Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966–2010

Abstract

Objectives/Hypothesis To investigate factors associated with hearing impairment (HI) in adolescent youths during the period 1966–2010. Study Design Cross‐sectional analyses of US sociodemographic, health, and audiometric data spanning 5 decades. Methods Subjects were youths aged 12 to 17 years who participated in the National Health Examination Survey (NHES Cycle 3, 1966–1970; n = 6,768) and youths aged 12 to 19 years in the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994; n = 3,057) and NHANES (2005–2010; n = 4,374). HI prevalence was defined by pure‐tone average (PTA) ≥ 20 dB HL for speech frequencies (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Multivariable logistic models were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Results Overall speech‐frequency HI prevalence was 10.6% (95% CI: 9.7%‐11.6%) in NHES, 3.9% (95% CI: 2.8%‐5.5%) in NHANES III, and 4.5% (95% CI: 3.7%–5.4%) in NHANES 2005 to 2010. The corresponding high‐frequency HI prevalences were 32.8% (95% CI: 30.8%‐34.9%), 7.3% (95% CI: 5.9%‐9.0%), and 7.9% (95% CI: 6.8%‐9.2%). After adjusting for sociodemographic factors, overall high‐frequency HI was increased twofold for males and cigarette smoking. Other significant risk factors in NHANES 2005 to 2010 included very low birth weight, history of ear infections/otitis media, ear tubes, fair/poor general health, and firearms use. Conclusions HI declined considerably between 1966 to 1970 and 1988 to 1994, with no additional decline between 1988 to 1994 and 2005 to 2010. Otitis media history was a significant HI risk factor each period, whereas very low birth weight emerged as an important risk factor after survival chances improved. Reductions in smoking, job‐related noise, and firearms use may partially explain the reduction in high‐frequency HI. Loud music exposure may have increased, but does not account for HI differences. Level of Evidence NA Laryngoscope, 129:1922–1939, 2019

Population-based age adjustment tables for use in occupational hearing conservation programs

“…However, outcroppings of socioacusis and nosoacusis are observable as changes in cross-sectional trends over time. For example, improvements in the hearing sensitivity of the U.S. population have been observed across all age groups during the last 60 years (Hoffman et al 2010(Hoffman et al , 2012(Hoffman et al , 2017(Hoffman et al , 2019, with significant improvements over the brief period between 1999-2004 and 2011-2012 (Hoffman et al 2017). Such improvements are attributable to changes in socioacusic and nosoacusic exposure profiles rather than changes in the inexorable effects of aging.…”

Childhood hearing loss and established risk factors: What is the contribution of tobacco exposure prenatally or after birth?

“…OM leads to conductive hearing loss (vs sensorineural) and is unquestionably a principal risk factor for childhood hearing loss; recent studies have also demonstrated associations with adult sensorineural hearing loss . To gain perspective and appreciation for the aetiology of childhood hearing loss, a fuller examination of established factors may be useful …”

“…These children were identified at ages 3, 4, or 5 years based on pure‐tone average thresholds across 500, 1000, and 2000 Hz in the moderate (40‐60 dB), severe (61‐90 dB), or profound (>90 dB) hearing loss range. The prevalence of moderate‐to‐worse hearing impairment among preschool‐aged children in The Netherlands was not provided; however, it is likely to be 1‐2 per 1000 children …”

“…Slight‐to‐mild sensorineural hearing loss in children is more common than moderate‐to‐worse hearing loss . Published prevalence estimates from developed countries fall between 0.88%‐3.0% for mild bilateral low‐, middle‐, or high‐frequency hearing loss in school‐aged children .…”

“…The author of this Commentary recently completed a study of risk factors for hearing loss in youths, 1966‐2010, based on comparisons of pure‐tone audiometric threshold assessments in three nationally representative US samples . Speech‐frequency hearing impairment (SFHI) was defined based on the pure‐tone average of thresholds at 500, 1000, 2000, and 4000 Hz equal to or greater than 20 dB HL in either ear.…”