Trends in Hearing Loss Among Adolescents

Global, Regional, and National Burdens of Hearing Loss for Children and Adolescents from 1990 to 2019: A Trend Analysis

This study presents a comprehensive analysis of global, regional, and national trends in the burden of hearing loss (HL) among children and adolescents from 1990 to 2019, using data from the Global Burden of Disease study. Over this period, there was a general decline in HL prevalence and years lived with disability (YLDs) globally, with average annual percentage changes (AAPCs) of -0.03% (95% uncertainty interval [UI], -0.04% to -0.01%; p = 0.001) and -0.23% (95% UI, -0.25% to -0.20%; p < 0.001). Males exhibited higher rates of HL prevalence and YLDs than females. Mild and moderate HL were the most common categories across all age groups, but the highest proportion of YLDs was associated with profound HL [22.23% (95% UI, 8.63%-57.53%)]. Among females aged 15-19 years, the prevalence and YLD rates for moderate HL rose, with AAPCs of 0.14% (95% UI, 0.06%-0.22%; p = 0.001) and 0.13% (95% UI, 0.08%-0.18%; p < 0.001). This increase is primarily attributed to age-related and other HL (such as environmental, lifestyle factors, and occupational noise exposure) and otitis media, highlighting the need for targeted research and interventions for this demographic. Southeast Asia and Western Sub-Saharan Africa bore the heaviest HL burden, while High-income North America showed lower HL prevalence and YLD rates but a slight increasing trend in recent years, with AAPCs of 0.13% (95% UI, 0.1%-0.16%; p < 0.001) and 0.08% (95% UI, 0.04% to 0.12%; p < 0.001). Additionally, the analysis revealed a significant negative correlation between sociodemographic index (SDI) and both HL prevalence (r = -0.74; p < 0.001) and YLD (r = -0.76; p < 0.001) rates. However, the changes in HL trends were not significantly correlated with SDI, suggesting that factors beyond economic development, such as policies and cultural practices, also affect HL. Despite the overall optimistic trend, this study emphasizes the continued need to focus on specific high-risk groups and regions to further reduce the HL burden and enhance the quality of life for affected children and adolescents.

Physical Activity, Sports Participation, and Psychosocial Health in Adolescents With Hearing Loss

PURPOSE

This study examined the association between hearing status (i.e., adolescents with and without hearing loss) and physical activity and sports participation. Secondarily, we explored the association between physical activity and sports participation and psychosocial outcomes among adolescents with hearing loss.

METHODS

Analyses included 29,034 adolescents (52.1% male, 13.8 ± 2.3 (M ± SD) years) from the combined 2018-2019 National Survey of Children's Health. Adolescents were grouped by hearing status. Adjusted logistic regression models assessed physical activity level (i.e., 0, 1-3, 4-6, and 7 days/week) and sports participation (i.e., participation in sports within the past 12 months) by hearing status. Secondary analyses examined associations between physical activity and sports participation with psychosocial outcomes among adolescents with hearing loss adjusting for relevant confounders.

RESULTS

Relative to their hearing peers, adolescents with hearing loss (n = 359) were 40% [adjusted odds ratio (AOR), 0.60; 95% confidence interval (CI), 0.44, 0.81], 43% [AOR, 0.57; 95% CI, 0.41, 0.80], and 33% [AOR, 0.67; 95% CI, 0.47, 0.95] less likely to engage in 1-3 days/week of physical activity, 4-6 days/week of physical activity, and meet physical activity guidelines, respectively. Further, adolescents with hearing loss were 31% [AOR, 0.69; 95% CI, 0.55, 0.85] less likely to participate in sports. Sports participation, but not physical activity, was associated with a significant reduction in the likelihood of experiencing adverse psychosocial outcomes among adolescents with hearing loss (p's < .05).

DISCUSSION

Sports participation, but not physical activity, was associated with attenuated likelihood of experiencing adverse psychosocial outcomes in adolescents with hearing loss, suggesting unique characteristics of sports participation confer protection of psychosocial health. Increasing access to and reducing barriers to engagement in sports should be prioritized to improve psychosocial health in adolescents with hearing loss.

Association of polycyclic aromatic hydrocarbons exposure, systemic inflammation with hearing loss among adults and adolescents

The association between polycyclic aromatic hydrocarbons (PAHs) exposure and hearing loss is rarely assessed. We aimed to evaluate the relationship of polycyclic aromatic hydrocarbons (PAHs) exposure and hearing loss among US adults and adolescents, and to explore the mediating role of systemic inflammation in the associations. Participants from the National health and Nutrition Examination Surveys (NHANES, 2001-2016) were included. Multiple logistic regression models were used to explore the associations between PAH metabolites and hearing loss. A total of 4200 adults and 1337 adolescents were included in the present analysis. For adults, we found positive association between urinary PAH metabolites and hearing loss, including total, speech-frequency and high-frequency hearing loss. The odds ratios (ORs) and 95% confidence intervals (CIs) for each one-unit increase in the log-transformed level of 3-Hydroxyfluorene (3-OHFlu), 2-Hydroxyfluorene (2-OHFlu) and 2 & 3-Hydroxyphenanthrene (2&3-OHPh) with total hearing loss were 1.17 (1.04-1.31), 1.24 (1.07-1.43), and 1.18 (1.03-1.37), respectively. For adolescents, urinary PAH metabolites were positively associated with total and speech-frequency hearing loss, not with high-frequency. The ORs and 95% CIs for each one-unit increase in the log-transformed level of 3-OHFlu, 2-OHFlu and total urinary PAH metabolites with total hearing loss were 1.34 (1.06-1.68), 1.48 (1.13-1.93), and 1.33 (1.04-1.72), respectively. Each one-unit increase in the log-transformed level 2-OHFlu (β = 0.112, 95%CI = 0.018-0.206) and 2&3-OHPh (β = 0.145, 95%CI = 0.037-0.253) were positively associated with C-reactive protein (CRP) among adolescents, but not among adults. No mediating effect for CRP on the association of urinary PAH metabolites with hearing loss was found (all P > 0.05). 3-OHFlu and 2-OHFlu are associated with increased prevalence of hearing loss among adults and adolescents. Systemic inflammation does not mediate the associations. Further studies should be conducted to verify the results.

Prevalence of Noise-Induced Hearing Loss in Middle and High School Band Members: A Preliminary Study

OBJECTIVE

This study was aimed at determining the risk of developing noise-induced hearing loss (NIHL) in middle school band (MSB) and high school band (HSB) members.

METHOD

Between-group comparison of hearing thresholds. Eleven MSB members and 6 MSNB controls, 20 HSB members and 5 HSNB controls.

RESULTS

Sixty-four percent of school-age band members presented with 15 dB HL or greater notch at 4,000 or 6,000 Hz in at least one ear. The high school students were slightly more likely to present with a notch.

CONCLUSIONS

Results indicate that participation in band even as early as middle school increases the risk of developing NIHL, and that the longer the participation the higher the risk. Steps to insure hearing preservation in school-age band members are recommended.

No Reliable Association Between Recreational Noise Exposure and Threshold Sensitivity, Distortion Product Otoacoustic Emission Amplitude, or Word-in-Noise Performance in a College Student Population

OBJECTIVES

The purpose of this study was to evaluate the relationship between recreational sound exposure and potentially undiagnosed or subclinical hearing loss by assessing sound exposure history, threshold sensitivity, distortion product otoacoustic emission (DPOAE) amplitudes, and performance on the words-in-noise (WIN) test.

DESIGN

Survey data were collected from 74 adult participants (14 male and 60 female), 18 to 27 years of age, recruited via advertisements posted throughout the University of Florida campus. Of these participants, 70 completed both the survey and the additional functional test battery, and their preferred listening level was measured in a laboratory setting.

RESULTS

There were statistically significant relationships between hearing thresholds and DPOAE amplitude. In contrast, performance on the WIN was not reliably related to threshold sensitivity within this cohort with largely normal hearing. The two most common exposures included bars or dance clubs, followed by music player use. There were no statistically significant relationships between individual or composite measures of recreational sound exposure, including preferred listening level, years of music player use, number of reported sound exposures, previous impulse noise exposure, or previous noise-induced change in hearing, and functional measures including threshold, DPOAE amplitude, and WIN measures. Some subjects were highly consistent in listening level preferences, while others were more variable from song to song.

CONCLUSIONS

No reliable relationships between common recreational sound exposure or previous noise-induced changes in hearing were found during analysis of threshold sensitivity, DPOAE amplitude, or WIN performance in this cohort. However, the study sample was predominantly female and Caucasian, which limits generalizability of the results.

Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only: A NOPHO-AML Study

BACKGROUND

As more children survive acute myeloid leukemia (AML) it is increasingly important to assess possible late effects of the intensive treatment. Hearing loss has only sporadically been reported in survivors of childhood AML. We assessed hearing status in survivors of childhood AML treated with chemotherapy alone according to 3 consecutive NOPHO-AML trials.

PROCEDURE

A population-based cohort of children treated according to the NOPHO-AML-84, NOPHO-AML-88, and NOPHO-AML-93 trials included 137 eligible survivors among whom 101 (74%) completed a questionnaire and 99 (72%) had otologic and audiologic examination performed including otoscopy (72%), pure tone audiometry (70%), and tympanometry (60%). Eighty-four of 93 (90%) eligible sibling controls completed a similar questionnaire.

RESULTS

At a median of 11 years (range, 4 to 25) after diagnosis, hearing disorders were rare in survivors of childhood AML and in sibling controls, with no significant differences. None had severe or profound hearing loss diagnosed at audiometry. Audiometry detected a subclinical hearing loss ranging from slight to moderate in 19% of the survivors, 5% had low-frequency hearing loss, and 17% had high-frequency hearing loss.

CONCLUSIONS

The frequency of hearing disorders was low, and hearing thresholds in survivors of childhood AML were similar to background populations of comparable age.