title: Exposure to loud noise, bilateral high-frequency hearing loss and coronary heart disease.
abstract: OBJECTIVE
  Bilateral high-frequency hearing loss is an indicator for chronic exposure to loud noise. This study aimed to examine the association between bilateral high-frequency hearing loss and the presence of coronary heart disease (CHD).
  
  
  METHODS
  This study included 5223 participants aged 20-69 years who participated in the audiometry examination of the National Health and Nutrition Examination Survey 1999-2004. Bilateral high-frequency hearing loss was defined as the average high-frequency (3, 4 and 6 kHz) hearing threshold ≥25 dB in both ears. CHD was defined as self-reported diagnoses by doctors or other health professionals.
  
  
  RESULTS
  Compared with those with normal high-frequency hearing, participants with bilateral high-frequency hearing loss were more likely to have CHD (OR 1.91; 95% CI 1.28 to 2.85) after adjustment for various covariates. This association was particularly strong for currently employed workers who were exposed to loud occupational noise (OR 4.23; 95% CI 1.32 to 13.55). For this subgroup, there was no significant association of CHD with unilateral high-frequency hearing loss, and unilateral or bilateral low-frequency hearing loss. Furthermore, there was no significant association of CHD with any types of hearing loss for participants who were not exposed to loud noise. Stratified analyses for participants exposed to loud noise showed that the observed association was particularly strong for those who were less than 50 years of age, less educated and current smokers.
  
  
  CONCLUSIONS
  On the basis of an objective indicator for personal chronic exposure to loud noise, this study confirmed that exposure to loud occupational noise is associated with the presence of CHD.
authors.affiliation: Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, Kentucky, USA.
authors.forename: Wen Qi
authors.initials: WQ
authors.lastname: Gan
authors.affiliation: Department of Occupational Medicine, Epidemiology and Prevention, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Great Neck, New York, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Moline
authors.affiliation: Department of Occupational Medicine, Epidemiology and Prevention, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, Kentucky, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Mannino
mesh_terms: D000328:Adult; D001299:Audiometry; D001309:Auditory Threshold; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006316:Hearing Loss, High-Frequency / Q000209:etiology*; D006317:Hearing Loss, Noise-Induced / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009623:Noise, Occupational / Q000009:adverse effects*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012307:Risk Factors