Risk Factors for Hearing Loss

描述（由申请人提供）：听力损失是美国最常见的感觉障碍，困扰着超过3600万人；因此，确定可改变的风险因素是一个至关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疾病的常见和潜在可改变的风险因素的前瞻性数据有限。除噪音外，与听力损失风险潜在相关的因素还包括止痛药、维生素、酒精、更年期状况和绝经后激素的使用。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。我们对男性的初步研究发现，定期适度使用阿司匹林、非甾体抗炎药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、维生素A、维生素C、维生素D和维生素E，在维持听力方面可能起重要作用。酒精摄入可能对听力产生不同程度的影响，这取决于饮酒的程度。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。我们将在涉及超过15万名妇女的大型正在进行的队列研究（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进行修改以保护听力的因素，将在NHS II中3000名无听力损失或轻度听力损失的女性中检查听力测量3年以上的听力敏感性变化。次要结果将是整个研究人群中自我报告的专业诊断的听力损失。我们预计将通过补充问卷确定并确认每个女性队列中超过5000例事件病例。我们将采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系。

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.