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A letter to the editor is presented in response to the article ?Self-reported hearing problems among older adults: prevalence and comparison to measured hearing impairment? by S. Hannula, R. Bloigu, K. Majamaa, M. Sorri and E. Mäki-Torkko in the 2011 issue.

The author discusses a study entitled "Assessment of the American Medical Association guide to the evaluation of binaural hearing impairment" by J. H. Macrae. He argues with the biases found in the said study concerning the participation of veterans. He also discusses findings of the study which determined the correlation of Hearing Measurement Scale (HMS) total score in both American Medical Association method of estimating hearing disability and Macrae's modified method.

The article presents information on a research to show the effects of folic acid supplementation on age-related hearing impairments. In the research, one group of older people having hearing disorders was given folic acid supplementation and another group was a placebo. After 3 years, the hearing of the group that received the supplementation improved. The result of the study may prove to be very helpful in treating age-related hearing impairments.

A letter to the editor is presented in response to the article "Impact of dizziness and obesity on the prevalence of falls and fall-related injuries" by H.W. Lin and N. Bhattachryya, published in 2014 issue of the journal.

A letter to the editor is presented in response to the study "Determinants of Bilateral Audiometric Notches in Noise-Induced Hearing Loss" by Hsu et al. in the November 2013 issue.

The author examines the burden of noise-induced hearing loss and tinnitus in developed countries and developing countries. Part of the adult-onset hearing loss burden in wealthier countries is attributed to occupational and non-occupational noise. The relative burden of occupational noise is greater in developing countries due to the relocation of manufacturing jobs and a shorter average lifespan. Measures to reduce noise exposure are also discussed.

Focuses on the worldwide problem of otitis media. Effects of otitis media on speech and language development; Results of the study on the childhood otitis media conducted by the National Study of Hearing; Organization of conferences to discuss the issue.

Averaged scalp potentials evoked by continuous pseudorandom noise can be cross correlated with the evoking stimulus, yielding a cross-correlation function (CCF) that reflects neural phase locking and is quite sensitive for low-frequency stimulus components [M. J. Wilson and R. A. Dobie, Electroencephalogr. Clin. Neurophysiol. 66, 529-538 (1987)]. However, for higher frequency signals, replicable CCFs can only be obtained at moderate to high intensity. Since auditory neurons also respond to envelopes of complex sounds, even for high-frequency carriers, scalp responses were compared to the envelopes of complex sounds; the resultant envelope cross-correlation functions (ECCFs) contained replicable response components primarily below 1000 Hz, regardless of the evoking stimulus spectrum. The ECFF thresholds for three octave-band stimuli (830-1562, 1611-3125, and 3174-6201 Hz) were more sensitive than CCF thresholds (p = 0.018), averaging 35-dB spectrum level for ten normal subjects. When stimuli with only odd harmonics were used, replicable odd-component responses were seen only in the spectral range of the stimuli, while even-component responses (presumably to stimulus envelope) were seen only in the low-passed scalp responses. [ABSTRACT FROM AUTHOR]

Context: Numerous studies have demonstrated that hearing aids provide significant benefit for a wide range of sensorineural hearing loss, but no carefully controlled, multicenter clinical trials comparing hearing aid efficacy have been conducted.Objective: To compare the benefits provided to patients with sensorineural hearing loss by 3 commonly used hearing aid circuits.Design: Double-blind, 3-period, 3-treatment crossover trial conducted from May 1996 to February 1998.Setting: Eight audiology laboratories at Department of Veterans Affairs medical centers across the United States.Patients: A sample of 360 patients with bilateral sensorineural hearing loss (mean age, 67.2 years; 57% male; 78.6% white).Intervention: Patients were randomly assigned to 1 of 6 sequences of linear peak clipper (PC), compression limiter (CL), and wide dynamic range compressor (WDRC) hearing aid circuits. All patients wore each of the 3 hearing aids, which were installed in identical casements, for 3 months.Main Outcome Measures: Results of tests of speech recognition, sound quality, and subjective hearing aid benefit, administered at baseline and after each 3-month intervention with and without a hearing aid. At the end of the experiment, patients ranked the 3 hearing aid circuits.Results: Each circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech (all 52-dB and 62-dB conditions, PConclusions: Each circuit provided significant benefit in quiet and noisy listening situations. The CL and WDRC circuits appeared to provide superior benefits compared with the PC, although the differences between them were much less than the differences between the aided vs unaided conditions. JAMA. 2000;284:1806-1813. [ABSTRACT FROM AUTHOR]

Acoustic trauma (AT) is permanent hearing loss after a single noise exposure. A few human cases resulting from continuous, i.e., nonimpulsive noise, have been reported as reviewed by Ward [(1991). "Hearing loss from noise and music," presented at Audio Engineering Society, New York, October 4-8]. This paper updates that review by examining 11 cases in nine reports, from 1950 to 2006, with the intention of determining minimum exposures that may cause AT, including the potential risk of exposure to noise from magnetic resonance imaging machines. Diffuse-field related levels above 120 dBA for 10 s or more, or above 130 dBA for 2-3 s (values well above OSHA's unprotected exposure limits), can lead to AT. These cases appear to represent a susceptible fraction of the population, because much more intense exposures (e.g., 130 dBA for 32 min) have been tolerated by groups of volunteers who suffered only temporary threshold shifts. AT from continuous noise is unlikely to occur in OSHA-compliant hearing conservation programs, and probably rare enough in the general civilian population that clinical trials of drugs aimed at treating it are unlikely to be practical. AT from impulse noise, such as gunfire, which is specifically not the topic of the current work, is more amenable to clinical trials, especially in military settings.

Objectives/hypothesis: To investigate factors associated with hearing impairment (HI) in adolescent youths during the period 1966-2010., Study Design: Cross-sectional analyses of US sociodemographic, health, and audiometric data spanning 5 decades., Methods: Subjects were youths aged 12 to 17 years who participated in the National Health Examination Survey (NHES Cycle 3, 1966-1970; n = 6,768) and youths aged 12 to 19 years in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994; n = 3,057) and NHANES (2005-2010; n = 4,374). HI prevalence was defined by pure-tone average (PTA) ≥ 20 dB HL for speech frequencies (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Multivariable logistic models were used to estimate the odds ratio (OR) and 95% confidence interval (CI)., Results: Overall speech-frequency HI prevalence was 10.6% (95% CI: 9.7%-11.6%) in NHES, 3.9% (95% CI: 2.8%-5.5%) in NHANES III, and 4.5% (95% CI: 3.7%-5.4%) in NHANES 2005 to 2010. The corresponding high-frequency HI prevalences were 32.8% (95% CI: 30.8%-34.9%), 7.3% (95% CI: 5.9%-9.0%), and 7.9% (95% CI: 6.8%-9.2%). After adjusting for sociodemographic factors, overall high-frequency HI was increased twofold for males and cigarette smoking. Other significant risk factors in NHANES 2005 to 2010 included very low birth weight, history of ear infections/otitis media, ear tubes, fair/poor general health, and firearms use., Conclusions: HI declined considerably between 1966 to 1970 and 1988 to 1994, with no additional decline between 1988 to 1994 and 2005 to 2010. Otitis media history was a significant HI risk factor each period, whereas very low birth weight emerged as an important risk factor after survival chances improved. Reductions in smoking, job-related noise, and firearms use may partially explain the reduction in high-frequency HI. Loud music exposure may have increased, but does not account for HI differences., Level of Evidence: NA Laryngoscope, 129:1922-1939, 2019., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

: Occupational hearing loss is preventable through a hierarchy of controls, which prioritize the use of engineering controls over administrative controls and personal protective equipment. The occupational and environmental medicine (OEM) physician plays a critical role in the prevention of occupational noise-induced hearing loss (NIHL). This position statement clarifies current best practices in the diagnosis of occupational NIHL.

Importance: As the US population ages, effective health care planning requires understanding the changes in prevalence of hearing loss., Objective: To determine if age- and sex-specific prevalence of adult hearing loss has changed during the past decade., Design, Setting, and Participants: We analyzed audiometric data from adults aged 20 to 69 years from the 2011-2012 cycle of the US National Health and Nutrition Examination Survey, a cross-sectional, nationally representative interview and examination survey of the civilian, noninstitutionalized population, and compared them with data from the 1999-2004 cycles. Logistic regression was used to examine unadjusted, age- and sex-adjusted, and multivariable-adjusted associations with demographic, noise exposure, and cardiovascular risk factors. Data analysis was performed from April 28 to June 3, 2016., Interventions: Audiometry and questionnaires., Main Outcomes and Measures: Speech-frequency hearing impairment (HI) defined by pure-tone average of thresholds at 4 frequencies (0.5, 1, 2, and 4 kHz) greater than 25 decibels hearing level (HL), and high-frequency HI defined by pure-tone average of thresholds at 3 frequencies (3, 4, and 6 kHz) greater than 25 decibels HL., Results: Based on 3831 participants with complete threshold measurements (1953 men and 1878 women; mean [SD] age, 43.6 [14.4] years), the 2011-2012 nationally weighted adult prevalence of unilateral and bilateral speech-frequency HI was 14.1% (27.7 million) compared with 15.9% (28.0 million) for the 1999-2004 cycles; after adjustment for age and sex, the difference was significant (odds ratio [OR], 0.70; 95% CI, 0.56-0.86). Men had nearly twice the prevalence of speech-frequency HI (18.6% [17.8 million]) as women (9.6% [9.7 million]). For individuals aged 60 to 69 years, speech-frequency HI prevalence was 39.3% (95% CI, 30.7%-48.7%). In adjusted multivariable analyses for bilateral speech-frequency HI, age was the major risk factor (60-69 years: OR, 39.5; 95% CI, 10.5-149.4); however, male sex (OR, 1.8; 95% CI, 1.1-3.0), non-Hispanic white (OR, 2.3; 95% CI, 1.3-3.9) and non-Hispanic Asian race/ethnicity (OR, 2.1; 95% CI, 1.1-4.2), lower educational level (less than high school: OR, 4.2; 95% CI, 2.1-8.5), and heavy use of firearms (≥1000 rounds fired: OR, 1.8; 95% CI, 1.1-3.0) were also significant risk factors. Additional associations for high-frequency HI were Mexican-American (OR, 2.0; 95% CI, 1.3-3.1) and other Hispanic race/ethnicity (OR, 2.4; 95% CI, 1.4-4.0) and the combination of loud and very loud noise exposure occupationally and outside of work (OR, 2.4; 95% CI, 1.4-4.2)., Conclusions and Relevance: Adult hearing loss is common and associated with age, other demographic factors (sex, race/ethnicity, and educational level), and noise exposure. Age- and sex-specific prevalence of HI continues to decline. Despite the benefit of delayed onset of HI, hearing health care needs will increase as the US population grows and ages.

Objective: A discussion on whether recent research on noise-induced cochlear neuropathy in rodents justifies changes in current regulation of occupational noise exposure., Design: Informal literature review and commentary, relying on literature found in the authors' files. No formal literature search was performed., Study Sample: Published literature on temporary threshold shift (TTS) and cochlear pathology, in humans and experimental animals, as well as the regulations of the US Occupational Safety and Health Administration (OSHA)., Results: Humans are less susceptible to TTS, and probably to cochlear neuropathy, than rodents. After correcting for inter-species audiometric differences (but not for differences in susceptibility), exposures that caused cochlear neuropathy in rodents already exceed OSHA limits. Those exposures also caused "pathological TTS" (requiring more than 24 h to recover), which does not appear to occur with human broadband noise exposure permissible under OSHA., Conclusion: It would be premature to conclude that noise exposures permissible under OSHA can cause cochlear neuropathy in humans.

Background: Physicians and audiologists are often asked to decide whether standard threshold shifts (STSs) are work-related; epidemiological data can inform these decisions., Methods: Predictions of ISO (2013) for both age-related and noise-induced threshold shifts, for the 2, 3, and 4 kHz average used in calculating OSHA STSs, are presented, in tables, graphs, and an Excel spreadsheet calculator. Specifically, the ISO 1999 model estimates age-related thresholds based on age and sex; it estimates noise-induced threshold shifts based on noise level and duration. It specifies that to estimate the final hearing thresholds for a person of given percentile, age, sex, and noise exposure, the expected age-related threshold is to be added to the expected noise-induced threshold shift. Examples show how these data can predict the relative contributions of aging and occupational noise to an STS., Results: Early-career STSs, especially with high levels of noise exposure, are more likely to be primarily noise-induced. After the first decade of exposure, most STSs will be primarily age-related., Conclusion: Given a worker's age, sex, and occupational noise exposure history, ISO 1999 estimates of the expected contributions of aging and noise can supplement clinical judgment., (© 2015 Wiley Periodicals, Inc.)