Abstract

BackgroundLead and cadmium have been identified as risk factors for hearing loss in animal studies, but large-scale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey.MethodsThe study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Low-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsAmong men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161–2.287) and women (OR = 1.502, 95% CI = 1.027–2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex.ConclusionsThe present study findings suggest that even exposure to low-level lead is a risk factor for high-frequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.

Highlights

  • Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but largescale studies targeting the general human population are rare

  • In a study based on the 2010–2012 Korea National Health and Nutrition Examination Surveys (KNHANES), it was estimated that people with mild hearing impairment comprise 20.5% of the population over the age of 19 years, and 70% of the population over the age of 65 years [4]

  • 6582 participants aged 20 years or older underwent pure tone audiometry and blood tests to assess the level of heavy metals

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Summary

Introduction

Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but largescale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey. In a study on the general population, Park et al confirmed a link between low-level lead exposure and hearing impairment [16]. The relationship between hearing impairment and exposure to lead and cadmium was confirmed in a study by Shargorodsky et al of American adolescents [17], and in a study of American adults by Choi et al [18]

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