Though learning was accounted for by training, and a long individual run-up to the actual measurement was incorporated in the test, a learning effect still appeared. The learning effect may have led to higher estimated SRT values, especially for the first ear measured, and the relatively high number of false-positive HFHL classifications. A relatively large measurement error was found, possibly due to a learning effect between the single ear measurements within one test.
Based on the classification of HFHL for at least one ear versus no HFHL for both ears, the sensitivity on the individual level was 90% and the specificity was 77%. The discriminative ability of OEC was calculated on the individual level, which means that the results of both ears were taken into account. In the second phase, the improved test was evaluated in an unselected group of noise-exposed employees in a quiet office room at the work place (Sheikh Rashid et al. In the first phase, the concept was improved for HFHL, and tested in a well-controlled laboratory setting in a population that was recruited by means of a two-gate design, with normal-hearing cases on the one hand, and known HFHL cases on the other (Sheikh Rashid et al. A phased approach was maintained to evaluate this test for screening purposes in noise-exposed workers. This study focuses on the Occupational Earcheck (OEC), a Dutch internet-based speech-in-noise hearing screening test for occupational HFHL, developed at the Department of Audiology of the Leiden University Medical Center, commissioned by the Netherlands Hearing Health Foundation (Ellis et al. These tests facilitate audiometric hearing evaluation of noise-exposed workers in the workplace: a trained audiometrist, a soundproof room, and specialized, and costly technical equipment are no longer required, as is the case for the more conventional pure-tone air conduction screening audiometry (Stenfelt et al. Studies have shown that these tests can be used as a proper screening tool (Smoorenburg 1992 Smits et al. Over the past few years several internet-based speech-in-noise self-tests have been developed and investigated (Smits et al. Therefore, secondary prevention (i.e., early identification) of HFHL by screening is of great importance, and stimulates to take actions to prevent progression of the hearing loss (Meyer-Bisch 1996). In the Dutch construction industry, it is one of the most commonly reported occupational diseases (van der Molen et al. High-frequency hearing loss (HFHL), caused by excessive exposure to noise in the workplace, also known as noise-induced hearing loss (NIHL), is an important public health problem worldwide (May 2000 Sliwinska-Kowalska and Davis 2012).
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