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.

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.

BackgroundThe prevalence of diabetes is higher among Mexican Americans than among non-Hispanic whites. Higher serum levels of organochlorine pesticides in Mexican Americans have been reported. Few studies have explored the association between pesticide exposure and diabetes.ObjectivesWe set out to examine the association between self-reported diabetes and serum concentrations of organochlorine pesticides among Mexican Americans residing in the southwestern United States from 1982 to 1984.MethodsThis study was conducted among a sample of 1,303 Mexican Americans 20–74 years of age from the Hispanic Health and Nutrition Examination Survey. Serum concentrations were available for seven pesticides or pesticide metabolites at quantifiable levels in at least 1% of the study population: p,p′-DDT (dichlorodiphenyltrichloroethane), p,p′-DDE (dichlorodiphenyldichloro-ethylene), dieldrin, oxychlordane, β-hexachlorocyclohexane, hexachlorobenzene, and trans-nonachlor. We used logistic regression to evaluate the association of self-reported diabetes with exposure to organochlorine pesticides, with and without adjustment for total serum lipids. Nonfasting serum glucose values were compared among exposure groups.ResultsSelf-reported diabetes was significantly associated with serum levels above the detectable limit for trans-nonachlor, oxychlordane, and β-hexachlorocyclohexane and among those with the highest level of exposure to p,p′-DDT and p,p′-DDE. On adjustment for total serum lipids, the association with p,p′-DDT remained significant. Serum glucose levels were elevated among those exposed to trans-nonachlor and β-hexachlorocyclohexane.ConclusionThis study suggests that higher serum levels of certain organochlorine pesticides may be associated with increased prevalence of diabetes. Additional studies with more extensive clinical assessment are needed to confirm this association.