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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 4kHz 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.<\/jats:p>","DOI":"10.1121\/1.3050304","type":"journal-article","created":{"date-parts":[[2009,2,9]],"date-time":"2009-02-09T21:35:10Z","timestamp":1234215310000},"page":"995-1013","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":50,"title":["Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions"],"prefix":"10.1121","volume":"125","author":[{"given":"Lynne","family":"Marshall","sequence":"first","affiliation":[{"name":"Naval Submarine Medical Research Laboratory , Groton, Connecticut 06349-5900"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judi A.","family":"Lapsley Miller","sequence":"additional","affiliation":[{"name":"Naval Submarine Medical Research Laboratory , Groton, Connecticut 06349-5900"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie M.","family":"Heller","sequence":"additional","affiliation":[{"name":"Naval Submarine Medical Research Laboratory , Groton, Connecticut 06349-5900"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S.","family":"Wolgemuth","sequence":"additional","affiliation":[{"name":"Naval Medical Center San Diego , San Diego, California 92134-5000"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Naval Submarine Medical Research Laboratory , Groton, Connecticut 06349-5900"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley D.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center , Omaha, Nebraska 68198"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Kopke","sequence":"additional","affiliation":[{"name":"Naval Medical Center San Diego DOD Spatial Orientation Center, , San Diego, California 92134-5000"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"231","reference":[{"key":"2023072520125062800_c1","first-page":"11","article-title":"Audiologic management of individuals receiving cochleotoxic drug therapy [guidelines]","volume":"34","author":"American Speech-Language-Hearing Association","year":"1994","journal-title":"ASHA"},{"key":"2023072520125062800_c2","volume-title":"Maximum Permissible Ambient Noise Levels for Audiometric Test Rooms (ANSI S3.1)","author":"ANSI","year":"1991"},{"key":"2023072520125062800_c3","volume-title":"Specifications for Audiometers (ANSI S3.6-1996, R1973)","author":"ANSI","year":"1996"},{"key":"2023072520125062800_c4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1001\/archotol.125.2.215","article-title":"High-frequency hearing influences lower-frequency distortion-product otoacoustic emissions","volume":"125","year":"1999","journal-title":"Arch. 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