Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 267–281)

1. Commonly used “noise thermometers”

   • often display data that underestimate true peak levels of firearm noise

   • are based on measurements from commonly available instrumentation (commercial sound level meters and dosimeters) that “saturate” or “clip” at approximately 150 dB

   • can provide misleading information that may cause an underestimation of auditory risk of firearm noise

   • should be updated to reflect true peak levels of firearm noise as measured at the shooter's ear

   • all of the above

2. Who of the following may be at risk for auditory damage from firearm noise?

   • The shooter

   • A bystander standing 1 meter to the left of the shooter

   • Sports officials using starter pistols

   • Athletes and spectators near officials who are firing starter pistols

   • All of the above

3. Although there are no mandated impulse noise limits imposed on recreational firearm shooters, the World Health Organization recommends peak sound pressure levels not exceeding

   • 100 dB for adults and 110 dB for youth

   • 120 dB for adults and 120 dB for youth

   • 140 dB for adults and 120 dB for youth

   • 160 dB for adults and 100 dB for youth

   • 150 dB for adults with no recommendation for youth

4. Which of the following increases the risk of damage to the auditory system?

   • The use of muzzle brakes (ports)

   • The number of shots fired

   • Shooting in an enclosed (reverberant) environment

   • The use of high-velocity (supersonic) ammunition

   • All of the above

5. A firearm suppressor

   • will consistently reduce the peak sound pressure level (SPL) values to below hazardous levels

   • will negate the need for the use of hearing protection

   • will reduce the peak SPL values of firearm noise, but the levels may still be hazardous to hearing

   • may also be called “silencers,” because they completely silence the impulse noise from a firearm

   • will reduce the SPL of supersonic ammunition to below 100 dB

6. Which of the following statements is accurate regarding the attenuation provided by specialized hearing protectors (electronic, small-orifice, filtered) designed for shooting sports?

   • Specialized hearing protectors provide audibility of low-level environmental sounds while attenuating high-level impulse signals.

   • The electronics are designed to be fast enough to attenuate the peak impulse noise signal.

   • The labeled Noise Reduction Rating may underestimate the actual attenuation provided by the device for impulse noise signals.

   • The fit of the electronic hearing protector is unimportant.

   • All of the above are accurate.

   Article Two (pp. 282–297)

7. The authors suggest that to increase effectiveness, hearing health messages should focus on

   • decreasing personal listening device (PLD) listening volume only

   • decreasing PLD listening duration only

   • stopping the use of PLDs

   • decreasing listening volume and/or durations based on listening activities and individual usage patterns

   • limiting PLD use to 2 hours per day

8. In the current study, listening durations and volumes showed an association with

   • age: listening durations decreased with age and younger users listened at higher volumes than those age 50 and over

   • age: listening durations increased with age and younger users listened at lower volumes than those age 50 and over

   • sex: males listened for longer durations and at higher volumes

   • sex: females listened for longer durations and at higher volumes

   • B and C

9. This study showed that

   • all PLD users are at high risk of hearing damage

   • PLD users are safe from hearing damage as long as they do not participate in other noisy activities

   • only young PLD users are at risk of hearing damage

   • approximately 15% of PLD users are at risk for hearing damage from their PLD listening habits alone

   • approximately 50% of PLD users are at risk for hearing damage from their PLD listening habits alone

10. Compared with the low-risk group, the higher-risk PLD groups

    • showed a greater proportion of selfreported hearing loss

    • were more likely to report experiencing difficulties relating to speech and conversation

    • reported listening at higher volumes

    • were more likely to listen for longer durations for most activities

    • all of the above

11. This article examined risk in relation to PLD daily noise dose (DND). A single PLD DND is equivalent to

    • listening for 90 minutes at a volume of 80 dB

    • listening for 8 hours at a volume of 85 dB

    • listening for 22 minutes at 90% volume

    • listening for 3 hours at 70% volume

    • both A and C

    Article Three (pp. 298–318)

12. Unlike occupational noise, recreational noise is likely to be

    • easier to assess as a potential hazard for hearing loss

    • a fluctuating exposure of shorter duration as compared with occupational noise

    • an exposure that imposes a potentially high risk for hearing loss

    • a hazard that may result in “hidden hearing loss” based on data from a number of human studies

    • more frequently and consistently experienced

13. In the noise exposure questionnaire, the annual recommended exposure limit was

    • calculated for the combined occupational and nonoccupational exposures for 8,760 hours per year

    • a daily limit of 85 A-weighted decibels for 24 hours.

    • calculated for occupational exposures only

    • derived using a 5 dB exchange rate

    • derived using a 3 dB exchange rate for occupational exposures and a 5 dB exchange rate for recreational exposures

14. In the current study, women generally had

    • higher wave I amplitudes for tonebursts only

    • lower signal-to-noise ratios on the Words in Noise test

    • higher auditory brainstem response (ABR) wave I amplitudes

    • equal ABR wave I amplitudes compared with men

    • reduced ABR wave I amplitudes for clicks and tone-bursts as a function of increased noise exposure

15. Reductions in ABR wave I amplitude have been associated with which of the following in the literature?

    • Aging

    • All cases of hazardous noise exposure

    • Permanent threshold shifts only

    • Mice with low-frequency temporary threshold shifts

    • Permanent shifts in distortion product otoacoustic emission thresholds

16. Why is the concept of “hidden hearing loss” important?

    • It suggests that noise exposure that produces a temporary threshold shift can also have long-term consequences.

    • It consistently occurs in humans and underlies speech-in-noise difficulty in normal-hearing persons.

    • It appears to be undetectable by the most common clinical tests of hearing (the audiogram and distortion product otoacoustic emissions).

    • It is not important. The audiogram is sufficient for identifying noise injuries to the auditory system.

    • Both A and C are correct.

    Article Four (pp. 319–331)

17. Approximately what proportion of participants believed that using a personal stereo player is a risk for hearing injury?

    • One in five

    • 90%

    • Close to one-third

    • Less than 5%

    • 75%

18. Which of the following statements is false?

    • Compared with normal hearing (NH) group participants, significantly fewer young adults with hearing impairment (HI) believed a future change in their hearing is likely.

    • Approximately 25% of participants with HI were not worried about the possibility of their hearing getting worse in the future.

    • There was no statistically significant difference between the HI and NH groups in worry about hearing getting worse in the future.

    • More participants with HI believed nightclubs and concerts pose a threat to hearing health than NH participants.

    • Half of the participants in the HI group were concerned about the possibility of their hearing getting worse in the future.

19. For young people in general, which of the following statements is correct?

    • Approximately 65% of all participants believed nightclubbing or loud concerts pose a risk.

    • More than 80% of NH group participants believed leisure-noise exposure contributes to developing a hearing loss.

    • A significantly higher proportion of the HI group believed the leisure activities of their peer group place them at risk.

    • Only one-third of the NH group believed their own activities pose a risk.

    • Use of personal stereo players was most frequently rated as a risk factor (both HI and NH groups).

20. Hearing aid use was reported during which of the following activities?

    • Nightclubbing

    • Shooting

    • Using power tools

    • Doing motor sports

    • All of the above

21. Which of the following points is made in the conclusion section of the article?

    • More research into the leisure activities of young people is needed.

    • Noise reduction in social venues should be pursued as a public health initiative.

    • Audiologists should place more emphasis on hearing loss prevention education.

    • Making hearing protectors more accessible would reduce community noise risk.

    • Lowering noise in social venues would make them less attractive to patrons.

    Article Five (pp. 332–347)

22. A positive attitude to noise indicates

    • that loud noise is not perceived as dangerous

    • that a person dislikes loud noise

    • that a person can hear better in loud noise

    • that loud noise is perceived as dangerous

    • a belief that ears get used to loud noise

23. At what decibel level can frequent exposure become risky?

    • 50

    • 70

    • 90

    • 110

    • 130

24. Which one of these factors was not identified as a barrier to earplug use?

    • They look silly.

    • They make the music sound muffled.

    • They do not protect your ears.

    • It is difficult to hear conversation.

    • They are uncomfortable.

25. The typology described in this article grouped participants based on

    • whether they have tinnitus or hearing loss

    • positive or negative attitudes to noise

    • how much loud music they listen to

    • their attitudes and behaviors toward leisure noise and hearing protection

    • how long they have had their hearing problems

26. Which one of these factors was a motivator for wearing earplugs?

    • Earplugs were a requirement of the venue

    • Previous experience of noiseinduced hearing problems

    • Wanting to protect their hearing

    • A and B

    • B and C

    Article Six (pp. 348–358)

27. What is the perceived benefit of loud sound?

    • Arousal/excitement

    • Facilitation of socialization

    • Masking of both external sound and unwanted thoughts

    • To emphasize and enhance personal identity

    • All of the above

28. In classical conditioning, what is the unconditioned stimulus?

    • A naturally desirable stimulus

    • A naturally undesirable stimulus.

    • A stimulus that is initially neutral but that becomes desirable through conditioning

    • Loud sound

    • Any detectable stimulus

29. What is meant by “auditory adaptation”?

    • Processes such as inserting earplugs or otherwise attenuating sound

    • Turning down the volume on music amplifiers

    • Changes in the sensory cells and neurons of the auditory system in response to the ambient sound levels

    • Raising one's voice to talk in noisy rooms

    • All of the above

30. What are the soundscape dimensions of relevance to the perception of music in nightclubs?

    • Fun and excitement

    • Speed and activation

    • Loudness and pitch

    • Eventfulness and pleasantness

    • All of the above

31. What are the two main components of the theory of why people like loud sound proposed here?

    • Earplugs should be worn in nightclubs, and personal audio systems should be volume-limited.

    • The enjoyment of loud sound is conditioned, and tolerance to loud sound occurs via physiological adaptation.

    • Loud sound is fun, and people want it.

    • Everybody likes loud sound, and nightclubs meet that desire.

    • Loud music has psychological benefits, and other loud sounds cause harm.