[Skip to Content]
[Skip to Content Landing]
Views 1,868
Citations 0
Original Investigation
May 2018

Self-reported Hearing Difficulty and Risk of Accidental Injury in US Adults, 2007 to 2015

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of California Irvine, Irvine
  • 2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2018;144(5):413-417. doi:10.1001/jamaoto.2018.0039
Key Points

Question  Is hearing difficulty associated with risk of accidental injuries?

Findings  This cross-sectional analysis of National Health Interview Survey data found that, of the 6.6 million US adults who experienced accidental injuries annually between 2007 and 2015, approximately 1 in 6 considered their hearing to be less than “excellent” or “good.” Risk of accidental injuries increased with degree of self-perceived hearing difficulty, with those with “a lot of trouble” hearing being twice as likely to have incurred an accidental injury.

Meaning  Hearing difficulty is associated with an increased risk of accidental injuries.


Importance  Accidental injuries are a leading cause of morbidity and mortality in the United States. Hearing problems may be associated with an increased risk for such injuries.

Objective  To investigate associations between hearing difficulty and risk of accidental injuries among US adults.

Design, Setting, and Participants  Cross-sectional analysis of responses of a nationally representative sample of 232.2 million individuals 18 years or older who participated in the National Health Interview Survey from 2007 to 2015 and responded to the questions related to the hearing and injury modules.

Main Outcomes and Measures  The main outcome variable was accidental injury in the preceding 3 months. Hearing status was self-reported as “excellent,” “good,” “a little trouble,” “moderate trouble,” “a lot of trouble,” and “deaf.” Prevalence of accidental injuries was analyzed based on demographic characteristics and hearing status. Odds ratios (ORs) and 95% CIs for injuries adjusted for demographics were calculated for degrees of hearing difficulty. A secondary outcome was association of hearing status with type of injury and was classified as driving related, work related, or leisure/sport related.

Results  Of 232.2 million US adults, 120.2 million (51.7%) were female, and 116.3 million (50.1%) considered their hearing to be less than excellent. Accidental injuries occurred in 2.8% of survey respondents. In comparison with normal-hearing adults (those with self-rated excellent or good hearing), the odds of accidental injury were higher in those with a little trouble hearing (4.1%; OR, 1.6; 95% CI, 1.5-1.8), moderate trouble hearing (4.2%; OR, 1.7; 95% CI, 1.4-1.9), and a lot of trouble hearing (4.8%; OR, 1.9; 95% CI, 1.6-2.3). Work- and leisure-related injuries were more prevalent among those with self-perceived hearing difficulty. Multivariate analysis, adjusted for age and sex, revealed leisure-related injuries was most consistently associated with various degrees of hearing difficulty. Odds ratios were 1.2 (95% CI, 1.0-1.4) in those with a little trouble hearing, 1.4 (95% CI, 1.1-1.9) in those with moderate trouble hearing, and 1.5 (95% CI, 1.1-2.2) in those with a lot of trouble hearing.

Conclusions and Relevance  Hearing difficulty is significantly associated with accidental injury, especially injury related to work or leisure. Increased awareness about hearing difficulty and its proper screening and management may assist in decreasing accidental injury.