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

Objective. This analysis estimates the first nationally representative prev alence of noise-induced hearing threshold shifts (NITS) among US children. Historically, NITS has not been considered a common cause of childhood hear ing problems. Among children, NITS can be a progressive problem with contin ued exposure to excessive noise, which can lead to high-frequency sound dis crimination 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 testin g 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 NH ANES 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 chil dren meeting NITS criteria, only 1 ear and only 1 frequency are affected. I n this analysis, all children identified with NITS passed compliance testin g, which essentially rules out middle ear disorders such as conductive hear ing loss. The prevalence estimate of NITS differed by sociodemographics, in cluding age and sex. Conclusions. These findings suggest that children are being exposed to exce ssive amounts of hazardous levels of noise, and children's hearing is vulne rable to these exposures. These data support the need for research on appro priate hearing conservation methods and for NITS screening programs among s chool-aged children. Public health interventions such as education, trainin g, audiometric testing, exposure assessment, hearing protection, and noise control when feasible are all components of occupational hearing conservati on that could be adapted to children's needs with children-specific researc h.