Noise & health · 2026
Socio-Demographic, Environmental, and Self-Mediated Aural Practices Determinants of Aural Health in Urban Slums of Bhubaneswar, India: A multivariable Analysis to Suggest Recommendations.
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Kar Sonali, Ray Angana, Samantaray Kabikanta, Rath Gouri Kumar, Mohapatra Nirmalya, Panda Prem Sagar
Аннотация
BACKGROUND: Aural morbidity remains an under-recognized public health concern in urban slum populations where environmental noise exposure, poor housing, and unsafe hygiene practices co-exist. Evidence on combined socio-environmental determinants of ear health in such settings remains limited.
METHODS: A community-based, stratified, cross-sectional study was conducted among 384 residents aged 10-50 years from six urban slums in Bhubaneswar, stratified into low-, medium-, and high-noise zones. Data were collected using a pre-tested semi-structured questionnaire, otoscopic examination, and tuning fork tests. Associations between socio-demographic, environmental, and behavioral factors with aural morbidity were analyzed using chi-square tests and multivariable logistic regression.
RESULTS: Overall aural morbidity prevalence was 21.1% (95% confidence interval (CI): 17.3-25.5), comprising infection only (11.2%), hearing loss only (2.6%), and combined morbidity (7.3%). Screening detected hearing loss prevalence increased across exposure gradients-low (2.4%), medium (11%), and high noise zones (15.6%) ( P = 0.001). Unsafe ear cleaning ( P = 0.017), prior infection (<0.001), ear piercing ( P = 0.002), and lack of ear check-ups ( P = 0.021) were significantly associated. High noise exposure independently predicted morbidity (AOR), i.e., adjusted odds ratio 8.52; 95% CI: 2.90-25.08). Housing factors, including insect presence, flooding, and unsafe water sources, also demonstrated significant associations.
CONCLUSION: Aural morbidity in urban slums reflects intersecting environmental, behavioral, and socio-housing risks. Integrating ear and hearing care within National Health Mission (NHM) platforms and Comprehensive Primary Health Care (CPHC) services can advance progress toward Sustainable Development Goals SDG 3 (Health), SDG 11 (Sustainable Cities), and SDG 6 (Sanitation) through multisectoral urban health interventions.
METHODS: A community-based, stratified, cross-sectional study was conducted among 384 residents aged 10-50 years from six urban slums in Bhubaneswar, stratified into low-, medium-, and high-noise zones. Data were collected using a pre-tested semi-structured questionnaire, otoscopic examination, and tuning fork tests. Associations between socio-demographic, environmental, and behavioral factors with aural morbidity were analyzed using chi-square tests and multivariable logistic regression.
RESULTS: Overall aural morbidity prevalence was 21.1% (95% confidence interval (CI): 17.3-25.5), comprising infection only (11.2%), hearing loss only (2.6%), and combined morbidity (7.3%). Screening detected hearing loss prevalence increased across exposure gradients-low (2.4%), medium (11%), and high noise zones (15.6%) ( P = 0.001). Unsafe ear cleaning ( P = 0.017), prior infection (<0.001), ear piercing ( P = 0.002), and lack of ear check-ups ( P = 0.021) were significantly associated. High noise exposure independently predicted morbidity (AOR), i.e., adjusted odds ratio 8.52; 95% CI: 2.90-25.08). Housing factors, including insect presence, flooding, and unsafe water sources, also demonstrated significant associations.
CONCLUSION: Aural morbidity in urban slums reflects intersecting environmental, behavioral, and socio-housing risks. Integrating ear and hearing care within National Health Mission (NHM) platforms and Comprehensive Primary Health Care (CPHC) services can advance progress toward Sustainable Development Goals SDG 3 (Health), SDG 11 (Sustainable Cities), and SDG 6 (Sanitation) through multisectoral urban health interventions.