Hearing loss in relation to sound exposure of professional symphony orchestra musicians.

OBJECTIVES: The objectives of this study were to: (1) estimate the hearing status of classical symphony orchestra musicians and (2) investigate the hypothesis that occupational sound exposure of symphony orchestra musicians leads to elevated hearing thresholds. DESIGN: The study population comprised all the musicians from five symphony orchestras. Questionnaires were filled in by 337 subjects, and 212 subjects performed an audiometric test. For a group of 182 musicians (363 ears) the results of the audiometry was analyzed in relation to the individual exposure, which was estimated on the basis of sound measurements and questionnaire data regarding the exposure time. The mean hearing threshold at the frequencies 3, 4, and 6 kHz, corrected for age and sex, was used as outcome. RESULTS: The musician ears with the highest exposure (29 of 363) had an additional threshold shift of 6.3 dB compared with the 238 ears with lowest exposure. The observed hearing loss of musicians was smaller compared with the noise-induced permanent threshold shift (NIPTS) predicted from ISO1999. A remaining confounding effect of age after ISO7029 age corrections could be observed to explain the difference in observed and predicted NIPTS. However, the observed hearing loss difference between the left and the right ear of musicians was 2.5 dB (95% confidence interval 1.5-3.6), which was similar to the NIPTS predicted from ISO1999. Most of the musicians had better hearing at 3, 4, and 6 kHz for age than expected, however, 29 ears with the highest exposure above 90.4 dBA with a mean exposure time of 41.7 years had significantly elevated hearing thresholds. Trumpet players and the left ear of first violinists had significantly elevated hearing thresholds compared with other musicians. CONCLUSION: Most of the symphony orchestra musicians had better hearing than expected but they had a work-related risk of developing additional noise-induced hearing loss. The additional NITPS of the left ear compared with the right ear was at the expected level based on the cumulated sound exposure and ISO1999, indicating that performing music may induce hearing loss to the same extent as industrial noise.

Auditory Profile-Based Hearing Aid Fitting: Self-Reported Benefit for First-Time Hearing Aid Users.

Background: Although hearing aids (HAs) can compensate for reduced audibility, functional outcomes and benefits vary widely across individuals. As part of the Danish 'Better hEAring Rehabilitation' (BEAR) project, four distinct auditory profiles differing in terms of audiometric thresholds and supra-threshold hearing abilities were recently identified. Additionally, profile-specific HA-fitting strategies were proposed. The aim of the current study was to evaluate the self-reported benefit of these profile-based HA fittings in a group of new HA users. Methods: A total of 205 hearing-impaired older adults were recruited from two Danish university hospitals. Participants were randomly allocated to one of two treatment groups: (1) NAL-NL2 gain prescription combined with default advanced feature settings ('reference fitting') or (2) auditory profile-based fitting with tailored gain prescription and advanced feature settings ('BEAR fitting'). Two months after treatment, the participants completed the benefit version of the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12-B) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. Results: Overall, participants reported a clear benefit from HA treatment. However, no significant differences in the SSQ12-B or IOI-HA scores between the reference and BEAR fittings were found. Conclusion: First-time users experience clear benefits from HA treatment. Auditory profile-based HA fitting warrants further investigation.

Adapting to New Hearing Aids and Hearing Aid Adjustments in Adult Danish Users.

PURPOSE: This study was aimed at understanding the effect of time taken to adapt to the new hearing aids (HAs) and the timeline of HA adjustments performed over more than a year of rehabilitation on self-reported HA outcomes. METHOD: A self-report of the time it took to get accustomed to the new HAs and adjustment of the HAs during a year of rehabilitation collected from 690 HA users using a nonstandardized questionnaire were analyzed. The abbreviated version of the Speech, Spatial, and Quality of Hearing questionnaire and the International Outcome Inventory for Hearing Aids were used as the self-reported HA outcome. RESULT: Out of 690 participants, 442 (64%) got accustomed to HAs within 2 months. Ninety-one participants (13%) did not get accustomed to the HAs at all, out of which 74 (81%) were first-time HA users. Eighty-four participants (12%) did not receive any HA adjustments after their initial fitting, and 49 (7%) had their HAs adjusted four or more times during the 1 year of rehabilitation. Three hundred ninety (57%) participants got their HA adjusted only at the 2-month follow-up visit, showing the intent to adjust given an opportunity. The stepwise multiple linear regression results showed the significant impact of getting accustomed to the HA and having HA adjusted at multiple instances on the self-reported HA outcomes. CONCLUSION: This study showed the importance of getting accustomed to the HA and having a minimal number of adjustments to have a better long-term self-reported HA outcome.

Sudden Sensorineural Hearing Loss Following Immunization With BNT162b2 or mRNA-1273: A Danish Population-Based Cohort Study.

OBJECTIVE: To compare the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) to the occurrence among unvaccinated individuals. STUDY DESIGN: Cohort study. SETTING: Nationwide Danish health care registers comprised all Danish residents living in Denmark on October 1, 2020, who were 18 years or older or turned 18 in 2021. METHODS: We compared the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) (first, second, or third dose) against unvaccinated person time. Secondary outcomes were a first-ever hospital diagnosis of vestibular neuritis and a hearing examination, by an ear-nose-throat (ENT) specialist, followed by a prescription of moderate to high-dose prednisolone. RESULTS: BNT162b2 or mRNA-1273 vaccine was not associated with an increased risk of receiving a discharge diagnosis of sudden sensorineural hearing loss (adjusted hazard ratio [HR]: 0.99, confidence interval [CI]: 0.59-1.64) or vestibular neuritis (adjusted HR: 0.94, CI: 0.69-1.24). We found a slightly increased risk (adjusted HR: 1.40, CI, 1.08-1.81) of initiating moderate to high-dose oral prednisolone following a visit to an ENT specialist within 21 days from receiving a messenger RNA (mRNA)-based Covid-19 vaccine. CONCLUSION: Our findings do not suggest an increased risk of sudden sensorineural hearing loss or vestibular neuritis following mRNA-based COVID-19 vaccination. mRNA-Covid-19 vaccination may be associated with a small excess risk of a visit to an ENT specialist visit followed by a prescription of moderate to high doses of prednisolone.

Self-Reported Hearing-Aid Use Patterns in an Adult Danish Population.

The retrospective reporting of users' hearing aid (HA) usage can provide insight into individualized HA usage patterns. Understanding these HA usage patterns can help to provide a tailored solution to meet the usage needs of HA users. This study aims to understand the HA usage pattern in daily-life situations from self-reported data and to examine its relationship to self-reported outcomes. A total of 1537 participants who responded to questions related to situations where they always took off or put on the HAs were included in the study. A latent class analysis was performed to stratify the HA users according to their HA usage pattern. The results showed distinct usage patterns in the latent classes derived for both scenarios. The demographics, socio-economic indicators, hearing loss, and user-related factors were found to impact HA usage. The results showed that the HA users who reported using the HAs all the time (regular users) had better self-reported HA outcomes than situational users, situational non-users, and non-users. The study explained the underlying distinct HA usage pattern from self-reported questionnaires using latent class analysis. The results emphasized the importance of regular use of HAs for a better self-reported HA outcome.

Confidence Limits of Word Identification Scores Derived Using Nonlinear Quantile Regression.

The relation between degree of sensorineural hearing loss and maximum speech identification scores (PBmax) is commonly used in audiological diagnosis and rehabilitation. It is important to consider the relation between the degree of hearing loss and the lower boundary of PBmax, as the PBmax varies largely between subjects at a given degree of hearing loss. The present study determines the lower boundary by estimating the lower limit of the one-tailed 95% confidence limit (CL) for a Dantale I, word list, in a large group of young and older subjects with primarily sensorineural hearing loss. PBmax scores were measured using Dantale I, at 30 dB above the speech reception threshold or at the most comfortable level from 1,961 subjects with a wide range of pure-tone averages. A nonlinear quantile regression approach was applied to determine the lower boundary (95% CL) of PBmax scores. At a specific pure-tone average, if the measured PBmax is poorer than the lower boundary (95% CL) of PBmax, it may be considered disproportionately poor.