Risk Factors For Hearing Impairment Research Articles

Retesting of Neonatal Hearing Screening Before and During the COVID-19 Pandemic: A Longitudinal Study

Introduction: Universal Newborn Hearing Screening (UNHS) plays an essential role in the early identification of hearing loss in neonates. Risk factors for hearing impairment may include family history, prematurity, and exposure to ototoxic substances. Coronavirus Disease 2019 (COVID-19) might be a significant contributing factor affecting the structures of the inner ear. Objective: To assess the auditory follow-up process of retesting for UNHS before and during the COVID-19 pandemic among neonates from an Outpatient Auditory Health Service (SASA) in the state of Santa Catarina with SUS (Unified Health System) assistance. Methods: A retrospective longitudinal study analyzed data from neonates attended at a SUS Auditory Health Service (SASA) from January 2018 to December 2022. Information related to UNHS and retest outcomes was assessed. Data were analyzed using Microsoft Excel® and MedCalc® Statistical Software version 22.006, utilizing statistical measures and regression analyses to identify factors associated with UNHS failures and retesting. Results: A failure to retest rate of 2.6% in the right ear and 2.2% in the left ear was observed among evaluated neonates. The average age of mothers of neonates who did not pass the test was 33 years, while the overall average was 27 years. Failure to pass the retest and a longer interval between UNHS and retesting were associated with UNHS Initial Retest Default (IRD). There was an increase in dropout rates for UNHS retesting, and the time interval between UNHS and retesting was extended during the pandemic. Conclusion: Several factors, including the interval between tests, mothers' age, and medical conditions, influenced the retest outcomes. The pandemic led to a significant increase in dropout rates and extended time for retesting.

Tobacco Smoking as a Risk Factor of Hearing Impairment in Workers Exposed to Occupational Noise: A Literature Review

Background: Sensorineural hearing loss ranks first among occupational diseases in workers of noisy occupations. Recent studies have proven the role of tobacco smoking as a risk factor for hearing impairment in workers exposed to industrial noise. Objective: To summarize and systematize the results of studying the impact of tobacco smoking on hearing impairment in workers employed in noisy jobs. Materials and methods: We have searched Scopus, Web of Science, PubMed, and RSCI databases for the studies published in 1990–2023 using the following keywords and phrases in Russian and English: smoking, hearing loss, occupational noise-induced hearing loss, sensorineural hearing loss, noise, and pathogenesis. Materials from 36 full-text sources containing information on the role of tobacco smoking and the pathogenetic mechanisms of hearing loss in individuals exposed to noise at work were used for the review. Results: Currently, there is no consensus on primary targets and the main pathogenetic mechanism of hearing loss. An increasing role in its development has been assigned recently to metabolic disorders with subsequent activation of signaling pathways leading to cell apoptosis. We have established that tobacco smoking can be an independent risk factor for hearing loss at high frequencies, while the combined exposure to tobacco smoking and occupational noise has an additive effect. Smoking can act as an independent factor causing hearing impairment at lower noise levels in the workplace, and quitting smoking reduces the risk of hearing loss. Conclusion: Our findings allow us to expand the understanding of the role of tobacco smoking in hearing loss in workers employed in noisy jobs and the pathogenetic mechanisms of hearing impairment related to chronic occupational noise exposure in smokers in order to substantiate a comprehensive, integrated approach to its treatment and prevention.

Hearing Loss and Risk Factors in Very Low Birth Weight Infants.

The incidence of sensorineural hearing loss (SNHL) is still high in very low birth weight (VLBW) infants. The purpose of our study was to provide the prevalence rates of SNHL and to analyze the risk factors of hearing impairment and changes in hearing thresholds in a cohort of VLBW infants. A retrospective observational study was conducted in our neonatal intensive care unit (NICU) from 2012 to 2016. All VLBW infants included were screened by transient evoked otoacoustic emissions (TEOAEs) and diagnostic auditory brainstem response (ABR). In total, we enrolled 316 infants and SNHL was diagnosed in 68, leading to an early incidence of 21.5% as 36 infants out of 68 improved. Finally, SNHL was confirmed in 20 patients (6.3%) who needed hearing aids. They were significantly smaller, sicker, had longer hospitalizations, and received more ototoxic therapies. Logistic regression analysis showed that gestational age (GA) influenced the association between drugs and SNHL. The results underlined how the total exposure to antibiotics is significantly associated with SNHL, even after GA correction. In conclusion, GA, birth weight and, above all, the length and complexity of NICU stay quantify the risk of SNHL and should be considered at the individual level for parent counseling.

Hearing impairment after asphyxia and neonatal encephalopathy: a Norwegian population-based study.

The purpose of this study is to evaluate the association between perinatal asphyxia, neonatal encephalopathy, and childhood hearing impairment. This is a population-basedstudy including all Norwegian infants born ≥ 36weeks gestation between 1999 and 2014 and alive at 2years (n = 866,232). Data was linked from five national health registries with follow-up through 2019. Perinatal asphyxia was defined as need for neonatal intensive care unit (NICU) admission and an Apgar 5-min score of 4-6 (moderate) or 0-3 (severe). We coined infants with seizures and an Apgar 5-min score < 7 as neonatal encephalopathy with seizures. Infants who received therapeutic hypothermia were considered to have moderate-severe hypoxic-ischemic encephalopathy (HIE). The reference group for comparisons were non-admitted infants with Apgar 5-min score ≥ 7. We used logistic regression models and present data as adjusted odds ratios (aORs) with 95% confidence intervals (CI). The aOR for hearing impairment was increased in all infants admitted to NICU: moderate asphyxia aOR 2.2 (95% CI 1.7-2.9), severe asphyxia aOR 5.2 (95% CI 3.6-7.5), neonatal encephalopathy with seizures aOR 7.0 (95% CI 2.6-19.0), and moderate-severe HIE aOR 10.7 (95% CI 5.3-22.0). However, non-admitted infants with Apgar 5-min scores < 7 did not have increased OR of hearing impairment. The aOR for hearing impairment for individual Apgar 5-min scores in NICU infants increased with decreasing Apgar scores and was 13.6 (95% CI 5.9-31.3) when the score was 0. Conclusions: An Apgar 5-min score < 7 in combination with NICU admission is an independent risk factor for hearing impairment. Children with moderate-severe HIE had the highest risk for hearing impairment. What is Known: • Perinatal asphyxia and neonatal encephalopathy are associated with an increased risk of hearing impairment. • The strength of the association, and how other co-morbidities affect the risk of hearing impairment, is poorly defined. What is New: • Among neonates admitted to a neonatal intensive care unit (NICU), decreased Apgar 5-min scores, and increased severity of neonatal encephalopathy, were associated with a gradual rise in risk of hearing impairment. • Neonates with an Apgar 5-min score 7, but without NICU admission, did not have an increased risk of hearing impairment.

Evaluation and analysis of risk factors of hearing impairment for nasopharyngeal carcinoma treated using intensity-modulated radiotherapy

BackgroundTreating nasopharyngeal carcinoma (NPC) with radiotherapy frequently causes hearing impairment (HI). HI risk data haven’t been evaluated quantitatively. This study aimed to analyze the probability of HI and sever HI (SHI), develop a nomogram to quantify individual prediction, and provide dose limitation suggestions. Methods and materialsThis single-center, retrospective study was conducted based on 588 adolescents and young adults with non-metastatic NPC treated using intensity modulated radiation therapy (IMRT) at Sun Yat-sen University Cancer Center between 2010 and 2016. A least absolute shrinkage and selection operator (LASSO) logistic regression model and univariate analysis were used to screen potential risk factors. The concordance index and a calibration curve evaluated the nomogram models' predictive ability, with bootstrap resampling validation. ResultsWe analyzed 588 patients with NPC, with a median follow-up of 103.4 months. HI occurred in 39.5 % of patients, with 29.7 % experiencing SHI. Two factors were classified as precursors for HI (volume 45 Gy of the inner ear (IEV45) and volume 50 Gy of the internal auditory canal (IACV50)), and IACmin and IACV60 for SHI, respectively. Prognostic nomograms were developed to predict HI and SHI probabilities, showing excellent discriminative abilities (c-index values = 0.806 and 0.793, respectively). We also suggested IEV45 < 50 % and/or IACV50 < 40 % as rational dose limitations for HI, and IACmin < 44 Gy and/or the IACV60 < 40 % for SHI. ConclusionComprehensive analysis could predict the risk of HI and SHI in NPC after IMRT, proposing rational dose limitations and improving long-term quality of life.

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

PurposeNewborns who fail the transient evoked otoacoustic emissions (TEOAE) but pass the automatic auditory brainstem response (AABR) in universal newborn hearing screening (UNHS), frequently have no further diagnostic test or follow-up. The present study aimed to investigate whether hearing loss might be missed by ignoring neonatal TEOAE failure in the presence of normal AABR.MethodsA retrospective analysis was conducted in newborns presenting between 2017 and 2021 to a tertiary referral centre due to failure in the initial UNHS. The main focus was on infants who failed TEOAE tests, but passed AABR screening. The clinical characteristics and audiometric outcomes were analysed and compared with those of other neonates.ResultsAmong 1,095 referred newborns, 253 (23%) failed TEOAE despite passing AABR screening. Of the 253 affected infants, 154 returned for follow-up. At 1-year follow-up, 46 (28%) achieved normal audiometric results. 32 (21%) infants had permanent hearing loss (HL) confirmed by diagnostic ABR, 58 (38%) infants had HL solely due to middle ear effusion (MEE), and for 18 (12%) infants HL was suspected without further differentiation. The majority of permanent HL was mild (78% mild vs. 13% moderate vs. 9% profound). The rate of spontaneous MEE clearance was rather low (29%) leading to early surgical intervention in 36 children. The profile of the risk factors for hearing impairment was similar to that of newborns with failure in both, TEOAE and AABR; however, there was a stronger association between the presence of risk factors and the incidence of HL (relative risk 1.55 vs. 1.06; odds ratio 3.61 vs. 1.80).ConclusionIn newborns, the discordance between a “refer” in TEOAE and a “pass” in AABR screening is associated with a substantial prevalence of hearing impairment at follow-up, especially in the presence of risk factors.

Risk Factors of Hearing Impairment in New Born Infants at Prof. Dr. I.G.N.G Ngoerah General Hospital: A Retrospective Study

Introduction: The first year of life is the key to normal speech and language development, as well as intellectual and emotional growth. Identification of risk factors for hearing loss is very important for early detection, early initiation of therapy, and assessing the baby's prognosis. This study aims to determine the risk factors for hearing loss in newborns. Methods: This research is a retrospective study with a case-control study design that was conducted from January to December 2021. The research sample was newborns with hearing loss at Prof. Dr. I.G.N.G. Ngoerah hospital. Hearing loss was assessed by Otoacoustic Emission (OAE). All data were analyzed with SPSS version 25. Results: This study got a total of 55 cases of newborns with hearing loss and 55 control groups without hearing loss. Based on multivariate analysis, the factor that significantly influenced hearing loss in newborns was premature birth (adjusted OR=7.120; 95% CI: 1.902-26.654; p=0.004). There was no significant relationship between length of stay, APGAR score, birth weight, family history, hyperbilirubinemia, mechanical ventilation, meningitis, congenital abnormalities, and ototoxic drugs with hearing loss in newborns. Conclusion: Prematurity is a risk factor for hearing loss in newborns. Premature babies should be screened for hearing to detect hearing loss early. Keywords: hearing loss, neonates, premature

Parent Awareness and Perceived Barriers Regarding Hearing Impairment among School Age Children in Taif Region of Saudi Arabia.

Hearing impairment (HI) is the most common global disabling condition. It is a considerable public health condition in childhood that is associated with long-term socio-emotional-academic, and communication difficulties. The current study explored the knowledge and awareness of HI among school-age children and its related factor in Taif, Saudi Arabia. A cross-sectional study was done on 268 Saudi school-age children in the population of the Taif region of Saudi Arabia. A predesigned questionnaire was used to collect their demographic data, consanguinity, education level, and academic performance. About 45.9% of parents had good awareness related to hearing loss and its impact on children's life. Only 19% (n = 51) of parents reported that their children encountered language problems in communicating with others. When we assessed the relationship between this language problem and academic performance, it was found that children with language problems had below-average academic performance (P < 0.001). The study showed that parents' awareness about children's hearing was not that satisfactory, and there was a considerable amount of difficulties faced by the children in their personal and social life due to these hearing problems. It is imperative to create awareness among the public regarding various modifiable risk factors of HI by conducting health awareness campaigns.

Risk Factors For Treatment-Induced Hearing Impairment: Perspective From A Resource-Poor African Setting

Background - Treatment-induced hearing impairment can result from prolonged administration of potentially ototoxic medications often in the pharmacotherapeutic management of chronic illnesses such as drug-resistant tuberculosis. Whereas drug ototoxicity may be idiosyncratic, it is imperative to be aware of its potential risk factors while treating patients. We aimed in our study to identify risks factors for hearing impairment in patients treated for drug-resistant pulmonary tuberculosis at our Centre. Patients and methods – This study was a 24-month prospective study of drug-resistant tuberculosis patients treated at the pulmonology unit of Federal Medical Centre, Owerri, Nigeria. Each patient had pure tone audiometry before commencement of treatment (baseline) and after three months of treatment for comparison. Clinical data was obtained using pre-tested examiner-administered questionnaire. Data collected was analyzed with SPSS version 25.0 and statistical significance set at p &lt; 0.05. Results - Thirty-eight (38) participants completed the study with a male-to-female (M:F) ratio of 1.53:1. The modal age group was 41-50 years and median duration of presenting complaints 9.9 weeks. HIV seroprevalence was 18.4% among the study participants. The baseline prevalence of hearing impairment was 73.7% but increased to 89.5% after three months of treatment with a cumulative incidence of 15.8% which was statistically significant (p &lt; 0.001). The identified risk factors for hearing impairment were age (&gt;50 years), family history of hearing impairment, kanamycin administration and BMI &lt;18.5kg/m2 . Conclusion – Kanamycin was associated with more severe hearing impairment than capreomycin. Advancing age, family history of hearing impairment and BMI &lt; 18.5kg/m2 were risk factors for development of hearing impairment in patients treated for drug-resistant tuberculosis in our setting.

Effect of Neonatal Hearing Screening Results on the Lost to Follow-Up at the Diagnostic Level.

(1) Background: An important part of any neonatal hearing screening program is monitoring diagnostic visits to confirm or exclude the presence of hearing loss. In addition, time plays an important role in the diagnosis. We identified the number of children who came for a diagnostic visit and analyzed the time of the first audiological visit, depending on the result of the hearing screening test performed in the first days of a child's life and the presence or absence of risk factors of hearing impairment. (2) Methods: We analyzed 6,580,524 children, of which 8.9% required further diagnostics. The mean time of follow-up diagnostic visit in the analyzed group was 130 days and differed due to the presence or absence of risk factors for hearing loss before and after the neonatal period. (3) Results: Although the risk of hearing loss in children with risk factors is 2.31 to 6.38 times higher than in children without risk factors depending on the result of the screening test, more than 40% of parents do not report to scheduled audiological visits. (4) Conclusions: Doctors, nurses, and midwives who screen hearing at the neonatological level play an important role in educating parents about the possibility of hearing loss in a child and the need for an audiological examination.

Predictive value of serum d-serine level for hearing impairment in uremic patients

Objective To investigate the predictive value of serum d-serine level for hearing impairment (HI) in uremic patients. Methods In this study, 30 uremic patients with HI and 30 with normal hearing were selected. The basic conditions, biochemical indicators, and serum serine levels of the two groups were compared to analyze the influencing factors of HI. Results The age and d-serine levels were higher in the HI group, while the l-serine level was lower than uremia in the normal hearing group. Logistic regression analysis showed that d-serine level ≥10 μM and older age increased the risk of HI. The area of the receiver operating characteristic (ROC) curve drawn by the prediction probability of HI was 0.838, indicating that age, d-serine, and l-serine had predictive diagnostic values for HI (p < .001). Among these, the ROC curve area of d-serine in predicting HI in uremic patients was 0.822 (p < .001). Conclusions Increased d-serine and age are two risk factors for HI, while l-serine is a protective factor. d-Serine level has a predictive value for HI in uremic patients. Uremic patients are recommended hearing assessment, estimation of d-serine levels, and early intervention.

Hearing Outcomes in the Audiology Department of a Children Hospital.

The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk infants. In this study, we assessed the incidence of hearing impairment in normal term (≥ 37 wga) infants (control group), in children with suspicion and/or risk factors of hearing loss, included premature infants (< 37weeks gestational age (wga) and/or low birth weight < 2,5 Kgr), in children diagnosed with a specific syndrome and in children with speech disorder, candidate for speech therapy. Hearing impairment is a severe consequence of prematurity and its prevalence is inversely related to the maturity of the baby based on gestation age and /or birth weight. Both above parameters are of particular importance and it has not been found that one factor prevails over the other. Premature infants have many concomitant risk factors for hearing impairment. The most important other risk factors were ototoxic medications, very low birth weight and "treatment in the intensive care unit '' (low Apgar score and mechanical ventilation). Frequent risk factors such as congenital infections and family history of hearing loss, although frequently recorded, does not seem to be very significant. Children with speech disorder do not seem to suffer from hearing impairment more frequently than children in general population.

Evaluating the Incidence of Audiological Derangement in Cases of Thyroid Hormone Imbalance.

Thyroid hormone disorders are both congenital as well as acquired. According to a projection from several studies on thyroid diseases, it has been estimated that about 42 million people in India suffer from various kind of thyroid diseases (1) Thyroid hormone is closely associated with the development of the cognitive functions, thus deficiency of this hormone is said to have effect an overall impact on proper functioning of the body. The normal functioning of the thyroid gland and adequate levels in the blood are Needed for the formation and functioning of the middle ear, inner ear and the central auditory pathway. Thus, congenital hypothyroidism (CH) can be a potential risk factor for hearing impairment (2) if the hormones decrease or are absent during the development of the peripheral and central auditory system structures. This study was undertaken with the objective of studying the pattern of hearing loss in patients who have a deranged thyroid profile. The study was conducted among 50 patients who were known cases of thyroid disorder in the Otorhinolaryngology Department of our institute. The study was hospital based observational clinical study. The patients were subjected to thyroid profile test After this, those who satisfied the inclusion and exclusion criteria and were included, after detailed history and examination, patients were subjected to PTA, hearing loss was classified according to WHO guidelines. The age group of the patients was from 30-55 yrs. with the mean age being 42. On the basis of the t3, t4 and tsh levels, in the current study out of 50 patients,40 were hypothyroid (80%),with male to female ratio of 6:4. On pure tone audiometry, 15 patients had decreased hearing. The other 25 had normal hearing. The incidence of hearing loss in hypothyoroid patients in our study is 37.5%. On analaysis the PTA reports of these patients,9 patients (22.5%) had conductive hearing loss of mild variety, the mean value of hearing loss being 26.2 decibels. 2 (5%) patients had mixed variety of hearing loss, with sensorineural hearing loss at higher frequencies. All the remaining patients had sensorineural type of hearing loss, i.e., 10%. Of the 10 patients, that have hyperthyroidism 8 were female and 2 were male. 3 patients (30%) had hearing loss, all these 3 patients reported hearing losses at high frequencies and had moderate type of sensorineural hearing loss. Conclusion- From our current study, we could see that hearing loss is present in both extremes of thyroid hormone imbalance The dominant variety of hearing loss in thyroid disorder is sensorineural type, because thyroid hormone imbalance affects the inner ear function.

Correlation study of FGF23/D-serine in maintenance hemodialysis patients with combined hearing impairment.

Recent studies have reported an association between chronic renal failure and hearing impairment. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the expression of fibroblast growth factor 23 (FGF23) and D-serine in maintenance hemodialysis (MHD) patients with end-stage renal disease (ESRD) complicated with hearing impairment and further investigated the correlation between FGF23/D-serine and hearing impairment. A total of 90 subjects, including 30 MHD patients complicated with hearing impairment, 30 MHD patients with normal hearing, and 30 controls, were included in this case-control study. Relevant data were obtained by questionnaire survey, audiometric test, enzyme-linked immunosorbent assay (ELISA) to determine FGF23 level, and high-performance liquid chromatography to determine D-serine level. MHD patients showed abnormally high expression of FGF23 and D-serine, where FGF23 and D-serine levels were significantly higher in the group with hearing impairment than in the group with normal hearing and normal controls (all P<0.01). Also, elevated FGF23 and D-serine were identified as risk factors for hearing impairment in ESRD, with ORs of 16.54 (95%CI, 2.75-99.55) and 15.22 (95%CI, 2.59-89.51), respectively. Further Person correlation analysis showed a moderate positive correlation between FGF23 and D-serine (r = 0.683, P<0.001). This study provides potential biomarkers for the early detection of hearing impairment complicated by chronic renal failure, and the reduction of FGF23/D-serine may provide a potential target for the treatment of hearing impairment complicated by chronic renal failure.

Risk Factors Associated with Newborn Hearing Impairment in the Neonatal ICU of a Tertiary Hospital

Introduction: Hearing impairment has a devastating, detrimental, and adverse impact on the development of the newborn. Unfortunately, this hidden disability remains undetected for many newborns until it is too late to prevent undesirable and often irreversible damage. It has long been recognized that undiagnosed hearing loss, even a mild loss at birth, can negatively affect speech and language development, Resulting in poor academic achievement and social-emotional development. According to WHO 2009, newborns in the NICU are 10-20 times at higher risk of developing hearing loss. The risk factors associated with newborn hearing impairment vary from country to country and even within countries. There has been a paucity of studies on this topic from Bangladesh. This study was done to identify the risk factors associated with newborn hearing impairment in the study place. The objective of the study: To identify risk factors associated with newborn hearing impairment in the study group.&#x0D; Methodology: A prospective observational study was conducted in the department of neonatology, BSMMU. After taking consent from the parents/guardians, a thorough history of these newborns, including particulars of the neonates, family history of hearing loss, treatment history, antenatal, natal, and postnatal history, was recorded in a data collection form. Newborn admitted to the NICU during the study period was the study population. The newborn who meet the inclusion criteria was screened with Transient Evoked Otoacoustic Emissions (TEOAE) close to discharge from the NICU or before one month of age. A second screen was done with TEOAE again after one month of 1st screen but prior to 3 months of postnatal age if referred in 1st screen. Diagnostic Auditory Brain stem Response (ABR) was made to confirm the hearing impairment, and it was done prior to 3 months of postnatal age if referred in both the 1st and 2nd screens. Data were analyzed by statistical package for social sciences (SPSS) version 20.&#x0D; Results: 426 valid recordings from 493 newborns admitted in the NICU enrolled consecutively constitute the basis of this study. 14 newborns were found to have hearing impairment among 426 newborns. APGAR ≤ 6 at 5 minutes (odds ratio 20.34, p-value 0.01), TORCH infection (odds ratio 0.64, p-value 0.01), IUGR odds ratio 8.92, p-value 0.02) were independent significant risk factors for hearing impairment.&#x0D; Conclusion: APGAR ≤ 6 at 5 minutes, TORCH infection, and IUGR are independent significant risk factors for newborn hearing impairment. Newborns in NICU with these risk factors should have mandatory audiological evaluation.&#x0D; TAJ 2022; 35: No-2: 59-65

Neonatal hearing screening in Soba University Hospital, Khartoum, Sudan: a cross-sectional study

BackgroundHearing loss in children constitutes a serious obstacle to their optimal development; early detection of hearing disability is vital to improve the outcome of management; currently, in Sudan, there is no national neonatal hearing screening program. The aim of this study is to discuss the results of neonatal hearing screening among newborns admitted to neonatal intensive care unit (NICU) and well-baby nursery, at Soba University Hospital, Khartoum (Sudan), and to reflect the magnitude of risk factors for hearing impairment present in these two different groups of newborns.MethodsIn this hospital-based cross-sectional study, newborns who were admitted to the NICU or being observed in the well-baby nursery in the period from February 2014 to February 2019 were screened for hearing loss using automated otoacoustic emission (OAE) device after recording the risk factors for hearing loss according to the Joint Committee on Infant Hearing (JCIH) year 2007 position statement and after conducting a detailed ear and general physical examination. Newborns who failed this screening test were rescreened using the same device after 48 h, and if they failed again, they underwent confirmatory auditory brainstem response test when they are 6 months old.ResultsOne thousand one hundred twenty newborns were tested; 736 were NICU and 384 were well-baby nursery newborns. The prevalence of hearing impairment after confirmatory test was found to be 10.8 per 1000 in the NICU group and 5.2 per 1000 in the well-baby nursery group considering that the drop rate for the confirmatory test was 50% and 66% respectively which is very high and reflect the poor compliance to the program. The risk factors for hearing loss were more encountered in the NICU group compared to well-baby nursery group. Unmonitored ototoxic drug use was found to be very prevalent and need urgent reconsideration.ConclusionIn this study, the estimated prevalence of neonatal hearing impairment is alarming; risk factors are very evident especially in the NICU group; this reflect the urgent need for establishing an efficient national program for neonatal hearing screening and working to eliminate the preventable risk factors for neonatal hearing impairment in this developing country.

Hearing loss in Type 2 diabetes: Impact of duration, glycemic control, and oxidative stress

Background: Type 2 diabetes mellitus (T2DM) has been linked to many problems, including hearing loss, which research studies have not paid much attention to. This study looks into the possible links between hearing loss in people with T2DM, the duration of time they have had diabetes, how well they control their blood sugar, and measures of reactive stress. Understanding how these things work together can help doctors find problems faster, develop better ways to treat them, and improve their patients’ health. Aims and Objectives: This study aims to see if there are any links between hearing loss and duration of T2DM, levels of glycemic control, and measures of oxidative stress in people with T2DM. The results of this study will help come up with early identification and healing ways to improve patient care. Materials and Methods: In a cross-sectional study at Government Medical College, Kozhikode, 63 diabetic patients aged 30–60 were compared with 63 age and sex-matched controls. Blood sugar was assessed using the glucose oxidase peroxidase method, hemoglobin A1C (HbA1C) through cation exchange high-performance liquid chromatography, serum malondialdehyde (MDA) through the thiobarbituric acid test, and superoxide dismutase (SOD) using the technique by Marklund and Marklund, with the latter two assessed spectrophotometrically. Hearing abilities were evaluated using pure tone audiometry. Results: Diabetic participants exhibited a marked increase in hearing loss incidence compared to controls (P &lt; 0.001). Males with diabetes showed a higher prevalence of hearing loss than females (P = 0.043). A significant correlation was found between hearing loss and the duration of diabetes (P &lt; 0.001), elevated glycemic levels (fasting blood sugar, random blood sugar, and HbA1c, all P &lt; 0.001), and altered oxidative stress parameters. Specifically, MDA levels were higher in people with diabetes (P &lt; 0.001) and associated with hearing loss (P = 0.033), while SOD levels were reduced (P &lt; 0.001) and significantly linked to hearing loss (P = 0.047). Logistic regression identified age, sex, HbA1c, MDA, and SOD as independent risk factors for hearing impairment in Type 2 diabetes patients. Conclusion: Our findings emphasize the significant association between Type 2 diabetes and heightened risk of hearing loss, influenced by age, gender, glycemic levels, and oxidative stress markers. Regular audiological assessments are crucial for early detection and intervention in diabetic patients.

Hearing Impairment in French Merchant Seafarers: Retrospective Study on Data from 8308 Audiometric Tests.

Background: A high level of occupational noise exposure has been noted in the fishing sector. Yet, less is known regarding other navigation groups, such as merchant seafarers, since a French study in the 1980s. This study assesses hearing impairment (HI) in a French merchant seafarers’ population. Methods: We collected data of all audiograms performed in 2018 and 2019 for French merchant seafarers. For each seafarer, hearing ability was measured in both ears using pure-tone audiometry at the following frequencies: 0.5, 1, 2, 3, 4, 6, and 8 kHz. Hearing threshold levels (HTLs), or the intensity of sound below which no sound is detected, were measured in decibels Sound Pressure Level (dB SPL) at each frequency and recorded in 5 dB increments. For HI, we used the validated definition of the American Speech–Language–Hearing Association (ASHA). Results: We were able to include statistical analysis results of 8308 audiograms. In a multiple logistic regression adjusted for age, experience, and class of navigation, we found that experience of more than 14 years Odds Ratio OR 1.28 (CI 95% 1.07–1.53), age 31–40 OR 2.2 (CI 95% 1.4–3.4), and >40 years OR 14, 3 (IC 95% 9.7–21) and marine engineers OR 1.26 (IC 95% 1.01–1.57) were still risk factors for HI. Conclusion: In 2018, Marine engineers were still the workers’ group with a higher risk of HI in merchant seafarers but, notch at 4 Hz, specific of noise-induced hearing loss, has improved. They have an HI close to the definition of socioacousis and mean deficit differences with deck and services’ merchant seafarers improved. Our results could be interpreted as a limitation of occupational noise exposure impact in a merchant seafarers’ population, needing an improvement in prevention measures and also encouraged to continue to improve onboard working conditions.

Risk factors for hearing impairment in infants and toddlers in the Gaza governorates: a case-control study

BackgroundThe risk factors for congenital or early-onset hearing loss vary across countries. This study aimed to explore the risk factors for hearing impairment in children younger than 3 years in Gaza governorates to inform preventive strategies. MethodsThis case-control study started in February, 2017, and ended in July, 2018. Ethical approval was obtained from the Helsinki Committee in Palestine, a national committee established in 1986 that reviews all proposals for heath research, and whose approval is a requirement before any health research in Palestine. Data were collected through face-to-face household interviews. Cases were defined as children diagnosed with moderate, severe, or profound sensorineural hearing impairment within the first 3 years of life (n=169), whereas controls were children who had been screened and found to have unimpaired hearing (n=169). Cases and controls were randomly selected through a systematic sampling approach from the screening lists of the Atfaluna Society for Deaf Children, a registered Palestinian non-governmental organisation that has been working in the field of deaf education and allied services since 1992 and that regularly leads hearing screening campaign for neonates and children younger than 5 years in primary health centres over all Gaza governorates. SPSS version 21 was used for data entry and logistic regression analysis with the chi-square test, odds ratio, and t test. FindingsMaternal unemployment was more prevalent in cases than in controls (p=0·025). Having a family history and consanguinity were more prevalent in cases than in controls (p=0·001 for both). Taking folic acid during the preconception period (p=0·007) and iron supplements during pregnancy (p=0·002) were associated with a lower prevalence of hearing loss. The proportion of mothers of cases who were registered as having received antenatal care during the first trimester was lower for cases than for controls (odds ratio 0·341 [95% CI 0·181–0·640]; p=0·002). Prematurity (p=0·006), low birthweight (p<0·0001), and admission to a neonatal intensive care unit (p=0·002) were strongly associated with hearing impairments. The study also showed that children with recurrent otitis media were at a greater risk of hearing impairment (p<0·0001), as were children who had been exposed to sporadic loud noises, such as nearby bombing, or continuous loud noise at home, such as from nearby factories. (p=0·01). InterpretationThe study concluded that hearing impairment among children younger than 3 years is associated with a wide array of socioeconomic, health, and environmental vulnerabilities. A health promotion programme should be established to address consanguinity, prematurity prevention, and timely and appropriate preconception and antenatal care, alongside universal screening for all children, particularly those at risk as identified in this study. FundingNone.

Appraising the need for audiological assessment before autism spectrum disorder referral.

Mandatory audiological testing before autism spectrum disorder (ASD) assessment is common practice. Hearing impairment (HI) in the general paediatric population is estimated at 3%; however, hearing impairment prevalence among children with ASD is poorly established. Our objective was to determine which children referred for ASD assessment require preliminary audiological assessment. Retrospective chart review of children (n=4,173; 0 to 19 years) referred to British Columbia's Autism Assessment Network (2010 to 2014). We analyzed HI rate, risk factors, and timing of HI diagnosis relative to ASD referral. ASD was diagnosed in 53.4%. HI rates among ASD referrals was 3.3% and not significantly higher in children with ASD (ASD+; 3.5%) versus No-ASD (3.0%). No significant differences in HI severity or type were found, but more ASD+ females (5.5%) than ASD+ males (3.1%) had HI (P<0.05). Six HI risk factors were significant (problems with intellect, language, vision/eye, ear, genetic abnormalities, and prematurity) and HI was associated with more risk factors (P<0.01). Only 12 children (8.9%) were diagnosed with HI after ASD referral; all males 6 years or younger and only one had no risk factors. ASD+ children with HI were older at ASD referral than No-ASD (P<0.05). Children with ASD have similar hearing impairment rates to those without ASD. HI may delay referral for ASD assessment. As most children were diagnosed with HI before ASD referral or had at least one risk factor, we suggest that routine testing for HI among ASD referrals should only be required for children with risk factors.