Guidelines on the diagnosis and quantification of NIHL
Produced in partnership with Sue Brown
Guidelines on the diagnosis and quantification of NIHL

The following PI & Clinical Negligence guidance note Produced in partnership with Sue Brown provides comprehensive and up to date legal information covering:

  • Guidelines on the diagnosis and quantification of NIHL
  • The 2000 CLB guidelines
  • Requirement R1—High frequency impairment
  • Requirement R2(a)—Noise exposure (higher level)
  • Requirement R2(b)—Noise exposure (lower level)
  • Requirement R3(a)—Audiometric configuration
  • Requirement R3(b)
  • Modifying factor MF1—Clinical picture
  • Modifying factor MF2—Compatibility with age and noise exposure
  • Modifying factor MF3—Robinson’s criteria
  • more

The primary resource used by medicolegal experts and the courts in the diagnosis of noise-induced hearing loss (NIHL) is the document by R. E. Coles, M. E. Lutman and J. T. Buffin entitled 'Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes' published in April 2000 . The Guidelines in the industry are known as the CLB guidelines.

In 2015, the same authors wrote further guidelines on the quantification of NIHL and these were published in 2016 as the ‘Guidelines for quantification of noise-induced hearing loss in a medicolegal context’. The newer guidelines are known in the industry as the LCB guidelines. They were published to overcome the fact that the CLB guidelines were restricted to diagnosis of NIHL and could not be used for quantification of NIHL. Both guidelines are considered below.

The 2000 CLB guidelines

One of the difficulties with NIHL claims is that it is not enough to establish that the claimant

  1. (a) was exposed to hazardous noise levels at work, and

  2. (b) is deaf

in order to persuade a court that (a) caused (b). The damage caused by noise generally affects hearing in the higher frequencies, but the deafness caused by the ageing process (presbyacusis) also primarily affects the same frequencies, so some guidelines are needed to assist experts and the courts in distinguishing NIHL