{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:28:09Z","timestamp":1763749689360,"version":"3.45.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forte","doi-asserted-by":"crossref","award":["2018-00418"],"award-info":[{"award-number":["2018-00418"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preschool children are regularly exposed to high noise levels that may affect hearing. A previous study has linked preschool noise exposure to reduced distortion product otoacoustic emission (DPOAE) amplitudes. Since DPOAEs primarily reflect outer hair cell (OHC) activity, they provide an indirect marker of cochlear function. Measurement accuracy can be affected by middle-ear pressure. Pressurised DPOAEs (pDPOAEs) compensate for middle-ear pressure during recording.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study aimed to examine the relationship between preschool noise exposure and pDPOAE amplitudes while accounting for middle-ear pressure. Seventy-five children (4\u20136 years old) were monitored using dosimeters to measure the equivalent continuous sound level (L\n                      <jats:sub>AeqTi)<\/jats:sub>\n                      and the 95th percentile of maximum levels (L\n                      <jats:sub>AFmax,95).<\/jats:sub>\n                      Of these, 56 children completed pDPOAE testing at four time points during the preschool week. Linear mixed-effects models evaluated associations with noise exposure, time of day and progression across the week.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For personal dosimetry, the mean L\n                      <jats:sub>AeqTi<\/jats:sub>\n                      was 80 dB (range: 60\u201398 dB) and the mean L\n                      <jats:sub>AFmax,95<\/jats:sub>\n                      was 97 dB (range: 77\u2013110 dB). Most L\n                      <jats:sub>AeqTi<\/jats:sub>\n                      levels (86.2%) were between 75\u201385 dB, with L\n                      <jats:sub>AFmax<\/jats:sub>\n                      levels exceeding 115 dB in 53.8% of the cases. No significant associations were found between L\n                      <jats:sub>AeqTi<\/jats:sub>\n                      or L\n                      <jats:sub>AFmax,95<\/jats:sub>\n                      and pDPOAE amplitudes (p\u2009&gt;\u20090.05). Time-of-day differences were observed, with higher amplitudes in the afternoon at 4\u2009kHz (p\u2009=\u20090.045) and 6\u2009kHz (p\u2009=\u20090.047) in the right ear, and 3\u2009kHz in the left ear (p\u2009=\u20090.021). Girls showed higher amplitudes than boys at 4\u2009kHz in the left ear (p\u2009=\u20090.030).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although pDPOAE amplitudes varied with time of day, and sex, a direct exposure\u2013response relationship with preschool noise was not demonstrated. Short-term variations in typical preschool noise exposure may not measurably affect cochlear function in young children. Future research should refine exposure assessment and recording protocols to reduce variability and improve detection of small physiological changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0332863","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:22:22Z","timestamp":1763749342000},"page":"e0332863","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term impact of preschool sound exposure on outer hair cell function in young children: An analysis using pressurised distortion product otoacoustic emissions"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9377-2143","authenticated-orcid":true,"given":"Loisa","family":"Sandstr\u00f6m","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"Fredriksson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elina","family":"M\u00e4ki-Torkko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"\u00d6gren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8694-7750","authenticated-orcid":true,"given":"Janina","family":"Fels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3789-4557","authenticated-orcid":true,"given":"Kerstin Persson","family":"Waye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"pone.0332863.ref001","volume-title":"Key data on early childhood education and care in Europe -2025","author":"EACEA European Comission","year":"2025"},{"key":"pone.0332863.ref002","volume-title":"Curriculum for the preschool: Lpf\u00f6 18","year":"2019"},{"issue":"10","key":"pone.0332863.ref003","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1080\/14992027.2025.2459228","article-title":"Effect of pre-school sound exposure on children\u2019s hearing function: results from preparatory studies assessing hearing function by distortion product otoacoustic emissions","volume":"64","author":"L Sandstr\u00f6m","year":"2025","journal-title":"Int J Audiol"},{"issue":"1","key":"pone.0332863.ref004","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3109\/00206099909073001","article-title":"Sensitivity of transient evoked and distortion product otoacoustic emissions to the direct effects of noise on the human cochlea","volume":"38","author":"BM Vinck","year":"1999","journal-title":"Audiology"},{"key":"pone.0332863.ref005","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.3389\/fpsyg.2019.01954","article-title":"The others are too loud! children\u2019s experiences and thoughts related to voice, noise, and communication in nordic preschools","volume":"10","author":"A McAllister","year":"2019","journal-title":"Front Psychol"},{"issue":"8","key":"pone.0332863.ref006","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s00420-019-01453-0","article-title":"Working in preschool increases the risk of hearing-related symptoms: a cohort study among Swedish women","volume":"92","author":"S Fredriksson","year":"2019","journal-title":"Int Arch Occup Environ Health"},{"key":"pone.0332863.ref007","article-title":"Toward child-appropriate acoustic measurement methods in primary schools and daycare centers","volume":"8","author":"K Loh","year":"2022","journal-title":"Front Built Environ"},{"key":"pone.0332863.ref008","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.apacoust.2016.08.009","article-title":"Acoustics and activity noise in school classrooms in Finland","volume":"114","author":"E Sala","year":"2016","journal-title":"Applied Acoustics"},{"key":"pone.0332863.ref009","doi-asserted-by":"crossref","DOI":"10.3389\/fbuil.2021.688836","article-title":"Sound quality characteristics of importance for preschool children\u2019s perception and wellbeing after an acoustic intervention","volume":"7","author":"K Persson Waye","year":"2021","journal-title":"Front Built Environ"},{"issue":"4","key":"pone.0332863.ref010","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1121\/1.3479535","article-title":"Impact of three hours of discotheque music on pure-tone thresholds and distortion product otoacoustic emissions","volume":"128","author":"J M\u00fcller","year":"2010","journal-title":"J Acoust Soc Am"},{"key":"pone.0332863.ref011","volume-title":"Compendium of WHO and other UN guidance on health and environment, 2022 update. 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