Hearing loss in Korean adolescents: The prevalence thereof and its association with leisure noise exposure

Leisure noise exposure and hearing outcomes among Canadians aged 6 to 79 years

OBJECTIVE

To examine the association between individual and cumulative leisure noise exposure in addition to acceptable yearly exposure (AYE) and hearing outcomes among a nationally representative sample of Canadians.

DESIGN

Audiometry, distortion-product otoacoustic emissions (DPOAEs) and in-person questionnaires were used to evaluate hearing and leisure noise exposure across age, sex, and household income/education level. High-risk cumulative leisure noise exposure was defined as 85 dBA or greater for 40 h or more per week, with AYE calculations also based on this occupational limit.

STUDY SAMPLE

A randomised sample of 10,460 respondents, aged 6-79, completed questionnaires and hearing evaluations between 2012 and 2015.

RESULTS

Among 50-79 year olds, high-risk cumulative leisure noise was associated with increased odds of a notch while high exposure to farming/construction equipment noise was associated with hearing loss, notches and absent DPOAEs. No associations with hearing loss were found however, non-significant tendencies observed included higher mean hearing thresholds, notches and hearing loss odds.

CONCLUSION

Educational outreach and monitoring of hearing among young and middle-aged populations exposed to hazardous leisure noise would be beneficial.

Association between mobile phone use and hearing impairment: a systematic review and meta-analysis

OBJECTIVES

To investigate whether a possible association of mobile phone use with hearing impairment was conducted a systematic review and meta-analysis.

CONTENT

This is a systematic review and meta-analysis. A comprehensive literature search was carried out based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) methodology using PubMed, Scopus, Web of Science, OVID, and Cochrane. The Robins-I tool was used for quality assessment and risk of bias. Two investigators independently reviewed all articles. Pooled effect size was calculated and meta-analysis was performed to compute an overall effect size.

SUMMARY

Overall, five relevant studies (two cross-sectional and three cohort studies) with 92,978 participants were included in the analysis. The studies were stratified by design, there was no significant association between mobile phone use and hearing impairment in cross-sectional studies (OR=0.94, 95% CI=0.57-1.31) and cohort studies (OR=1.09, 95% CI=0.93-1.25). In addition, the effect estimates did not differ significantly between cross-sectional and cohort studies (Q=0.50, p=0.48). Overall, the pooled odds ratio (OR) of hearing impairment was 1.07 (95% CI: 0.94-1.20), which indicates no significant association between mobile phone use and hearing impairment.

OUTLOOK

Our findings indicate no association between mobile phone use and hearing impairment. However, these findings must be interpreted with caution.

Hearing loss and the COVID-19 pandemic

Objective

Hearing loss is an important public health problem. Its causes vary, including infections, noise, and aging. The first wave of the COVID-19 pandemic occurred in April 2020 in Japan. During the pandemic, people were urged to stay at home and drastically changed their lifestyles. This study aimed to examine hearing loss before and during the pandemic. The prevalence during the pandemic after April 2020 was compared for the period in 2019. Study subjects were those who received health checkups in both periods. Hearing loss was defined as a hearing threshold of > 30 dB at 1 kHz and > 40 dB at 4 kHz in either ear using pure-tone audiometry.

Results

A total of 2367 persons presented in both 2019 and 2020. The overall rates of hearing loss were 9.5% and 13.2% before and after the pandemic, respectively. After controlling for age, sex, current smoking, regular exercise and alcohol consumption, the rate of hearing loss showed a significant increase in 2020 (p =  < 0.0001). With age stratification, an increase was observed in the participants aged < 40 years (1.3% vs. 3.1%, p < 0.001) and 40–59 years (7.2% vs. 12.6%, p < 0.001). Further studies are needed to confirm the impact of the COVID-19 pandemic on hearing loss.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06120-1.

The Relevance of Leisure Noise to Hearing Threshold Shifts: A Longitudinal Analysis Among Adolescents

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.

Effect of Phlorofucofuroeckol A and Dieckol Extracted from Ecklonia cava on Noise-induced Hearing Loss in a Mouse Model

One of the well-known causes of hearing loss is noise. Approximately 31.1% of Americans between the ages of 20 and 69 years (61.1 million people) have high-frequency hearing loss associated with noise exposure. In addition, recurrent noise exposure can accelerate age-related hearing loss. Phlorofucofuroeckol A (PFF-A) and dieckol, polyphenols extracted from the brown alga Ecklonia cava, are potent antioxidant agents. In this study, we investigated the effect of PFF-A and dieckol on the consequences of noise exposure in mice. In 1,1-diphenyl-2-picrylhydrazyl assay, dieckol and PFF-A both showed significant radical-scavenging activity. The mice were exposed to 115 dB SPL of noise one single time for 2 h. Auditory brainstem response(ABR) threshold shifts 4 h after 4 kHz noise exposure in mice that received dieckol were significantly lower than those in the saline with noise group. The high-PFF-A group showed a lower threshold shift at click and 16 kHz 1 day after noise exposure than the control group. The high-PFF-A group also showed higher hair cell survival than in the control at 3 days after exposure in the apical turn. These results suggest that noise-induced hair cell damage in cochlear and the ABR threshold shift can be alleviated by dieckol and PFF-A in the mouse. Derivatives of these compounds may be applied to individuals who are inevitably exposed to noise, contributing to the prevention of noise-induced hearing loss with a low probability of adverse effects.

Personal Music Players and Hearing Loss: The HUNT Cohort Study

It is unclear whether the current average use of personal music players (PMPs) including mobile phones has affected hearing in the general population. The association between the use of PMPs and hearing loss was assessed in a large population cross-sectional and follow-up study with the following distribution: cross-sectional (2018): n = 26,606, 56% women, mean age 54 years and 20-year follow-up (baseline 1998): n = 12,115, 57% women, mean age at baseline 43 years. Hearing threshold was determined as pure-tone average over the frequencies 3, 4, and 6 kHz. We used linear regression to assess relationships between hearing threshold and PMP use (yes), duration (1–2/2–6/>6 h per week), or sound volume (low/medium/high), with nonuse as reference. The PMP use increased from 8% in 1998 to 30% in 2018. Compared with nonusers, neither use nor duration was related to hearing threshold. As to sound volume, listening at low levels was associated with better thresholds (−2.5 dB [−4.1 to −0.8]), while listening at high levels was associated with worse thresholds (1.4 dB [0.1 to 2.8]). We adjusted for age, sex, baseline hearing threshold, education, noise exposure, ear infections, head injury, and daily smoking. The association with sound volume was nearly twice as strong when adjusting for hearing threshold at baseline. Accordingly, the possibility of reverse causality was reduced although not eliminated by the follow-up design. This large population study showed no association between normal PMP use and 20-year progression in hearing; however users listening to high levels increased their hearing threshold.

Health Issues with Learning to Use Smart Devices in the Digital Age: Using a Grounded Theory Approach

The Korean government has announced a plan for a national policy to deliver smart education among all students. As a result, many people are worried about the possible health-related adverse effects. This qualitative study aimed at analyzing health issues related to middle school students who learn by using smart devices using the grounded theory approach. We conducted in-depth interviews with 30 students at four middle schools who used smart devices for more than a year. The analysis of this research data was based on the constant comparative method, using grounded theory as a theoretical framework. The data analysis revealed many concepts in 28 subcategories and 13 categories related to smart learning health issues, with the central phenomenon being experience with health problems. Students' health-related experiences were classified as physical or psychosocial symptoms. Adverse health effects related to smart learning were related to unsafe smart learning behavior and an inefficient smart learning environment. The consequences appeared to be the formation of diverse digital habits through the ambivalent use of smart devices and differences in ability to control health problems. Our findings suggest that students can form ideal habits for using smart devices if their health issues are well monitored and managed.

Loud Music and Leisure Noise Is a Common Cause of Chronic Hearing Loss, Tinnitus and Hyperacusis

High sound levels capable of permanently damaging the ear are experienced not only in factories and war zones but in concert halls, nightclubs, sports stadiums, and many other leisure environments. This review summarizes evidence that loud music and other forms of "leisure noise" are common causes of noise-induced hearing loss, tinnitus, and hyperacusis, even if audiometric thresholds initially remain within clinically normal limits. Given the huge global burden of preventable noise-induced hearing loss, noise limits should be adopted in a much broader range of settings, and education to promote hearing conservation should be a higher public health priority.

Hearing health information in Malaysian public schools: a step towards addressing a public health concern

OBJECTIVE

This study aimed to examine hearing-related information in public school textbooks in Malaysia to gain insight into the country's hearing health education.

DESIGN

Qualitative content analysis on all textbooks used in Malaysian public schools in the year 2019 were conducted to identify the content and structure of information delivery through 11 years of formal education. Information related to hearing health was extracted and categorised according to the themes that emerged. Further analysis was done to characterise the usefulness of the information in promoting active hearing care based on the type of information delivered.

STUDY SAMPLE

A total of 148 elementary and secondary school textbooks were reviewed.

RESULTS

Fourteen textbooks (4 elementary and 10 secondary levels) were found to have relevant hearing health information covering topics of sound, ear and hearing, noise and hearing loss. The contents were mostly theoretical and lacked information about noise-induced hearing loss and proper hearing care.

CONCLUSION

Minimal hearing health information was present in the Malaysian school curriculum. The content was inadequate for teaching students about hearing loss prevention. Areas of improvement and research are recommended to improve school-based hearing health education in Malaysia.

Associations between adolescents' earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students

Few epidemiological studies have examined the relationship between earphone usage and hearing loss in adolescents. This study identified the prevalence of hearing loss in South Korean adolescents using representative national survey data and evaluated the relationship between earphone usage in a noisy environment and hearing loss. This study analyzed 532 subjects (12-19 years) who participated in a 2012 national survey and completed health and noise environment exposure questionnaires and pure tone audiometry (PTA) test. Hearing loss was defined as an average hearing threshold of 26 Decibel-A (dBA) or higher in PTA. The relationship between earphone usage and hearing loss was analyzed using a hierarchical logistic regression model. Adolescents who were exposed to high noise levels via headphones in a noisy environment had a hearing loss prevalence of 22.6% and adolescents who used earphones 80 minutes or more per day on average had the hearing loss prevalence of 22.3%. The results of the logistic regression analysis revealed that adolescents who used earphones in a noisy environment had a 4.5-fold higher risk of hearing loss and an 8.4 times higher risk of having a subjective hearing problem than those who did not use earphones (prevalence odds ratio (pOR) = 4.54, 95% confidence interval (CI): 1.35-15.24; pOR = 8.39, 95% CI: 1.12-62.83, respectively). Additionally, adolescents who used earphones more than 80 minutes per day in a noisy environment had a 4.7 times higher risk of hearing loss than those who used them less than 80 minutes per day (pOR = 4.68, 95% CI: 1.08-20.22). Longitudinal studies are needed to provide evidence of causality between earphone usage and hearing loss.

Personal Listening Device Use Habits, Listening Belief, and Perceived Change in Hearing Among Adolescents

PURPOSE

This study aimed to identify personal listening device (PLD) usage habits, listening belief, and perceived change in hearing, and to investigate how the variables related to perceived change in hearing among adolescents.

METHODS

The participants were 183 middle school students and 233 high school students from Ulsan. Data were collected by self-reported questionnaires from August 1, 2019, to October 22, 2019, and analyzed with descriptive statistics, χ² test, Mann-Whitney U test, and hierarchical multiple logistic regression.

RESULTS

Most students started to use PLDs from elementary school, and mean preferred listening level was 70.13 dB. Mean perceived susceptibility to music-induced hearing loss (MIHL) and perceived barriers to prevent MIHL were 5.18 and 3.40, respectively. Perceived change in hearing was reported on 14.2% of middle school students and 32.2% of high school students, and as the average score of perceived barriers to prevent MIHL increases by one point, the odds of decrease in hearing increase by 2.05 times (p < .001) and 1.35 times (p < .05), respectively.

CONCLUSION

Considering that most adolescents are exposed to PLD in elementary schools and about a quarter experienced a decrease in hearing after PLD use, educational programs on hearing conservation are required to start as early as in schools. Particularly, knowledge and skills to overcome barriers to prevent MIHL should be emphasized in educational programs.

Renal Syndromic Hearing Loss Is Common in Childhood-onset Chronic Kidney Disease

BACKGROUND

Hearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population. This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD.

METHODS

In this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2-5, age at onset of renal symptom < 18 years) were recruited. We referred to the "renal" syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD.

RESULTS

A total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL.

CONCLUSION

One-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.

Antioxidant Therapy against Oxidative Damage of the Inner Ear: Protection and Preconditioning

Oxidative stress is an important mechanism underlying cellular damage of the inner ear, resulting in hearing loss. In order to prevent hearing loss, several types of antioxidants have been investigated; several experiments have shown their ability to effectively prevent noise-induced hearing loss, age-related hearing loss, and ototoxicity in animal models. Exogenous antioxidants has been used as single therapeutic agents or in combination. Antioxidant therapy is generally administered before the production of reactive oxygen species. However, post-exposure treatment could also be effective. Preconditioning refers to the phenomenon of pre-inducing a preventative pathway by subtle stimuli that do not cause permanent damage in the inner ear. This renders the inner ear more resistant to actual stimuli that cause permanent hearing damage. The preconditioning mechanism is also related to the induction of antioxidant enzymes. In this review, we discuss the mechanisms underlying antioxidant-associated therapeutic effects and preconditioning in the inner ear.

Prevalence, associated factors, and comorbidities of tinnitus in adolescents

The aim of this study was to investigate the prevalence of tinnitus among adolescents, and the factors known or hypothesized to be associated with tinnitus. Based on random sampling of school types and regions, a nationwide hearing survey of the first-year middle and high school students of South Korea was performed. The subjects underwent an otologic examination followed by pure tone audiometry up to 8 kHz. Questionnaires about the factors associated with hearing and tinnitus were completed by the students and their parents. Among the 1,593 subjects who completed the questionnaire and underwent pure tone audiometry, the prevalence of tinnitus was 46.0% and that of severe tinnitus was 9.1%. Tinnitus was associated with age, female gender, history of ear infection and sinusitis, leisure noise exposure due to karaoke and local-area-network gaming, alcohol consumption, and cigarette smoking. Noticeable hearing loss was not detected but participants with tinnitus complained of difficulty with sound localization, hearing in noise, and verbal working memory and were more susceptible to fatigue. The subjects with tinnitus also suffered more physical and mental health problems than did those without tinnitus. Thus, protection of the ears from noise and appropriate counseling should be considered for adolescents with tinnitus.

Impact of hearing loss on the performance of auditory processing measured by questionnaires in Korean adolescents

Increasing use of personal listening devices has been accompanied by increase in the prevalence of hearing loss (HL) among youth in Korea, as in other countries. Auditory processing disorder (APD) is one of the main factors affecting academic achievement at school. This study aimed to investigate the prevalence of HL in students attending general middle- and high schools and compare the findings with the APD survey results. From June 1 to December 31, 2016, Korean adolescents (n = 2,791) in the first years of middle- and high school underwent audiometric testing and otologic examination and completed questionnaires on APD. The survey was sponsored by the Korean Society of Otolaryngology-Head and Neck Surgery and the Korean Otology Society. The prevalence of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) in the poorer ear was 11.6% and 10.3%, respectively, among Korean adolescents. We analysed data from the Scale of Auditory Behaviors, Fisher’s Auditory Problems Checklist, and KNISE-Auditory Behavioral Checklist and compared these with the results of hearing tests. We observed positive correlations among the APD questionnaire results and mean hearing levels. This study suggested that hearing loss, especially bilateral high-frequency hearing loss, may affect central auditory processing.