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Heigl K, Gerstner D, Huß J, Weilnhammer V, Jenkac C, Perez-Alvarez C, Steffens T, Herr C, Heinze S. The validity of using a self-report single question as a means to detect hearing loss in an adolescent population. Int J Audiol 2023; 62:1196-1203. [PMID: 36271818 DOI: 10.1080/14992027.2022.2129852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/21/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The overall objective in the study was to compare self-reported hearing based on a single question ("how good would you currently rate your hearing?") to measure hearing loss determined by audiometry in a cohort of adolescents. Prevalence of audiometrically measured hearing loss and frequencies of self-reported poor hearing as well as factors that have an impact on self-reported hearing were examined. DESIGN Baseline and 5-year follow-up data of the Ohrkan study were used. Participants filled in a questionnaire and underwent audiometric measurements. STUDY SAMPLE Data from 979 adolescents were analysed. Participants were 54.7% female and aged between 13 and 18 years at baseline and 17-21 years at 5-yr follow-up. RESULTS The single question on self-reported hearing ability achieved a sensitivity of 41.9% and a positive predictive value of 7.1% at baseline. For the 5-yr follow-up, sensitivity was 40.0%, positive predictive value was 13.9%. Factors influencing self-reported poor hearing were gender, tinnitus, "muffled" ears after exposure to loud noise (e.g. after a concert) and low-frequency hearing loss. CONCLUSIONS The single question about hearing ability used in the Ohrkan study is not sufficient to replace audiometry to detect hearing loss as defined in the study in adolescents.
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Affiliation(s)
- Katharina Heigl
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute for Medical Informatics, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-Universität München, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Doris Gerstner
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Jonas Huß
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Veronika Weilnhammer
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Christina Jenkac
- Comprehensive Cancer Center of the Ludwig-Maximilians-University, Munich, Germany
| | - Carmelo Perez-Alvarez
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Steffens
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig-Maximilians-University, Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Health and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig-Maximilians-University, Munich, Germany
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Dehankar SS, Gaurkar SS. Impact on Hearing Due to Prolonged Use of Audio Devices: A Literature Review. Cureus 2022; 14:e31425. [DOI: 10.7759/cureus.31425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022] Open
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Bhatt IS, Washnik N, Torkamani A. Suprathreshold Auditory Measures for Detecting Early-Stage Noise-Induced Hearing Loss in Young Adults. J Am Acad Audiol 2022; 33:185-195. [PMID: 36195294 PMCID: PMC10858682 DOI: 10.1055/s-0041-1740362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
BACKGROUND Over 1 billion young adults are at risk for developing noise-induced hearing loss (NIHL) due to their habit of listening to music at loud levels. The gold standard for detecting NIHL is the audiometric notch around 3,000 to 6,000 Hz observed in pure tone audiogram. However, recent studies suggested that suprathreshold auditory measures might be more sensitive to detect early-stage NIHL in young adults. PURPOSE The present study compared suprathreshold measures in individuals with high and low noise exposure backgrounds (NEBs). We hypothesized that individuals with high NEB would exhibit reduced performance on suprathreshold measures than those with low NEB. STUDY SAMPLE An initial sample of 100 English-speaking healthy adults (18-35 years; females = 70) was obtained from five university classes. We identified 15 participants with the lowest NEB scores (10 females) and 15 participants with the highest NEB scores (10 females). We selected a sample of healthy young adults with no history of middle ear infection, and those in the low NEB group were selected with no history of impulse noise exposure. DATA COLLECTION AND ANALYSIS The study included conventional audiometry, extended high-frequency audiometry, middle ear muscle reflex (MEMR) thresholds, distortion-product otoacoustic emissions (DPOAEs), QuickSIN, and suprathreshold auditory brainstem response (ABR) measures. We used independent sample t-tests, correlation coefficients, and linear mixed model analysis to compare the audiometric measures between the NEB groups. RESULTS The prevalence of audiometric notch was low in the study sample, even for individuals with high NEB. We found that: (1) individuals with high NEB revealed significantly reduced QuickSIN performance than those with low NEB; (2) music exposure via earphone revealed a significant association with QuickSIN; (3) individuals with high NEB revealed significantly reduced DPOAEs and ABR wave I amplitude compared with individuals with low NEB; (4) MEMR and ABR latency measures showed a modest association with NEB; and (5) audiometric thresholds across the frequency range did not show statistically significant association with NEB. CONCLUSION Our results suggest that young adults with high NEB might exhibit impaired peripheral neural coding deficits leading to reduced speech-in-noise (SIN) performance despite clinically normal hearing thresholds. SIN measures might be more sensitive than audiometric notch for detecting early-stage NIHL in young adults.
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Affiliation(s)
- Ishan S Bhatt
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa
| | - Nilesh Washnik
- Department of Communication Sciences & Disorders, Ohio University, Athens, Ohio
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Translational Science Institute, La Jolla, California
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Walser-Reichenbach SM, Gerstner DG, Twardella D, Jenkac C, Weilnhammer V, Hendrowarsito L, Perez-Alvarez C, Steffens T, Stilianakis NI, Herr CEW, Heinze S. The Relevance of Leisure Noise to Hearing Threshold Shifts: A Longitudinal Analysis Among Adolescents. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1186-1195. [PMID: 35226539 DOI: 10.1044/2021_jslhr-21-00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The aim of this study was to analyze the association of total leisure noise exposure and hearing threshold shifts over 5 years among adolescents enrolled in the Ohrkan cohort study. METHOD The Ohrkan cohort of 2,148 students aged 13-19 years was recruited from 2009 to 2011 and followed up 5 years later. Complete baseline and follow-up reports on exposure and outcome were available for 989 participants. Leisure noise exposure was assessed by questionnaires, and clinical audiometric examinations were performed. Two outcomes were defined: occurrence of the Niskar notch pattern and audiometry showing maximum hearing threshold values at 3, 4, and 6 kHz (both ears). Longitudinal analysis using generalized estimating equations was performed. RESULTS High total leisure noise exposure, defined as an energy equivalent of a 40-hr week of > 85 dBA, was estimated for 32.7% of students at baseline and 63.8% at follow-up. A noise notch was observed in 1.1% of adolescents at baseline and 3.3% at follow-up. At baseline, the maximum measured threshold shift was 55 dB, which increased to 85 dB at the follow-up. Longitudinal analysis did not reveal an association between leisure noise exposure and hearing thresholds. Hearing threshold shifts or noise notches were associated with sex, school type, and time point of measurement. CONCLUSIONS No relationship was found between leisure noise and hearing thresholds. Male adolescents and those attending secondary general schools, with graduation following completion of ninth or 10th grade, had a greater likelihood of developing hearing threshold shifts. Prevention programs should focus on these risk groups. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19233462.
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Affiliation(s)
- Sandra M Walser-Reichenbach
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Doris G Gerstner
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Dorothee Twardella
- Centre for Early Cancer Detection and Cancer Registration, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | - Christina Jenkac
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Comprehensive Cancer Center, University Hospital, LMU Munich, Germany
| | - Veronika Weilnhammer
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Lana Hendrowarsito
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | | | - Thomas Steffens
- Department of Otorhinolaryngology, University Hospital Regensburg, Germany
| | - Nikolaos I Stilianakis
- Joint Research Centre, European Commission, Ispra, Italy
- Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Germany
| | - Caroline E W Herr
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- University of Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany
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Moore BCJ, Humes LE, Cox G, Lowe D, Gockel HE. Modification of a Method for Diagnosing Noise-Induced Hearing Loss Sustained During Military Service. Trends Hear 2022; 26:23312165221145005. [PMID: 36518073 PMCID: PMC9761234 DOI: 10.1177/23312165221145005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Moore (2020) proposed a method for diagnosing noise-induced hearing loss (NIHL) sustained during military service, based on an analysis of the shapes of the audiograms of military personnel. The method, denoted M-NIHL, was estimated to have high sensitivity but low-to-moderate specificity. Here, a revised version of the method, denoted rM-NIHL, was developed that gave a better balance between sensitivity and specificity. A database of 285 audiograms of military noise-exposed men was created by merging two previously used databases with a new database, randomly shuffling, and then splitting into two, one for development of the revised method and one for evaluation. Two comparable databases of audiograms of 185 non-exposed men were also created, again one for development and one for evaluation. Based on the evaluation databases, the rM-NIHL method has slightly lower sensitivity than the M-NIHL method, but the specificity is markedly higher. The two methods have similar overall diagnostic performance. If an individual is classified as having NIHL based on a positive diagnosis for either ear, the rM-NIHL method has a sensitivity of 0.98 and a specificity of 0.63. Based on a positive diagnosis for both ears, the rM-NIHL method has a sensitivity of 0.76 and a specificity of 0.95.
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Affiliation(s)
- Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, 2152University of Cambridge, Cambridge, UK
| | - Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
| | - Graham Cox
- ENT Department (retired), 6397Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Lowe
- ENT Department, 156705James Cook University Hospital, Middlesbrough, Cleveland, UK
| | - Hedwig E Gockel
- Cambridge Hearing Group, MRC Cognition and Brain Sciences Unit, 2152University of Cambridge, Cambridge, UK
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Pudrith C, Phillips S, Labban J. Association of self-reported noise exposure and audiograms processed with algorithms proposed to quantify noise-induced hearing loss. Int J Audiol 2021; 61:809-817. [PMID: 34634215 DOI: 10.1080/14992027.2021.1983216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study was to assess the association of self-reported noise exposure and audiograms processed with ten algorithms proposed to quantify noise-induced hearing loss using receiver operating characteristic (ROC) curves. DESIGN Participants were placed into groups based on self-reported noise exposure. Self-reported noise exposure served as a predictor for noise-induced hearing loss (NIHL). Audiograms were analysed with ten algorithms: The Guidelines, Brewster's Rules, two versions of military Noise-induced Hearing Loss, the Bulge Depth, the age-adjusted 8 kHz threshold and four versions of a new algorithm called the Adjusted Notch Depth (AND). The area under the ROC curves were calculated for each algorithm. STUDY SAMPLE Data were collected from three cycles of the National Health and Nutrition Examination Survey. RESULTS Only one version the AND significantly identified those with self-reported noise exposure with an area under the curve of 0.562. CONCLUSIONS The association between the AND and self-reported noise exposure was marginally better than the previous algorithms in identifying those with self-reported noise exposure. These findings do not support using puretone thresholds for identifying those with NIHL in a cross-sectional research study without stratifying the participants. More research is needed to determine how the AND can be applied to stratified designs.
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Affiliation(s)
- Charles Pudrith
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Susan Phillips
- Department of Communication Sciences and Disorders, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Jeffrey Labban
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
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The Significance of Audiometric Notching in Individuals With a History of Noise Exposure: A Systematic Review. Ear Hear 2021; 42:1109-1118. [PMID: 33908409 DOI: 10.1097/aud.0000000000001034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The diagnosis of noise-induced hearing loss (NIHL) is reliant on the appraisal of audiometric data. A notch, dip or bulge, centered at the 4-kHz frequency is considered to be pathognomonic. However, guidelines applied to assist the diagnosis of NIHL often allow for a notch centered between the 3- and 6-kHz frequencies. The primary outcome of this review is to document the relationship between audiometric notching at particular frequencies and the populations in which they have been identified. DESIGN We included all population-based studies, cohort, cross-sectional, case-control, case-series, and case reports of adults and children, with exposure to noise and with a notch, dip or bulge. The review has been registered with Prospero (Registration: CRD42017079901) and prepared in line with the PRISMA guidelines. RESULTS We included 84 articles in the final systematic review. There were a total of 1,438,987 individuals, aged 7 to 80 years old. The studies were conducted in 26 different countries. Fourteen studies identified notching at 3 kHz, 63 studies identified notching at 4 kHz, and 47 studies identified notching at 6 kHz. The Newcastle-Ottawa risk assessment tool was performed on 82 of the studies emphasizing the high risk of bias in observational studies. CONCLUSIONS The overwhelming outcome of this systematic review demonstrates that the relationship between noise exposure and a 3- to 6-kHz audiometric notch is not straight-forward. A handful of articles have displayed a clear association between an individual's noise exposure and an audiometric notch. Unilateral notches, notches observed at 3 kHz and notches in the absence of continued high-intensity noise exposure must be scrutinized thoroughly. The ambiguous nature of NIHL directs its continued interest.
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Association Analysis of Candidate Gene Polymorphisms and Audiometric Measures of Noise-Induced Hearing Loss in Young Musicians. Otol Neurotol 2021; 41:e538-e547. [PMID: 32176153 DOI: 10.1097/mao.0000000000002615] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study aimed to investigate the association between candidate genetic variants and audiometric measures of noise-induced hearing loss (NIHL) in young musicians. METHODS The study analyzed a database by Phillips et al. (Feasibility of a bilateral 4000-6000 Hz notch as a phenotype for genetic association analysis. Int J Audiol 2015;54:645-52.) which included behavioral hearing thresholds, distortion-product otoacoustic emissions (DPOAE), tympanometric, and genetic data of 166 participants meeting the inclusion criteria. Nineteen single nucleotide polymorphisms (SNPs) in 13 cochlear genes previously associated with NIHL in factory workers were included in the present investigation. The average hearing threshold at 3000 and 4000 Hz (AHT) and average DPOAE signal to noise ratio (DPOAE SNR) in both ears were calculated. RESULTS The regression analyses showed that two SNPs- one in KCNE1 (rs2070358) and the other in CAT (rs12273124) revealed a statistically significant relationship with DPOAE SNR in both ears. Two SNPs in MYH14 and one in GJB4 revealed a significant association with DPOAE SNR in the left ear. Two SNPs in HSP70, one in CDH23 and one in KCNJ10 showed significant association with DPOAE SNR in the right ear. None of the included SNPs showed association with AHT in both ears. CONCLUSIONS A genetic variant in KCNE1 was associated with the strength of the cochlear amplifier as assessed by DPOAE SNR. Musicians carrying causal genetic variants to NIHL might exhibit changes in their auditory functions early in the lifespan even when most subjects had their hearing thresholds within normal limits. These participants are likely to show the clinical manifestation of NIHL in the future if no preventive measures are applied.
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Liebenberg A, Brichta AM, Nie VM, Ahmadi S, James CL. Hearing threshold levels of Australian coal mine workers: a retrospective cross-sectional study of 64196 audiograms. Int J Audiol 2021; 60:808-819. [PMID: 33612050 DOI: 10.1080/14992027.2021.1884908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study examined the hearing threshold levels (HTL) of workers commencing employment in Australian coal mines in the State of New South Wales (NSW). The aim was to establish if some degree of hearing loss was identifiable in the mandatory pre-employment audiograms of workers. DESIGN This was an observational, retrospective, repeated cross-sectional study. STUDY SAMPLE De-identified audiometric records of 64196 employees entering NSW coal mining in three representative five-year periods between 1991-2015 were utilised. RESULTS Although HTLs were lower (better) in more recent years, the results showed clinically significant hearing loss (≥25dBHL) for older workers, 45-60 years. Pure tone average (PTA) hearing losses were greater at the higher frequencies associated with excessive noise exposure (3-6 kHz), than at the speech frequencies (0.5-4 kHz). Hearing loss in the left ears were higher compared to the right ears, with higher prevalence of audiometric notches in males. CONCLUSION Almost a fifth (14.8-20.1%) of male workers commencing work in NSW coal mines presented with an audiometric notch at 4 kHz. Further research is required to determine if these notches represent true NIHL, and how the residual hearing of workers may be conserved.
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Affiliation(s)
- Adelle Liebenberg
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Alan M Brichta
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Valerie M Nie
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Sima Ahmadi
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Carole L James
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
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Feder K, McNamee J, Marro L, Portnuff C. Personal listening device usage among Canadians and audiometric outcomes among 6-29 year olds. Int J Audiol 2021; 60:773-788. [PMID: 33586578 DOI: 10.1080/14992027.2021.1878398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To describe personal listening device (PLD) usage and sociodemographic variables among a nationally representative sample of Canadians and examine audiometric outcomes among a subsample. DESIGN Audiometry and in-person questionnaires were used to evaluate hearing and PLD usage across age, sex, household income/education level. PLD exposure was quantified using a common occupational noise limit. STUDY SAMPLE A randomised sample of 10,460 respondents, aged 6-79, with audiometric analysis of a subsample (n = 4807), aged 6-29, tested between 2012 and 2015. RESULTS Loud PLD usage was reported by19.5% of Canadians. The highest prevalence was among teenagers (44.2%) and young adults (36.3%). Among children, 13.1% of users listened at loud volumes. High PLD usage (equivalent to or above 85 dBA, LEX 40) among 12-19 year olds was double that of 20-29 year olds: 10.2% versus 5.1%E. Five years or more of loud PLD usage was associated with significantly higher mean hearing thresholds compared to less years. No association between loud or high PLD usage and mean thresholds were found. CONCLUSION The majority used PLDs safely, however a small proportion reported high risk usage which will impact hearing should this pattern persist over many years.
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Affiliation(s)
- Katya Feder
- Non-Ionizing Radiation, Health Sciences Division, Health Canada, Ottawa, ON, Canada.,Audiology and Speech-Language Pathology Program, School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - James McNamee
- Non-Ionizing Radiation, Health Sciences Division, Health Canada, Ottawa, ON, Canada
| | - Leonora Marro
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Cory Portnuff
- UCHealth Hearing and Balance Clinic, Aurora, CO, USA.,Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA
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Bluher A, Kawai K, Wang A, Stiles D, Licameli G. Obesity as a Possible Risk Factor for Pediatric Sensorineural Hearing Loss. Laryngoscope 2020; 131:1416-1419. [PMID: 33264432 DOI: 10.1002/lary.29289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Childhood hearing loss impacts linguistic, academic, social, and psychologic development, and may have lasting implications for future workforce performance. Current evidence for obesity as a pediatric sensorineural hearing loss (SNHL) risk factor is intriguing but equivocal. We hypothesized that obesity is associated with a higher risk of SNHL. We additionally examined whether underweight is associated with a higher risk of SNHL. STUDY DESIGN Retrospective database review. METHODS A single-institution audiologic database from 2015 to 2020 was queried for audiograms with type-A tympanograms from children aged 5 to 18 years old. Comorbidities known to be associated with hearing loss were excluded. We then examined both for sub-clinical (≥15 dB) high- or low-frequency hearing loss, and for clinical (≥21 dB) hearing loss, with the aim of examining the association between obesity and SNHL. Multivariable logistic regression was performed to adjust for age, gender, diabetes mellitus, attention deficit hyperactivity disorder, and autism. RESULTS A total of 3,142 children were included. Obesity was not associated with risk of SNHL (adjusted OR 0.82; 95% CI: 0.60, 1.12). Underweight children had a higher risk of SNHL than normal weight children (adjusted OR 1.78; 95% CI: 1.08, 2.95). Autism was significantly associated with increased risk of sub-clinical SNHL only (adjusted OR 2.00; 95% CI 1.34, 2.98). CONCLUSIONS No association was found between obesity and pediatric SNHL. Underweight children may represent a higher-risk population for SNHL. There appears to be an increasing risk of SNHL as children approach adolescence. Further study of systemic risk factors for SNHL is indicated. LEVEL OF EVIDENCE 3 Laryngoscope, 131:1416-1419, 2021.
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Affiliation(s)
- Andrew Bluher
- Department of Otolaryngology and Communication Enhancement, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Kosuke Kawai
- Department of Otolaryngology and Communication Enhancement, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Alicia Wang
- Department of Otolaryngology and Communication Enhancement, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Derek Stiles
- Department of Otolaryngology and Communication Enhancement, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Greg Licameli
- Department of Otolaryngology and Communication Enhancement, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, U.S.A
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Bhatt IS. Determinants of the Audiometric Notch at 4000 and 6000 Hz in Young Adults. J Am Acad Audiol 2020; 31:371-383. [DOI: 10.3766/jaaa.19030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
Background Noise-induced hearing loss (NIHL) is often characterized by the presence of an audiometric notch at 3000-6000 Hz in a behavioral audiogram. The audiometric notch is widely used to investigate NIHL in children and young adults. However, the determinants of the audiometric notch in young adults largely remain unknown.
Purpose The study aimed to investigate the determinants of the audiometric notch in young adults.
Research Design A cross-sectional design was adopted for the study.
Study Sample A sample of 124 adults (38 males and 86 females) aged 18-35 years with normal otoscopic and tympanometric findings was recruited.
Data Collection and Analysis Hearing thresholds and real-ear sound pressure levels (RESPLs) were obtained with calibrated ER-3A (Etymotic Research, Elk Grove Village, IL) andTDH-50P receivers (Telephonics, Farmingdale, NY). Distortion-product otoacoustic emissions (DPOAEs) were used to evaluate the cochlear function. The external auditory canal (EAC) length was measured using the acoustical method. Noise exposure background (NEB) was estimated using the Noise Exposure Questionnaire. The notched audiograms were identified using: Phillips, Coles, and Niskar criteria.
Results The prevalence of notched audiograms was substantially higher for TDH-50P supra-aural receivers than for ER-3A insert receivers. RESPLs at 6000 and 8000 Hz were the major predictors of notched audiograms for TDH-50P receivers. These predictors explained around 45% of the variance in the notched audiograms. The notched audiograms obtained with TDH-50P receivers showed no association with NEB. Individuals with notched audiograms measured using TDH-50P did not show convincing evidence of cochlear dysfunction as assessed by DPOAEs. Individuals with notched audiograms obtained with TDH-50P receivers revealed an average of shorter EAC and a poorer hearing threshold at 6000 Hz.
Conclusions The calibration error in the RESPLs at 6000 and 8000 Hz that are likely to be influenced by the shorter EAC was the major determinant of the notched audiograms when the supra-aural transducers were used to measure hearing thresholds. Therefore, the supra-aural receivers should not be used to estimate the prevalence of NIHL in children and young adults when the less restrictive notch identification criteria are used to identify NIHL. Real-ear calibration techniques that are least influenced by the standing waves in the EAC should be preferred when investigating the prevalence of and risk factors for NIHL in young adults.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences & Disorders, Northern Arizona University, Flagstaff, AZ
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Smith AF, Shinkins B, Hall PS, Hulme CT, Messenger MP. Toward a Framework for Outcome-Based Analytical Performance Specifications: A Methodology Review of Indirect Methods for Evaluating the Impact of Measurement Uncertainty on Clinical Outcomes. Clin Chem 2019; 65:1363-1374. [PMID: 31444309 PMCID: PMC7055686 DOI: 10.1373/clinchem.2018.300954] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/20/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND For medical tests that have a central role in clinical decision-making, current guidelines advocate outcome-based analytical performance specifications. Given that empirical (clinical trial-style) analyses are often impractical or unfeasible in this context, the ability to set such specifications is expected to rely on indirect studies to calculate the impact of test measurement uncertainty on downstream clinical, operational, and economic outcomes. Currently, however, a lack of awareness and guidance concerning available alternative indirect methods is limiting the production of outcome-based specifications. Therefore, our aim was to review available indirect methods and present an analytical framework to inform future outcome-based performance goals. CONTENT A methodology review consisting of database searches and extensive citation tracking was conducted to identify studies using indirect methods to incorporate or evaluate the impact of test measurement uncertainty on downstream outcomes (including clinical accuracy, clinical utility, and/or costs). Eighty-two studies were identified, most of which evaluated the impact of imprecision and/or bias on clinical accuracy. A common analytical framework underpinning the various methods was identified, consisting of 3 key steps: (a) calculation of "true" test values; (b) calculation of measured test values (incorporating uncertainty); and (c) calculation of the impact of discrepancies between (a) and (b) on specified outcomes. A summary of the methods adopted is provided, and key considerations are discussed. CONCLUSIONS Various approaches are available for conducting indirect assessments to inform outcome-based performance specifications. This study provides an overview of methods and key considerations to inform future studies and research in this area.
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Affiliation(s)
- Alison F Smith
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK;
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
| | - Bethany Shinkins
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
- CanTest Collaborative, UK
| | - Peter S Hall
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Claire T Hulme
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK
- Health Economics Group, University of Exeter, Exeter, UK
| | - Mike P Messenger
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
- CanTest Collaborative, UK
- Leeds Centre for Personalised Medicine and Health, University of Leeds, Leeds, UK
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14
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Wei W, Heinze S, Gerstner DG, Walser SM, Twardella D, Reiter C, Weilnhammer V, Perez-Alvarez C, Steffens T, Herr CEW. Audiometric notch and extended high-frequency hearing threshold shift in relation to total leisure noise exposure: An exploratory analysis. Noise Health 2019; 19:263-269. [PMID: 29319010 PMCID: PMC5771058 DOI: 10.4103/nah.nah_28_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Studies investigating leisure noise effect on extended high frequency hearing are insufficient and they have inconsistent results. The aim of this study was to investigate if extended high-frequency hearing threshold shift is related to audiometric notch, and if total leisure noise exposure is associated with extended high-frequency hearing threshold shift. MATERIALS AND METHODS A questionnaire of the Ohrkan cohort study was used to collect information on demographics and leisure time activities. Conventional and extended high-frequency audiometry was performed. We did logistic regression between extended high-frequency hearing threshold shift and audiometric notch as well as between total leisure noise exposure and extended high-frequency hearing threshold shift. Potential confounders (sex, school type, and firecrackers) were included. RESULTS Data from 278 participants (aged 18-23 years, 53.2% female) were analyzed. Associations between hearing threshold shift at 10, 11.2, 12.5, and 14 kHz with audiometric notch were observed with a higher prevalence of threshold shift at the four frequencies, compared to the notch. However, we found no associations between total leisure noise exposure and hearing threshold shift at any extended high frequency. CONCLUSION This exploratory analysis suggests that while extended high-frequency hearing threshold shifts are not related to total leisure noise exposure, they are strongly associated with audiometric notch. This leads us to further explore the hypothesis that extended high-frequency threshold shift might be indicative of the appearance of audiometric notch at a later time point, which can be investigated in the future follow-ups of the Ohrkan cohort.
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Affiliation(s)
- Wenjia Wei
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the University of Munich, Germany
| | - Doris G Gerstner
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Sandra M Walser
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Dorothee Twardella
- Centre for Early Cancer Detection and Cancer Registration, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | - Christina Reiter
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Veronika Weilnhammer
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | | | - Thomas Steffens
- Department of Otorhinolaryngology, University Hospital Regensburg, Germany
| | - Caroline E W Herr
- Department of Occupational and Environmental Health, Epidemiology, Bavarian Health and Food Safety Authority, Munich; University of Munich, Germany
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15
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Scinicariello F, Przybyla J, Carroll Y, Eichwald J, Decker J, Breysse PN. Age and sex differences in hearing loss association with depressive symptoms: analyses of NHANES 2011-2012. Psychol Med 2019; 49:962-968. [PMID: 29909806 PMCID: PMC8114788 DOI: 10.1017/s0033291718001617] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression is a common and significant health problem. Hearing loss is the third most common chronic physical condition in the USA and might be a factor in depression. To determine whether hearing loss is associated with depressive symptoms in US adults ages 20-69 years. METHODS National Health and Nutrition Examination Survey (NHANES) data (2011-2012) were used to assess the potential relationship between hearing loss and depression, in adults (20-69 years) who answered the Patient Health Questionnaire (PHQ-9) depression screening module, with pure tone audiometry measurements, and complete information on the co-variates data (n = 3316). The degree of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were defined as slight/mild hearing loss ⩾26-40 dB; moderate/worse hearing loss ⩾41 dB by pure tone audiometry examination. RESULTS Moderate/worse HFHL was statistically significantly associated with depressive symptoms (OR 1.54, 95% CL 1.04-2.27) when the analyses were conducted among all participants. Further stratification by gender and age groups found that moderate/worse HFHL (OR 3.85, 95% CL 1.39-10.65) and moderate/worse SFHL (OR 5.75, 95% CL 1.46-22.71) were associated with depressive symptoms in women ages 52-69 years. CONCLUSIONS Moderate/worse speech frequency and HFHL are associated with depression in women ages 52-69 years, independent of other risk factors. Hearing screenings are likely to reduce delays in diagnosis and provide early opportunities for noise prevention counseling and access to hearing aids. Health professionals should be aware of depressive signs and symptoms in patients with hearing loss.
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Affiliation(s)
- Franco Scinicariello
- Division for Toxicology and Human Health Services, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA, USA
| | - Jennifer Przybyla
- Division for Toxicology and Human Health Services, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA, USA
| | - Yulia Carroll
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - John Eichwald
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - John Decker
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Patrick N. Breysse
- Office of the Director, National Center for Environment Health, CDC, Atlanta, GA, USA
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16
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Scinicariello F, Carroll Y, Eichwald J, Decker J, Breysse PN. Association of Obesity with Hearing Impairment in Adolescents. Sci Rep 2019; 9:1877. [PMID: 30755633 PMCID: PMC6372622 DOI: 10.1038/s41598-018-37739-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022] Open
Abstract
Hearing loss (HL) is the third most common chronic physical condition in the United States. Obesity has become an increasingly important public health concern, as the prevalence in children, adolescents and adults has increased over the past few decades. The objectives of this study is to investigate whether obesity is associated with audiometric notches indicative of noise-induced hearing loss (NIHL), speech frequency hearing loss (SFHL), and high frequency hearing loss (HFHL) in adolescent participants of the National Health and Nutrition Examination Survey 2007–2010. The prevalence of overall audiometric notches in the adolescent population was 16.0% with higher prevalence in females than males. The prevalence of SFHL and HFHL were higher in males than females (SFHL, 7.3% vs. 5.4%, respectively; and HFHL 14.3% vs. 8.1%, respectively). Obese adolescents had a higher adjusted OR to have audiometric notches (OR = 1.93; 95% CI: 1.33–2.81) and HFHL (OR = 1.95; 95% CI: 1.19–3.21). Continued preventative efforts towards reducing obesity might also help to reduce the risk for HL and NIHL.
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Affiliation(s)
- Franco Scinicariello
- Division for Toxicology and Human Health Services, Agency for Toxic Substances and Disease Registry, Atlanta, USA.
| | - Yulia Carroll
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - John Eichwald
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - John Decker
- Office of Science, National Center for Environment Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Patrick N Breysse
- Office of the Director, National Center for Environment Health, Centers for Disease Control and Prevention, Atlanta, USA
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17
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Barczik J, Serpanos YC. Accuracy of Smartphone Self-Hearing Test Applications Across Frequencies and Earphone Styles in Adults. Am J Audiol 2018; 27:570-580. [PMID: 30242342 DOI: 10.1044/2018_aja-17-0070] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 05/31/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate smartphone-based self-hearing test applications (apps) for accuracy in threshold assessment and validity in screening for hearing loss across frequencies and earphone transducer styles. METHOD Twenty-two adult participants (10 = normal hearing; 12 = sensorineural hearing loss; n = 44 ears) underwent conventional audiometry and performed 6 self-administered hearing tests using two iPhone-based apps (App 1 = uHear [Version 2.0.2, Unitron]; App 2 = uHearingTest [Version 1.0.3, WooFu Tech, LLC.]) each with 3 different transducers (earbud earphones, supra-aural headphones, circumaural headphones). Hearing sensitivity results using the smartphone apps across frequencies and transducers were compared with conventional audiometry. RESULTS Differences in accuracy were revealed between the hearing test apps across frequencies and earphone styles. The uHear app using the iPhone standard EarPod earbud earphones was accurate to conventional thresholds (p > .002 with Bonferroni correction) at 1000, 2000, 4000, and 6000 Hz and found valid (81%-100% sensitivity, specificity, positive and negative predictive values) for screening mild or greater hearing loss (> 25 dB HL) at 500, 1000, 2000, 4000, and 6000 Hz. The uHearingTest app was accurate in threshold assessment and determined valid for screening mild or greater hearing loss (> 25 dB HL) using supra-aural headphones at 2000, 4000, and 8000 Hz. CONCLUSIONS Self-hearing test apps can be accurate in hearing threshold assessment and screening for mild or greater hearing loss (> 25 dB HL) when using appropriate transducers. To ensure accuracy, manufacturers should specify earphone model instructions to users of smartphone-based self-hearing test apps.
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Affiliation(s)
- Jessica Barczik
- Adelphi University, Department of Communication Sciences and Disorders, Garden City, NY
- Long Island Doctor of Audiology Consortium (Adelphi, Hofstra, St. John's Universities), Garden City, NY
| | - Yula C. Serpanos
- Adelphi University, Department of Communication Sciences and Disorders, Garden City, NY
- Long Island Doctor of Audiology Consortium (Adelphi, Hofstra, St. John's Universities), Garden City, NY
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18
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Pure-Tone Audiometry With Forward Pressure Level Calibration Leads to Clinically-Relevant Improvements in Test–Retest Reliability. Ear Hear 2018; 39:946-957. [DOI: 10.1097/aud.0000000000000555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Bhatt IS. Supra-aural transducer-related artifact contributes to overestimation of noise-induced hearing loss. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 143:2055. [PMID: 29716271 PMCID: PMC10836961 DOI: 10.1121/1.5030924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study compared the effects of supra-aural and insert receivers on the prevalence of noise-induced hearing loss (NIHL) in young adults. NIHL prevalence was found to be substantially higher when hearing thresholds were obtained with supra-aural compared to insert receivers on the same subjects. Real-ear sound pressure levels at 4000, 6000, and 8000 Hz were the major predictors of notched-audiograms obtained with supra-aural headphones. Distortion-product otoacoustic emissions were not significantly different between ears with and without notched-audiograms obtained with supra-aural headphones. The results demonstrated that supra-aural transducer-related artifacts can mimic a notch-like pattern leading to overestimation of NIHL prevalence.
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Affiliation(s)
- Ishan S Bhatt
- Department of Communication Sciences & Disorders, Northern Arizona University, 208 East Pine Knoll Drive, Flagstaff, Arizona 86011, USA
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20
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Muhr P, Johnson AC, Rosenhall U. Declining and fluctuating prevalence values of hearing impairment in 18-year old Swedish men during three decades. Hear Res 2017; 353:1-7. [DOI: 10.1016/j.heares.2017.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/22/2017] [Accepted: 07/21/2017] [Indexed: 11/15/2022]
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21
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Bhatt IS, Guthrie O. Analysis of audiometric notch as a noise-induced hearing loss phenotype in US youth: data from the National Health And Nutrition Examination Survey, 2005–2010. Int J Audiol 2017. [DOI: 10.1080/14992027.2017.1278799] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ishan S. Bhatt
- Department of Communication Sciences & Disorders, Northern Arizona University, Flagstaff, AZ, USA and
| | - O’neil Guthrie
- Department of Communication Sciences & Disorders, Northern Arizona University, Flagstaff, AZ, USA and
- Director of the Cell & Molecular Pathology Laboratory, Northern Arizona University, Flagstaff, AZ, USA
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22
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23
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Twardella D, Raab U, Perez-Alvarez C, Steffens T, Bolte G, Fromme H. Usage of personal music players in adolescents and its association with noise-induced hearing loss: A cross-sectional analysis of Ohrkan cohort study data. Int J Audiol 2016; 56:38-45. [DOI: 10.1080/14992027.2016.1211762] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dorothee Twardella
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany,
- Bavarian Health and Food Safety Authority, Centre for Early Cancer Detection and Cancer Registration, Nuremberg, Germany,
| | - Ulla Raab
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany,
- Bavarian Health and Food Safety Authority, Centre of Prevention and Health Promotion, Munich, Germany,
| | - Carmelo Perez-Alvarez
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany,
| | - Thomas Steffens
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany,
| | - Gabriele Bolte
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany,
- Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany, and
| | - Hermann Fromme
- Department of Toxicology and Chemical Safety, Bavarian Health and Food Safety Authority, Munich, Germany
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24
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Williams W, Carter L, Seeto M. Pure tone hearing thresholds and leisure noise: Is there a relationship? Noise Health 2015; 17:358-63. [PMID: 26356379 PMCID: PMC4900508 DOI: 10.4103/1463-1741.165066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
This paper reports on the examination of the relationship between self-reported historical noise exposure during leisure activities and audiological indicators: Measured hearing threshold levels (HTLs) and otoacoustic emissions (OAEs). The research was conducted by a cross-sectional survey of 1,432 individuals whose ages ranged from 11 years to 35 years. Methodology included a comprehensive audiometric assessment including otoscopy, pure tone audiometry (PTA) (air- and bone-conduction), OAEs, and tympanometry. A comprehensive questionnaire gathered information on demographics, hearing health status, and participation in work, non-work, and leisure activities. Using the history of work, non-work, and leisure noise exposure, a cumulative lifetime noise exposure was estimated. No correlation was found between cumulative lifetime noise exposure and audiometric PTA or OAE parameters.
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Affiliation(s)
- Warwick Williams
- National Acoustic Laboratories, Sydney, and The Hearing Cooperative Research Centre, Melbourne, Australia
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25
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Serpanos YC, Senzer D, Renne B, Langer R, Hoffman R. The Efficacy of Routine Screening for High-Frequency Hearing Loss in Adults and Children. Am J Audiol 2015; 24:377-83. [PMID: 25885798 DOI: 10.1044/2015_aja-15-0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/10/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study was conducted to investigate the efficacy of routine screening for high-frequency hearing loss (HFHL) including 3000, 6000, and 8000 Hz frequencies with conventional test frequencies (1000, 2000, and 4000 Hz) in adults and children in a university outreach program. METHOD Screening outcomes were examined in 2 cohorts of adults (Cohort 1, N = 315, M = 66.2 years; Cohort 2, N = 67, M = 68.3 years) and children (Cohort 1, N = 177, M = 6.5 years; Cohort 2, N = 57, M = 6.9 years) with a high-frequency screen protocol (1000-8000 Hz at 25 dB HL for adults and 20 dB HL for children) using supra-aural headphones. A rescreen was conducted in Cohort 2 with a modified protocol using insert earphones and monitored ambient noise levels. RESULTS Average total test time significantly increased (p < .0001) and nearly doubled with inclusion of 3000-, 6000-, and 8000-Hz frequencies, adding approximately 1 min. Rescreen referral rates decreased by approximately 2%-16% at 1000-8000 Hz (approximately 13%-16% at 6000 and 8000 Hz) using the modified protocol in adults and children, supporting false-positive responses using supra-aural headphones. CONCLUSION Screening for HFHL should include insert earphones in order to prevent potential errors, particularly at 6000 and 8000 Hz.
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Affiliation(s)
- Yula C. Serpanos
- Adelphi University, Garden City, New York
- Long Island Doctor of Audiology Consortium, New York
| | - Deborah Senzer
- Adelphi University, Garden City, New York
- Long Island Doctor of Audiology Consortium, New York
| | - Brittany Renne
- Adelphi University, Garden City, New York
- Long Island Doctor of Audiology Consortium, New York
| | - Rebecca Langer
- Adelphi University, Garden City, New York
- Long Island Doctor of Audiology Consortium, New York
| | - Roxanne Hoffman
- Adelphi University, Garden City, New York
- Long Island Doctor of Audiology Consortium, New York
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26
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Dehnert K, Raab U, Perez-Alvarez C, Steffens T, Bolte G, Fromme H, Twardella D. Total leisure noise exposure and its association with hearing loss among adolescents. Int J Audiol 2015; 54:665-73. [DOI: 10.3109/14992027.2015.1030510] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Mehrparvar AH, Mirmohammadi SJ, Hashemi SH, Davari MH, Mostaghaci M, Mollasadeghi A, Zare Z. Concurrent effect of noise exposure and smoking on extended high-frequency pure-tone thresholds. Int J Audiol 2014; 54:301-7. [PMID: 25470622 DOI: 10.3109/14992027.2014.978906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Concurrent effect of noise and smoking on hearing loss is a recent concern. In this study, the concurrent effect of noise and smoking on hearing loss in conventional frequencies and frequencies higher than 8 kHz was assessed. DESIGN This was a cross-sectional study on workers exposed to noise who were divided into two groups: smokers and non-smokers. Hearing thresholds were assessed by conventional audiometry, and HFA. Data were analysed using non-parametric tests and Student's t-test. STUDY SAMPLE There were 212 workers. RESULTS Ninety-seven subjects were smokers and 115 individuals were non-smokers. All subjects were exposed to 92.1 ± 2.4 dBA (Leq8h). The highest threshold in conventional and high-frequency audiometry was observed at 6 kHz and 16 kHz, respectively. Hearing threshold at frequencies above 1 kHz was significantly higher in the smokers than non-smokers. There was no correlation between hearing thresholds and pack-years of smoking. CONCLUSIONS Concurrent exposure to noise and smoking may be associated with more hearing loss than exposure to noise alone in the conventional and high frequencies. However, other differences between smokers and non-smokers may explain these differences as well.
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Affiliation(s)
- Amir Houshang Mehrparvar
- * Occupational Medicine Department and Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
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Sekhar DL, Zalewski TR, Ghossaini SN, King TS, Rhoades JA, Czarnecki B, Grounds S, Deese B, Barr AL, Paul IM. Pilot study of a high-frequency school-based hearing screen to detect adolescent hearing loss. J Med Screen 2014; 21:18-23. [PMID: 24523012 DOI: 10.1177/0969141314524565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Like most of the United States, school-based hearing screening in Pennsylvania focuses on low-frequency, conductive hearing losses typical for young children, rather than the high-frequency, noise-induced hearing loss more prevalent among adolescents. The objective of this study was to compare the sensitivity and specificity of current school hearing screening in Pennsylvania with hearing screening including high frequencies, designed to detect adolescent hearing loss. SETTING A single public high school. METHODS In the Autumn of 2011 the high-frequency screen was delivered alongside the Pennsylvania school screen for students in the 11(th) grade. Screening referrals and a subset of passes returned for "gold standard" testing with audiology in a sound treated booth, in order to determine the sensitivity and specificity of the screening tests. RESULTS Of 282 participants, five (2%) were referred on the Pennsylvania school screen, and 85 (30%) were referred on the high-frequency screen. Of the 48 who returned for gold standard testing with audiology, hearing loss was diagnosed in 9/48 (19%). Sensitivity of the Pennsylvania and high-frequency screens were 13% (95% confidence interval [CI] 0-53%) and 100% (95% CI 66-100%) respectively. Specificity of the Pennsylvania and high-frequency screens were 97% (95% CI 87-100%) and 49% (95% CI 32-65%) respectively. CONCLUSIONS Current school hearing screens have low sensitivity for detection of adolescent hearing loss. Modifying school-based protocols may be warranted to best screen adolescents, and make optimal use of school nurse time and effort.
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Dobie RA. In reference to Determinants of bilateral audiometric notches in noise-induced hearing loss. Laryngoscope 2013; 123:E129. [PMID: 23794110 DOI: 10.1002/lary.24271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/25/2013] [Accepted: 04/25/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Robert A Dobie
- Department of Otolaryngology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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30
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Jin SH, Nelson PB, Schlauch RS, Carney E. Hearing Conservation Program for Marching Band Members: A Risk for Noise-Induced Hearing Loss? Am J Audiol 2013; 22:26-39. [DOI: 10.1044/1059-0889(2012/11-0030)] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
To examine the risk for noise-induced hearing loss (NIHL) in university marching band members and to provide an overview of a hearing conservation program for a marching band.
Method
Sound levels during band rehearsals were recorded and audiometric hearing thresholds and transient otoacoustic emission were measured over a 3-year period. Musician's earplugs and information about hearing loss were provided to the students. The hearing thresholds of other college students were tested as a partial control.
Results
There were no significant differences in hearing thresholds between the two groups. During initial testing, more marching band members showed apparent high-frequency notches than control students. Follow-up hearing tests in a subsequent year for the marching band members showed that almost all notches disappeared. Persistent standard threshold shift (STS) across tests was not observed in the band members.
Conclusion
Band members showed no evidence of STS or persistent notched audiograms. Because accepted procedures for measuring hearing showed a lack of precision in reliably detecting early NIHL in marching band members, it is recommended that signs of NIHL be sought in repeated measurements compared to baseline audiograms rather than in a single measure (a single notch). A hearing conservation program for this population is still recommended because of lengthy rehearsal times with high sound-level exposure during rehearsals.
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Wilson WJ, O'Brien I, Bradley AP. The audiological health of horn players. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2013; 10:590-596. [PMID: 24116664 DOI: 10.1080/15459624.2013.818227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Among orchestral musicians, horn players are one of the most at-risk groups for noise-induced hearing loss (NIHL). To investigate this group further, pure tone audiometry and a 14-item questionnaire were used to assess the hearing health, as well as attitudes and practices regarding hearing conservation, among 142 French horn players attending an international horn conference in Brisbane, Australia. Of this study's French horn players, 11.1% to 22.2%, and 17.7% to 32.9% of those aged ≤40 years, showed some form of hearing loss (corrected for age and gender) typical of NIHL, using conservative versus lenient criteria, respectively. Stepwise multiple regression analyses showed no obvious predictor of hearing loss in this study's participants. Of the 18% of participants who reported using hearing protection, 81% used this protection "sometimes" and 50% used generic, foam, or other inferior forms of protection. Continued efforts to better manage the hearing health of horn players is warranted particularly as any hearing loss will affect a horn player's ability to perform and therefore his or her livelihood. Managing the hearing health of horn players will be challenging, however, with no simple predictor of NIHL loss being identified in this study's sample.
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Affiliation(s)
- Wayne J Wilson
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
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Noise-induced hearing threshold shift among US adults and implications for noise-induced hearing loss: National Health and Nutrition Examination Surveys. Eur Arch Otorhinolaryngol 2012; 270:461-7. [PMID: 22389092 DOI: 10.1007/s00405-012-1979-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 02/21/2012] [Indexed: 10/28/2022]
Abstract
The objective of this study was to estimate the prevalence and evaluate the associated risk factors of the noise-induced hearing threshold shift (NITS) in the US adult population based on the National Health and Nutrition Examination Surveys (NHANES). The study population consisted of 5,418 individuals aged 20-69 years who had complete audiologic data from the NHANES database. Stringent criteria were used to define NITS. Prevalence of unilateral, bilateral, and total NITS and their association with several socio-demographic and hearing-related factors were evaluated. The prevalence of unilateral, bilateral, and total NITS was 9.4, 3.4 and 12.8%, respectively. Prevalence of bilateral NITS was higher in subjects with older age, male gender, white (non-Hispanic) and Hispanic ethnicities, education level less than or equal to high school diploma, married/living with partner status, Mexico as country of birth, service in armed forces, smoking history, diabetes, and different kinds of noise exposure. Odds of NITS were only higher in older people, males, and smokers. This study provides comprehensive information on the prevalence of NITS in the US adult population and its associated risk factors. More targeted interventions may be done for educational, preventative, and screening purposes.
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Schlauch RS, Carney E. The challenge of detecting minimal hearing loss in audiometric surveys. Am J Audiol 2012; 21:106-19. [PMID: 22271907 DOI: 10.1044/1059-0889(2012/11-0012)] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This tutorial provides framework and context for understanding the complex interaction of hearing measurement methodology and cohort social factors, as well as their relation to approaches to data interpretation and identification of minimal hearing loss (HL) in audiometric surveys. METHOD Pertinent archival studies were reviewed, and an original analysis on U.S. Centers for Disease Control and Prevention (CDC) audiometric survey data from children (ages 6-19) was performed. CONCLUSION The definition of an otologically normal individual, the pass-fail criterion representing the upper limit of the range of normal hearing, and the quality of the audiometry affect the percentage of persons who are falsely identified as having a minimal HL. An upper limit of normal hearing of 15 dB HL yields an unacceptably high false-positive rate, particularly when the more variable higher audiometric frequencies are examined. When air-conduction thresholds are assessed in isolation to estimate potential noise damage, the failure to exclude persons who have possible middle and external ear problems, including earwax, results in high false-positive rates. When these factors and other limitations are considered, audiograms from teens from a recent CDC survey do not show evidence consistent with widespread noise-induced HL. Suggestions are made to improve the effectiveness of pure-tone audiometry and the identification of minimal HL.
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Punch JL, Elfenbein JL, James RR. Targeting hearing health messages for users of personal listening devices. Am J Audiol 2011; 20:69-82. [PMID: 21474557 DOI: 10.1044/1059-0889(2011/10-0039)] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To summarize the literature on patterns and risks of personal listening device (PLD) use, which is ubiquitous among teenagers and young adults. The review emphasizes risk awareness, health concerns of PLD users, inclination to take actions to prevent hearing loss from exposure to loud music, and specific instructional messages that are likely to motivate such preventive actions. METHOD We conducted a systematic, critical review of the English-language scholarly literature on the topic of PLDs and their potential effects on human hearing. We used popular database search engines to locate relevant professional journals, books, recent conference papers, and other reference sources. CONCLUSIONS Adolescents and young adults appear to have somewhat different perspectives on risks to hearing posed by PLD use. Messages designed to suggest actions they might take in avoiding or reducing these risks, therefore, need to be targeted to achieve optimal outcomes. We offer specific recommendations regarding the framing and content of educational messages that are most likely to be effective in reducing the potentially harmful effects of loud music on hearing in these populations, and we note future research needs.
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