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Original Investigation
September 2017

Prevalence of Hearing Loss in US Children and Adolescents: Findings From NHANES 1988-2010

Author Affiliations
  • 1Department of Head & Neck Surgery, University of California–Los Angeles, Los Angeles
  • 2School of Medicine, University of California–San Francisco, San Francisco
  • 3Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco
JAMA Otolaryngol Head Neck Surg. 2017;143(9):920-927. doi:10.1001/jamaoto.2017.0953
Key Points

Questions  How has prevalence of hearing loss in US children and adolescents changed from 1988 to 2010, and are changes associated with risk factors such as noise exposures?

Findings  In this analysis of nationally representative US surveys, there was no overall change in prevalence of hearing loss, and no consistent associations were identified between hearing loss and noise exposures. In the most recent survey cycle, racial/ethnic minorities and those from low socioeconomic backgrounds were at increased risk of hearing loss.

Meaning  Long-term monitoring of this population is needed to further understand relationships between hearing loss, noise exposures, and minority and low-income groups.


Importance  There have been concerns about increasing levels of hearing impairment in children and adolescents, especially in relation to noise exposure, because even mild levels of hearing loss can affect educational outcomes.

Objective  To further characterize changes in prevalence of hearing loss and noise exposures in the US pediatric population over time.

Design, Setting, and Participants  This is a retrospective analysis of demographic and audiometric data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994), NHANES 2005-2006, NHANES 2007-2008, and NHANES 2009-2010. The NHANES are nationally representative survey data sets collected and managed by the US National Center for Health Statistics, and this study includes a total of 7036 survey participants ages 12 to 19 years with available audiometric measurements.

Exposures  Hearing-related behaviors and risk factors such as history of ear infections, noise exposures, firearm use, and hearing protection use.

Main Outcomes and Measures  Level of hearing loss measured by pure-tone audiometry, as well as high-frequency and low-frequency hearing loss and noise-induced threshold shifts.

Results  Overall, data from 7036 survey participants ages 12 to 19 years with available audiometric measurements were analyzed. The prevalence of hearing loss increased from NHANES III to NHANES 2007-2008 (17.0% to 22.5% for >15 dB hearing loss; absolute difference, 5.5%; 95% CI, 6.1%-10.3%) but decreased in the NHANES 2009-2010 to 15.2% (absolute difference, 7.2%; 95% CI, 2.0%-12.4%) with no significant overall secular trend identified. There was an overall rise in exposure to loud noise or music through headphones 24 hours prior to audiometric testing from NHANES III to NHANES 2009-2010. However, noise exposure, either prolonged or recent, was not consistently associated with an increased risk of hearing loss across all surveys. The most recent survey cycle showed that nonwhite race/ethnicity and low socioeconomic status are independent risk factors for hearing loss.

Conclusions and Relevance  This analysis did not identify significant changes in prevalence of hearing loss in US youth ages 12 to 19 years over this time period despite increases in reported noise exposures. No consistent associations were shown between noise exposure and hearing loss, though there was an association between racial/ethnic minority status and low socioeconomic status and increased risk of hearing loss. Ongoing monitoring of hearing loss in this population is necessary to elucidate long-term trends and identify targets for intervention.