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not noticed until losses at the speech fre quencies, 500, 1000 and 2000 Hz are 15 dB (ASA 1951) or 25 dB (ISO 1964) Substantial losses may occur at frequencies from 3000 to 6000 Hz without producing any subjective awareness of changes in heanng The pro duction of noise-induced hearing loss is a slow insidious process and years of exposure may elapse before anv significant noticeable loss of hearing occurs (Fig 45-5) Second, the deletenous effects of noiseexposure cannot be directly equated to the energy content of the noise That is, doubling the energy content m the noise does not pro duce twice the hearing loss It is logical that the larger the total energy content of the noise is the smaller will be the time of exposure re quired to produce the same amount of hear ing loss, but the exact relation between time and energy is not known Third, the total amount of heanng loss produced by noise-exposure depends on many more vanables than was thought ongmally Heanng loss varies with the type of exposure and its degree of intermittency, with the individual exposed, the total dura tion of the exposure, and with the degree of consistency of use of ear protection Noise-exposure and permanent heanng loss.