Personally Modifiable Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review

Abstract

Background Pediatric hearing loss is an increasingly recognized problem with significant implications. Increasing our quantitative understanding of potentially modifiable environmental risk factors for hearing loss may form the foundation for prevention and screening programs. Objective To determine whether specific threshold exposure levels of personally modifiable risk factors for hearing loss have been defined, with the overarching goal of providing actionable guidance for the prevention of pediatric hearing loss. Data Sources A systematic review was performed. Computerized searches of PubMed, EMBASE, and the Cochrane Library were completed and supplemented with manual searches. Review Methods Inclusion/exclusion criteria were designed to determine specific threshold values of personally modifiable risk factors on hearing loss in the pediatric population. Searches and data extraction were performed by independent reviewers. Results There were 38 criterion-meeting studies, including a total of 50,651 subjects. Threshold noise exposures significantly associated with hearing loss in youth included: (1) more than 4 hours per week or more than 5 years of personal headphone usage, (2) more than 4 visits per month to a discotheque, and (3) working on a mechanized farm. Quantified tobacco levels of concern included any level of in utero smoke exposure as well as secondhand exposure sufficient to elevate serum cotinine. Conclusions Specific thresholds analyses are limited. Future studies would ideally focus on stratifying risk according to clearly defined levels of exposure, in order to provide actionable guidance for children and families.

Grade repetition and parents' perception of hearing loss: An analysis of data from children in the United States

“…It is certainly possible, however, that we were not able to account for all comorbidities leading to some form of cognitive and medical impairment. The issue of poor school performance may be able to be addressed by allocating more resources to help those with hearing loss and through modifying behavior . Pediatric hearing loss is significantly associated with the following personally modifiable risk factors: more than 4 hours per week or more than 5 years of personal headphone usage, more than 4 visits per month to a discotheque, and working on a mechanized farm .…”

“…16 Pediatric hearing loss is significantly associated with the following personally modifiable risk factors: more than 4 hours per week or more than 5 years of personal headphone usage, more than 4 visits per month to a discotheque, and working on a mechanized farm. 16 If this trend of increased noise exposure continues, it may result in more children failing higher grades, and this certainly bears ongoing scrutiny. In the United States, total cost estimates for public elementary and secondary school are over $600 billion per year.…”

“…The issue of poor school performance may be able to be addressed by allocating more resources to help those with hearing loss and through modifying behavior . Pediatric hearing loss is significantly associated with the following personally modifiable risk factors: more than 4 hours per week or more than 5 years of personal headphone usage, more than 4 visits per month to a discotheque, and working on a mechanized farm . If this trend of increased noise exposure continues, it may result in more children failing higher grades, and this certainly bears ongoing scrutiny.…”

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus

“…Very recently, in 2014, the second systematic review entitled “Personally modifiable risk factors associated with pediatric hearing loss” has been published [ 28 ]. Although the objective of this publication was to determine threshold levels of personally modified risk factors for hearing loss in the pediatric population, specific thresholds analyses were limited.…”

“…The available systematic reviews aimed at assessing the relationship between exposures to non-occupational noise in the general population and permanent hearing outcomes are very limited in number. The quality of evidence was low [ 33 ], the review was published more than five years ago [ 17 ], or was dedicated to a pediatric subpopulation [ 28 ], and the threshold levels of exposures increasing the risk for NIHL have not been established so far. Therefore, the main objective of this paper was to provide an overview of randomized and non-randomized studies and to determine whether the exposure-response relationship can be established between exposures to non-occupational noise (measured in sound pressure levels, SPLs, and expressed in L Aeq8h values) and permanent hearing outcomes, such as permanent hearing loss and permanent tinnitus.…”