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吸烟与听力损失:听力损失研究的流行病学

Cigarette smoking and hearing loss: the epidemiology of hearing loss study.

作者信息

Cruickshanks K J, Klein R, Klein B E, Wiley T L, Nondahl D M, Tweed T S

机构信息

Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-2397, USA.

出版信息

JAMA. 1998 Jun 3;279(21):1715-9. doi: 10.1001/jama.279.21.1715.

Abstract

CONTEXT

Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults.

OBJECTIVE

To evaluate the association between smoking and hearing loss.

DESIGN

Population-based, cross-sectional study.

SETTING

Community of Beaver Dam, Wis.

PARTICIPANTS

Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study.

MAIN OUTCOME MEASURES

The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear.

RESULTS

After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non-age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74).

CONCLUSIONS

These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.

摘要

背景

临床研究表明,吸烟可能与听力损失有关,听力损失是影响老年人的一种常见病症。

目的

评估吸烟与听力损失之间的关联。

设计

基于人群的横断面研究。

地点

威斯康星州比弗代尔社区。

参与者

年龄在48至92岁之间的成年人。在4541名符合条件的受试者中,3753人(83%)参与了听力研究。

主要观察指标

检查包括耳镜检查、筛查鼓室导抗图,以及纯音气导和骨导听力测定。吸烟史通过自我报告确定。听力损失定义为较差耳的纯音平均听阈(0.5、1、2和4千赫)大于25分贝听力级。

结果

在对其他因素进行调整后,当前吸烟者发生听力损失的可能性是非吸烟者的1.69倍(95%置信区间,1.31 - 2.17)。对于没有职业噪声暴露史的人以及排除非年龄相关性听力损失患者的分析中,这种关系依然存在。有微弱证据表明存在剂量反应效应。与吸烟者共同生活的非吸烟参与者发生听力损失的可能性高于未接触吸烟家庭成员的人(优势比,1.94;95%置信区间,1.01 - 3.74)。

结论

这些数据表明,环境暴露可能在年龄相关性听力损失中起作用。如果纵向研究证实这些发现,改变吸烟习惯可能预防或延缓听力敏感度的年龄相关性下降。

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