Abstract Background: Noise-induced hearing loss (NIHL) is a critical occupational hazard in military aviation. Current Hearing Conservation Programs (HCPs) rely on pure-tone audiometry (PTA), detecting manifest hearing loss, but missing early subclinical cochlear damage. This study aimed to evaluate Distortion Product Otoacoustic Emissions (DPOAE) efficacy as an early biomarker for NIHL risk and identify associated occupational factors. Material and Methods: A cross-sectional observational study included 100 male naval personnel (200 ears), aged 20–50 years, at a naval air station. Participants underwent standard PTA (reference) and hand-held DPOAE testing (index). Demographic and occupational data (D-SON, D-ONE, HPF) were recorded. Chi-square tests and logistic regression determined associations and predictors of OAE-positive NIHL risk. Results: PTA identified clinically manifest NIHL risk in 14% of personnel (9% of ears), while DPOAE detected subclinical cochlear dysfunction in 32% (39.5% of ears). DPOAE showed 100% sensitivity and 66.5% specificity against PTA, identifying early dysfunction in an additional 61 ears. Logistic regression revealed significant predictors for OAE-positive NIHL risk: closer proximity to noise (D-SON; P =0.048), longer daily noise exposure (D-ONE; P =0.007), and lower hearing protection factor (HPF; P =0.042). Discussion: DPOAE demonstrated superior utility in detecting subclinical cochlear damage earlier than PTA, identifying a higher prevalence of NIHL risk. These findings, coupled with significant occupational predictors (D-SON, D-ONE, HPF), provide actionable insights for refining HCPs. Conclusion: Integrating DPOAE screening with assessment of occupational risk factors offers a robust framework for proactive, targeted interventions. This approach safeguards hearing health and enhances operational readiness in naval aviation.
Mohapatra et al. (Wed,) studied this question.