Yi Xu,1,* Jie Liu,2â 4,* Chao Dong,1 Sitong Guo,1 Hui Cao,1 Jing Zhang,1 Mingxin Wang,1 Jinghua Wang,2â 4 Xin Li,5 Dong Yang1 1Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin, 300052, Peopleâs Republic of China; 2Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, Peopleâs Republic of China; 3Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, Peopleâs Republic of China; 4Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, Peopleâs Republic of China; 5Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital,School of Clinical Medicine, Tsinghua University, Beijing, 102218, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Dong YangDepartment of Otorhinolaryngology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, Peopleâs Republic of ChinaTel +86-22-60814958Fax +86-22-60362400Email zyyentyd@163.comXin LiDepartment of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168, Litang Road, Changping District, Beijing, 102218, Peopleâs Republic of ChinaTel +86 13263358503Fax +86-10-56118969Email entlixin@sina.comObjective: Hearing impairment (HI) has become one of the most common causes of disability worldwide. To date, few studies have examined the hearing of women in these frequently rural regions. Thus, we explored the HI prevalence and risk factors among low-income, middle-aged, and elderly women in Tianjin, China.Methods: Between October and November 2013, female residents aged ⥠45 years of rural Tianjin, China were recruited into the study. The participants completed questionnaire surveys, physical examinations, and hearing tests. The hearing at frequencies of 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz was used to analyze the hearing characteristics of specific frequency bands, and HI was defined as the better ear pure tone averages (PTA) > 25 dB HL.Results: Among the 1416 participants, the prevalence of HI was 46.0%. Among those aged 45â 54-years, most (65.3%) demonstrated normal hearing; in other age groups, slight HI accounted for the largest proportions of individuals. Compared with women who did not drink, the odds ratio (OR) of HI among women who consumed alcohol was 4.2 (95% confidence interval [CI]: 1.844â 9.574; P = 0.001). Compared with pre-menopausal women, the OR of HI among postmenopausal women was 1.8 (95% CI: 1.261â 2.667; P = 0.001). Further, each 1-year increase in age in women resulted in a 7.1% increase in HI risk (P < 0.001).Conclusion: The burden of HI among women is heavy in rural northern China, especially among those who experienced menopause. Additionally, the results suggest that to further reduce the risk of developing HI, women in rural areas should stop consuming alcohol. The problem of HI among women in rural areas should be taken seriously; moreover, the measures implemented to prevent HI in high-risk women should be strengthened.Keywords: hearing impairment, women, risk factors, epidemiology, population-based study