These findings suggest that children are being exposed to excessive amounts of hazardous levels of noise, and children's hearing is vulnerable to these exposures. These data support the need for research on appropriate hearing conservation methods and for NITS screening programs among school-aged children. Public health interventions such as education, training, audiometric testing, exposure assessment, hearing protection, and noise control when feasible are all components of occupational hearing conservation that could be adapted to children's needs with children-specific research.

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Context.-Hearing loss in children influences the development of communication and behavioral skills, but few studies in the United States have used pure-tone audiometry to derive hearing loss prevalence estimates for children.Objective.-To describe the prevalence of hearing loss among US children by sociodemographic characteristics, reported hearing loss, and audiometric screening factors.Design.-National population-based cross-sectional survey with an in-person interview and audiometric testing at 0.5 to 8 kHz.Setting/Participants.-A total of 6166 children aged 6 to 19 years completed audiometry in the mobile examination center of the Third National Health and Nutrition Examination Survey conducted between 1988 and 1994.Main Outcome Measure.-Hearing loss, defined as audiometric threshold values of at least 16-dB hearing level based on a low or high pure-tone average.Results.-A total of 14.9% of children had low-frequency or high-frequency hearing loss of at least 16-dB hearing level, 7.1% had low-frequency hearing loss of at least 16-dB hearing level, and 12.7% had high-frequency hearing loss of at least 16-dB hearing level. Most hearing loss was unilateral and slight in severity (16to 25-dB hearing level). Of those with measured hearing loss, 10.8% were reported to have current hearing loss during the interview.Conclusions.-This analysis indicates that 14.9% of US children have lowfrequency or high-frequency hearing loss of at least 16-dB hearing level in 1 or both ears. Among children in elementary, middle, and high school, audiometric screening should include low-frequency and high-frequency testing to detect hearing loss.

The present study investigates differences between a Swedish and an American sample of young students regarding attitudes towards noise and the use of hearing protection at concerts. The study population was comprised of 179 participants from Sweden and 203 participants from the United States, who ranged in age from 17 to 21 years. Questionnaires were used to gather information on hearing symptoms and attitudes towards noise (Youth Attitude to Noise Scale). Multivariate analysis of variance revealed that attitudes towards noise differed significantly due to gender and country. Men had slightly more positive attitude towards noise than women, and men from the USA had more positive attitudes than men from Sweden. Least positive were the women from Sweden (except regarding attitudes towards the ability to concentrate in noisy environments). Multivariate logistic regression analysis was used to examine the influence of attitudes towards noise and country on young people's use of hearing protection at concerts. The results indicated that attitudes and country explained 50% of the variance in use of hearing protection.

The purpose of the present study was to investigate possible associations between college students' attitudes, risk-taking behaviour related to noisy activities, and hearing problems such as threshold shifts or self-experienced hearing symptoms. The sample included 258 students aged between 17 and 21 enrolled at the University of Pennsylvania, USA. A questionnaire measuring attitudes towards noise, use of hearing protection, and self-reported hearing symptoms was distributed among the students. After completing the questionnaire a hearing screening, including pure-tone audiometry and tympanometry, was conducted. The result revealed that 26% had thresholds poorer than the screening level of 20 dBHL. Attitudes were significantly related to self-experienced hearing symptoms, but not to threshold shifts. Attitudes and noise sensitivity was, significantly related to use of hearing protection. Hearing protection use was found in activities such as using firearms, mowing lawns, and when using noisy tools but was less reported for concerts and discotheques. It can be concluded that the young adults in this study expose themselves to hearing risks, since the use of hearing protection is in general very low.