Tinnitus, sound intolerance, and mental health: the role of long-term occupational noise exposure

Is occupational noise associated with arthritis? Cross-sectional evidence from US population

BACKGROUND

The impact of occupational noise exposure on various diseases, including ear and cardiovascular diseases, has been studied extensively. Nevertheless, the connection between osteoarthritis (OA) and rheumatoid arthritis (RA) and occupational noise exposure remains largely unexplored in real-world scenarios. This study assessed the association between occupational noise exposure and the prevalence of two types of arthritis.

METHODS

This study used database data from 2005 to 2012 and 2015-March 2020 from the prepandemic National Health and Nutrition Examination Survey (NHANES) related to occupational noise exposure and arthritis. Multivariate logistic regression analysis was used to estimate the association between occupational noise exposure and RA/OA, adjusting for age, gender, race, education level, marital status, the ratio of family income to poverty, trouble sleeping, smoking status, alcohol consumption, diabetes, hypertension, body mass index (BMI), metabolic equivalents (METs), and thyroid disease.

RESULTS

This study included 11,053 participants. Multivariate logistic regression analysis demonstrated that previous exposure to occupational noise was positively associated with self-reported RA (OR = 1.43, 95% CI = 1.18-1.73) and OA (OR = 1.25, 95% CI = 1.07-1.46). Compared to individuals without a history of occupational noise exposure, those with an exposure duration of 1 year or greater exhibited higher odds of prevalent RA, though there was no apparent exposure response relationship for noise exposure durations longer than 1 year. The results of our subgroup analyses showed a significant interaction between age and occupational noise exposure on the odds of self-reported prevalent OA.

CONCLUSIONS

Our findings suggest an association between occupational noise exposure and the prevalence of RA and OA. Nevertheless, further clinical and basic research is warranted to better explore their associations.

Meteorological extremes and their impact on tinnitus-related emergency room visits: a time-series analysis

PURPOSE

Extreme weather events are rising due to the accelerating pace of climate change. These events impact human health and increase emergency room visits (EV) for many morbidities. Tinnitus is a common cause of EVs within otolaryngology in Germany and Austria. The effect of extreme weather conditions on tinnitus-related EVs is unknown.

METHODS

A total of 526 tinnitus-related EVs at a tertiary care hospital in Vienna were identified. A distributed lag non-linear model with a maximum lag period of 14 days was fitted to investigate the immediate and delayed effect of single-day and prolonged (three-day) extreme atmospheric pressure, relative humidity, mean temperature, precipitation and mean wind speed on EV rates. Extreme conditions were defined as the 1st, 5th, 95th, and 99th percentile of the meteorological variables. Relative risk (RR) is defined as risk for tinnitus-related EVs at an extreme condition compared to the risk at the median weather condition. Cumulative RR (cRR) is the total cumulated EV risk for a given time period.

RESULTS

High relative humidity increased same-day RR for tinnitus-related EVs to 1.75. Both low and high atmospheric pressure raised cRR as early as three days after an event to a maximum of 3.24. Low temperatures mitigated cRR within 4 days, while high temperatures tended to increase risk. Prolonged precipitation reduced cRR within one day.

CONCLUSION

Extreme meteorological conditions are associated with tinnitus-related EV rates. Further investigation into potential causative links and underlying pathophysiological mechanisms is warranted.

Noise Exposure in Palestinian Workers Without a Diagnosis of Hearing Impairment: Relations to Speech-Perception-in-Noise Difficulties, Tinnitus, and Hyperacusis

PURPOSE

Many workers in developing countries are exposed to unsafe occupational noise due to inadequate health and safety practices. We tested the hypotheses that occupational noise exposure and aging affect speech-perception-in-noise (SPiN) thresholds, self-reported hearing ability, tinnitus presence, and hyperacusis severity among Palestinian workers.

METHOD

Palestinian workers (N = 251, aged 18-70 years) without diagnosed hearing or memory impairments completed online instruments including a noise exposure questionnaire; forward and backward digit span tests; hyperacusis questionnaire; the short-form Speech, Spatial and Qualities of Hearing Scale (SSQ12); the Tinnitus Handicap Inventory; and a digits-in-noise (DIN) test. Hypotheses were tested via multiple linear and logistic regression models, including age and occupational noise exposure as predictors, and with sex, recreational noise exposure, cognitive ability, and academic attainment as covariates. Familywise error rate was controlled across all 16 comparisons using the Bonferroni-Holm method. Exploratory analyses evaluated effects on tinnitus handicap. A comprehensive study protocol was preregistered.

RESULTS

Nonsignificant trends of poorer SPiN performance, poorer self-reported hearing ability, greater prevalence of tinnitus, greater tinnitus handicap, and greater severity of hyperacusis as a function of higher occupational noise exposure were observed. Greater hyperacusis severity was significantly predicted by higher occupational noise exposure. Aging was significantly associated with higher DIN thresholds and lower SSQ12 scores, but not with tinnitus presence, tinnitus handicap, or hyperacusis severity.

CONCLUSIONS

Workers in Palestine may suffer from auditory effects of occupational noise and aging despite no formal diagnosis. These findings highlight the importance of occupational noise monitoring and hearing-related health and safety practices in developing countries.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22056701.

Vulnerability to chronic stress and the phenotypic heterogeneity of presbycusis with subjective tinnitus

Age-related functional reserve decline and vulnerability of multiple physiological systems and organs, as well as at the cellular and molecular levels, result in different frailty phenotypes, such as physical, cognitive, and psychosocial frailty, and multiple comorbidities, including age-related hearing loss (ARHL) and/or tinnitus due to the decline in auditory reserve. However, the contributions of chronic non-audiogenic cumulative exposure, and chronic audiogenic stress to phenotypic heterogeneity of presbycusis and/or tinnitus remain elusive. Because of the cumulative environmental stressors throughout life, allostasis systems, the hypothalamus-pituitary-adrenal (HPA) and the sympathetic adrenal-medullary (SAM) axes become dysregulated and less able to maintain homeostasis, which leads to allostatic load and maladaptation. Brain-body communication via the neuroendocrine system promotes systemic chronic inflammation, overmobilization of energetic substances (glucose and lipids), and neuroplastic changes via the non-genomic and genomic actions of glucocorticoids, catecholamines, and their receptors. These systemic maladaptive alterations might lead to different frailty phenotypes and physical, cognitive, and psychological comorbidities, which, in turn, cause and exacerbate ARHL and/or tinnitus with phenotypic heterogeneity. Chronic audiogenic stressors, including aging accompanying ontological diseases, cumulative noise exposure, and ototoxic drugs as well as tinnitus, activate the HPA axis and SAM directly and indirectly by the amygdala, promoting allostatic load and maladaptive neuroplasticity in the auditory system and other vulnerable brain regions, such as the hippocampus, amygdala, and medial prefrontal cortex (mPFC). In the auditory system, peripheral deafferentation, central disinhibition, and tonotopic map reorganization may trigger tinnitus. Cross-modal maladaptive neuroplasticity between the auditory and other sensory systems is involved in tinnitus modulation. Persistent dendritic growth and formation, reduction in GABAergic inhibitory synaptic inputs induced by chronic audiogenic stresses in the amygdala, and increased dendritic atrophy in the hippocampus and mPFC, might involve the enhancement of attentional processing and long-term memory storage of chronic subjective tinnitus, accompanied by cognitive impairments and emotional comorbidities. Therefore, presbycusis and tinnitus are multisystem disorders with phenotypic heterogeneity. Stressors play a critical role in the phenotypic heterogeneity of presbycusis. Differential diagnosis based on biomarkers of metabonomics study, and interventions tailored to different ARHL phenotypes and/or tinnitus will contribute to healthy aging and improvement in the quality of life.

Association between age-related hearing loss with tinnitus and cognitive performance in older community-dwelling Chinese adults

AIM

To examine how the severity of age-related hearing loss (ARHL) and tinnitus or the presentation of ARHL with tinnitus is associated with overall cognition, in terms of specific cognitive domains in older community-dwelling Chinese adults.

METHODS

The study recruited 429 participants aged ≥58 years (mean age, 72.91 ± 7.014 years; female proportion, 57.30%), excluding those with dementia, disability, and severe mental illness. Patients were classified into normal cognition, pre-mild cognitive impairment (pre-MCI), and MCI according to the normative z-scores of neuropsychological test battery. The severity of ARHL and tinnitus was measured by pure-tone audiometry and the Tinnitus Handicap Inventory. Cognitive impairment and low functions in specific cognitive domains were used as dependent variables in multiple regression analyses adjusted for covariates.

RESULTS

ARHL severity was positively associated with MCI and low executive function, delayed memory, and language function. Only individuals with mild (odds ratio (OR) 1.791; CI, 0.952-3.373; P = 0.071), and moderate and the disaster tinnitus (OR, 2.493; CI, 0.982-6.328; P = 0.055) were marginally associated with increased odds of MCI in model 1. Individuals with ARHL and tinnitus (OR, 3.888, CI = 1.481-10.205; OR, 4.471, CI = 1.636-12.219) were independently associated with high risk for MCI in models 1 and 2.

CONCLUSIONS

ARHL severity and the presentation of ARHL or ARHL with tinnitus were associated with overall cognition. ARHL severity was independently associated with executive function, delayed memory, and language function. The association between tinnitus severity and cognition is not clear. But the group with ARHL and tinnitus is a high-risk group with cognitive impairment.

CLINICALTRIALS

gov identifier: NCT2017K020.