噪音暴露史与年龄相关的听力变化。

IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY JAMA otolaryngology-- head & neck surgery Pub Date : 2025-01-09 DOI:10.1001/jamaoto.2024.4768
Lauren K Dillard, Larry E Humes, Lois J Matthews, Judy R Dubno
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引用次数: 0

摘要

重要性:噪音暴露是听力损失的一个主要的可改变的危险因素,但它是否影响听力下降的速度在老龄化尚不清楚。目的:探讨噪声暴露史与每年纯音阈值变化率的关系。设计、环境和参与者:这项纵向队列研究是在南卡罗来纳医科大学正在进行的基于社区的年龄相关性听力损失纵向队列研究中进行的(1988年至今,样本位于南卡罗来纳查尔斯顿及其周边地区)。在全面的基线检查之后,参与者参加了年度检查,期间收集了听力测量数据。具有至少2次听力测试数据和噪声暴露史数据的参与者被纳入研究。数据分析时间为2023年9月至2024年7月。暴露:噪音暴露史,由自我报告的问卷和兵役史确定,被分类为无/很少,一些,或高暴露。主要结局和测量指标:结局测量指标为个体听力学阈值(0.25 kHz至8.0 kHz)和频率为0.5 kHz、1.0 kHz、2.0 kHz和4.0 kHz的阈值的纯音平均值(PTA),均为双侧平均值。使用线性混合回归模型估计年龄(每额外1年)与每个频率和PTA的阈值变化率之间的关系,对于每个噪声暴露类别。在回归模型中,噪声暴露与年阈值变化率的关系由年龄(纵向时间变量)和噪声暴露的交互项确定。结果:在1347名参与者中,平均(SD)基线年龄为63(14)岁,其中772(57%)为女性。平均(SD)随访时间为5.1(5.7)年。与无噪声/低噪声暴露组相比,有噪声暴露组和高噪声暴露组的基线阈值分别为2.0 kHz至8.0 kHz和PTA, 1.0 kHz至8.0 kHz和PTA。在1.0 kHz和2.0 kHz时,高噪声暴露者(与无噪声或低噪声暴露者相比)的阈值年变化率更高。在已经发生听力损失的3.0 kHz至8.0 kHz和4.0 kHz至8.0 kHz范围内,接触一些噪音和高噪音的参与者每年的变化率较低。每年PTA的变化率在噪声暴露组之间没有差异。结论和相关性:在这项队列研究中,噪音暴露与较差的基线听力和某些中频的较高年下降率有关。噪音暴露会对听力产生直接和潜在的长期负面影响。
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Noise Exposure History and Age-Related Changes to Hearing.

Importance: Noise exposure is a major modifiable risk factor for hearing loss, yet it is not known whether it affects the rate of hearing decline in aging.

Objective: To determine the association of noise exposure history with the rate of pure-tone threshold change per year.

Design, setting, and participants: This longitudinal cohort study was conducted in the ongoing community-based Medical University of South Carolina Longitudinal Cohort Study of Age-Related Hearing Loss (1988 to present with the sample based in Charleston, South Carolina, and surrounding area). Following a comprehensive baseline examination, participants attended annual examinations, during which audiometric data were collected. Participants with audiometric data from at least 2 examinations and noise exposure history data were included in the study. Data were analyzed between September 2023 and July 2024.

Exposure: Noise exposure history, determined by a self-reported questionnaire and history of military service, was categorized as no/little, some, or high exposure.

Main outcomes and measures: Outcome measures were individual audiometric thresholds (0.25 kHz to 8.0 kHz) and pure-tone average (PTA) of thresholds at frequencies 0.5 kHz, 1.0 kHz, 2.0 kHz, and 4.0 kHz, averaged bilaterally. Linear mixed regression models were used to estimate the association of age (per every 1 additional year) with the rate of threshold change at each frequency and PTA, for each noise exposure category. The association of noise exposure with the rate of annual threshold change was determined by an interaction term of age (longitudinal time variable) and noise exposure in regression models.

Results: Of 1347 participants, the mean (SD) baseline age was 63 (14) years, and 772 (57%) were female. The mean (SD) follow-up time was 5.1 (5.7) years. Compared to the no/little noise exposure group, groups with some and high noise exposure had significantly higher baseline thresholds from 2.0 kHz to 8.0 kHz and PTA, and 1.0 kHz to 8.0 kHz and PTA, respectively. Those with high noise exposure (vs no/little) showed higher rates of threshold change per year at 1.0 kHz and 2.0 kHz. Participants with some and high noise exposure showed lower rates of change per year at 3.0 kHz to 8.0 kHz and 4.0 kHz to 8.0 kHz, respectively, where hearing loss had already occurred. The rate of PTA change per year did not differ across noise exposure groups.

Conclusions and relevance: In this cohort study, noise exposure was associated with poorer baseline hearing and higher rates of annual decline at some midfrequencies. Noise exposure can have immediate and potentially long-term negative impacts on hearing.

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来源期刊
CiteScore
9.10
自引率
5.10%
发文量
230
期刊介绍: JAMA Otolaryngology–Head & Neck Surgery is a globally recognized and peer-reviewed medical journal dedicated to providing up-to-date information on diseases affecting the head and neck. It originated in 1925 as Archives of Otolaryngology and currently serves as the official publication for the American Head and Neck Society. As part of the prestigious JAMA Network, a collection of reputable general medical and specialty publications, it ensures the highest standards of research and expertise. Physicians and scientists worldwide rely on JAMA Otolaryngology–Head & Neck Surgery for invaluable insights in this specialized field.
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