Serum Per- and Polyfluoroalkyl Substances Are Associated with Increased Hearing Impairment: A Re-Analysis of the National Health and Nutrition Examination Survey Data

Exploring the association of organochlorine pesticides exposure and hearing impairment in United States adults

Hearing loss (HL) is a highly prevalent public health concern. Organochlorine pesticides (OCPs) are widely used environmental pollutants harmful to human health. Studies investigating the effects of OCPs exposure on the auditory system in the general population are rare. To explore the association between OCPs exposure and HL in adults, 366 adults aged 20–69 years who participated in the National Health and Nutrition Examination Survey (NHANES, 2003–2004) were investigated. HL was defined as a pure-tone average (PTA) ≥ 20 dB in the better ear. Multivariate linear and logistic regression analyses were conducted to evaluate the association of four selected serum OCPs with PTAs and the risk of HL. In participants aged < 60 years, hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (p, p'-DDE) exposure was positively associated with low- and speech-frequency PTAs, and with low-frequency HL, respectively. Risk of HL increased in the highest tertile compared with the lowest tertile of serum HCB and p, p'-DDE (odds ratio [OR]: 4.38, 95% confidence interval [CI]: 0.97–19.80; OR: 16.66, 95% CI: 2.64–105.09, respectively). In this study of US adults aged < 60 years, HCB and p, p'-DDE exposure was positively associated with HL. HCB and p, p'-DDE may be potential risk factors for HL.

Urinary phenols and parabens in relation to hearing loss: The National Health and Nutrition Examination Survey

INTRODUCTION

The animal studies raise concerns about the possible ototoxicity of phenolic chemicals. Therefore, we conducted an epidemiologic study to examine the associations of phenols and parabens with hearing impairment.

MATERIALS AND METHODS

Bisphenol A (BPA), benzophenone-3 (BP-3), and triclosan (TCS) were measured in urine samples in the National Health and Nutrition Examination Survey (NHANES) 2003-06 and 2009-12. Methyl paraben (MPB) and propyl paraben (PPB) were measured in urine samples in NHANES 2005-06 and 2009-12. Hearing impairment was defined as a hearing threshold of more than 25 dB at each hearing frequency in the better ear. Tests for linear trend were conducted using the median concentrations of urinary phenols or parabens in each quartile as a continuous variable.

RESULTS

A total of 1809 participants (women = 52.0%) aged 20 and above were included in the final analysis (For MPB and PPB, the sample size was 1188). After adjusting for potential confounders, we found positive associations between BPA and hearing impairment at 3 K (p-trend = 0.04); between TCS and hearing impairment at 6 K (p-trend = 0.03); However, the odds ratio (OR) for the highest compared with the lowest quartile of both BPA and TCS did not reach statistical significance. In contrast, we found unexpected negative associations between BP-3 and hearing impairment at 0.5 K (p-trend = 0.04), 1 K (p-trend = 0.02), 2 K (p-trend <0.01), 6 K (p-trend = 0.03), and 8 K Hz (p-trend = 0.02), respectively.

CONCLUSIONS

The present study offers limited evidence that background phenol and paraben exposures are ototoxicants for the United States adult population.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40201-021-00779-7.

Urine caffeine metabolites and hearing threshold shifts in US adults: a cross-sectional study

Previous studies have reported the relationship between effect of caffeine and many diseases. However, studies to evaluate the association between caffeine and hearing loss are contradictory. To examine the relationship of urinary caffeine metabolites with the hearing threshold in US adults, a total of 849 adults aged 20–69 years who participated in the National Health and Nutrition Examination Survey (NHANES, 2011–2012) were enrolled in this study. Urinary caffeine and its 14 metabolites were applied as biomarkers to assess caffeine exposure. Hearing loss was defined as mean pure tone averages > 25 dB HL at 500, 1000, and 2000 Hz in both ears (low frequency); and 3000, 4000, and 6000 Hz in both ears (high frequency). Univariate and multivariate linear regression analyses were conducted to examine the associations of urinary caffeine metabolites with low- and high-frequency hearing thresholds, respectively. Low-frequency hearing loss were 5.08% and 6.10% in male and female participants, respectively; and high-frequency hearing loss were 31.81% and 15.14% in male and female participants, respectively. In the unadjusted model, the P value for trend shows that urinary caffeine metabolites 137X and AAMU were significantly associated with low-frequency PTA, and that 17X, 137X, AAMU were significantly associated with high-frequency PTA, but when the model was adjusted for sex, age, education level, firearm noise exposure, occupational noise exposure, recreational noise exposure, serum cotinine, body mass index, diabetes, hypertension, these were no longer statistically significant. In conclusion, urinary caffeine metabolites were not associated with the hearing threshold shifts in US adults.