Author Identifier (ORCID)
Abstract
Objective: To explore the associations between major modifiable risk factors and hearing loss.
Methods: This serial cross-sectional study was conducted within the National Health and Nutrition Examination Survey 1999–2020 in the United States. Associations were assessed using modified Poisson regression and within-sample population attributable fraction (PAF).
Results: Eight thousand seven hundred and seventy adults aged 40–85 years were included in the analyses, the mean (SD) age was 58.0 (11.7) years, with 4002 men (45.6%). Hearing loss was associated with low educational attainment with prevalence ratio 1.23, 95% confidence interval (1.15, 1.31); low income 1.11 (1.04, 1.19); diabetes 1.10 (1.03, 1.18); HDL-C dyslipidaemia 1.13 (1.06, 1.21); obesity 1.08 (1.01, 1.15) and tobacco use 1.11 (1.04, 1.19). Within our analysis, over 25% of hearing loss cases were attributed to modifiable risk factors, with low education or income, HDL-C dyslipidaemia, obesity and tobacco use being the leading contributors, though relative rankings varied slightly in survey-weighted analyses.
Conclusion: Hearing promotion policies should prioritise related modifiable factors to reduce the burden of hearing loss.
Keywords
hearing loss, modifiable risk factors, population attributable fraction, prevalence ratio
Document Type
Journal Article
Date of Publication
1-1-2026
E-ISSN
17494486
ISSN
17494478
Publication Title
Clinical Otolaryngology
Publisher
Wiley
School
Centre for Precision Health / Nutrition and Health Innovation Research Institute / School of Science
Funding Information
This work was supported by the Western Australian Future Health Research and Innovation (FHRI) Fund through the WA Near-Miss Awards Ideas Grants (WANMA IG) 2025–26 Program, the Australian Government Research Training Program (RTP) Scholarship and the ECU Stan Perron Foundation Top Up Scholarship funded by the Stan Perron Charitable Foundation Limited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Zheng, Y., Li, T., Wu, Z., Zhu, Y., Guo, Z., & Li, X. (2026). Modifiable risk factors and hearing loss: The National Health and Nutrition Examination Survey 1999–2020. Clinical Otolaryngology. Advance online publication. https://doi.org/10.1111/coa.70153