Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010
Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010
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DOI：
10.1002/lary.27419
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发表时间：
2019-08-01
期刊：
影响因子：
2.6
通讯作者：
Flamme, Gregory A.
中科院分区：
文献类型：
--
作者：
Hoffman, Howard J.;Dobie, Robert A.;Flamme, Gregory A.
目的/假设探讨1966-2010年间青少年听力障碍的相关因素。研究设计对美国社会人口、健康和听力测量数据进行横断面分析，时间跨度为50年。方法研究对象为参加全国健康体检调查(NHES周期3,1966-1970；n=6,768)和第三次全国健康与营养体检调查(NHANES III，1988-1994，n=3,057)和NHANES(2005-2010，n=4,374)的12~17岁青年。Hi患病率的定义是：语音频率(0.5、1、2和4 kHz)和高频(3、4和6 kHz)的纯音平均(PTA)=20dBHL。用多因素Logistic模型估计优势比(OR)和95%可信区间(CI)。结果总体语频HI患病率NHES为10.6%(95%CI：9.7%-11.6%)，NHANES III为3.9%(95%CI：2.8%-5.5%)，NHANES 2005-2010为4.5%(95%CI：3.7%-5.4%)。相应的高频HI患病率分别为32.8%(95%CI：30.8%~34.9%)、7.3%(95%CI：5.9%~9.0%)和7.9%(95%CI：6.8%~9.2%)。在调整了社会人口因素后，男性和吸烟的总体高频HI增加了两倍。在2005年至2010年的NHANES中，其他重要的危险因素包括非常低的出生体重、耳朵感染/中耳炎病史、耳管、一般健康状况良好/较差以及枪支使用。结论HI值在1966~1970年和1988~1994年间显著下降，1988~1994年和2005~2010年间无进一步下降。中耳炎病史在每个时期都是HI的重要危险因素，而极低出生体重在生存机会提高后成为重要的危险因素。吸烟、与工作有关的噪音和枪支使用的减少可能是高频HI减少的部分原因。吵闹的音乐暴露可能有所增加，但不能解释HI的差异。证据水平NA喉镜，129：1922-1939,2019年
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