Risk Factors for Hearing Loss

听力损失是美国最常见的感觉障碍，影响超过3600万人;因此，识别可改变的风险因素是一个重要的公共卫生问题。引人注目的是，关于这种高度流行的致残性疾病的常见和潜在可改变的风险因素，只有有限的前瞻性数据。除了噪音，与听力损失风险潜在相关的因素包括止痛药、维生素、酒精、绝经状态和绝经后激素使用。 阿司匹林、对乙酰氨基酚和布洛芬是美国最常用的三种药物。高剂量水杨酸盐的耳毒性作用是众所周知的。我们在男性中的初步研究发现，定期适度使用阿司匹林，NSAID和对乙酰氨基酚会增加听力损失的风险;然而，这还没有在女性中进行前瞻性研究。维生素，如叶酸，A，C，D和E，可能在维持听力方面发挥重要作用。酒精摄入量可能会对听力产生不同的影响，这取决于使用水平。此外，雌激素可能在听力功能中发挥作用，因此绝经状态和绝经后激素的使用可能对听力损失有重要影响。我们将在涉及15万多名女性的大型队列研究（护士健康研究I和II）中前瞻性地研究这些问题。 为了确定可以在早期阶段修改以保护听力的因素，将在NHS II中的3000名无听力损失或轻度听力损失的女性的子集中检查听力测量的听力灵敏度变化超过3年。次要结局将是整个研究人群中自我报告的专业诊断的听力损失。我们预计每个女性队列中将有5000多例事件病例通过补充问卷进行识别和确认。我们将使用多学科方法来研究这些常见因素与听力损失风险之间的关联。

DESCRIPTION (provided by applicant): Hearing loss is the most common sensory disorder in the US, afflicting over 36 million people; thus, identification of modifiable risk factors is a vital public health issue. Strikingly, there are only limited prospective data on common and potentially modifiable risk factors for this highly prevalent, disabling condition. In addition to noise, factors potentially associated with risk of hearing loss include analgesics, vitamins, alcohol, menopausal status and postmenopausal hormone use. Aspirin, acetaminophen and ibuprofen are the three most commonly used drugs in the U.S. The ototoxic effects of high dose salicylates are well-known. Our preliminary studies in men found an increased risk of hearing loss with regular moderate use of aspirin, NSAIDs, and acetaminophen; however, this has not been prospectively studied in women. Vitamins, such as folate, A, C, D, and E, may play important roles in maintenance of hearing. Alcohol intake may have a variable impact on hearing, depending on the level of use. Additionally, estrogen may play a role in hearing function, thus menopausal status and postmenopausal hormone use may have important implications for hearing loss. We will examine these issues prospectively in large ongoing cohort studies involving over 150,000 women (Nurses' Health Studies I and II). To identify factors that can be modified at an early stage to conserve hearing, will examine audiometrically measured change in hearing sensitivity over 3 years in a subset of 3000 women in NHS II with either no or mild hearing loss. The secondary outcome will be selfreported professionally diagnosed hearing loss in the entire study population. We expect more than 5000 incident cases in each female cohort to be identified and confirmed by a supplementary questionnaire. We will use a multidisciplinary approach to examine the association between these common factors and the risk of hearing loss.