“…Across studies, one of the potential risk factors for hearing loss is sex, with males having worse thresholds than females, although the influence of sex are difficult to interpret given sex-based differences in noise history (see Marlenga et al, 2012; Mahboubi et al, 2013). Other potentially important risk factors include race/ethnicity (Lin et al, 2012), education /socioeconomic status (Agrawal et al, 2008; Henderson et al, 2011; Zhan et al, 2011), noise exposure (Agrawal et al, 2009; Zhan et al, 2011; Mahboubi et al, 2013), smoking and second-hand smoke (Cruickshanks et al, 1998; Fabry et al, 2011), diabetes (Bainbridge et al, 2008), cardiovascular health (Agrawal et al, 2009; Nash et al, 2011), ototoxic drugs (Laurell et al, 1996), and there are some genes associated with vulnerability to hearing loss based on population studies (for reviews, see Liu & Yan, 2007; Uchida et al, 2011). The selection of modifying factors to include in these studies is a significant issue.…”