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.
In Russia, hair, rather than blood, is usually used as a substrate for screening children for lead poisoning. We attempted to gauge the accuracy of this method by comparing these two methods. The evaluation was done in Saratov, Russia. We collected hair and blood samples from 189 children who attended 11 kindergartens. Their mean blood lead concentration was 9.8 microg/dl (range = 3.1-35.7 microg/dl), and their mean hair lead concentration was 7.2 microg/g (range = 1.0-7.2 microg/g [i.e., 1.0 being the lowest detectable limit]). Hair lead concentration as a screening method had 57% sensitivity and resulted in 18% of the children being classified as false-negatives. We conclude, therefore, that measuring hair lead concentration is not an adequate method with which to screen children for lead poisoning.
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