Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Data Extraction and Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Literature Search
3.2. Characteristics of the Included Studies
3.3. Association between Current Smokers and Risk of NIHL
3.4. Association between Former Smokers and Risk of NIHL
3.5. Subgroup Analyses
3.6. Dose-Response Analysis
3.7. Sensitivity Analysis and Publication Bias
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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First Author and Year | Country | n | Mean Age/Age Range | Gender | Smoking Information | Diagnostic Criteria of NIHL | Adjusting or Matching Variables | Quality Assessment |
---|---|---|---|---|---|---|---|---|
Cohort study | ||||||||
Dement, 2018 [11] | USA | 4275 | 59.2 | Both | Never smoked, Past smoker, Current smoker, Smoking | Index weighted average threshold >25 dB at 1, 2, 3, and 4 kHz | Age, race, sex, organic solvent exposure, duration of trade work, loud or very loud noise exposure, hypertension | 8 |
Pettersson, 2014 [30] | Sweden | 184 | NA | Male | Smoker, Non-smoker | >30 dB at 0.5 kHz or >25 dB at 1–2 kHz and >25 dB for at least one of the frequencies of 3, 4, 6 kHz | VWF in the right hand, age, exposure | 8 |
Li, 2008 [47] | China | 408 | 26.5 | Both | Smoking number per day: 0, −10, 10–20, >20 | Hearing any tone >25 dB | Cumulative noise exposure (CNE) | 6 |
Burr, 2005 [40] | Denmark | 1237 | 18–59 | Both | Never, past, currently <15 g/day, currently ≥15 g/day | Question: ‘Do you have reduced hearing to such an extent that you feel it is difficult to follow a conversation between several people without using a hearing aid?’ | Gender, age and smoking stratified by occupational noise exposure | 7 |
Case-control study | ||||||||
Jiao, 2017 [19] | China | Case 286/control 286 | 40.2 | Both | Smoker, Non-smoker | Average hearing threshold ≥40 dB at 3, 4, 6 kHz | Gender, age, job category and time of exposure to noise | 7 |
Jeffree, 2016 [28] | Malaysia | Case 49/control 98 | 41.3 | Male | Smoking in pack-years: 0, 1–10, 11–20, >20 | Average audibility threshold ≥25 dB at 0.5, 1, 2, 3 kHz | Daily noise dose, duration of services, HPD used frequency, perception about HPD | 8 |
Cross-sectional study | ||||||||
Wang,2017 [10] | China | 11,196 | 67.1 | Both | Smoking in pack-years: 0, 0–25, >25 | Average audibility threshold ≥25 dB at 0.5, 1, 2, 4 kHz in both ears | Age, sex, race, shift work, occupational noise exposure, drinking status, hypertension, ototoxicity medicine, chronic diseases (diabetes mellitus, coronary heart disease, myocardial infarction and stroke) | 10 |
Sari, 2017 [12] | Indonesia | 122 | 18–40 | Male | Smoker, Non-smoker | Average hearing threshold >25 dB at 0.5, 1, 2, 4 kHz | NA | 6 |
Sriopas, 2017 [13] | Thailand | 180 | 20–50 | NA | Pack-years smoking: <10, ≥10 | Average threshold >25 dB at 3, 4, 6, 8 kHz | Noise exposure level, employment duration, age, factory group, job position, and education level/noise exposure level, and education level | 8 |
Win, 2015 [29] | Brunei | 543 | 35.6 | Both | Smoker, Non-smoker | Hearing loss of >25 dB at 4 kHz | NA | 7 |
Sun, 2014 [45] | China | 471 | 39.8 | Male | Smoker, Non-smoker | Hearing any tone at 0.5, 1, 2 KHz >25 dB or average hearing threshold ≥40 dB at 3, 4, 6 kHz | Age, alcohol | 9 |
Ferrite, 2013 [31] | Brazil | 364 | 33.9 | Female | Never smoked, Past smoker, Current smoker | Average threshold >25 dB at 0.5, 1, 2, 3, 4 kHz in the worse ear | Age, job type, solvent exposure and high blood pressure | 10 |
Tao, 2013 [32] | China | 517 | 37.9 | Male | Smoker, Non-smoker | Hearing threshold >40 dB at 4 kHz in the worse ear | Age, CNE | 8 |
Shen, 2013 [46] | China | 495 | 40.6 | Male | Smoker, Non-smoker | Average hearing threshold >40 dB at 3, 4, 6 kHz | Age, alcohol | 8 |
Nasir, 2012 [33] | Malaysia | 358 | 31.9 | Both | Smoker, Non-smoker | Average hearing threshold ≥25 dB at 0.5, 1, 2, 3 kHz | Age, job type, Service duration, exposure duration, exposure to explosion, exposure to vibration | 9 |
Shrestha, 2011 [7] | Nepal | 110 | 29.8 | Both | Smoker, Non-smoker | Average hearing loss >25 dB at 1, 2, 3 KHz | NA | 6 |
Mohammadi, 2010 [34] | Iran | 622 | 42.1 | Male | Smoker, Non-smoker; Smoking in pack-years: 0, <20, ≥20 | Average audibility threshold ≥25 dB at 0.5, 1, 2, 3 kHz | Age, duration of exposure | 9 |
Attarchi, 2010 [35] | Iran | 478 | 33.5 | Male | Smoker, Non-smoker; Smoking in pack-years: 0, ≤8, >8 | Hearing threshold differences ≥30 dB between 4 KHz and 1 KHz in both ears | Age, duration of exposure | 8 |
Chang, 2009 [36] | China | 75 | 42.4 | Male | Smoker, Non-smoker | Average hearing loss >25 dB at 0.5, 1, and 2 kHz | Exposure status, age, tea or coffee, physical activity, BMI | 8 |
Pouryaghoub, 2007 [37] | Iran | 412 | 42.1 | Male | Smoking in pack-years: 0, ≤10, >10 | Hearing threshold >25 dB at 4 KHz in the better ear | Age, duration of exposure | 8 |
Rachiotis, 2006 [38] | Greece | 145 | 40.3 | Both | Smoker, Non-smoker | Average threshold ≥25 dB at 4 KHz | Sex, age, occupational exposure to waste, duration of employment | 8 |
Dement, 2005 [39] | USA | 2469 | 56.6 | Both | Smoker, Non-smoker | Index weighted average threshold >25 dB at 1, 2, 3, and 4 kHz | Age, race, and gender | 9 |
Nomura, 2005 [41] | Japan | 163 | 21–66 | Male | Never smoked, Past smoker, Current smoker | Hearing loss >40 dB at 4 kHz | NA | 7 |
Fortunato, 2004 [42] | Italy | 94 | 43 | Male | Smokers in cigarettes/day: ≤10, >10 | Hearing any tone >25 dB | PON2 (S/C) and SOD2 IVS3-23 T/Gmand IVS3-60 T/G polymorphisms, age | 8 |
Palmer, 2004 [20] | Britain | 2232 | 16–64 | Both | Never smoked, Past smoker, Current smoker | Question: ‘‘How well can you hear a person who is talking to you when he is sitting on your right [left] side in a quiet room?’’. | age, sex, and self report of frequent | 8 |
Mizoue, 2003 [43] | Japan | 1386 | NA | Male | cigarettes/day: 0, 1–14, 15–24, ≥25 | Hearing threshold >25 dB at 1 KHz and threshold > 40 dB at 4 KHz | Age | 8 |
Barone, 1987 [44] | USA | 1210 | 35.4 | Male | Never smoked, Past smoker, Current smoker | Average hearing loss >25 dB at 1,2,3 KHz with a 5:1 weighting of the better to poorer ear | Age, years of present job | 9 |
Subgroup | Number of Studies | Pooled OR | 95% CI | P Value for Q Test | I2 (%) |
---|---|---|---|---|---|
Study design | |||||
Cohort | 4 | 1.19 | 1.10–1.28 | 0.504 | 0 |
Case-control | 3 | 2.25 | 1.59–3.19 | 0.418 | 0 |
Cross-sectional | 22 | 2.21 | 1.74–2.81 | <0.001 | 89 |
Gender | |||||
Both | 13 | 1.50 | 1.28–1.76 | <0.001 | 68 |
Male | 14 | 3.05 | 1.90–4.89 | <0.001 | 92 |
Female | 1 | 1.52 | 1.03–2.27 | - | - |
Mean age | |||||
<40 | 11 | 2.18 | 1.51–3.14 | <0.001 | 86 |
≥40 | 16 | 2.03 | 1.59–2.61 | <0.001 | 89 |
Race | |||||
Mongoloid | 16 | 1.88 | 1.50–2.36 | <0.001 | 76 |
Caucasian | 12 | 2.41 | 1.70–3.42 | <0.001 | 93 |
others | 1 | 1.52 | 1.03–2.27 | - | - |
Quality of studies | |||||
High quality | 24 | 2.14 | 1.73–2.64 | <0.001 | 88 |
Moderate quality | 5 | 1.91 | 1.05–3.45 | <0.001 | 82 |
Number of adjusting variables | |||||
0 | 4 | 1.58 | 0.86–2.90 | <0.001 | 79 |
≥1 | 25 | 2.18 | 1.77–2.69 | <0.001 | 88 |
Publication year | |||||
<2010 | 12 | 2.27 | 1.53–3.34 | <0.001 | 87 |
≥2010 | 17 | 1.90 | 1.53–2.36 | <0.001 | 87 |
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Li, X.; Rong, X.; Wang, Z.; Lin, A. Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies. Int. J. Environ. Res. Public Health 2020, 17, 1201. https://doi.org/10.3390/ijerph17041201
Li X, Rong X, Wang Z, Lin A. Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies. International Journal of Environmental Research and Public Health. 2020; 17(4):1201. https://doi.org/10.3390/ijerph17041201
Chicago/Turabian StyleLi, Xiaowen, Xing Rong, Zhi Wang, and Aihua Lin. 2020. "Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies" International Journal of Environmental Research and Public Health 17, no. 4: 1201. https://doi.org/10.3390/ijerph17041201