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The Epidemiology of Hearing Loss Study

Karen J. Cruickshanks, PhD; Ronald Klein, MD; Barbara E. K. Klein, MD; Terry L. Wiley, PhD; David M. Nondahl, MS; Ted S. Tweed, MS

JAMA. 1998;279:1715-1719.

Context.— Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults.

Objective.— To evaluate the association between smoking and hearing loss.

Design.— Population-based, cross-sectional study.

Setting.— Community of Beaver Dam, Wis.

Participants.— Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study.

Main Outcome Measures.— The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear.

Results.— After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non–age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74).

Conclusions.— These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.

From the Department of Ophthalmology and Visual Sciences (Drs Cruickshanks, R. Klein, and B. E. K. Klein and Messrs Nondahl and Tweed) and the Department of Communicative Disorders (Dr Wiley and Mr Tweed), University of Wisconsin, Madison.

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