Risk Factors For Hearing Loss Research Articles

Parental Awareness of Risks and Causes of Hearing Loss and the Acceptance of the Intervention in Taif City, Saudi Arabia

Background and Objectives: Pediatric hearing loss (HL) hinders or delays a child's auditory and speech development. This issue that results in anxiety and stress among parents affects the child's ability to engage in communication, participation in age-appropriate activities, and functional and language skills. This study aimed to assess parents' knowledge about risks and causes of HL and the acceptance of the intervention among Saudi parents living in Taif city. Methodology: A cross-sectional study was conducted between July 2020 and December 2020 through a pretested questionnaire that was published using an online-based (electronic) form. The questionnaire included items related to sensorineural HL, otitis media, conductive HL, and oto-acoustic emission. The total knowledge scores were calculated based on correct and wrong answers, and the relationship between knowledge level and other variables was determined. Results: In this study, the reported prevalence of HL among children was 5.6%. The knowledge related to various types of HL and their risk factors was determined to be good at only 4.5% of the participants. There was no statistically significant difference observed in knowledge between male and female parents (P = 0.620), different age groups (P = 0.591), and education levels of the participants (0.096). Conclusion: Parents need to be educated about conventional risk factors for HL because there was inadequate knowledge among our study population. In addition, it is necessary to increase awareness about various audiology services to facilitate early detection and intervention.

Hearing Loss After Radiation and Chemotherapy for CNS and Head-and-Neck Tumors in Children.

Hearing loss (HL) is a serious secondary effect of treatment for CNS and head-and-neck tumors in children. The goal of this study was to evaluate incidence and risk factors for HL in patients with multiple ototoxic exposures. We evaluated 340 ears from 171 patients with CNS or head-and-neck tumors treated with radiation, with or without chemotherapy, who had longitudinal audiologic evaluation. International Society of Pediatric Oncology-Boston grades were assigned to 2,420 hearing assessments. Multivariable weighted ordinal logistic regression was fitted to evaluate the effect of clinicopathologic features on HL. Mean cochlea dose (odds ratio [OR] 1.04 per Gy, P < .001), time since radiotherapy (RT; OR 1.21 per year, P < .001), cisplatin dose (OR 1.48 per 100 mg/m2, P < .001), and carboplatin dose (OR 1.41 per 1,000 mg/m2, P = .002) were associated with increasing International Society of Pediatric Oncology-Boston grade of HL. There was no synergistic effect of RT and cisplatin (interaction term, P = .53) or RT and carboplatin (interaction term, P = .85). Cumulative incidence of high-frequency HL (> 4 kHz) was 50% or greater at 5 years after RT if mean cochlea dose was > 30 Gy, while incidence of HL across all frequencies continued to increase beyond 5 years after RT. Children treated with radiation and chemotherapy experience a high incidence of HL over time, with associations found between more severe HL and cisplatin or carboplatin dose as well as mean cochlea dose. Mean cochlea dose of ≤ 30 Gy is proposed as a goal to reduce the risk of HL; a lower threshold (20-25 Gy) may be considered in patients receiving platinum chemotherapy to reduce cumulative HL burden.

Prevalence and influencing factors of hearing status for workers with different subjective perception of hearing in Wuhan City from 2017 to 2019

Objective To investigate the hearing status and influencing factors of hearing among people with different subjective perception of hearing in Wuhan City from 2017 to 2019. Methods A cross-sectional survey was conducted to select some automobile manufacturing workers who underwent physical examination in Wuhan Prevention and Treatment Center for Occupational Disease from Jan 2017 to Dec 2019 as the research subjects. Questionnaire survey and pure tone threshold test were conducted. After excluding individuals with missing information, a total of 15 594 individuals were finally included for analysis and research. Logistic regression analysis was used to explore the influencing factors of hearing status for workers with different subjective perception of hearing. Results Among the 15 594 male workers in automobile manufacturing industry, the proportion of subjective feeling of hearing for good, general and poor was 45.86% (7 152/15 594), 51.75% (8 070/15 594) and 2.39% (372/15 594), respectively. In terms of speech frequency, the proportion of hearing loss of the workers with good subjective hearing was 3.45%. In terms of high frequency, the proportion of hearing loss of workers with good subjective hearing was 18.47%. Age≥40 (OR=4.53, 95% CI=3.34-6.14, P Conclusion Some people with good subjective perception of hearing still have hearing loss, and risk factors of hearing loss among people with different subjective perception of hearing are different.

Trends in Hearing Protection Use With Occupational Noise Exposure in the United States 1999 to 2016.

Determine hearing protection use in relation to occupational noise exposure, tinnitus, and audiometry-measured hearing loss in the United States from 1999 to 2016. Cross-sectional study utilizing US National Health and Nutritional Examination Survey (NHANES) 1999 to 2016 with occupation, reported occupational noise exposure, hearing protection use, tinnitus, and audiometry-measured hearing loss data. Subgroup analysis divided data into two cohorts early 2000s and 2010s. Population-based study using NHANES database capturing representative sample of US population. Individuals with complete data 1999 to 2004 (n = 10,347) and 2011 to 2012 with 2015 to 2016 (n = 9,383). Participants self-reported occupational noise exposure lasting more than 4 h/d for more than 3 months. Self-reported hearing protective device uses and tinnitus frequency. Audiometric hearing loss objectively measured. Hearing protection use. Secondary measures included self-reported bothersome tinnitus and audiometrically measured hearing loss. Across occupations, reported occupational noise exposure was higher in 2010s [32%, 95% CI: 29.6-34.6%] than 2000s [12.5%, 95% CI: 11.2-13.9%], while hearing protection use remained low in 2000s [41.3%, 95% CI: 37.8-44.8%] and 2010s [32.8%, 95% CI: 29.8-35.8%]. Less hearing protection use was associated with absence of bothersome tinnitus. Factors associated with increased hearing protection use were younger age, male sex, college education or higher, and white race in a multivariate model. Reported occupational noise exposure appeared to increase from 2000s to 2010s yet hearing protection use remained stable at low use rate. As noise exposure is a major risk factor for hearing loss, significant education and reinforcement of appropriate hearing protection use for workplace noise exposures is necessary to preserve workers' hearing.

Late Breaking Abstracts

Late Breaking Abstracts

Factors Associated with Hearing Loss in Helicopter Aircrew of Indonesian Army Aviation Center, Semarang

Introduction: Hearing loss and tinnitus may occur in pilots due to exposure of the high noise level (ranges from 104-110 dB) generated by aircraft/helicopters. In addition, flying time, acoustic trauma, diabetes mellitus, hypertension and smoking are risk factors of hearing loss. Objective : to identify the factors associated with hearing loss in the crew of the Indonesian Army Aviation Center, Semarang Methods: in the cross-sectional research, 114 military helicopter aircrews aged 20-58 years, working for the Army Aviation Center in Semarang were included. The exclusion criteria were history of previous ear surgery, infection of the outer and middle ear, the use of ototoxic drugs (kanamycin, cisplatin and carboplatin). The level of hearing loss and tinitus was assessed by otoscopy and audiometry. Whereas, tinnitus was obtained from the history taking. Data were analyzed using chi-square test and fisher's exact and Yates’s correction. Results: One hundred and fourteen subjects (mean age of 26.54 + 4.72) were included. Several factors such as flight time (p = 0.698), acoustic trauma (p = 0.151), diabetes mellitus (p = 0.596), smoking (p = 0.222), hypertension (p = 0.356) were not associated with sensorineural hearing loss. Several factors such as flight time (p = 0.706), acoustic trauma (p = 0.5160), diabetes mellitus (p = 0.789), smoking (p = 0.495), hypertension (p = 0.112) were not associated with tinnitus. Conclusion: There is no association between flight time, acoustic trauma, diabetes mellitus, hypertension, and smoking and hearing loss.

Socialization Program for Prevention and Early Detection of Congenital Hearing Loss in the Families of Deaf School children

Objective: socializing hearing loss examination and early detection to patients and their families in deaftype B schools. Methods: A community service program in the form of socialization was performed to thefamily of patients with hearing loss in deaf school type B, Surabaya, Indonesia. Pretest and posttest wereconducted to determine the initial understanding and post socialization knowledge of these people. We alsoasked the participants to fill on a questionnaire regarding the possible causes of the hearing loss (familyhistory, drug use, history of disease, and history of head trauma). Results: Based on the summary of pretestand posttest from the participants, an increase in participants’ knowledge of hearing lost was found. Thisactivity was attended by 90 family members of 37 patients with hearing loss. Pre and post test results. Theresults of the questionnaire showed that 94.59% of the patients came from Javanese ethnicity. As many as21.62% of patients had a family history of hearing loss, and even 2 patients had a father, mother, and siblingwith hearing loss. A total of 18.92% had a history of using ototoxic drugs, 16.22% had a history of maternalRubella infection during pregnancy, and 2.7% had a history of head trauma. Conclusion: Socializationprogram was effective to increase knowledge of congenital hearing loss for family of deaf schoolchildren.The result of the questionnaire showed that deaf schoolchildren had several risk factors for the occurrenceof hearing loss. Similar program can be performed in communities in other areas to increase prevention andearly detection of hearing loss in Indonesia.

Chronic Obstructive Pulmonary Disease is a Risk Factor for Sensorineural Hearing Loss: A US Population Study.

The goal of this study is to determine if chronic obstructive pulmonary disease (COPD) is associated with sensorineural hearing loss (SNHL) in a national database. Cross-sectional study. National sample of the United States population. Adults with audiometric and spirometry data from the National Health and Nutrition Examination Study (NHANES) database. None. A total of 2,464 adults with spirometry and audiometry data from the NHANES database (2009-2012) were studied. Outcome measures included hearing, measured by high-frequency pure tone average (HFPTA; 3, 4, 6, 8 kHz) and low-frequency pure tone average (LFPTA; .5, 1, 2 kHz) frequencies. SNHL was defined as a HFPTA or LFPTA threshold more than 25 decibels (dB) in the better ear. Multivariable regression analyses explored the association between hearing loss and COPD. The prevalence of COPD was 19.8% in individuals with SNHL in the better ear and 4.7% in individuals with normal hearing (p < 0.001). Presence of COPD was associated with elevated hearing thresholds (worse hearing) at each individual frequency. The presence of COPD was independently associated with a 3.29 dB (95% CI: 1.48, 5.09) increase in HFPTA (p < 0.001), and 2.32 dB (1.13, 3.50) increase in LFPTA (p < 0.001) after controlling for medical, social, and environmental covariates. The presence of COPD was independently associated with a 1.85-fold (1.12, 3.06) increased odds of isolated low-frequency SNHL (p = 0.017). COPD was independently associated with sensorineural hearing loss after controlling for multiple confounding factors. These results contribute to the evidence that COPD and pulmonary dysfunction can be comorbid with hearing decline.

Examination of hearing loss among school-aged children in Greenland

BackgroundThe highest prevalence of chronic suppurative otitis media is seen among children in Greenland. The purpose of this study was to investigate the prevalence of hearing loss among school children in Sisimiut, the second-largest city in Greenland. Material and methodAll 423 children from 5th to 10th grade from the two schools in Sisimiut and the nearby settlements were invited to participate. Participants filled out a questionnaire at home with their parents before ear-examination and audiometry. Risk factors for hearing loss and otitis media (OM) related otoscopy findings were analyzed by binomial logistic regression. ResultsA total of 185 children between 9 and 15 years of age (median: 11 years, IQR: 10–13) were included; 60% (n = 111) were girls. Fifty-four children (29%) were found to have hearing impairment using a PTA of 15 dB for either low or high frequencies or both as threshold. When using 25 dB as threshold, the number of children with hearing impairment was 18 (10%). None of the children had hearing aids. Of 355 otoscopies available for evaluation, the majority were normal (n = 249, 70.1%). Perforation of the tympanic membrane was found in six ears (1.7%), of which all were unilateral. Other sequelae related to OM (i.e., circular atrophy and myringosclerosis) were found in 37 ears (10.4%). Children with OM-related otoscopy findings had significantly lower hearing tresholds compared to children without. ConclusionA high prevalence of untreated hearing loss was found among examined school children in Sisimiut. Children with otoscopy findings indicating prior OM had significantly lower hearing tresholds compared to children without.

Characteristics and recovery of hearing loss in 573 patients with bacterial meningitis

Objective: To analyze the characteristics and prognosis of hearing loss in children with bacterial meningitis. Methods: This was a single-center retrospective cohort study. Patients diagnosed with bacterial meningitis who were hospitalized in Beijing Children's Hospital between 2010 and 2016 and older than 28 days and younger than 18 years at symptom onset were included in this study (n=573). All clinical information including hearing assessment results during hospitalization were reviewed. All patients with hearing loss were followed up to repeat their hearing test and assess their hearing condition with parents' evaluation of aural and (or) oral performance of children (PEACH). Patients were grouped according to their hearing assessment results, and Logistic regression analysis was used to analyze the risk factors for hearing loss in patients with bacterial meningitis. Results: Five hundred and seventy-three patients were enrolled in this study, including 347 males and 226 females. The onset age ranged from 29 days to 15.8 years. Two hundred and forty-six patients had identified causative pathogens, among whom 92 cases (37.4%) were pneumococcal meningitis cases. Hearing loss was found in 160 cases (27.9%) during hospitalization, involving 240 ears. Permanent hearing loss was found in 20 cases (16.9%), involving 32 ears. In the patients with permanent hearing loss, 87.5% (28/32) of ears were identified as severe or profound hearing loss during hospitalization. Logistic regression analysis showed that dystonia, the protein concentration level in cerebrospinal fluid>1 g/L, glucose concentration level lower than 1 mmol/L and subdural effusion were independent risk factors for hearing loss (OR=2.426 (1.450-4.059), 1.865 (1.186-2.932), 1.544 (1.002-2.381) and 1.904 (1.291-2.809)). Conclusions: Hearing loss is a common sequela of bacterial meningitis in children. Most patients have transient hearing loss, but patients with severe or profound hearing impairment have a higher risk of developing permanent hearing loss.

SCREENING OF HEARING DISORDER IN CHILDREN AGED 13-14 YEARS IN TEGAL

ABSTRACT Background: Hearing loss is an impairment or inability of hearing, which is a threshold value of hearing more than 40 decibels (dB) in adults or more than 30 decibels (dB) in children. Hearing loss can result in decreased learning achievement at school, problems in communication, psychological problems, and if complications have occurred, it will cost more for the treatment.Aim : This study aims to determine characteristics of hearing loss in children aged 13-14 years.Methods : This study is a descriptive study with a total sample of 61 students taken by simple random sampling method from a total of 599 students aged 13-14 years. The data were obtained from the questionnaires and physical examination of the ear. Simple auditory function was examined using a tuning fork.Results : The results in this study indicate that the largest group is 14 years old and male gender (52%). It was found that 13 students (21%) had a tympanic membrane and 1 student (2%) had a tympanic membrane perforated in the right ear. In the hearing function, it was found that 1 student with a conductive type disorder. From the questionnaire on the risk factors for hearing loss, there were the use of cotton buds for 53 students (87%), routine checkups for 1 student (2%), use of headsets for 48 students (79%), allergic rhinitis 9 students (15%), chronic tonsillitis 17 students (28%) and ISPA 1 student (2%).Conclusion : The percentage of hearing loss is 2%, the type of hearing loss is CHL (Conductive Hearing Loss). Percentage of risk factors for hearing loss using cotton buds (87%), headset use (79%), allergic rhinitis (15%), chronic tonsillitis (28%), ARI (1%), routine check-ups (1%). Keywords : Hearing loss, hearing function examination, risk factors for hearing loss

Analysis of influencing factors of high-frequency hearing loss among male noise workers in an automobile manufacturing enterprise

Objective: To analysis of high-frequency hearing loss status and risk factors among male noise workers in an automobile manufacturing enterprise in Guangzhou. Methods: From February 2020, a cluster sampling method was used to select 3486 male workers exposed to noise in an automobile manufacturing enterprise in Guangzhou in 2018. After screening, 2608 were selected as the research objects. Pure tone hearing threshold test, noise exposure level test and questionnaire survey were conducted, and the cumulative noise exposure was calculated. Chi square test and unconditional logistic regression were used to analyze the correlation between various factors and high frequency hearing loss. Results: The detection rate of high-frequency hearing loss in noise exposed workers was 34.20% (892/2608) , there were significant differences in the two groups among age, marital status, years of noise exposure, noise exposure equivalent A sound level, CNE, different working hours and exposure to electromagnetic radiation (P<0.05) . Multiple logistic regression analysis showed that age, CNE and exposure to electromagnetic radiation were independent risk factors for high-frequency hearing loss (P<0.05) , three shifts and two shifts were the protective factors for the occurrence of high-frequency hearing loss (OR=0.523, P<0.01) . Conclusion: Noise exposure is the main influencing factor of high-frequency hearing loss of noise-receiving workers in automobile manufacturing enterprises. Enterprises should strengthen noise control in the workplace, improve the working environment of electromagnetic radiation, and implement a scientific and healthy work shift system.

A Longitudinal Exploration of Self-Reported Hearing Loss, Tinnitus, and Posttraumatic Stress Disorder Treatment Outcomes in Australian Veterans.

Tinnitus, hearing loss, and posttraumatic stress disorder (PTSD) are common conditions among veterans. Shared underlying symptoms, such as hypervigilance and heightened sense of threat, may interfere with talk-based psychological treatments. The aim was to investigate the prevalence and risk factors for self-reported tinnitus and hearing loss among Australian treatment-seeking veterans, as well as links with PTSD symptoms and quality of life (QOL) after treatment. Australian veterans participating in hospital-based PTSD treatment (n = 523) completed self-report measures of subjective hearing impairment, service-related factors, PTSD symptoms, and QOL at treatment intake and discharge, as well as 3- and 9-month follow-ups. Univariate analyses of covariance modeled symptom change over time. More than half of veterans on PTSD treatment self-reported doctor-diagnosed hearing loss or tinnitus, whereas 43% reported both. However, 75% reported subjective mild to moderate hearing impairment, and only 1% reported severe impairment. Service-related factors, such as longer length of service and exposure to explosions, were risk factors for having any hearing condition. After controlling for intake scores, there were no significant differences on PTSD or QOL outcomes over time between those with and without hearing conditions. Although self-reported tinnitus and hearing loss are prevalent among veterans, those with severe hearing impairments are unlikely to be represented in this context. There is a need for psychological treatments that are accessible to patients with severe hearing impairments, which should be examined routinely among military members accessing psychological treatments.

Outcomes of a universal neonatal hearing screening program of 9941 newborns over a one-year period in Campinas, Brazil

ObjectivesTo characterize the outcomes of a universal neonatal hearing screening program in Brazil. MethodsRetrospective documentary analysis of the hearing screening of the neonates born in the hospital from August 2019 to July 2020. The universal neonatal hearing screening program performed the examination of TEOAE in newborn without risk factors for hearing loss and TEOAE and aABR in neonates with risk factors for hearing loss. Results9941 neonatal records were studied, 9088 newborns (91,42%) with no risk factors for hearing loss and 849 newborns (8.54%) with risk factors for hearing loss. 4 newborns (0.04%) had hearing loss in the group without risk factors and 16 newborns (1.88%) in the group with risk factors. In retesting those newborns who failed the UNHS test stage, we had 4 newborns (0.04%) without risk factors and 2 newborns (0,24%) with risk factors who evaded and did not return to service. ConclusionIt was possible to survey the outcomes of one year of the UNHS service and observe that the coverage rate of the service was 99.96%. The use of the combined methodology guaranteed a number of forwardings for less returns. Through this study, it was possible to observe that this service complies with the quality indicators recommended by the guidelines.

Development of a case definition for hearing loss in community-based older adults: a cross-sectional validation study.

Background:Research based in primary care suggests that hearing loss may be underreported as well as inconsistently recorded in patient histories. In this study, we aimed to develop and validate a case definition for hearing loss among older adults in primary care, using electronic medical records.Methods:We used data from adult patients aged 55 years and older from 13 practices in the Southern Alberta Primary Care Research Network database, part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), from Dec. 1, 2014, to Dec. 31, 2016. We developed a hearing loss case definition that was translated into an electronic algorithm. A record review was undertaken as the reference standard, followed by application of the algorithm to the sample. Validation metrics included sensitivity, specificity, positive predictive value and negative predictive value, as well as prevalence. We assessed risk factors using the Fisher exact test and odds ratios.Results:The sample included 1000 patients; 496 (49.6%) were female and the mean age was 67.5 (standard deviation 9.6) years. Sensitivity of the case definition algorithm was determined to be 87.3% (95% confidence interval [CI] 76.5%–94.4%) with specificity valued at 94.8% (95% CI 93.1%–96.1%). Positive and negative predictive values were 52.9% (95% CI 42.8%–62.8%) and 99.1% (95% CI 98.2%–99.6%), respectively. The prevalence of hearing loss within the sample was 6.3% (95% CI 4.9%–7.9%). Older age was a significant risk factor for hearing loss (t = 4.98, 95% CI 3.76–8.65). Men had greater odds of hearing loss than women (odds ratio 1.65, 95% CI 0.98–2.79).Interpretation:The validated case definition for hearing loss in community-based older adults had high sensitivity and specificity. It may be applied to surveillance and future epidemiologic research within the CPCSSN database.

Risk factors of sensory hearing loss in nasopharyngeal carcinoma patients obtaining conventional radiotherapy

Previous studies proven that cochlear hair cells’ death plays an important role in sensorineural hearing loss due to radiation exposure. Other studies compared the differences between the impact of conventional radiotherapy (CRT) and intensity modulated radiation therapy (IMRT) on hearing loss in patients with nasopharyngeal carcinoma. Although, few differences found in some clinical manifestation, however no statistical analysis had been carried out. The aim of study was to evaluate the risk of sensory hearing loss in nasopharyngeal carcinoma patients who received CRT compared to IMRT. A case control study was performed on nasopharyngeal carcinoma patients who received radiotherapy at Dr. Sardjito General Hospital, Yogyakarta. The result of DPOAE between NPC patients who received CRT and IMRT was compared in this study. Statistical analysis was performed using chi square test and multivariate analysis. The result showed that patients who received CRT significantly altered the risk for sensory hearing loss in the contralateral ear as much as 11.2 times according to the multivariate analysis (CI 95%: 2.2 – 56.6; p=0.004). In conclusion, the risk of sensory hearing loss in patients with nasopharyngeal carcinoma who received CRT is a greater compared to IMRT.

Neonatal Hearing Screening: Prevalence of Unilateral and Bilateral Hearing Loss and Associated Risk Factors.

Introduction: Newborn hearing screening is essential for early identification of hearing loss to decrease the adverse effects of hearing loss. The objective of this study was to determine the prevalence of hearing loss and risk factors of congenital hearing loss in newborns.Methods: In this analytical case-control study, a hearing screening test was performed for all newborns aged 3-14 days.Results: Of 5,500 newborns evaluated, 24 newborns had hearing loss. The prevalence of hearing loss was 4.36 per 1,000. Of 24 hearing-impaired newborns, 15 had bilateral hearing loss (BHL) (62.5%) and nine had unilateral hearing loss (UHL) (37.5%). Among the neonates with hearing loss, the prevalence of hearing loss was higher (77.8%) in the right ear. The main risk factors identified in this study were low gestational age (P=0.001), hospitalization in the neonatal intensive care unit (NICU) (P=0.008), exposure to ototoxic drugs (P=0.001), gestational diabetes P=0.01), craniofacial anomalies (P=0.01), convulsion (P=0.03), consanguineous marriage of parents (P=0.001), low birth weight (P=0.01), and hyperbilirubinemia (P=0.001).Conclusion: The prevalence of hearing loss was higher in the right ear than in the left ear. NICU stay, use of ototoxic drugs, low gestational age (<35 weeks), gestational diabetes, craniofacial anomalies, convulsion, consanguineous marriage of parents, low birth weight, and hyperbilirubinemia were significant risk factors for congenital hearing loss in studied newborns.

Research progress of hidden hearing loss in occupational health surveillance

According to the research on the pathogenesis of the hidden hearing loss in recent years, the occurrence of the hidden hearing loss is earlier than the permanent hearing threshold shift. This paper reviews the risk factors of hidden hearing loss, the pathogenesis of noise-induced hidden hearing loss, and the detection methods of hidden hearing loss. To explore the significance of hidden hearing loss in occupational health surveillance, and to provide reference for hearing protection of workers exposed to noise and hearing loss early in the future.

A Study of JCIH (Joint Commission on Infant Hearing) Risk Factors for Hearing Loss in Babies of NICU and Well Baby Nursery at a Tertiary Care Center.

Babies in Neonatal Intensive Care Units (NICU) have an additional risk for hearing loss due to various risk factors like, prematurity, low birth weight, mechanical ventilation, hyperbillirubinemia, ototoxic drugs, low APGAR score etc. as compared to the babies from well baby nursery (WBN) who, poses risk factors mostly family history, syndromic deafness. So the present study was aimed know the risk factors responsible for hearing loss in NICU and WBN babies and to assess the incidence of deafness. A total of 800 babies from NICU (n = 402) and WBN (n = 398) underwent hearing screening from a tertiary care center. Hearing screening was done using two staged screening protocol as per JCIH guidelines with Distortion product Evoked Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Responses (A-ABR). According to DPOAE test, 311 from NICU and 383 from WBN passed the test and during second screening, 80 out of 91 from NICU and 11 out of 13 from WBN passed the DPOAE test. Further BERA was done at the 3rd month of corrected age where 6 out of 11 showed positive responses from NICU and 3 babies from WBN had profound hearing loss. Data analysis revealed that family history of deafness, anemia and hypertension in ANC, TORCH in mother, low Apgar score and hyperbillirubinemia in newborns were a major risk factor for hearing impairment. We conclude that the diagnoses of auditory disorders at early stage due to various risk factors are important since appropriate therapeutic intervention and rehabilitation would help in better development of children.

Recommendations for All-Round Newborns and Infants Hearing Screening in Russian Federation

Background. Nowadays there is a need to revise the Russian list of risk factors of hearing loss and deafness based on their study according to the evidence-based medicine and the analysis of the audiology service capabilities. Moreover, audiologic screening system for newborns and infants should be revised in every region to identify the reasons of mismatch with international standards and to find ways of its efficacy improvement. Objective. The aim of the study is to increase the efficacy of Russian program of all-round newborns and infants hearing screening. Methods. This study consisted of two parts. 1) The first stage of audiological screening audit on the example of 78 medical institutions in Saint-Petersburg. The availability and correct function of hearing research equipment, specialists’ qualifications, study technique and conditions, documents and results transmitting accuracy were estimated. 2) Updating the list of risk factors of hearing loss. The prevalence rate of these factors in Russian population according to the literature and official statistics was studied. Evaluation of predictive significance of risk factors was based on retrospective data in the cohort of 393 children born in 2012 (280 with hearing loss, 113 healthy) examined in National Research Centre for Audiology and Hearing Rehabilitation at the age of 0–4 years. Results. The first stage of audiological screening audit has shown that only 14% of included institutions fully meet the criteria of its effective implementation. The following problems were revealed: purchase and renewal of equipment, its timely adjustment, ensuring the continuity of screening stages, specialists training, compliance with methodology and study conditions, results documentation. We were able to increase by 8.5% (close to targeted indicator) the coverage of newborns with first stage of audiological screening as well as to increase the rate of children at the diagnostic stage from 33% to 51%, due to the results of this audit and methodological assistance to the institutions. According to the analysis of prognostic significance and prevalence of risk factors of hearing loss and deafness in Russian population of newborns, it is necessary to perform full hearing examination regardless of the results of newborns and infants hearing screening with the following risk factors: 1) cases of persistent child hearing loss in the family; 2) syndromes associated with hearing loss; 3) auricle, ear canal and dentofacial anomalies; 4) congenital infection (cytomegalovirus, rubella, syphilis, toxoplasmosis); 5) stay in newborns intensive care unit for more than 2 days; 6) prematurity of 32 weeks or less; birth weight less than 1500 g; 7) hyperbilirubinemia in perinatal period (exchange blood transfusion; total bilirubin level when exchange blood transfusion is needed); 8) usage of ototoxic drugs; 9) severe perinatal damage to the central nervous system, neurodegenerative diseases; 10) ambiguous reaction to sounds, developmental delay. Conclusion. Maintenance of all-round newborns hearing screening algorithm will allow us to avoid the diagnosis delay, to start the rehabilitation earlier and further to significantly increase the efficacy of modern high-tech methods for correcting hearing disorders in children. We have to check the presence of risk factors of hearing loss and deafness in every child. Timely referral of children with risk factors for the second stage of audiological screening, diagnosis and correction of hearing disorders creates conditions for normal child oral-aural development.