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Environ Health Perspect. 2017 Jun 8;125(6):067003. doi: 10.1289/EHP565.

Environmental Exposures to Lead, Mercury, and Cadmium and Hearing Loss in Adults and Adolescents: KNHANES 2010-2012.

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Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
Gachon Advanced Institute for Health Sciences and Technology, Incheon, Republic of Korea
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA



The prevalence of hearing loss increases rapidly with aging. Hearing loss is common in all age groups, even in young adults and adolescents. A growing body of evidence has suggested that heavy metals have ototoxic effects, yet few epidemiological studies have investigated the association between heavy metals and hearing loss in a general population that includes adults and adolescents.


We examined the association between environmental exposures to lead, mercury, and cadmium and the risk of hearing loss in adults and adolescents while controlling for potential confounding factors, including noise exposures and clinical factors.


We analyzed cross-sectional data from 5,187 adults and 853 adolescents in the Korean National Health and Nutrition Examination Survey 2010-2012. Pure-tone average (PTA) of hearing thresholds at high frequency (3, 4, and 6 kHz) were computed, and hearing loss was defined as a PTA>25 dB in adults and PTA>15 dB in adolescents.


In adults, the highest (vs. lowest) quartiles of blood lead and cadmium were associated with 1.70 (95% CI: 1.25, 2.31) and 1.47 (95% CI: 1.05, 2.05) odds ratios for high-frequency hearing loss (p-trend<0.001 and=0.007), respectively. In adolescents, the highest quartile (vs. lowest) of blood cadmium had an odds ratio of 3.03 (95% CI: 1.44, 6.40) for high-frequency hearing loss (p-trend=0.003), but blood lead was not associated with hearing loss. No significant association between blood mercury and hearing loss was suggested in either adults or adolescents.


The results of the present study suggest that exposure to environmental lead and cadmium in adults and exposure to environmental cadmium in adolescents may play a role in the risk of hearing loss.

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