Subjective and clinically assessed hearing loss; a cross-sectional register-based study on a swedish population aged 18 through 50 years.

Pernilla Videhult Pierre,Anders Fridberger,Ann-Christin Johnson

doi:10.1371/journal.pone.0123290

Pernilla Videhult Pierre, Anders Fridberger + Show 1 more

Open Access

https://doi.org/10.1371/journal.pone.0123290

Copy DOI

Abstract

ObjectivesQuestionnaire studies suggest that hearing is declining among young adults. However, few studies have examined the reliability of hearing questionnaires among young adult subjects. This study examined the associations between pure tone audiometrically assessed (PTA) hearing loss and questionnaire responses in young to middle aged adults.Materials and MethodsA cross-sectional study using questionnaire and screening PTA (500 through 6000 Hz) data from 15322 Swedish subjects (62% women) aged 18 through 50 years. PTA hearing loss was defined as a hearing threshold above 20 dB in both ears at one or more frequencies. Data were analysed with chi-square tests, nonlinear regression, binary logistic regression, and the generalized estimating equation (GEE) approach.ResultsThe prevalence of PTA hearing loss was 6.0% in men and 2.9% in women (p < 0.001). Slight hearing impairment was reported by 18.5% of the men and 14.8% of the women (p < 0.001), whereas 0.5% of men and women reported very impaired hearing. Using multivariate GEE modelling, the odds ratio of PTA hearing loss was 30.4 (95% CI, 12.7-72.9) in men and 36.5 (17.2-77.3) in women reporting very impaired hearing. The corresponding figures in those reporting slightly impaired hearing were 7.06 (5.25-9.49) in men and 8.99 (6.38-12.7) in women. These values depended on the sound stimulus frequency (p = 0.001). The area under the ROC curve was 0.904 (0.892-0.915) in men and 0.886 (0.872-0.900) in women.ConclusionsSubjective hearing impairment predicted clinically assessed hearing loss, suggesting that there is cause for concern as regards the future development of hearing in young to middle-aged people.

Highlights

Recent large-scale questionnaire studies have reported an increasing prevalence of subjective hearing impairment in young and middle-aged people [1]
The prevalence of pure tone audiometrically assessed (PTA) hearing loss was 6.0% in men and 2.9% in women (p < 0.001)
It is unclear whether subjective hearing impairment in young adults is correlated to hearing threshold elevations measured with pure tone audiometry, the current gold standard for hearing assessment, as few studies examined the reliability of questionnaires in this age group

Summary

Introduction

Recent large-scale questionnaire studies have reported an increasing prevalence of subjective hearing impairment in young and middle-aged people [1]. Questionnaire data on hearing problems are often difficult to interpret, because responses may be affected by many factors, including sensory cell function [2], general health [3], symptom severity [4], culture [5], expectations [6], and labor market participation [4]. It is unclear whether subjective hearing impairment in young adults is correlated to hearing threshold elevations measured with pure tone audiometry, the current gold standard for hearing assessment, as few studies examined the reliability of questionnaires in this age group. This positive development may be due to improved economic and social welfare, including better medical care for children with ear infections [13] and reduced occupational noise exposure [14]

Objectives

Results

Conclusion