Chapter 2 58 audiometry evaluates the detection of sounds in a quiet environment, and speechin-noise tests measure the ability to understand speech in a noisy environment (Rashid, 2018). Since difficulties with understanding speech in noise are the major complaint of people with hearing loss, speech-in-noise tests are considered most suitable for assessing functional hearing (Rashid, 2018; Smits et al., 2013). The Occupational Ear Check (OEC) is a Dutch speech-in-noise test that has been developed for occupational screening purposes (Ellis et al., 2006). For both ears separately, the signal-to-noise ratio (SNR) is assessed at which 50 percent of the speech stimuli can be identified correctly. Many researchers have investigated the reliability and validity of speech-in-noise screening tests for identifying hearing loss, which is also the case for the OEC (Leensen, 2013; Rashid, 2018). However, it is yet unclear if the poorer screening outcomes are also associated with higher LE and higher NFR.Therefore, the value of occupational hearing screening for identifying employees with subjective listening difficulties and/or difficulties with work participation is still unclear. In an earlier study, the outcome of a speech-in-noise test was significantly associated with LE, but not with the NFR (Van der Hoek-Snieders et al., 2020). This study included a clinical population and used a speech-in-noise test that is not designed for screening, but for clinical purposes. Also, the association between the outcome of the hearing screening, LE, andNFRmight be different for employees that experience different noise levels at their workplace, but an interaction effect with occupational noise was not investigated thus far. Therefore, the aim of this study was to assess the association between the hearing status measured with an occupational hearing-innoise screening test, LE, and NFR in employees, as well to examine whether these associations depend on the perceived noise level at the workplace. Methods Study design This cross-sectional and observational study was conducted at a manufactural company that produces coatings. We analyzed the outcome of an online survey and the outcome of an internet-based hearing screening. This screening is routinely administered at the company as part of a voluntary administered health check. The ethics Committee of the Academic Medical Center declared that no formal approval
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