{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T23:29:41Z","timestamp":1786318181127,"version":"build-2736575974"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Innovations Guidance Special Program for New-type Research and Development Institutions in Jiaxing, China","award":["2025YDZX027"],"award-info":[{"award-number":["2025YDZX027"]}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["1R01DC015990"],"award-info":[{"award-number":["1R01DC015990"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trends in Hearing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Young adults with normal conventional audiograms may nonetheless show early noise-related auditory differences that routine surveillance misses. We evaluated a clinically feasible test battery using 280 occupationally noise-exposed workers and 100 age-matched low-noise controls (20-40 years; \u226420 dB HL at 0.5-8 kHz). Measures included conventional and extended high-frequency (EHF; 9-16 kHz) audiometry, distortion-product otoacoustic emissions (DPOAEs; 0.5-10 kHz), ipsilateral acoustic reflex thresholds (ARTs; 0.5, 1, and 2 kHz; 226-Hz probe tone), click-evoked auditory brainstem responses (ABR; wave I, wave V, and V\/I ratio at 50 and 90 dBnHL), and Mandarin Bamford-Kowal-Bench speech-in-noise testing (SiN). Noise-exposed participants showed elevated ARTs at all elicitor frequencies, with the largest elevation at 2 kHz, as well as poorer EHF thresholds and lower DPOAE levels. In contrast, click-evoked ABR metrics did not differ between groups. After controlling for conventional-frequency pure-tone average (PTA\n                    <jats:sub>4<\/jats:sub>\n                    ; 0.5, 1, 2, and 4 kHz) and extended high-frequency pure-tone average (PTA\n                    <jats:sub>EHF<\/jats:sub>\n                    ; 9\u201316 kHz), lower DPOAE amplitudes were associated with higher ARTs. ARTs were not significantly associated with SiN performance, quantified as the signal-to-noise ratio (SNR) required for 50% correct recognition (SNR-50), cumulative noise exposure, or ABR measures. The noise-exposed group showed higher SNR-50 values, indicating poorer speech-in-noise performance. Within the noise-exposed group, SNR-50 was associated with PTA\n                    <jats:sub>4<\/jats:sub>\n                    and cumulative noise exposure, whereas its association with PTA\n                    <jats:sub>EHF<\/jats:sub>\n                    was weaker and did not remain significant after correction for multiple comparisons. Together, these findings suggest that cochlear-status measures, conventional ARTs, and functional SiN performance provide complementary information beyond the conventional audiogram in occupational hearing surveillance.\n                  <\/jats:p>","DOI":"10.1177\/23312165261477842","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:22:54Z","timestamp":1786148574000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Auditory Differences in Occupationally Noise-Exposed Workers With Normal Conventional Audiograms: A Multi-Measure Surveillance Approach"],"prefix":"10.1177","volume":"30","author":[{"given":"Wulan","family":"Zhao","sequence":"first","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4303-7172","authenticated-orcid":false,"given":"Alexis","family":"Pinsonnault-Skvarenina","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Centre Int\u00e9gr\u00e9 Universitaire en Sant\u00e9 et en Services Sociaux de La Capitale-Nationale"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meibian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chinese Center for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhili","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hangze","family":"Mao","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"},{"name":"The First Affiliated Hospital of Zhejiang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shixing","family":"Bai","sequence":"additional","affiliation":[{"name":"Yangtze Delta Region Institute of Tsinghua University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zou","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Guo","sequence":"additional","affiliation":[{"name":"Henan Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyan","family":"Yu","sequence":"additional","affiliation":[{"name":"Chinese Center for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Fuente","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre de Recherche de L\u2019Institut Universitaire de G\u00e9riatrie de Montr\u00e9al - CIUSSS Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1654-6158","authenticated-orcid":false,"given":"Wei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Yangtze Delta Region Institute of Tsinghua University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2013.03.006"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/23312165251343757"},{"issue":"12","key":"e_1_3_7_4_1","first-page":"19","article-title":"Detection and clinical diagnosis of noise-induced hearing loss by otoacoustic emissions","volume":"3","author":"Attias J.","year":"2001","unstructured":"Attias J., Horovitz G., El-Hatib N., Nageris B. 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