Josef Shargorodsky, M.D., and colleagues analyzed data from the annual National Health and Nutrition Examination Survey and compared the record of the softest sounds that could be heard by American 12- to 19-year-olds in 1988 through 1994 with those recorded from adolescents of the same age in 2005 and 2006. Their fi ndings, published in the August 18 issue of the Journal of the American Medical Association (JAMA), indicate that the prevalence of hearing loss increased from 14.9 percent in 1988-1994, to 19.5 percent in 2005-2006. The percentages of teens with "slight" (between 15 and 25 dB) and "mild" (greater than 25 dB) hearing loss also increased during this time frame.
What are possible reasons for these increases in hearing loss among our nation's children? One difference between the groups emerged in the JAMA report: 55 percent of children in 1988 through 1994 reported a history of three or more ear infections in their lifetime; this prevalence increased to 61 percent for children surveyed in 2005 to 2006. A greater number of ear infections might contribute to the higher prevalence of hearing loss seen in the more recently surveyed teens. Because these children exhibited more high-frequency hearing loss than their 1988-1994 counterparts, it is also possible that they experienced more exposure to loud sounds and are starting to develop noise-induced hearing loss.
The recent study by Shargorodsky et al. is not the fi rst to demonstrate that hearing loss among children is increasing. Studies by Charles Woodford, Gail Chermak, Judith Montgomery and their colleagues reported similar increases in the 1980s and 1990s. Even though the degree of change in hearing loss detected in these studies was generally mild and usually not even noticed by the children involved, Norman Lass and others warned that mild hearing loss in adolescents may deteriorate to debilitating hearing loss in later life. A 2006 study by Sharon Kujawa and Charles Liberman demonstrated that exposure to loud sound early in life makes hearing loss more likely to occur later in life.
Studies have shown that children with hearing loss tend to have more learning diffi culties, behavioral problems and lower self esteem than their classmates who have normal hearing. In 1998, Fred Bess and colleagues reported that children with minimal sensorineural hearing loss scored signifi cantly lower on the Comprehensive Test of Basic Skills compared with normal-hearing children.
In response to this trend of increasing hearing loss among children, numerous experts have recommended that hearing loss prevention should be taught in our nation's schools. In 2008, the Centers for Disease Control and Prevention (CDC) added noiseinduced hearing loss to its list of "important topics that affect the health and well-being of children and adolescents." On the Healthy Youth Web site (www.cdc.gov/healthyyouth/noise), the CDC recommends that hearing loss prevention education programs and curricula should be implemented in schools on a regular basis. Under "Links," the Web site lists many resources and programs that can be used to teach children to protect their hearing from exposure to loud sounds, including the Noisy Planet program from National Institute on Deafness and Other Communication Disorders (www.noisyplanet.nidcd.nih.gov), of which Deafness Research Foundation is a partner, along with Dangerous Decibels (www.dangerousdecibels.org), and many more.
If children are taught to implement healthy behaviors and strategies in noisy situations, future generations may reverse the trend of increased hearing loss seen during the last few decades. Many people will then be spared the debilitating and expensive consequences of hearing loss and tinnitus.
Robert L. Folmer, Ph.D., is a research investigator at the National Center for Rehabilitative Auditory Research at the Portland VA Medical Center in Portland, Ore. Contact him at Robert.Folmer@va.gov.
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