Noise-induced hearing loss in children and adolescents.

Abstract

Occupational noise exposure remains the most commonly identified cause of noise-induced hearing loss (NIHL) in the general population. The issue of NIHL in children has received scant attention. Parents and public policy makers have expressed increasing concern about hearing risks to children and adolescents posed by noise sources such as: rock music, ‘‘boom’’ cars, loud toys, recreational vehicles, and personal cassette players. This report focuses on 114 children and adolescents (ages 19 and under; 90.3% males) who were diagnosed as having probable NIHL on the basis of clinical history and audiometric configuration. Forty-two children had unilateral losses, while 72 had sensorineural losses of varying degree in the contralateral ear. The mean age of referral for evaluation was 12.7 yr (range 1.2 to 19.8 yr, s.d. 4.21 yr), although 26% of the children were age 10 or younger at the time of referral. Inherent weaknesses of currently available clinical studies of NIHL in nonoccupational settings include imprecision in diagnosis and lack of quantification in characterizing the nature and duration of exposure. The occurrence of irreversible but potentially preventable hearing loss among a preschool and school-age sample should prompt improved observational and interventional, prospective longitudinal studies of NIHL in children and adolescents. Advances in molecular medicine as related to hearing loss, incorporated into such studies, could enhance understanding of individual variation in susceptibility to hearing damage from noise associated with age, gender, racial or ethnic status, and genetic make-up. Psychosocial measures should address the issue of improving compliance in the utilization of ear protectors among the younger age group.