title: Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: the Third National Health and Nutrition Examination Survey, 1988-1994, United States.
abstract: OBJECTIVE
  This analysis estimates the first nationally representative prevalence of noise-induced hearing threshold shifts (NITS) among US children. Historically, NITS has not been considered a common cause of childhood hearing problems. Among children, NITS can be a progressive problem with continued exposure to excessive noise, which can lead to high-frequency sound discrimination difficulties (eg, speech consonants and whistles).
  
  
  METHODS
  The Third National Health and Nutrition Examination Survey (NHANES III) was conducted from 1988 to 1994. NHANES III is a national population-based cross-sectional survey with a household interview, audiometric testing at 0.5 to 8 kHz, and compliance testing. A total of 5249 children aged 6 to 19 years completed audiometry and compliance testing for both ears in NHANES III. The criteria used to assess NITS included audiometry indicating a noise notch in at least 1 ear.
  
  
  RESULTS
  Of US children 6 to 19 years old, 12.5% (approximately 5.2 million) are estimated to have NITS in 1 or both ears. In the majority of the children meeting NITS criteria, only 1 ear and only 1 frequency are affected. In this analysis, all children identified with NITS passed compliance testing, which essentially rules out middle ear disorders such as conductive hearing loss. The prevalence estimate of NITS differed by sociodemographics, including age and sex.
  
  
  CONCLUSIONS
  These findings suggest that children are being exposed to excessive amounts of hazardous levels of noise, and children's hearing is vulnerable to these exposures. These data support the need for research on appropriate hearing conservation methods and for NITS screening programs among school-aged children. Public health interventions such as education, training, audiometric testing, exposure assessment, hearing protection, and noise control when feasible are all components of occupational hearing conservation that could be adapted to children's needs with children-specific research.
authors: National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. aniskar@cdc.gov
authors: A S
authors: AS
authors: Niskar
authors: S M
authors: SM
authors: Kieszak
authors: A E
authors: AE
authors: Holmes
authors: E
authors: E
authors: Esteban
authors: C
authors: C
authors: Rubin
authors: D J
authors: DJ
authors: Brody
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001299:Audiometry; D001309:Auditory Threshold; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology* / Q000517:prevention & control; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D017058:Mexican Americans / Q000706:statistics & numerical data; D011159:Population Surveillance; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data