Jordan Jaxon, Baiduc Rachael R, Spankovich Christopher
Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson, Mississippi.
Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, Colorado.
J Am Acad Audiol. 2022 Feb;33(2):58-65. doi: 10.1055/s-0041-1735520. Epub 2022 Sep 1.
The United States Preventative Service Taskforce recently determined that there was insufficient evidence to recommend hearing screening in adults.
To determine the age to screen adults in the U.S. for hearing loss and identify factors related to increased odds of hearing loss.
Epidemiological Cross-Sectional Study.
Data from 3,409 individuals aged 20-69 years(y) were analyzed from the 1999-2000 and 2000-2002 cycles of the National Health and Nutrition Examination Survey (NHANES).
Hearing sensitivity from 0.5-8 kHz was assessed and hearing loss was defined as pure tone average 0.5, 1, 2, 4 kHz (PTA4) > 15 dBHL for the worse ear. Thresholds were examined separately for men and women in 2-year intervals. A multivariate ordinal regression model adjusting for age, sex, race/ethnicity, and education was used to examine relationship to determinants.
Slight (>15 dBHL) hearing loss based on threshold at a single audiometric frequency was first evident in males aged 28-29y. For females, this occurred at age 34-35y. The age at which average PTA4 increased above 15 dBHL (slight hearing loss) was 46-47y for males and 56-57y for females. Multivariate ordinal regression revealed the following "high risk" factors: increased age, male sex, tinnitus, perceived hearing loss, and diabetes.
For the function of primary prevention, these data suggest screening should initiate at ∼30y for males and 35y for females, the ages when average hearing thresholds at a single frequency can be classified as slight hearing loss. For secondary prevention, the recommended screening ages are higher - 45y for males and 55y for females. Hearing screening is recommended for asymptomatic adults, especially those with high risk factors. Our results also highlight the limitations of PTA4 in identifying early indices of hearing loss.
美国预防服务工作组最近认定，没有足够证据支持对成年人进行听力筛查。
确定美国成年人听力损失筛查的年龄，并识别与听力损失几率增加相关的因素。
流行病学横断面研究。
分析了1999 - 2000年和2000 - 2002年国家健康与营养检查调查（NHANES）中3409名年龄在20 - 69岁的个体的数据。
评估了0.5 - 8千赫兹的听力敏感度，听力损失定义为较差耳的0.5、1、2、4千赫兹纯音平均听阈（PTA4）> 15分贝听力级（dBHL）。按2年间隔分别检查男性和女性的听阈。使用调整了年龄、性别、种族/族裔和教育程度的多变量有序回归模型来研究与决定因素的关系。
基于单个听力测试频率的阈值，轻度（> 15 dBHL）听力损失在28 - 29岁的男性中首次明显出现。对于女性，这发生在34 - 35岁。男性平均PTA4升高至15 dBHL以上（轻度听力损失）的年龄为46 - 47岁，女性为56 - 57岁。多变量有序回归揭示了以下“高风险”因素：年龄增加、男性、耳鸣、自觉听力损失和糖尿病。
对于一级预防功能，这些数据表明筛查应在男性约30岁、女性35岁时开始，此时单个频率的平均听力阈值可归类为轻度听力损失。对于二级预防，建议的筛查年龄更高——男性为45岁，女性为55岁。建议对无症状成年人进行听力筛查，尤其是那些有高风险因素的人。我们的结果还突出了PTA4在识别听力损失早期指标方面的局限性。
