Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 08 30 159 170 EN Sahand Nazeri Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Gholamreza Pouryaghoub Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran Ramin Mehrdad Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran Farzaneh Fatahi Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Tahereh Vahdati Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran 2025 05 20 2025 08 26 Background and Aim: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational concern, affecting high-frequency hearing sensitivity, which may impair speech perception in noisy environments. This study investigates the relationship between high-frequency hearing thresholds (4000–12500 Hz) and speech perception in noise, using the Persian Quick Speech-in-Noise (Quick SIN) test. The aim was to determine how these thresholds and speech perception in quiet correlate with and predict speech perception difficulties in noise. Methods: A cross-sectional study was conducted on 288 participants aged 18–60 at the Center for Research on Occupational Diseases, Tehran University of Medical Sciences, from March to August 2024. Participants underwent audiometric testing for conventional (250–8000 Hz) and extended high-frequency (12500 Hz) thresholds, Word Recognition Score (WRS), and the Persian Quick SIN test (basic and high-frequency lists). Pearson’s and Spearman’s correlations and multiple linear regression models evaluated relationships and predictive factors, with significance set at p<0.05. Results: Strong positive correlations were observed between basic and high-frequency Signal-to-Noise Ratio (SNR) loss and hearing thresholds at 4000–12500 Hz (r/ρ=0.738–0.84, p<0.001), with strong negative correlations with WRS (ρ=–0.756 to –0.785, p<0.001). Regression models identified 8000 and 12500 Hz thresholds, WRS, and education level as significant predictors of SNR loss (R²=0.764–0.812). High-frequency list SNR loss was significantly lower than basic list SNR loss (p<0.001). Conclusion: High-frequency hearing sensitivity, particularly at 8000 and 12500 Hz, significantly impacts speech perception in noise. Integrating high-frequency audiometry and speech-in-noise testing into occupational health assessments can improve early detection and management of NIHL. https://avr.tums.ac.ir/index.php/avr/article/view/1451