Abstract:

An epidemiologic study by LaLande and colleagues has found hearing loss among children of women who were occupationally exposed to industrial noise during pregnancy. Other populations of noise-exposed women should be studied to determine if these findings can be replicated and to characterize the dose--response curve. There are many challenges to overcome in order to carry out such a study. These include: (1) obtaining access to an exposed population; (2) obtaining a large enough sample size, while avoiding selection bias; (3) accurately measuring noise exposure levels during pregnancy; (4) assessing the potential impact of confounders, such as noise exposure during toddlerhood, medical causes of hearing loss not related to noise exposure, and others; (5) obtaining adequate follow up of the cohort of children, and then obtaining a high consent rate to perform audiograms to detect small but clinically important decrements in hearing thresholds; (6) maintaining audiometry quality control if subjects are geographically dispersed; (7) obtaining funding for the study; and (8) developing preventive interventions that will minimize discrimination against women who work in noisy environments. Although these challenges exist, they are not insurmountable.