Risk factors for hearing loss in US adults: Data from the National Health and Nutrition Examination Survey, 1999 to 2002

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To evaluate and compare the effects of cardiovascular risk factors (hypertension, smoking, diabetes) and noise exposure (occupational, recreational, firearm) on frequency-specific audiometric thresholds among US adults while assessing synergistic interactions between these exposures. DESIGN: National cross-sectional survey. SETTING/PARTICIPANTS: United States adults aged 20 to 69 years who participated in the 1999 to 2002 National Health and Nutrition Examination Survey (N = 3,527). MAIN OUTCOME MEASURES: Air-conduction thresholds at 0.5 to 8 kHz (dB) in the poorer-hearing ear. Multivariate models adjusted for age, sex, race/ethnicity, and educational level. RESULTS: Exposure to firearm noise was significantly associated with high-frequency (4-8 kHz) hearing loss (HL), whereas smoking and diabetes were associated with significantly increased hearing thresholds across the frequency range (0.5-8 kHz). A significant interaction was observed between exposure to firearm noise and heavy smoking such that firearm noise was associated with a mean 8-dB hearing loss in heavy smokers compared with a mean 2-dB hearing loss in nonsmokers at 8 kHz. We also observed significant interactions between firearm noise exposure and diabetes. CONCLUSION: Noise exposure was associated with high-frequency HL, whereas cardiovascular risk generated by smoking and diabetes was associated with both high- and low-frequency HL. The frequency-specific effects of these exposures may offer insight into mechanisms of cochlear damage. We demonstrated an interaction between cardiovascular risk and noise exposures, possibly as a result of cochlear vulnerability due to microvascular insufficiency. Such significant interactions provide proof of principle that certain preexisting medical conditions can potentiate the effect of noise exposure on hearing. Data-based stratification of risk should guide our counseling of patients regarding HL.

Original languageEnglish (US)
Pages (from-to)139-145
Number of pages7
JournalOtology and Neurotology
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Cardiovascular disease
  • Diabetes
  • Epidemiology
  • Firearm noise
  • Hearing loss
  • Smoking

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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