The Effects of Earphone Use and Environmental Lead Exposure on Hearing Loss in the Korean Population: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2010–2013

Abstract

BackgroundAlthough previous studies have reported that frequent earphone use and lead exposure are risk factors for hearing loss, most of these studies were limited to small populations or animal experiments. Several studies that presented the joint effect of combined exposure of noise and heavy metal on hearing loss were also mainly conducted on occupational workers exposed to high concentration.ObjectivesWe investigated both the individual and joint effects of earphone use and environmental lead exposure on hearing loss in the Korean general population.MethodsWe analyzed data from 7,596 Koreans provided by the Korea National Health and Nutrition Examination Survey (KNHANES) during the period 2010–2013. The pure-tone average (PTA) of hearing thresholds at 2, 3, and 4 kHz frequencies was computed, and hearing loss was defined as a PTA ≥ 25 dB in one or both ears.ResultsA dose-response relationship in hearing loss with earphone use time and blood lead level is observed after adjustment for confounding factors. With a 1-hour increase in earphone use time and 1 μg/dL increase in blood lead concentration, the odds of hearing loss increased by 1.19 and 1.43 times, respectively. For hearing loss, the additive and multiplicative effect of earphone use and blood lead level were not statistically significant.ConclusionsEarphone use and environmental lead exposure have an individual effect on hearing loss in the general population. However, the estimated joint effect of earphone use and lead exposure was not statistically significant.

Comparison of Pure-Tone Average Methods for Estimation of Hearing Loss Caused by Environmental Exposure to Lead and Cadmium: Does the Pure-Tone Average Method Which Uses Low-Frequency Ranges Underestimate the Actual Hearing Loss Caused by Environmental Lead and Cadmium Exposure?

“…In addition, a longitudinal study of 448 men found that an increase in tibia lead levels of 15 μg/g was associated with an OR of 1.19 (95% CI 0.92-1.53) and an increase in patella lead levels of 21 μg/g was associated with an OR of 1.48 (95% CI 1.14-1.91) for hearing loss measured in the speech frequency [Park et al, 2010]. In a recent study on the general Korean population, participants in the highest quintile of blood lead (2.920-26.507 μg/dL) had an OR of 1.52 (95% CI 1.11-2.10) for hearing loss in the frequencies 2, 3, and 4 kHz, compared to those in the lowest quintile (0.260-1.365 μg/dL), with a significant linear trend [Huh et al, 2016].…”

“…The hearing ability of a person can be easily determined using the average of hearing threshold levels at specified frequencies; however, there is no international guideline from which to choose the appropriate frequencies. A few studies that reported the association between heavy metal exposure and hearing loss calculated the PTA variably in the frequency range of 0.5-8 kHz, and most of those studies commonly used the range 0.5-4 kHz (the socalled speech frequency) [Counter et al, 1997;Chuang et al, 2007;Hwang et al, 2009;Park et al, 2010;Shargorodsky et al, 2011;Choi et al, 2012;Saunders et al, 2013;Choi and Kim, 2014;Huh et al, 2016;Choi and Park, 2017]. However, the PTA that is determined using the speech frequency is likely to underestimate the degree of hearing loss, because lead and cadmium affect the highfrequency hearing ability rather than the low-frequency hearing ability.…”

Personal Music Players and Hearing Loss: The HUNT Cohort Study

“…Huh et al analyzed hearing loss in 1,036 earphone users in KNHANES (2010-2013) out of 7,596 subjects aged 10 to 87 years. They found a relation between earphone use time and Huh et al, 2016). Several reviews have summarized the risk of developing permanent hearing loss due to the use of PMP.…”

“…The epidemiological evidence for an effect of music listening through personal music players (PMPs) on hearing has been limited and of low quality ( European Commission—Scientific Committee on Emerging and Newly Identified Health Risks, 2008 ; Sliwinska-Kowalska & Zaborowski, 2017 ). Among more recent studies, all except one minor follow-up study ( Marlenga et al., 2012 ) are cross-sectional ( Båsjö et al., 2016 ; Berg & Serpanos, 2011 ; Henderson et al., 2011 ; Hong et al., 2016 ; Huh et al., 2016 ; Kumar et al., 2017 ; le Clercq et al., 2018 ; Lee et al., 2015 ; Le Prell et al., 2018 ; Marron et al., 2014 ; Rhee et al., 2019 ; Su & Chan, 2017 ; Swierniak et al., 2020 ; Twardella et al., 2016 ) in which interpretation of causality is difficult. Temporality, that the cause precedes the effect, is the only criterion considered by Rothman and Lash (2008) as a true causal criterion.…”

The Joint Effects of Some Beverages Intake and Smoking on Chronic Obstructive Pulmonary Disease in Korean Adults: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2008–2015

“…Beverage intake was divided into ≤ 1 time/week (low) and, > 1 time/week (high), and smoking was divided into ≤20 pack-years (low) and, >20 pack-years (high). Then, we used the combinations of these categorical variables and classified them into the following four groups: low beverage intake and low pack-years (reference), low beverage intake and high pack-years, high beverage intake and low pack-years, and high beverage intake and high pack-years [15]. According to the recommendation of Knol and Vander-Weele, we calculated the additive scale (relative excess risk due to interaction, RERI) and the multiplicative scale (the ratio of ORs) [16].…”