Karlsmose B, Lauritzen T, Engberg M, Parving A
Department and Research Unit of General Practice, University of Aarhus, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark.
Br J Gen Pract. 2001 May;51(466):351-5.
Prophylactic strategies to counter acquired hearing impairment may involve routine audiometric screening of asymptomatic working-age adults attending general practice for regular health checks.
To evaluate the effect of adult hearing screening on subsequent noise exposure and hearing.
A randomised controlled population-based study of health checks and health discussions in general practice.
The project was initiated in the district of Ebeltoft, Aarhus county, Denmark.
Intervention group participants' hearing thresholds were determined audiometrically at 0.5, 1, 2, 3, and 4 kHz in each ear. Participants were advised to get their ears checked if the average hearing loss exceeded 20 dB hearing level (dBHL) in either ear. Noise avoidance was emphasised when thresholds exceeded 25 dBHL bilaterally at 4 kHz. Follow-up included questionnaires and audiometry.
Hearing loss was observed among 18.9% of the study sample at baseline. At the five-year follow-up we recorded no significant differences between the control and the intervention groups regarding subjective or objective hearing, or exposure to occupational noise. However, there was a tendency towards reduction in exposure to leisure noise among intervention participants (P = 0.045). Approximately 20% reported hearing problems; 16.5% reported tinnitus-related complaints; 0.8% used hearing aids; 35.0% reported frequent noise exposure; and occluding wax was suspected in 2.1%.
Preventive health checks with audiometry did not significantly affect hearing, but leisure noise exposure tended to become less frequent. The poor effect may be ascribed to inadequate audiological counselling or a higher priority to other advice, e.g. on cardiovascular risk or lifestyle.
预防后天性听力障碍的策略可能包括对参加常规健康检查的无症状工作年龄成年人进行常规听力筛查。
评估成人听力筛查对后续噪声暴露和听力的影响。
一项基于人群的关于普通医疗中健康检查和健康讨论的随机对照研究。
该项目在丹麦奥胡斯郡埃贝勒夫特地区启动。
干预组参与者每只耳朵在0.5、1、2、3和4千赫兹频率下通过听力测定确定听力阈值。如果任一只耳朵的平均听力损失超过20分贝听力级（dBHL），建议参与者检查耳朵。当4千赫兹频率下双侧阈值超过25 dBHL时，强调避免噪声。随访包括问卷调查和听力测定。
在基线时，研究样本中有18.9%观察到听力损失。在五年随访中，我们记录到对照组和干预组在主观或客观听力、或职业噪声暴露方面没有显著差异。然而，干预组参与者的休闲噪声暴露有减少的趋势（P = 0.045）。约20%报告有听力问题；16.5%报告有耳鸣相关症状；0.8%使用助听器；35.0%报告经常暴露于噪声；2.1%怀疑有耵聍堵塞。
听力测定的预防性健康检查对听力没有显著影响，但休闲噪声暴露往往变得不那么频繁。效果不佳可能归因于听力咨询不足或对其他建议（如心血管风险或生活方式方面的建议）给予了更高优先级。
