Acoustic reflexes are common but not pervasive: evidence from the National Health and Nutrition Examination Survey, 1999-2012

Objective: To determine whether acoustic reflexes are pervasive (i.e. sufficiently prevalent to provide 95% confidence of at least 95% prevalence) and might be invoked in damage-risk criteria (DRC) and health hazard assessments (HHA) for impulsive noise.Design: Cross-sectional analyses of a nationally-representative study.Study sample: National Health and Nutrition Examination Survey (NHANES) data collected between 1999 and 2012 were used. Over 60 thousand reflex traces obtained from 15,106 NHANES participants were used in the study, along with demographic, audiometric, health and exposure variables obtained in that study.Results: Acoustic reflexes were not sufficiently prevalent to be deemed pervasive by any detection method or in any subgroup defined by age or audiometric characteristics. The odds of observing acoustic reflexes were greater for women, young adults, and people with better hearing sensitivity. Abnormally high tympanometric admittance and Other race/ethnicity (i.e. people who do not self-identify as exclusively Non-Hispanic White, Non-Hispanic Black, Mexican-American, or Hispanic) were associated with lower odds.Conclusions: Acoustic reflexes are not sufficiently prevalent to be included in DRC and HHA for impulsive noise.