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Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies

by Xiaowen Li 1, Xing Rong 2, Zhi Wang 2,* and Aihua Lin 1,3,*
1
Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
2
The Institute of Occupational and Environmental Health, Guangzhou Medical University, 1 Tianqiang St., Huangpu West Ave., Guangzhou 510620, China
3
Department of Health Service and Management, Xinhua College of Sun Yat-sen University, Guangzhou 510520, China
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(4), 1201; https://doi.org/10.3390/ijerph17041201
Received: 7 January 2020 / Revised: 9 February 2020 / Accepted: 10 February 2020 / Published: 13 February 2020
The purpose of this study was to synthesize the results of previously published observational studies through meta-analysis to clarify the association between smoking and noise-induced hearing loss (NIHL). We searched several databases as of October 2019. Based on the results of heterogeneity analysis (Q statistic and I2 statistic), a fixed effect model (for no heterogeneity; Q test P > 0.1 and I2 ≤ 50%) or a random effects model (for heterogeneity) was used to calculate the pooled odds ratios (ORs). We explored the potential dose-response relationship between smoking and NIHL as well. In total, 27 studies involving 30,465 participants were included. Compared with non-smokers, the pooled OR of current smokers was 2.05 (95% Confidence interval (CI): 1.71–2.46), and of former smokers was 1.11 (95% CI: 1.05–1.18). We found a curve linear association between an increasing number of pack-years (packages/day × smoking years) and risk of NIHL. The dose-response meta-analysis suggested that when the number of pack-years was less than fifteen, the risk of NIHL was increasing, and the highest combined OR was 5.25 (95% CI: 2.30–11.96) for pack-years of fifteen. After fifteen pack-years, the pooled OR had a slow decline. Our study indicated that smoking is a risk factor for NIHL. Current smokers have a higher risk than former smokers, and there is a positive dose-response relationship between smoking and NIHL. View Full-Text
Keywords: noise-induced hearing loss; smoking; meta-analysis; dose-response relationship noise-induced hearing loss; smoking; meta-analysis; dose-response relationship
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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.

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