Factors Associated with Hearing Impairment in Adolescent Youths

What were the factors associated with hearing impairment (HI) in adolescent youths during the period of 1966–2010?

Bottom Line
HI declined considerably between 1966–1970 and 1988–1994, with no additional decline between 1988–1994 and 2005–2010. 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. Loud music exposure may have increased but does not account for HI differences.

Background: Portable music player use, as well as many adult hearing loss risk factors (demographic variables, non-occupational noise other than music, smoking, head injury), could predict child and adolescent hearing loss. Other risk factors (otitis media, meningitis, viral infections, congenital hereditary hearing loss, perinatal illness) are especially important for children.

Study design: Cross-sectional analyses of U.S. sociodemographic, health, and audiometric data of 6,768 youths aged 12 to 17 years and 7,431 youths aged 12 to 19 years.

Setting: U.S. National Center for Health Statistics National Health Examination Survey (NHES Cycle III, 1966–1970) and the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) and NHANES (2005–2010).

Synopsis: In 1966–1970, 89.4% of youths were free of speech-frequency HI, growing to about 96% in 1988–1994 and 2005–2010. Unilateral HI prevalence dropped from 7.4% in 1966–1970 to less than half that amount in later surveys. Bilateral HI showed similar patterns. From 3 kHz to 8 kHz, hearing levels were markedly worse in 1966–1970 than in 2005–2010. Differences were largest at 6 kHz, at the 90th percentile, and for worse ears. Audiometric patterns for 1966–1970 are all notched, suggestive of noise-induced hearing loss. They are more deeply notched in 1966–1970 than in 2005–2010, suggesting more noise-induced hearing loss in the earlier survey. Speech-frequency HI was more prevalent in boys and less prevalent in white youths in 1966–1970. Significant associations in 1966–1970 were observed in fully adjusted analyses for male sex; low family income; history of earaches, myringotomy, or more than one episode of otorrhea; cigarette smoking; and less-than-excellent health. Limitations included a lack of identically worded interview questions across the time span and the cross-sectional nature of national health surveys.

Citation: Hoffman HJ, Dobie RA, Losonczy KG, et al. Kids nowadays hear better than we did: declining prevalence of hearing loss in US youth, 1966–2010. Laryngoscope. 2019:1922–1939.