Workplace noise exposure and the prevalence and 10-year incidence of age-related hearing loss

Bamini Gopinath; Catherine McMahon; Diana Tang; George Burlutsky; Paul Mitchell

doi:10.1371/journal.pone.0255356

Peer Review History

Original SubmissionJanuary 4, 2021
6 May 2021 Decision Letter - Peter Rowland Thorne, Editor PONE-D-21-00280 Workplace Noise Exposure and the Prevalence and 10-Year Incidence of Age-Related Hearing Loss PLOS ONE Dear Dr. Gopinath, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We apologise for the length of time to get the reviews to you. The paper has now been reviewed by two reviewers who have raised a number of points in the manuscript needing attention or clarification. A key point needing attention relates to the statistical analysis of prevalence and associations, along with more detail on the approach and choice of statistical tests in the Methods. In particular, please consider the reviewer's suggestion to use other statistical approaches such as the prevalence risk ratio instead of odds ratio. These should be addressed in the revised manuscript. Please submit your revised manuscript by Jun 11 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Peter R Thorne, CNZM PhD Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. 3. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works. - http://www.audiologiabrasil.org.br/icaeia2010/ica2010_anais.pdf - https://doi.org/10.3945/jn.110.122010 We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable, even for works which you authored. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications. Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work. We will carefully review your manuscript upon resubmission, so please ensure that your revision is thorough. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you for your manuscript. Please find my comments and suggestions for your consideration below. ABSTRACT: Line 39: Participants reporting any past noise exposure at baseline (please add: were at a) greater risk of developing hearing loss 10 years later: multivariable-adjusted OR 1.67 (95% CI 1.19-2.33). INTRODUCTION: The term 'ageing' and 'aging' has been used interchangeably throughout this manuscript. Please use one spelling for consistency. My suggestion would be 'ageing'. The acronym 'ARHL' is introduced on line 61. Please add in brackets when first mentioned on line 50, first sentence. Line 75: please change 'expose' to 'exposure'. RESULTS (n=2015). 68 plus a further 15 (total 83) were excluded (line 151-153). Line 154 says that this resulted in a total of 1923 subjects but 2015 minus 83 = 1932. Can you clarify and account for the missing 10 please? Line 155: '...679 participants who reported previous exposure to occupational noise and 1244 with no prior exposure'. This suggests that in total 679 participants reported occupational noise exposure. However, the 'N' for noise exposure in Tables 1 and 2 don't add up to 679. Please clarify. Can you describe how you categorised the severity of noise exposure (tolerable and severe) in your methods after line 130. Was 'mostly quiet' treated as no exposure; 'tolerable but able to hear speech' as tolerable; and 'unable to hear anyone speaking' as severe? DISCUSSION: Line 253 to 255, '...and that this appears to be related in part to the difficulties imposed by such protection upon communication with other workers, especially in an emergency (REF?)' Please add reference. Line 255: 'Indeed, in our study cohort we 'observed' only 10% of those exposed to occupational noise used any form of hearing protection devices'. I am not sure if you observed HPD use. Perhaps reword to: ' Indeed, in our study cohort 10% of those reporting exposure to occupational noise reported using any form of hearing protection devices'. Line 269 to 272: Is almost a direct quotation from the Dobie paper. That was a 2008 paper. Do Audiologists currently not provide counselling and periodic audiometry for those exposed to occupational and non-occupational noise exposure? Line 275 to 277: '...audiometric testing to measure hearing sensitivity rather than self-report...' Correct, but you relied on self-reported accounts of exposure to noise (duration, severity, etc). Could this not be a limitation of your study? You touch on it by comparing recall bias of people with and without hearing impairment. My suggestion is to discuss (a paragraph) why hearing conservation programmes and efforts to prevent exposure to occupational noise has been successful or not successful. For example, line 263: 'Although, case studies show that significant reductions can be achieved, there is no evidence that this is realised in practice [27]'. Why? REFERENCES: There are a few dated references especially related to occupational noise and hearing protection use.. For example, reference 27. There is a recent Cochrane review that should be cited instead. Reviewer #2: The paper is well written and the authors are clearly experts in this area. This article warrants publication but could benefit from some changes, namely in the statistical approach. My comments are meant to improve this piece. Introduction Line 50 – It seems something is missing, age-related hearing loss is more frequent compared to what? The introduction’s content around the disconnect between findings of noise-induced hearing loss in animal models versus large observational trials is appreciated but it would benefit from further discussion as to why the authors believe this disconnect is present and why their data will improve the literature (i.e., is it a lack of long-term follow up, specifically?). Methods Lines 79-80 – it seems the dates of the study are incongruent – the first line says 1997-2004 but the next line indicates data collected in 1992-1994. Please clarify. Was noise exposure measured only once? The section on noise exposure would benefit from a concrete definition of how noise will be models (i.e., the specific variable definition) in the statistical models in addition to describing the questions asked. For the authors’ consideration on the statistics: 1. Given the prevalence of hearing loss (i.e., hearing is not a rare event), it is likely that odds ratios overestimate the size effect, prevalence risk ratios would be more conservative and offer a more easily interpretable coefficient for the reader 2. Cox proportional hazard models could better examine the time-to-event incident hearing loss 3. Given the data available, linear fixed effects models could better characterize the longitudinal associations Results/Discussion These sections are great. The attempts to place the current findings within the context of other studies is important and the discussion of prevention is well done. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0255356.r001
Revision 1
11 Jun 2021 Author Response Reviewer #1: ABSTRACT: Line 39: Participants reporting any past noise exposure at baseline (please add: were at a) greater risk of developing hearing loss 10 years later: multivariable-adjusted OR 1.67 (95% CI 1.19-2.33). Author response: As suggested by the Reviewer we have now reworded this sentence. INTRODUCTION: The term 'ageing' and 'aging' has been used interchangeably throughout this manuscript. Please use one spelling for consistency. My suggestion would be 'ageing'. Author response: As requested, we have now used the term ‘ageing’ throughout our manuscript. The acronym 'ARHL' is introduced on line 61. Please add in brackets when first mentioned on line 50, first sentence. Author response: Apologies, we have now removed this acronym and replaced it with ‘age-related hearing loss.’ Line 75: please change 'expose' to 'exposure'. Author response: We have now changed it to ‘exposure’. RESULTS (n=2015). 68 plus a further 15 (total 83) were excluded (line 151-153). Line 154 says that this resulted in a total of 1923 subjects but 2015 minus 83 = 1932. Can you clarify and account for the missing 10 please? Author response: Apologies, this was a typographical error it should have been ‘1932’ not ‘1923’ we have now corrected this in the Results section. Line 155: '...679 participants who reported previous exposure to occupational noise and 1244 with no prior exposure'. This suggests that in total 679 participants reported occupational noise exposure. However, the 'N' for noise exposure in Tables 1 and 2 don't add up to 679. Please clarify. Author response: The N (%) presented in tables 1 and 2 denote those who had any, mild or moderate-severe hearing loss according to the different noise exposure variables (duration and/or severity). However, not all 679 participants exposed to noise had a hearing loss, hence, the N presented in these tables do not add up to 679 (as we did not present data for the normal hearing function group). Can you describe how you categorised the severity of noise exposure (tolerable and severe) in your methods after line 130. Was 'mostly quiet' treated as no exposure; 'tolerable but able to hear speech' as tolerable; and 'unable to hear anyone speaking' as severe? Author response: We now clarify in the Methods (lines 132-133) that: ‘Participants were classified as being exposed to ‘severe’ noise levels, if their response was that they were ‘unable to hear anyone speak’, all other responses were classified as a ‘tolerable’ level of noise.’ DISCUSSION: Line 253 to 255, '...and that this appears to be related in part to the difficulties imposed by such protection upon communication with other workers, especially in an emergency (REF?)' Please add reference. Author response: We have now added a reference for this statement. Line 255: 'Indeed, in our study cohort we 'observed' only 10% of those exposed to occupational noise used any form of hearing protection devices'. I am not sure if you observed HPD use. Perhaps reword to: ' Indeed, in our study cohort 10% of those reporting exposure to occupational noise reported using any form of hearing protection devices'. Author response: Agreed. We have now reworded this sentence as suggested by the Reviewer. Line 269 to 272: Is almost a direct quotation from the Dobie paper. That was a 2008 paper. Do Audiologists currently not provide counselling and periodic audiometry for those exposed to occupational and non-occupational noise exposure? Author response: We have clarified this statement and have cited a 2018 reference to support this: ‘Moreover, audiologists and otolaryngologists see patients who have significant unprotected occupational and non-occupational noise exposure, and as such they play an important role in providing counselling, hearing protection and periodic audiometry for these patients [30].’ Line 275 to 277: '...audiometric testing to measure hearing sensitivity rather than self-report...' Correct, but you relied on self-reported accounts of exposure to noise (duration, severity, etc). Could this not be a limitation of your study? You touch on it by comparing recall bias of people with and without hearing impairment. Author response: Agreed. We have now added the following study limitation (line 283): ‘Limitations of the study include potential systematic recall bias: participants self-reported duration and severity of noise exposure and participants…’ My suggestion is to discuss (a paragraph) why hearing conservation programmes and efforts to prevent exposure to occupational noise has been successful or not successful. For example, line 263: 'Although, case studies show that significant reductions can be achieved, there is no evidence that this is realised in practice [27]'. Why? Author response: This is a good suggestion by the Reviewer and we have reworded this section in the Discussion (lines 266-276): ‘Currently, there is very low‐quality evidence that the use of hearing protection devices in well‐implemented hearing loss prevention programmes is linked to reduced hearing loss but this could not be demonstrated for other aspects, such as monitoring of noise levels, worker training or audiometry alone [28]. Additionally, engineering solutions such as new equipment, segregation of noisy equipment, installation of panels or curtains were shown to significantly reduce noise levels in control intervention case studies [28]. However, longitudinal research on the effects of engineering interventions to reduce noise is needed. For instance, field case studies with valid measures of personal noise doses of workers with prospective follow‐up would provide better evidence than what is currently available [28]. At a minimum, for an effective and successful hearing conservation program - noise surveys and monitoring, employee education, training, and motivation, hearing protection equipment, audiometric testing, and record-keeping, as well as noise control are important [29].’ REFERENCES: There are a few dated references especially related to occupational noise and hearing protection use.. For example, reference 27. There is a recent Cochrane review that should be cited instead. Author response: We have now cited the 2017 Cochrane Review reference rather than the 2009 review, additionally we have added some more recent references. Reviewer #2: Introduction Line 50 – It seems something is missing, age-related hearing loss is more frequent compared to what? Author response: Agreed. We have now reworded this sentence as the following: ‘Age-related hearing loss is the most frequent communication disorder…’ The introduction’s content around the disconnect between findings of noise-induced hearing loss in animal models versus large observational trials is appreciated but it would benefit from further discussion as to why the authors believe this disconnect is present and why their data will improve the literature (i.e., is it a lack of long-term follow up, specifically?). Author response: Yes, the reviewer is correct about the lack of long term data on the association between noise exposure and hearing loss. However, in lines 74-76 we have already discussed the reason for the disconnect and how our study improves the literature: ‘Despite the burden of noise and age-related hearing loss, there are very few large population-based studies that have evaluated both the cross-sectional and longitudinal contribution of noise exposure to age-related hearing loss. Therefore, we propose to explore the prevalence, 10-year incidence and progression of hearing loss associated with occupational noise exposure among older adults aged 50+ years at baseline.’ Moreover, we have expanded a sentence in the Introduction (lines 62-65) to also further clarify this disconnect: ‘There is a paucity of longitudinal population-based studies that have investigated noise exposure and hearing decline and observational studies have thus far provided equivocal findings on the relationship between noise exposure and subsequent hearing loss in adults.’ Methods Lines 79-80 – it seems the dates of the study are incongruent – the first line says 1997-2004 but the next line indicates data collected in 1992-1994. Please clarify. Author response: This is correct because in line 87-88 we indicate that while the Blue Mountains Eye Study started in 1992 (or BMES-1), hearing was only measured from BMES-2 onwards (i.e. from 1997-99). We have tried to clarify this better in the Methods now. Was noise exposure measured only once? Author response: No, noise exposure was measured throughout the 10-year period of the hearing study but for the purposes of the current report we analysed baseline noise exposure with the prevalence and incidence of hearing loss. The section on noise exposure would benefit from a concrete definition of how noise will be models (i.e., the specific variable definition) in the statistical models in addition to describing the questions asked. Author response: We have now clarified the specific variable definition (lines 129-132): ‘Based on whether a respondent answered ‘yes’ or ‘no’ to this question, they were classified as having any exposure to occupational noise or no exposure to occupational noise, respectively, and this was the specific variable included in statistical models.’ For the authors’ consideration on the statistics: 1. Given the prevalence of hearing loss (i.e., hearing is not a rare event), it is likely that odds ratios overestimate the size effect, prevalence risk ratios would be more conservative and offer a more easily interpretable coefficient for the reader 2. Cox proportional hazard models could better examine the time-to-event incident hearing loss 3. Given the data available, linear fixed effects models could better characterize the longitudinal associations Author response: We have taken these suggestions by the Reviewer into consideration, and we now present risk ratios obtained by using linear fixed effects for longitudinal data (i.e. using Poisson Regression approach to prospective studies with Log as link function) in Table 3 and all text in the manuscript has been updated accordingly. Attachments Attachment Submitted filename: PlosOne_Noise exposure & HL_rebuttal.docx https://doi.org/10.1371/journal.pone.0255356.r002
15 Jul 2021 Decision Letter - Peter Rowland Thorne, Editor Workplace Noise Exposure and the Prevalence and 10-Year Incidence of Age-Related Hearing Loss PONE-D-21-00280R1 Dear Dr. Gopinath, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Peter Rowland Thorne, CNZM PhD Academic Editor PLOS ONE Additional Editor Comments (optional): The reviewers comments have been amended appropriately. There are a few minor typographical errors as listed which should be addressed during processing of the manuscript: Line 52 Ageing-related degenerati(on) may.. Line 232 ..the cochlea(r). Line 266 program - .Check consistency of spelling throughout (program vs programme Reviewers' comments: https://doi.org/10.1371/journal.pone.0255356.r003
Formally Accepted
22 Jul 2021 Acceptance Letter - Peter Rowland Thorne, Editor PONE-D-21-00280R1 Workplace Noise Exposure and the Prevalence and 10-Year Incidence of Age-Related Hearing Loss Dear Dr. Gopinath: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Peter Rowland Thorne Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0255356.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .