunicable Desease; 2021.
- 2Boéchat EM, Menezes PL, Couto CM, Frizzo ACF, Scharlach RC, Anastasio ART. Tratado de audiologia. 2. ed. Rio de Janeiro: Guanabara Koogan; 2015.
- 3Irace AL, Sharma RK, Reed NS, Golub JS. Smartphone-based applications to detect hearing loss: a review of current technology. J Am Geriatr Soc. 2021;69(2):307-16. https://doi.org/10.1111/jgs.16985 PMid:33341098.
» https://doi.org/10.1111/jgs.16985 - 4Brasil. Ministério do Trabalho. Portaria n° 3.214, de 8 de junho de 1978. Norma regulamentadora nº. 7 (NR 7). Institui o Programa de Controle Médico de Saúde Ocupacional. Diário Oficial da União; Brasília; 1978 [cited 2021 Jun 15]. Available from: https://www.gov.br/trabalho-e-previdencia/ptbr/composicao/orgaos-especificos/secretaria-de-trabalho/inspecao/seguranca-e-saude-notrabalho/ctpp-nrs/norma-regulamentadora-no-7-nr-7
» https://www.gov.br/trabalho-e-previdencia/ptbr/composicao/orgaos-especificos/secretaria-de-trabalho/inspecao/seguranca-e-saude-notrabalho/ctpp-nrs/norma-regulamentadora-no-7-nr-7 - 5Brasil. Ministério da Saúde. Perda auditiva induzida por ruído (PAIR). Saúde do trabalhador: protocolos de complexidade diferenciada. Brasília, DF: MS; 2006. (Normas e Manuais Técnicos, Série A).
- 6Howgate S, Plack CJ. A behavioral measure of the cochlear changes underlying temporary threshold shifts. Hear Res. 2011;277(1-2):78-87. https://doi.org/10.1016/j.heares.2011.03.009 PMid:21439366.
» https://doi.org/10.1016/j.heares.2011.03.009 - 7Oliva FC, Morata TC, Lacerda ABM, Steinmetz L, Bramatti L, Vivan AG, et al. Significant auditory threshold shift among workers exposed to different noise levels. Soc Bras Fonoaudiol. 2011;16(3):260-5. https://doi.org/10.1590/S1516-80342011000300005
» https://doi.org/10.1590/S1516-80342011000300005 - 8Sandström J, Swanepoel D, Laurent C, Umefjord G, Lundberg T. Accuracy and reliability of smartphone self-test audiometry in community clinics in low income settings: a comparative study. Ann Otol Rhinol Laryngol. 2020;129(6):578-84. https://doi.org/10.1177/0003489420902162 PMid:31965808.
» https://doi.org/10.1177/0003489420902162 - 9Phanguphangu M, Ross AJ. Clinical utility of smartphone-based audiometry for early hearing loss detection in HIV-positive children: a feasibility study. Afr J Prim Health Care Fam Med. 2021;13(1):e1-4. https://doi.org/10.4102/phcfm.v13i1.3077 PMid:34636610.
» https://doi.org/10.4102/phcfm.v13i1.3077 - 10Bornman M, Swanepoel W, De Jager LB, Eikelboom RH. Extended high-frequency smartphone audiometry: validity and reliability. J Am Acad Audiol. 2019;30(3):217-26. https://doi.org/10.3766/jaaa.17111 PMid:30461416.
» https://doi.org/10.3766/jaaa.17111 - 11Jayawardena A, Waller B, Edwards B, Larsen-Reindorf R, Esinam Anomah J, Frimpong B, et al. Portable audiometric screening platforms used in low-resource settings: a review. J Laryngol Rhinol Otol. 2019;133(2):74-9. https://doi.org/10.1017/S0022215118001925 PMid:30392484.
» https://doi.org/10.1017/S0022215118001925 - 12Rodrigues LC, Ferrite S, Corona AP. Validity of hearTest smartphone-based audiometry for hearing screening in workers exposed to noise. J Am Acad Audiol. 2021;32(2):116-21. https://doi.org/10.1055/s-0040-1718931 PMid:33296933.
» https://doi.org/10.1055/s-0040-1718931 - 13Pernambuco L, Espelt A, Magalhães HV Jr, Lima KC. Recommendations for elaboration, transcultural adaptation and validation process of tests in speech, hearing and language pathology. CoDAS. 2017;29(3):e20160217. https://doi.org/10.1590/2317-1782/20172016217
» https://doi.org/10.1590/2317-1782/20172016217 - 14Kamil RJ, Genther DJ, Lin FR. Factors associated with the accuracy of subjective assessments of hearing impairment. Ear Hear. 2015;36(1):164-7. https://doi.org/10.1097/AUD.0000000000000075 PMid:25158982.
» https://doi.org/10.1097/AUD.0000000000000075 - 15Masterson EA, Themann CL, Luckhaupt SE, Li J, Calvert GM. Hearing difficulty and tinnitus among U.S. workers and non-workers in 2007. Am J Ind Med. 2016;59(4):290-300. https://doi.org/10.1002/ajim.22565 PMid:26818136.
» https://doi.org/10.1002/ajim.22565 - 16Livshitz L, Ghanayim R, Kraus C, Farah R, Even-Tov E, Avraham Y, et al. Application-based hearing screening in the elderly population. Ann Otol Rhinol Laryngol. 2017;126(1):36-41. https://doi.org/10.1177/0003489416672873 PMid:27913721.
» https://doi.org/10.1177/0003489416672873 - 17Masterson EA, Deddens JA, Themann CL, Bertke S, Calvert GM. Trends in worker hearing loss by industry sector, 1981-2010. Am J Ind Med. 2015;58(4):392-401. https://doi.org/10.1002/ajim.22429 PMid:25690583.
» https://doi.org/10.1002/ajim.22429 - 18Flahault A, Cadilhac M, Thomas G. Sample size calculation should be performed for design accuracy in diagnostic test studies. J Clin Epidemiol. 2005;58(8):859-62. https://doi.org/10.1016/j.jclinepi.2004.12.009 PMid:16018921.
» https://doi.org/10.1016/j.jclinepi.2004.12.009 - 19Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3(1):32-5. https://doi.org/10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3 PMid:15405679.
» https://doi.org/10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3 - 20Alves RF, Silva RP, Ernesto MV, Lima AGB, Souza FM. Gênero e saúde: o cuidar do homem em debate. Rev Psicol Teor Prat. [Internet]. 2023 [cited 2021 Jun 15];13(3):152-66. Available from: https://editorarevistas.mackenzie.br/index.php/ptp/article/view/3040
» https://editorarevistas.mackenzie.br/index.php/ptp/article/view/3040 - 21Rueda JMR, Monteiro RDM. Bateria Psicológica para Avaliação da Atenção (BPA): desempenho de diferentes faixas etárias. Psico-USF. 2013;18(1):99-108. https://doi.org/10.1590/S1413-82712013000100011
» https://doi.org/10.1590/S1413-82712013000100011 - 22Maciel ES, Vilarta R, Vasconcelos JS, Modeneze DM, Sonati JG, Vilela GB, et al. Correlação entre nível de renda e os domínios da qualidade de vida de população universitária brasileira. Revista Brasileira de Qualidade de Vida. 2023;5(1):53-62. https://doi.org/10.3895/S2175-08582013000100006
» https://doi.org/10.3895/S2175-08582013000100006 - 23Assunção AA, Abreu MNS, Souza PSN. Prevalência de exposição a ruído ocupacional em trabalhadores brasileiros: resultados da Pesquisa Nacional de Saúde, 2013. Cad Saude Publica. 2019;35(10):e00094218. https://doi.org/10.1590/0102-311x00094218 PMid:31596395.
» https://doi.org/10.1590/0102-311x00094218 - 24Drummond SP, Brown GG, Salamat JS, Gillin JC. Increasing task difficulty facilitates the cerebral compensatory response to total sleep deprivation. Sleep. 2004;27(3):445-51. PMid:15164897.
- 25Drummond SP, Meloy MJ, Yanagi MA, Orff HJ, Brown GG. Compensatory recruitment after sleep deprivation and the relationship with performance. Psychiatry Res. 2005;140(3):211-23. https://doi.org/10.1016/j.pscychresns.2005.06.007 PMid:16263248.
» https://doi.org/10.1016/j.pscychresns.2005.06.007 - 26Goel N, Rao H, Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2009;29(4):320-39. https://doi.org/10.1055/s-0029-1237117 PMid:19742409.
» https://doi.org/10.1055/s-0029-1237117 - 27Corona AP, Ferrite S, Bright T, Polack S. Validity of hearing screening using hearTest smartphone-based audiometry: performance evaluation of different response modes. Int J Audiol. 2020;59(9):666-73. https://doi.org/10.1080/14992027.2020.1731767 PMid:32134341.
» https://doi.org/10.1080/14992027.2020.1731767 - 28Gobbato LHFG, Costa EA, Sampaio MF, Gobbato FM. Estudo do efeito aprendizagem em exames audiométricos sequenciais de trabalhadores de indústria metalúrgica e suas implicações nos programas de conservação auditiva. Rev Bras Otorrinolaringol. 2000;66(6):622-8.
- 29IBGE: Instituto Brasileiro de Geografia e Estatística. Estimativas da população residente no Brasil e unidades da federação com data de referência em 1º de julho de 2019. Rio de Janeiro: IBGE; 2019 [cited 2021 Jun 15]. Available from: https://www.ibge.gov.br
» https://www.ibge.gov.br
Submitted date:
09/02/2024
Accepted date:
09/17/2025
