Annals of Occupational and Environmental Medicine

Volume 16 (4); December 2004

Case Report

A Case of Lung Cancer Caused by Long-Term Asbestos Exposure: Dong Young Yoon, Jin Wook Kang, Hyun Jae Lee, Jung Il Kim, Ji Eun Son, Kap Yeol Jung, Joon Youn Kim, Mee Sook Roh; Korean Journal of Occupational and Environmental Medicine 2004;16(4):499-507. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.499

OBJECTIVES
To report a case of lung cancer caused by long-term asbestos exposure in a shipyard.
METHODS
We evaluated chest X-ray, pulmonary function test, and chest CT and analyzed asbestos concentration in the lung tissue and bulk sample from the workplace. We also performed a workplace survey.
RESULTS
The patient had worked at the shipyard for 31 years. The biopsy samples were processed to determine the asbestos content in the lung tissue and bulk sample using a transmission electron microscope (TEM) equipped with an energy dispersive X-ray analyzer (EDX). The TEM-EDX analysis revealed many asbestos fibers, the majority of which were amosite. In addition, the concentration asbestos fibers in the workplace exceeded the occupational exposure limits of asbestos.
CONCLUSIONS
Our findings strongly suggest that this patient's lung cancer was related to the long-term asbestos exposure.

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Gastric and rectal cancers in workers exposed to asbestos: a case series
Byeong Ju Choi, Saerom Lee, Iu Jin Lee, Soon Woo Park, Sanggil Lee
Annals of Occupational and Environmental Medicine.2020;[Epub] CrossRef
Radiologic Diagnosis of Asbestos-Related Lung Cancer
Yoon Kyung Kim, Jeung Sook Kim, Yookyung Kim
Journal of the Korean Society of Radiology.2015; 73(6): 347. CrossRef
Comparison of cancer incidence between production and office workers at a shipyard in Korea: A retrospective cohort study from 1992 to 2005
Kyoung‐Sook Jeong, Yangho Kim, Moon‐Chan Kim, Cheol‐In Yoo
American Journal of Industrial Medicine.2011; 54(9): 719. CrossRef
Occupational Respiratory Cancer in Korea
Hye-Eun Lee, Hyoung Ryoul Kim
Journal of Korean Medical Science.2010; 25(Suppl): S94. CrossRef

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Original Article

Risk Factors of Work-related Musculoskeletal Symptoms Among Motor Engine Assembly Plant Workers: Young Ki Kim, Dong Mug Kang, Sang Baek Koh, Byung Chul Son, Jung Won Kim, Dae Whan Kim, Gun Hyung Kim, Seong Ho Han; Korean Journal of Occupational and Environmental Medicine 2004;16(4):488-498. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.488

Abstract PDF

OBJECTIVES
To determine the synthetic risk factors of musculoskeletal disorders, and to examine effect on musculoskeletal symptoms of physical work intensity and change of work intensity.
METHODS
Self-administered questionnaraire survey was conducted on 588 motor engine assembly workers, in Chanwon, Kyungnam provance, Korea, from April 1 to May 31, 2003. The contents of the questionnaire investigation included general characteristic items, workrelated characteristic items, presence of musculoskeletal symptoms, ergonomic risk factors items, job stress items, current physical work intensity and changes of work intensity items. The results underwent statistical analysis with frequency test, t-test, and logistic regression. The statistical significance level was 0.05, and SAS(v8.1) was used.
RESULTS
Multiple logistic regression analysis was used to examine the relationship between risk factors and musculoskeletal symptoms. From the results, significant variables were high Quick Exposure Check (QEC) score, high job demand control, physical work intensity, change of work intensity.
CONCLUSION
Among the known risk factors of musculoskeletal disorders, the outbreak of musculoskeletal symptoms was confirmed to be correlated with age, tenure, ergonomic risk factors, and job stress. Physical work intensity and the changes of work intensity were also related to musculoskeletal symptoms.

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Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers
Young Hoon Moon, Young Joon Yang, Sang Yoon Do, Jae Yoon Kim, Chul Gab Lee, Hong Jae Chae, Soo Hyeon Kim, Han Soo Song
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Work-related Musculoskeletal Disorders in Korea Provoked by Workers’ Collective Compensation Claims against Work Intensification
Dongmug Kang, Youngki Kim, Young-Il Lee, Sangbaek Koh, Inah Kim, Hoonkoo Lee
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef
Musculoskeletal Symptoms and Its Related Factors among Male Workers in a Nonferrous Manufacturing Industry
Yeon-Ok Jeong, Young-Chae Cho
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Ji-Hyuk Park, Hyun-Sul Lim, Kwan Lee
Journal of Preventive Medicine and Public Health.2010; 43(3): 205. CrossRef
Gender-related Factors Associated with Upper Extremity Function in Workers
Kyoo Sang Kim, Min Gi Kim
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Original Article

Effect of Soft Drink on Urinary Hippuric Acid Excretion in Workers Exposed to Low dose Toluene: Yong Jin Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(4):475-487. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.475

Abstract PDF

OBJECTIVES
To investigate the effect of soft drink containing benzoic acid on the excretion of urinary hippuric acid after ingestion of soft drink containing benzoic acid before working (Edthe deleted section is not an objective).
METHODS
Fifty workers (male, 35; female, 15) exposed to toluene in Choongchung province area were studied. Urinary samples were collected on two days. On the first day, all study subjects were required to avoid any soft drink containing benzoic acid for the 24-hour period before urine collection. After emptying their bladder before starting work, the total volume of urine for the full shift period was collected and spot urine was collected at the end of the shift. On the second day, all workers were provided with soft drink containing benzoic acid before the shift and the same urine collection procedure was applied as on the first day. The air concentrations of toluene for each workers was measured with personal air sampling with 3M organic solvent badge. Personal informations such as age, sex, smoking and drinking habit were collected by self-administered questionnaire method.
RESULTS
The geometric mean of urinary hippuric acid without ingestion of soft drink containing benzoic acid was 0.49+/-0.45 g/g creatinine in total volume urine, and 0.51+/-0.53 g/g creatinine in spot urine, whereas the equivalent results with ingestion of soft drink were increased to 0.92+/-0.61 g/g and 0.96+/-0.78 g/g, respectively. Stepwise multiple regression of urinary hippuric acid with air concentration of toluene, benzoic acid and other covariates revealed that 49% and 11% of urinary hippuric acid concentration in total volume urine analysis were attributed to the air concentration of toluene and benzoic acid, respectively, compared to 45% and 6% in spot urine analysis, respectively. On the other hand, taking the difference of urinary hippuric acid before and after ingestion of soft drink containing benzoic acid as a dependent variable and taking the air concentration of toluene, benzoic acid and other covariates as independent variables, stepwise multiple regression analysis revealed that 14% and 13% of urinary hippuric acid concentration in total volume urine analysis were attributed to the air concentration of toluene and benzoic acid, respectively, whereas only 9% of urinary hippuric acid concentration in spot urine analysis was attributed to the air concentration of toluene, (Ed- note that there is no respective comparison here).
CONCLUSION
Soft drink containing benzoic acid significantly affected the level of urinary hippuric acid after ingestion of soft drink before working. It is recommended that for the accurate elevation of urinary hippuric acid as an index of toluene exposure, detailed information on soft drink containing benzoic acid needs to be checked in the process of the health examination of toluene exposure workers.

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Effects of Factors Associated with Urine Hippuric Acid Correction Values in Urinary Creatinine by HPLC and Jaffe Method and Specific Gravity HPLC Jaffe Method
Key-Young Kim, Jong-Gyu Kim, Ki-Nam Yoon, Wha-Me Park, Hun-Hee Park
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 493. CrossRef

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Original Article

Level of Problem Drinking, Health Status and Perception of Need for Moderate Drinking by Male Blue-collar Workers in Steel Factory: In Young Yoo, Ji Yeon Choi, Moon Hee Jung; Korean Journal of Occupational and Environmental Medicine 2004;16(4):467-474. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.467

Abstract PDF

OBJECTIVE: This study was conducted to investigate the level of problem drinking by male blue-collar workers in light of their health status and their perception of drinking amount.
METHOD
A steel factory located in the central region of Korea was chosen and 182 questionnaire responses from male workers were analyzed using the SPSS/WIN 11.0 in reference to each worker's physical examination record.
RESULTS
According to the criteria set by WHO, 19 workers(10.4%) were found to have 'problem drinking', 81 workers(44.5%) 'alcohol use disorder'and 14 workers(7.7%) 'alcohol dependence'. Only the remaining 68 workers(37.4%) were found to have 'normal drinking'. In relation to the workers'health status by CMI, 'alcohol dependence'scored 62.92, and 'alcohol use disorder'scored 56.53, both of which were far higher than the 'problem drinking'score of 44.52, In particular, it was found that each of the diabetes group(t=2.32, p<.05) and the liverdisease group(t=2.01, p<.05) drank much more than the non-diabetes group or the non-liver-disease group. In terms of the workers'perception of drinking amount, 'alcohol use disorder'and 'alcohol dependence'scored 147.62 and 144.21 respectively, both of which were far higher than the 'problem drinking'score of 138.57.
CONCLUSION
The above results suggest the need to educate workers on the necessity and practices of moderate drinking before they enter a state of alcohol use disorder or alcohol dependence. Accordingly, as a part of early management and treatment of the workers'drinking problem, it may well be necessary to activate OAPs (Occupational Alcohol Programs).

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Association between Psychosocial Work Environments and Problem Drinking: Age Differences in Korean Male Workers
Gyeong-Suk Jeon, Eun-Sook Choi
Korean Journal of Occupational Health Nursing.2011; 20(2): 119. CrossRef

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Original Article

The Relationship between Heart Rate Variability and Metabolic Syndrome at a Rural Area: Kyoung Bok Min, Jin Young Min, Kyung Hee Jung-Choi, Hyung Joon Jhun, Sung Il Cho, Domyung Paek; Korean Journal of Occupational and Environmental Medicine 2004;16(4):459-466. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.459

Abstract PDF: OBJECTIVES
The purpose of the present study was to estimate the prevalence of metabolic syndrome and to investigate the relation between metabolic syndrome and heart rate variability in a community population.
METHODS
The study design was cross-sectional, and 1028 subjects, aged 20~87 years, were recruited. Heart rate variability was measured in the sitting position for five minutes. The recorded data were assessed by time-domain (standard deviation of RR interval) and frequencydomain analysis. All subjects were examined for five components of metabolic syndrome.
RESULTS
The prevalence of metabolic syndrome in male and female subjects was 25.9% and 27.7%, respectively. The mean value of heart rate variability of the subjects was significantly different between healthy subjects and those with metabolic syndrome. The regression model showed that metabolic syndrome was negatively correlated with heart rate variability.
CONCLUSIONS
The results demonstrate that metabolic syndrome has potentially negative effects on the cardiovascular system, and that these effects could be detected by heart rate variability. Follow-up studies able to control the cohort effect are necessary to evaluate the relation between metabolic syndrome and heart rate variability.

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Original Article

Relationship between Job Stress and Pulse Wave Velocity as a Cardiovascular Risk Factor: Jung Ok Kong, Sang Baek Koh, Sei Jin Chang, Bong Suk Cha, Ho Keun Chung, Hong Ryul Choi, Kyung Hee Jung-Choi, Soon Ja Jeon; Korean Journal of Occupational and Environmental Medicine 2004;16(4):450-458. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.450

Abstract PDF

OBJECTIVE: The objective of this study was to elucidate the relationship between job stress and pulse wave velocity (PWV) as a cardiovascular risk factor.
METHOD
The study design was cross-sectional, and a total of 234 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude) using a modified Karasek model. Cuffs were applied to the extremities and a microphone for phonocardiography was placed at the second intercostal space at the margin of the sternum. The subjects rested in a supine position for 5 min, and PWV was measured using a VP-1000(Colin Waveform analyzer).
RESULTS
There were significant correlations between blood pressure, glucose, total cholesterol, coagulation factor and PWV. The group with low decision latitude and high decision latitude showed higher levels of PWV, but the differences were not significan. The PWV (left) was significantly higher in the high strain group than in the lower strain group. After adjustment for age and cardiovascular risk factors, job strain was still associated with PWV.
CONCLUSION
These result suggest that the high strain group among workers is related to an increased risk of PWV as a marker of atherosclerosis.

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Original Article

Multilevel Analysis of Risk Factors Related to Musculoskeletal Symptoms among Caterers for Elementary School Lunch Services: Kyung Hee Jung-Choi, Sang Yun Lee, Myung Ki, Kee Hong Cho, Hee Tae Kang, Young Jun Kwon, Hyun Joo Kim, Myoung Hee Kim, Kyoung Bok Min, Hye Sook Park, Jeong Youn Kim, Eun Hee Ha, Do Myung Paek; Korean Journal of Occupational and Environmental Medicine 2004;16(4):436-449. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.436

Abstract PDF

OBJECTIVES
To examine the complaint proportion and characteristics of musculoskeletal symptoms and to find risk factors of musculoskeletal symptoms among caterers for school lunch services.
METHODS
The study subjects were 385 caterers who were working for school lunch services in 71 elementary schools and 114 housewives who had visited a hospital for routine health check-up. A self-recording questionnaire was used to investigate the general characteristics, labor conditions, job stress and nature of musculoskeletal symptom. Caterers were surveyed from September to October in 2003 and the housewives during September by post. The ergonomic risk factors were examined for the caterers of an elementary school in Kyonggi Province in November, 2003.
RESULTS
The complaint proportion of self-reported positive musculoskeletal symptoms was 52.0% and that of severe musculoskeletal symptoms was 24.9%. Ergonomic assessment revealed that washing the dishes, carrying the soup containers and cleaning the sewage drain were highly risky activities in terms of repetitive and heavy weight-bearing motions. As for personal factors, the caterers having severe musculoskeletal symptoms had high psychological job demand. As for the workplace factors, the proportion of schools having severe musculoskeletal symptoms was significant higher where each caterer prepared more than 150 lunches. Among schools without school lunchroom, more schools had caterers having severe musculoskeletal symptoms. Using multilevel analysis, we found that the number of lunches to be prepared per caterer was a significant risk factor of severe musculoskeletal symptoms (O.R. 4.67).
CONCLUSIONS
This study showed that the number of lunches prepared per caterer has a significant influence on the development of musculoskeletal disorder and that caterers work in an ergonomically highly risky job environment. The study results suggest that the number of caterers be increased to decrease the number of lunches prepared per caterer and the ergonomic environment be improved.

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Young Hoon Moon, Young Joon Yang, Sang Yoon Do, Jae Yoon Kim, Chul Gab Lee, Hong Jae Chae, Soo Hyeon Kim, Han Soo Song
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Job Stress and Musculoskeletal Disorder in Seoul City's School Foodservice Employees
Saerom Lee, KyooSang Kim, Eun-A Kim, Jihye Kim, Dohyung Kim
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Youn-Bum Sung, Hyung-Seok Seo, Jung-Ho Lee, Young-Han Park
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Kyung-Sun Lee, In-Seok Lee, Hyun-Joo Kim, KyungHee Jung-Choi, Jin-Wook Bahk, Myung-Chul Jung
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Original Article

Characteristics and Odds Ratio of Work Related Musculoskeletal Disorders According to Job Classification in Small-to-medium-sized Enterprises: Shin Goo Park, Jong Young Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(4):422-435. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.422

Abstract PDF

OBJECTIVES
This study was carried to investigate the prevalence and odds ratio of work related musculoskeletal disorders according to the job classification in small-to-medium-sized enterprises(<300 employee).
METHODS
A questionnaire survey was given to 746 workers in 8 workplaces. 501 workers (67.2%) were finally selected in this study. The workers in the 8 workplaces was divided into 7 jobs. Those were manufacturers(metal), assemblers(appliances), cashiers, packers(cosmetics), garbage collectors, and VDT workers. Multiple logistic regression was used to estimate the odds ratios of the musculoskeletal symptoms according to the job classification.
RESULTS
Univariate analysis showed that the significantly related risk factors for musculoskeletal symptoms are as follows; age, marital status, gender, work load change, work duration, hours worked per day, job demand, decision latitude, type of job. According to the type of job, the prevalence of musculoskeletal symptoms were 7.7%(clerks), 24.3%(manufacturers), 30.0%(assemblers), 23.0%(cashiers), 30.4%(packers), 11.9%(garbage collectors), 29.2%(VDT workers). Multiple logistic regression showed that the following significant odds ratios (referenceclerks): 7.32(packers), 5.63(assemblers), 5.11(cashiers), 4.79(VDT workers), 3.11(manufacturers).
CONCLUSION
In small-to-medium-sized enterprises, the job classification was major risk factor for work related musculoskeletal disorders. According to the job classification, the odds ratios of the work related musculoskeletal disorders were different. Considering the odds ratios, the establishment of a prevention program of work related mus-culoskeletal disorders is recommended.

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The association between long working hours and work-related musculoskeletal symptoms of Korean wage workers: data from the fourth Korean working conditions survey (a cross-sectional study)
Jae-Gwang Lee, Guang Hwi Kim, Sung Won Jung, Sang Woo Kim, June-Hee Lee, Kyung-Jae Lee
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Seung-Hyun Lee, Ju-Yeon Lee, Young-Chae Cho
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Kyoo Sang Kim, Min Gi Kim
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Original Article

Urinary Cotinine Concentrations of Cases with Green Tobacco Sickness: Kwan Lee, Hyun Sul Lim, Heon Kim, Si Hyun Nam; Korean Journal of Occupational and Environmental Medicine 2004;16(4):413-421. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.413

Abstract PDF

OBJECTIVES
This study was carried out to measure the urinary cotinine concentrations of Korean tobacco harvesters with green tobacco sickness (GTS).
METHODS
We conducted a questionnaire survey and measured the urinary cotinine concentrations among the cases who visited six health subcenters and the emergency room in the Health Center and County Hospital after harvesting tobacco leaves in Cheongsong-gun, from Jul 15 to Aug 15, 2002. Ten suspected GTS cases were compared to 10 controls matched for residence, age, and sex. Urinary cotinine was analyzed with a reverse-phase high performance liquid chromatography (HPLC) system and expressed as geometric mean and standard deviation. The data collected were evaluated using the SPSS/win statistical package and the urinary cotinine concentrations between the two groups were analyzed by Mann-Whitney U test.
RESULTS
In both the 10 cases and controls, there were 3 males and 7 females. Ages ranged from 22 to 70 years old. Half of the cases were reported within the 6 hours between 12:00 pm and 17:59 pm. The median time from starting work to initially feeling ill was 4.3 hours (min. 2.5; max. 11.0). The GTS symptoms reported were nausea in 10 cases (100.0%), dizziness in 9 (90.0%), weakness in 8 (80.0%), headache in 7 (70.0%) and other symptoms. The geometric mean of urinary cotinine concentrations was significantly higher (p<0.01) in cases at 497.6 +/- 2.5 ng/ml (min. 73.1; max. 2,574.3) than in controls at 32.7 +/- 1.8 ng/ml (min. 13.3; max. 76.9).
CONCLUSIONS
Our study suggests that many tobacco harvesters may suffer from GTS in Korea. Therefore, it is very important for doctors to diagnose exactly the GTS. Also we must develop the methods which can prevent GTS, and simple methods of analysis for urinary cotinine.

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Original Article

The Relationship between Musculoskeletal Symptoms and Job Stress & Intensity of Labor among Shipbuilding Workers: Inah Kim, Sang Baek Koh, Jeong Soo Kim, Dong Mug Kang, Mia Son, Yongkyu Kim, Jaechul Song; Korean Journal of Occupational and Environmental Medicine 2004;16(4):401-412. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.401

Abstract PDF

OBJECTIVES
This study aimed to reveal the multiple factors that are related to the work-related musculoskeletal disorders (WMSDs) of shipbuilding workers, and to elucidate the relationship between musculoskeletal symptoms and factors such as the change of working conditions, job stress and physical workload.
METHODS
The study sample comprised 1,059 shipbuilding workers. A structured-questionnaire was used to assess the general characteristics, job stress, psychosocial well-being index (PWI), physical workload, change of working conditions and information concerning musculoskeletal symptoms. We estimated the relations of job stress, physical workload and intensity of labour to musculoskeletal symptoms using univariate and multiple logistic regression analyses.
RESULTS
The symptom prevalence of musculoskeletal disorders in any part of the body was 89.5% by 'criteria 1'in the order of back (58.6%) and shoulder (56.3%). After adjustment for sociodemographic factors, posture factor (Odds ratio [OR]=1.06, 95% confidence interval [ C I ] = 1 . 0 0~1.12), non-posture factor (OR=1.17, CI=1.05~1.31), Borg scale (OR=1.15, C I = 1 . 0 0~1.32), relative work intensity increase (OR=1.92, CI=1.08~3.41), labor flexibility increase (OR=2.04, CI=1.04~4.01), high job demand (OR=2.68, CI=1.48~4.88), and high risk stress group (OR=13.50, CI=3.15~57.97) were all found to be significantly associated with musculoskeletal disorders.
CONCLUSION
These results suggest that WMSDs have multiple risk factors such as stress, physical workload and change of working conditions. High job demand, increased relative intensification of work and increased flexibility, especially such as subcontract, outsourcing and importing of contingent work, were very important factors associated with increasing WMSDs.

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Original Article

Evaluation of Ototoxicity by Mixed Organic Solvents Using the Upper Limit of Hearing: Ji Ho Lee, Cheol In Yoo, Choong Ryeol Lee, Hun Lee, Young Hee Choi, Nam Jung Kim, Yangho Kim; Korean Journal of Occupational and Environmental Medicine 2004;16(4):391-400. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.391

Abstract PDF: OBJECTIVES
This study evaluated the ototoxicity by mixed organic solvents on workers'hearing using the upper limit of hearing(ULH).
METHODS
Seven hundred ninety-seven male workers in the ship building industry who were evaluated by interview with an upper limit of hearing from August 2000 to July 2002 were enrolled in the study. The subjects were divided into 3 groups according to exposure profile and job: officers, field supporters, and painters. To assess the ototoxicity of mixed organic solvent exposure on hearing, with regard to confounders, the general liner model was used.
RESULTS
After controlling for the possible confounders, such as age, career, noise exposure level, tinnitus, alcohol intake, and smoking, the estimated mean for ULH of the painter group was higher than that of the officer and the field supporter groups. These differences of mean ULH were at the borderline of statistically significance(p=0.069).
CONCLUSIONS
The results of this study suggest that a relatively lower level of mixed organic solvent chronically affected the hearing organ or auditory pathway. ULH seems to be a useful method for early detection of the ototoxicity of organic solvents.

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Original Article

Acoustic Calibration of Clinical Audiometers Used for Special Periodic Health Examination: Kyoo Sang Kim, Yong Lim Won, Soo Young Chung, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 2004;16(4):381-390. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.381

Abstract PDF

OBJECTIVES
Various problems are encountered during audiometric testing. Deviation from reference threshold levels for supra-aural earphones is often a serious problem when hearing levels are measured. This paper reports the acoustic calibration of clinical audiometers used for special periodic health examination.
METHODS
ANSI S3.6-1996 Specification for Audiometers represents our most current and best resource for information regarding audiometers. The acoustic calibration was measured in 211 clinical audiometers and compared with the ANSI S3.6-1996 reference threshold levels for supra-aural earphones.
RESULTS
Among 211 clinical audiometers, 56 (26.5%) exceeded the permitted deviation from reference threshold levels at any test frequency in ANSI S3.6-1996 for left supra-aural earphones, and 54 (25.6%) for right. An exhaustive calibration was required for 16 audiometers (7.6%) in both supra-aural earphones. The absolute difference in dB deviation from reference threshold levels by performed acoustic calibration at least annually were statistically significant at any test frequency (p<.05).
CONCLUSIONS
The results of this study strongly indicate that clinical audiometry is being conducted with pure-tone audiometers having unallowable sound pressure levels deviations for supra-aural earphones. The validity of audiometric hearing thresholds are significantly affected by these deviations from the acoustic calibration levels of audiometers. Therefore audiometer calibration need to be checked functionally daily and acoustically at least annually.

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Development of Linux based Real-Time Spectrum Analyzer for Puretone Audiometer
Deok-Hun Kang, Bum-Joo Shin, Gye-Rok Jeon, Soo-Geun Wang
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(6): 2830. CrossRef

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