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Wang F, Böhnke F, Böck K, Wirth M. Population-based study of environmental heavy metal exposure and hearing loss: A systematic review and meta-analysis. Laryngoscope Investig Otolaryngol 2024; 9:e1230. [PMID: 38562156 PMCID: PMC10983717 DOI: 10.1002/lio2.1230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/18/2024] [Accepted: 02/03/2024] [Indexed: 04/04/2024] Open
Abstract
Background and Objectives Previous studies have shown an association between environmental exposure to heavy metals and hearing loss. However, the findings regarding the relationship between exposure to different metals and hearing loss development are inconsistent. To address this, we conducted a meta-analysis to explore the link between common heavy metal exposures and hearing loss. This study examined the effects of lead (Pb), cadmium (Cd), and mercury (Hg) pollution on hearing loss at various levels, and systematically reviewed the literature on manganese (Mn), barium (Ba), arsenic (As), and hearing loss. Methods We conducted systematic searches in five major databases, including PubMed, Web of Science, Embase, Cochrane Library, and Scopus. In addition, we searched three Chinese digital libraries: CNKI, Wanfang Data, and Wipu. From an initial pool of 649 articles, we carefully screened and selected 15 articles for further analysis. The effect sizes from these selected studies were synthesized through a meta-analysis to calculate the overall effect size. Results Our findings showed that: (1) There was a significant association between Pb and Cd exposure and hearing loss; (2) There is a proportional relationship between the increase of metal index detected in blood and hearing loss; (3) In the PTA measurement of hearing loss at different frequencies, the 4 kHz high frequency range had a stronger correlation with hearing loss than the low frequency, with OR 1.44 (1.22, 1.71); and (4) There was a more significant correlation between Barium (Ba) levels in nails and hair than in urine. Conclusions The study presented evidence of a significant association between human hearing loss and exposure to lead (Pb) and cadmium (Cd). It not only revealed a positive correlation between blood heavy metal concentrations and the incidence of hearing loss but also highlighted that long-term exposure indicators of heavy metals were more indicative of the correlation with hearing loss. Lastly, the study recommends utilizing high frequency 4 kHz for the effective assessment and diagnosis of hearing loss caused by exposure to heavy metals.
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Affiliation(s)
- Fang Wang
- Department of Otorhinolaryngology/Head & Neck SurgeryKlinikum rechts der Isar der Technischen Universität MünchenMünchenGermany
| | - Frank Böhnke
- Department of Otorhinolaryngology/Head & Neck SurgeryKlinikum rechts der Isar der Technischen Universität MünchenMünchenGermany
| | - Katja Böck
- Department of Otorhinolaryngology/Head & Neck SurgeryKlinikum rechts der Isar der Technischen Universität MünchenMünchenGermany
| | - Markus Wirth
- Department of Otorhinolaryngology/Head & Neck SurgeryKlinikum rechts der Isar der Technischen Universität MünchenMünchenGermany
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Li J, Lai ZG, Huang XH. Association of Thallium with Diabetes Risk among Patients with Hearing Loss: Result from NHANES 2013 to 2018. Medicine (Baltimore) 2024; 103:e37317. [PMID: 38428895 PMCID: PMC10906567 DOI: 10.1097/md.0000000000037317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
To evaluate the correlation between thallium and diabetes risk among participants with hearing loss. This retrospective cohort study extracted related data such as demographic characteristics, lifestyle factors, and laboratory findings from the National Health and Nutrition Examination Survey (NHANES) database (2013-2018). Logistic regression analysis and interaction analysis were adopted to analyze the correlation between thallium and diabetes risk among patients with hearing loss. Then, the restricted cubic spline was employed to assess the nonlinear relationship between thallium and diabetes risk. The receiver operating characteristic curve and decision curve analysis were used to assess the predictive values of 3 multivariate models with or without thallium for diabetes risk. The Delong test was adopted to assess the significant change of the area under the curves (AUCs) upon thallium addition. A total of 425 participants with hearing loss were enrolled in the study: without diabetes group (n = 316) and diabetes group (n = 109). Patients with hearing loss in the diabetes group had significantly lower thallium (P < .05). The thallium was an independent predictor for diabetes risk after adjusting various covariates (P < .05). The restricted cubic spline (RCS) result showed that there was a linear correlation between thallium and diabetes risk (P nonlinear > .05). Finally, the receiver operating characteristic and decision curve analysis results revealed that adding thallium to the models slightly increased the performance in predicting diabetes risk but without significance in AUC change. Thallium was an independent predictor of diabetes risk among patients with hearing loss. The addition of thallium might help improve the predictive ability of models for risk reclassification. However, the conclusions should be verified in our cohort in the future due to the limitations inherent in the NHANES database.
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Affiliation(s)
- Jing Li
- Otolaryngology department, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian, China
| | - Zhi-Gang Lai
- Otolaryngology department, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian, China
| | - Xiao-Hua Huang
- Otolaryngology department, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian, China
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Wang S, Luo J, Zhang F, Zhang R, Ju W, Wu N, Zhang J, Liu Y. Association between blood volatile organic aromatic compound concentrations and hearing loss in US adults. BMC Public Health 2024; 24:623. [PMID: 38413886 PMCID: PMC10897984 DOI: 10.1186/s12889-024-18065-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/10/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Benzene, ethylbenzene, meta/para-xylene, and ortho-xylene, collectively referred to as benzene, ethylbenzene, and xylene (BEX), constitute the main components of volatile organic aromatic compounds (VOACs) and can have adverse effects on human health. The relationship between exposure to BEX and hearing loss (HL) in the adult U.S. population was aimed to be assessed. METHODS Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for the years 2003-2004, 2011-2012, and 2015-2016 were analyzed. This dataset included complete demographic characteristics, pure-tone audiometry measurements, and volatile organic compound detection data from the NHANES database. A weighted multivariate logistic regression model was employed to investigate the associations between blood BEX concentrations HL, low-frequency hearing loss (SFHL), and high-frequency hearing loss (HFHL). RESULTS 2174 participants were included, with weighted prevalence rates of HL, SFHL, and HFHL being 46.81%, 25.23%, and 45.86%, respectively. Exposure to benzene, ethylbenzene, meta/para-xylene, and ortho-xylene, and cumulative BEX concentrations increased the risk of hearing loss (odds ratios [ORs] were 1.36, 1.22, 1.42, 1.23, and 1.31, respectively; all P < 0.05). In the analysis with SFHL as the outcome, ethylbenzene, m-/p-xylene, o-xylene, benzene, and overall BEX increased the risk (OR 1.26, 1.21, 1.28, 1.20, and 1.25, respectively; all P < 0.05). For HFHL, exposure to ethylbenzene, m-/p-xylene, o-xylene, benzene, and overall BEX increased the risk (OR 1.36, 1.22, 1.42, 1.22, and 1.31, respectively; all P < 0.05). CONCLUSION Our study indicated that a positive correlation between individual or cumulative exposure to benzene, ethylbenzene, meta/para-xylene, and ortho-xylene and the risk of HL, SFHL, and HFHL. Further research is imperative to acquire a more comprehensive understanding of the mechanisms by which organic compounds, notably BEX, in causing hearing loss and to validate these findings in longitudinal environmental studies.
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Affiliation(s)
- Senlin Wang
- College of Medicine, Southwest Jiaotong University, Chengdu, China
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jing Luo
- College of Medicine, Southwest Jiaotong University, Chengdu, China
- Department of Otolaryngology head and neck surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
| | - Fang Zhang
- Department of Otolaryngology head and neck surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
| | - Ruimin Zhang
- College of Medicine, Southwest Jiaotong University, Chengdu, China
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Wantao Ju
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, China
| | - Nianwei Wu
- Department of General Surgery, Center for Obesity and Metabolic Health, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
- Research Center for Obesity and Metabolic Health, College of Medicine, Southwest Jiaotong University, Chengdu, China.
- Medical Research Center, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
| | - Jianhui Zhang
- Department of Otolaryngology head and neck surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, 610031, China.
| | - Yanjun Liu
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
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Liang M, Guo X, Ding X, Song Q, Wang H, Li N, Su W, Liang Q, Sun Y. Combined effects of multiple metals on hearing loss: A Bayesian kernel machine regression approach. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 247:114279. [PMID: 36368114 DOI: 10.1016/j.ecoenv.2022.114279] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/15/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Exposure to heavy elements is considered one of the risks of hearing loss. The combined effect of multiple metals on different hearing losses has not been extensively studied. METHODS This study deals with the association between different metals (Ba, Cd, Co, Cs, Mo, Pb, Mn, Sn, Sb, Tl, W) and hearing loss in the 2013-2018 National Health and Nutrition Examination Survey (NHANES). Associations were estimated by a generalized linear regression model (GLM) adjusting for age, gender, race/ethnicity, educational level, marital status, drinking status, hypertension, diabetes, smoking status, noise exposure, body mass index, and income-poverty ratio. The joint effects of mixed exposure were assessed by weighted quantile sum (WQS) model and Bayesian kernel machine regression (BKMR). The effect of multiple metals on speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) was further calculated. The odds ratio (OR) indicates the risk of every metal exposure. RESULTS A total of 2205 adult participants were enrolled from NHANES. Cd, Pb, Sb and Sn had significant effects on total hearing loss. The WQS model found that mixed exposure to heavy elements was significantly positively associated with total hearing loss (OR: 1.136; 95% CI: 1.031, 1.253) after adjusting for various covariates. The ORs of mixed exposure in the SFHL and HFHL groups were 1.066 (95% CI: 0.994, 1.143) and 1.102 (95% CI: 1.013, 1.199), respectively. BKMR found a significant positive association between multiple metals and hearing loss. The results showed that there may be potential interactions between Cd, Pb and other metals. CONCLUSIONS Multiple metals have joint effects on hearing loss in the United States. The findings provide practitioners with important scientific evidence for possible interventions.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, PR China.
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