A randomised controlled trial of screening for adult hearing loss during preventive health checks.
BACKGROUND
Prophylactic strategies to counter acquired hearing impairment may involve routine audiometric screening of asymptomatic working-age adults attending general practice for regular health checks.


OBJECTIVE
To evaluate the effect of adult hearing screening on subsequent noise exposure and hearing.


METHODS
A randomised controlled population-based study of health checks and health discussions in general practice.


METHODS
The project was initiated in the district of Ebeltoft, Aarhus county, Denmark.


METHODS
Intervention group participants' hearing thresholds were determined audiometrically at 0.5, 1, 2, 3, and 4 kHz in each ear. Participants were advised to get their ears checked if the average hearing loss exceeded 20 dB hearing level (dBHL) in either ear. Noise avoidance was emphasised when thresholds exceeded 25 dBHL bilaterally at 4 kHz. Follow-up included questionnaires and audiometry.


RESULTS
Hearing loss was observed among 18.9% of the study sample at baseline. At the five-year follow-up we recorded no significant differences between the control and the intervention groups regarding subjective or objective hearing, or exposure to occupational noise. However, there was a tendency towards reduction in exposure to leisure noise among intervention participants (P = 0.045). Approximately 20% reported hearing problems; 16.5% reported tinnitus-related complaints; 0.8% used hearing aids; 35.0% reported frequent noise exposure; and occluding wax was suspected in 2.1%.


CONCLUSIONS
Preventive health checks with audiometry did not significantly affect hearing, but leisure noise exposure tended to become less frequent. The poor effect may be ascribed to inadequate audiological counselling or a higher priority to other advice, e.g. on cardiovascular risk or lifestyle.
Karlsmose
B
B
Department and Research Unit of General Practice, University of Aarhus, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark. bk@alm.au.dk
Lauritzen
T
T
Engberg
M
M
Parving
A
A
D000328:Adult; D001299:Audiometry; D003718:Denmark / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000453:epidemiology; D006320:Hearing Tests / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires