AUDIOMETRY—THE ULTIMATE TEST OF SUCCESS?*

Occupational audiometry is examined in relation to, what are termed in the paper, scientific validity and social validity; the examination concentrates on occupational audiometry legislated in connection with occupational deafness. Under the general heading of scientific validity, the principal purposes claimed for occupational audiometry are identified in connection with legislation, and also the manner in which these purposes might be fulfilled by scientific means, including audiometry. We discuss the evaluation of occupational audiometry relative to the principal role we see for it in connection with the principal purpose: screening. The probable consequences of the U.K.'s legislative proposals for audiometry are estimated. Under the general heading of social validity, the purposes claimed for audiometry are viewed in respect of their probable social consequences including human rights, the well-being, and physical and mental health of the individuals identified and subsequently labelled as suffering from hearing loss, falsely or not. A framework for the evaluation of the social validity of occupational audiometry is proposed; factors are identified which should be taken into account in that evaluation. The conclusions state that audiometry has never been conclusively and exhaustively tested for its overall validity, scientific and social, so that it cannot be said whether occupational audiometry is the ultimate test of actions aimed at prevention of occupational deafness. The conclusions also state that, in certain circumstances, scientific procedures other than occupational audiometry possess the primary role. We see occupational audiometry as a scientific test which produces data possessing the potential for prejudicing human rights and we see decisions about legislation for it as matters for the legitimate political authority rather than the scientific or professional community.