Laryngoscope investigative otolaryngology · 2026
Adolescent Hearing Loss in China and the United States: Trends, Socioeconomic Disparities, and Noise Exposure From GBD 1990-2023 and NHANES 2005-2020.
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Zhang Lei, Wu Xiaonan, Cao Yang, Li Jin, Zhang Jiao, Guan Jing, Guo Qian, Wang Dayong, Wang Qiuju
Аннотация
OBJECTIVES: Drawing on data from the Global Burden of Disease (GBD) 1990-2023 for China and the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2020, this study systematically analyzed the epidemiological trends and major risk factors for adolescent hearing loss, and explored the effects of sociodemographic development, noise exposure, and socioeconomic conditions on hearing health.
METHODS: Data on hearing loss prevalence, disability-adjusted life years (DALYs), and occupational noise-attributable burden for Chinese aged 10-19 years were extracted from the GBD 2023 database. Joinpoint regression was used to calculate the estimated annual percentage change (EAPC) and examine the relationship between the Sociodemographic Index (SDI) and hearing loss prevalence. In parallel, weighted logistic regression models were applied to NHANES data from U.S. adolescents aged 12-19 years (2005-2020) to assess the associations of noise exposure, household income, and education level with the risk of hearing loss.
RESULTS: From 1990 to 2023, the prevalence of hearing loss among Chinese adolescents showed a sustained increase (EAPC = 0.83%), with higher rates observed in males than in females. The SDI was significantly and inversely associated with hearing loss burden (β = -3.231, P < 0.001), although the protective effect plateaued at higher SDI levels. The DALY rate attributable to occupational noise declined markedly, from 17.35 per 100,000 population in 1990 to 12.23 per 100,000 population in 2023. NHANES results indicated that daily noise exposure significantly increased the risk of hearing loss (OR = 1.24, 95% CI:1.01-1.51), whereas a higher family income-to-poverty ratio (OR = 0.87, 95% CI:0.82-0.93) and higher educational attainment (OR = 0.65, 95% CI:0.43-0.97) exerted protective effects. Sex-stratified analysis revealed that males were more susceptible to noise-induced hearing loss (male OR = 1.39; female OR = 1.05).
CONCLUSION: Adolescent hearing health is shaped by socioeconomic status, education, and noise. While occupational noise burden has fallen, recreational and environmental noise may represent emerging threats. Accordingly, strengthened surveillance, school-based education, and noise management are warranted as public health priorities.
LEVEL OF EVIDENCE: 2.
METHODS: Data on hearing loss prevalence, disability-adjusted life years (DALYs), and occupational noise-attributable burden for Chinese aged 10-19 years were extracted from the GBD 2023 database. Joinpoint regression was used to calculate the estimated annual percentage change (EAPC) and examine the relationship between the Sociodemographic Index (SDI) and hearing loss prevalence. In parallel, weighted logistic regression models were applied to NHANES data from U.S. adolescents aged 12-19 years (2005-2020) to assess the associations of noise exposure, household income, and education level with the risk of hearing loss.
RESULTS: From 1990 to 2023, the prevalence of hearing loss among Chinese adolescents showed a sustained increase (EAPC = 0.83%), with higher rates observed in males than in females. The SDI was significantly and inversely associated with hearing loss burden (β = -3.231, P < 0.001), although the protective effect plateaued at higher SDI levels. The DALY rate attributable to occupational noise declined markedly, from 17.35 per 100,000 population in 1990 to 12.23 per 100,000 population in 2023. NHANES results indicated that daily noise exposure significantly increased the risk of hearing loss (OR = 1.24, 95% CI:1.01-1.51), whereas a higher family income-to-poverty ratio (OR = 0.87, 95% CI:0.82-0.93) and higher educational attainment (OR = 0.65, 95% CI:0.43-0.97) exerted protective effects. Sex-stratified analysis revealed that males were more susceptible to noise-induced hearing loss (male OR = 1.39; female OR = 1.05).
CONCLUSION: Adolescent hearing health is shaped by socioeconomic status, education, and noise. While occupational noise burden has fallen, recreational and environmental noise may represent emerging threats. Accordingly, strengthened surveillance, school-based education, and noise management are warranted as public health priorities.
LEVEL OF EVIDENCE: 2.