中国与美国青少年听力损失：基于GBD 1990-2023和NHANES 2005-2020的趋势、社会经济差异与噪声暴露
Adolescent Hearing Loss in China and the United States: Trends, Socioeconomic Disparities, and Noise Exposure From GBD 1990-2023 and NHANES 2005-2020.
文献信息
| PMID | 42828005 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lei Zhang |
| 作者单位 | Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA Beijing China. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 基于全球疾病负担研究（GBD）1990-2023年中国数据以及美国国家健康与营养调查（NHANES）2005-2020数据，本研究系统分析了青少年听力损失的流行病学趋势和主要危险因素，并探讨了社会人口发展、噪声暴露和社会经济状况对听力健康的影响。
方法： 从GBD 2023数据库中提取中国10-19岁人群听力损失患病率、伤残调整生命年（DALYs）以及职业噪声归因负担的数据。采用Joinpoint回归计算估计年度百分比变化（EAPC），并检验社会人口指数（SDI）与听力损失患病率之间的关系。同时，对美国12-19岁青少年（2005-2020年）的NHANES数据应用加权logistic回归模型，以评估噪声暴露、家庭收入和教育水平与听力损失风险之间的关联。
结果： 1990年至2023年，中国青少年听力损失患病率呈持续上升趋势（EAPC=0.83%），男性高于女性。SDI与听力损失负担呈显著负相关（β=-3.231，P<0.001），尽管这种保护效应在较高SDI水平时趋于平台。职业噪声归因的DALY率显著下降，从1990年的每10万人口17.35降至2023年的每10万人口12.23。NHANES结果表明，每日噪声暴露显著增加听力损失风险（OR=1.24，95% CI：1.01-1.51），而较高的家庭收入-贫困比（OR=0.87，95% CI：0.82-0.93）和较高的教育程度（OR=0.65，95% CI：0.43-0.97）具有保护作用。性别分层分析显示，男性更易发生噪声诱导的听力损失（男性OR=1.39；女性OR=1.05）。
结论： 青少年听力健康受社会经济状况、教育和噪声的影响。虽然职业噪声负担已经下降，但娱乐性和环境噪声可能构成新出现的威胁。因此，加强监测、开展学校教育和噪声管理应作为公共卫生优先事项。
证据等级： 2。
英文摘要
OBJECTIVES: Drawing on data from the Global Burden of Disease (GBD) 1990-2023 for China and the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2020, this study systematically analyzed the epidemiological trends and major risk factors for adolescent hearing loss, and explored the effects of sociodemographic development, noise exposure, and socioeconomic conditions on hearing health.
METHODS: Data on hearing loss prevalence, disability-adjusted life years (DALYs), and occupational noise-attributable burden for Chinese aged 10-19 years were extracted from the GBD 2023 database. Joinpoint regression was used to calculate the estimated annual percentage change (EAPC) and examine the relationship between the Sociodemographic Index (SDI) and hearing loss prevalence. In parallel, weighted logistic regression models were applied to NHANES data from U.S. adolescents aged 12-19 years (2005-2020) to assess the associations of noise exposure, household income, and education level with the risk of hearing loss.
RESULTS: From 1990 to 2023, the prevalence of hearing loss among Chinese adolescents showed a sustained increase (EAPC = 0.83%), with higher rates observed in males than in females. The SDI was significantly and inversely associated with hearing loss burden (β = -3.231, P < 0.001), although the protective effect plateaued at higher SDI levels. The DALY rate attributable to occupational noise declined markedly, from 17.35 per 100,000 population in 1990 to 12.23 per 100,000 population in 2023. NHANES results indicated that daily noise exposure significantly increased the risk of hearing loss (OR = 1.24, 95% CI:1.01-1.51), whereas a higher family income-to-poverty ratio (OR = 0.87, 95% CI:0.82-0.93) and higher educational attainment (OR = 0.65, 95% CI:0.43-0.97) exerted protective effects. Sex-stratified analysis revealed that males were more susceptible to noise-induced hearing loss (male OR = 1.39; female OR = 1.05).
CONCLUSION: Adolescent hearing health is shaped by socioeconomic status, education, and noise. While occupational noise burden has fallen, recreational and environmental noise may represent emerging threats. Accordingly, strengthened surveillance, school-based education, and noise management are warranted as public health priorities.
LEVEL OF EVIDENCE: 2.