title: Shooting history and presence of high-frequency hearing impairment in swedish hunters: A cross-sectional internet-based observational study.
abstract: The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI). All hunters registered with an e-mail address in the membership roster of the Swedish Hunters' Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR), were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years), and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%), while 23/202 (11%) exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19%) had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%), had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI) 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institute and Aleris Specialist Center, Sabbatsberg, Stockholm, Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: Honeth
authors.forename: Peter
authors.initials: P
authors.lastname: Ström
authors.forename: Alexander
authors.initials: A
authors.lastname: Ploner
authors.forename: Dan
authors.initials: D
authors.lastname: Bagger-Sjöbäck
authors.forename: Ulf
authors.initials: U
authors.lastname: Rosenhall
authors.forename: Olof
authors.initials: O
authors.lastname: Nyrén
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001299:Audiometry / Q000379:methods; D001309:Auditory Threshold; D002648:Child; D003430:Cross-Sectional Studies; D004430:Ear Protective Devices; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005260:Female; D005389:Firearms; D006316:Hearing Loss, High-Frequency / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D020407:Internet; D008297:Male; D009622:Noise / Q000009:adverse effects*; D011998:Recreation / Q000502:physiology*; D011795:Surveys and Questionnaires; D013548:Sweden