Abstract
Although studies have shown that per- and polyfluoroalkyl substances (PFAS) are potential environmental ototoxicants, epidemiologic study has been limited. I conducted a cross-sectional study to re-examine the associations between PFAS and hearing impairment. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999–2000, 2003-06, 2009-12, and 2015-16. Perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) were measured in serum samples. Participants were divided into quartiles for each PFAS. Air conduction pure-tone audiometry was administered. Hearing impairment (1: yes, 0: no) was defined as a hearing threshold of more than 25 dB at 500, 1000, 2000, 4000, and 8000 Hz in the worse ear. I assessed the relation of serum PFAS with hearing impairment by the generalized linear mixed model with a logit link and binary distribution. Tests for linear trend across quartiles of serum PFAS were conducted using the median serum PFAS in each quartile as a continuous variable. After adjusting for age, sex, body mass index, education, ethnicity group, and family income, I found positive correlations between PFOA and hearing impairment at 2000 Hz (p-trend < 0.01) and 3000 Hz (p-trend = 0.02); between PFOS and hearing impairment at 500 Hz (p-trend < 0.01), 2000 Hz (p-trend < 0.0001) and 3000 Hz (p-trend = 0.02); between PFNA and hearing impairment at 2000 Hz (p-trend = 0.05), 3000 Hz (p-trend < 0.01), 4000 Hz (p-trend = 0.02), and 8000 Hz (p-trend < 0.01); between PFHxS and hearing impairment at 500 Hz (p-trend = 0.04), 1000 Hz (p-trend = 0.03), and 2000 Hz (p-trend < 0.01). However, some of the findings were not significant when only comparing the highest with the lowest quartile of PFASs. In conclusion, several background serum PFASs are positively correlated with hearing impairment in the United States adult population.
Highlights
Several background serum polyfluoroalkyl substances (PFAS) are positively correlated with hearing impairment in the United States adult population
According to the World Health Organization, an estimated 360 million people have some degree of hearing loss around the world [1], and exposure to loud noise is considered the major cause of impaired hearing function
I used data obtained from the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey conducted by the US Centers for Disease Control and Prevention and the National Center for Health Statistics
Summary
According to the World Health Organization, an estimated 360 million people have some degree of hearing loss around the world [1], and exposure to loud noise is considered the major cause of impaired hearing function. Some studies further pointed out that in utero exposure to POPs might be associated with hearing impairment [8,9] This evidence suggested that the public should pay more attention to the potential ototoxicants. A study examined the associations between PFAS exposure and hearing impairment using the data from the National Health and Nutrition Examination Survey (NHANES) [12]. The study somehow did not include the data from NHANES 1999–2000, which contained per- and polyfluoroalkyl substances (PFAS) and audiometry data They found that no associations were observed between PFAS exposure and hearing impairment when comparing the participants with serum PFASs ≥ 90th versus
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