Medicolegal significance of asymmetrical hearing loss in cases of industrial noise exposure.

摘要

OBJECTIVE: In Australia, the current guidelines for evaluation of noise-induced hearing loss suggest that, in cases of asymmetrical loss, 'the worse ear be equated to the better ear' for purposes of compensation. This study aimed to establish that such a method was prejudicial to the worker (i.e. the plaintiff). In consideration of the legal duty 'to co-construct the ideas of truth and the ideas of justice in the context of legal proceedings', our study objectives were (1) to document the incidence of asymmetrical hearing loss in compensation cases seen in our practice, and (2) to provide a reasoned argument for inclusion of the same for compensation considerations. STUDY DESIGN: Open, retrospective, clinical study. SETTING: Australian plaintiffs with asymmetrical hearing loss (who comprise a significant percentage of industrial hearing loss legal cases) may be excluded from full consideration of their hearing loss as a result of the current guidelines. In contrast to the process of medical diagnosis and treatment, it appeared that the application of accepted probability standards within the legal process may permit inclusion of such clients' hearing loss in compensation considerations. METHODS: This study included 208 consecutive clients referred by legal practitioners for assessment of hearing loss for compensation purposes. RESULTS AND CONCLUSION: A total of 22.6 per cent of clients (47 of 208) had asymmetrical hearing loss, with the left side having the greater loss in 60 per cent of cases. We believe that asymmetrical hearing loss should be included in compensation considerations, both on medical and legal grounds.