Introduction. This study is relevant due to the practice’s need for physiologically adequate criteria for diagnosing the state of the hearing organ of personnel exposed to the cumulative effects of high-intensity pulsed low-frequency noise. 
 The aim of the study was the theoretical and experimental substantiation of the criteria for diagnosing the state of the hearing organ according to the results of the study of the acoustic reflex.
 Materials and methods. Using the two-microphone technique of acoustic measurements, experimental studies of changes in the acoustic reflex were carried out in representatives of the experimental (subjected to cumulative effects of high-intensity pulsed low-frequency noise, n=5) and control (not subjected to such effects, n=12) groups. A total of 256 measurements were made within 6 days (191 in the control group and 65 in the experimental group) before exposure (background) and at the end of the working day. The measurement results were processed using methods of mathematical statistics: tests to determine outliers in the data set, estimates of the coefficient of variation, standard deviation, and boundaries of the 99% confidence interval of changes in the studied indicators were calculated.
 Results. Studies of the effect of high-intensity impulse noise on the organ of hearing showed that with minor changes in the threshold of the acoustic reflex, significant changes in the similarity coefficient were recorded in the experimental group, compared with the control group, which indicates its diagnostic informativeness. In the future, to establish new hygienic standards for regulation the load of high-intensity impulse noise, more extensive studies of the acoustic reflex threshold and the similarity coefficient are needed, as the most informative and sensitive methods for assessing adverse effects.
 The limitations of the study are determined by its focus on use in screening medical examinations of personnel exposed to the cumulative effects of high-intensity low-frequency impulse noise.
 Conclusion. The obtained results demonstrate the potential for studying the acoustic reflex threshold as an objective approach to early detection and prediction of negative changes in the state of the hearing organ of personnel exposed to the cumulative effect of high-intensity low-frequency impulse noise.
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