The Laryngoscope C 2014 The American Laryngological, V
Rhinological and Otological Society, Inc.
The Prevalence of Hearing Loss in South Korea: Data From a Population-Based Study Hyung J. Jun, MD, PhD; Soon Y. Hwang, PhD; Soo H. Lee, MD; Ji E. Lee, MS; Jae-Jun Song, MD, PhD; Sungwon Chae, MD, PhD Objectives/Hypothesis: In the present study, we aimed to determine the prevalence of hearing loss in the South Korean population and to understand the correlation between aging, sex, and hearing loss prevalence through the analysis of data collected from the Korea National Health and Nutrition Examination Survey (KNHANES). Study Design: Cross-sectional epidemiological study. Methods: The KNHANES is an ongoing population study that started in 1998. Examinations to detect diseases of the ear, nose, and throat, including audiological testing and otologic examinations, have been conducted since 2010. We included a total of 18,650 participants in the KNHANES, from 2010 to 2012, in the present study. Pure-tone audiometric testing was conducted in participants aged 12 years. The frequencies tested were 0.5, 1, 2, 3, 4, and 6 kHz. Results: The prevalence of hearing loss in speech-relevant frequencies in the South Korean population was 9.31% for unilateral hearing loss and 13.42% for bilateral hearing loss. The overall hearing loss (unilateral or bilateral) was 22.73%. Male and older participants were more often affected by hearing loss than female and younger participants. High-frequency hearing loss appeared earlier than hearing loss at speech-relevant frequencies, and unilateral hearing loss showed a weaker correlation with aging than bilateral hearing loss. Conclusion: The prevalence of hearing loss in South Korea was higher in men and older participants according to the data collected from the KNHANES. The patterns of hearing loss differed between hearing loss at speech-relevant frequencies and at high frequencies. Key Words: hearing loss, prevalence. Level of Evidence: 2b. Laryngoscope, 125:690–694, 2015
INTRODUCTION Hearing loss is the most common sensory impairment.1 Hearing loss can interfere with the ability to understand speech sounds, leading to difficulties in communication and learning, reduced work productivity, and social isolation. Furthermore, hearing loss can prevent language acquisition in cases of congenital and childhood-onset hearing loss. Any pathologic condition in the auditory pathway (middle ear, cochlea, auditory nerve, brainstem, and auditory cortex in the brain) can cause hearing loss. Various risk factors for hearing loss include noise exposure, gender, ototoxic medications, and aging. Aging is a well-known risk factor that contributes to hearing loss.2–4 Age-related hearing loss, which begins in the third decade of life, initially involves sounds at high frequencies. As the expected lifespans have
From the Department of Otolaryngology–Head and Neck Surgery (H.J.J., S.H.L., J.E.L., J-J.S., S.C.); and the Department of Medical Statistics (S.Y.H.), Korea University College of Medicine, Seoul, Republic of Korea. Editor’s Note: This Manuscript was accepted for publication August 11, 2014. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Sungwon Chae, MD, PhD, Department of Otolaryngology–Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Seoul, South Korea. E-mail: [email protected] DOI: 10.1002/lary.24913
Laryngoscope 125: March 2015
690
increased, aging populations have increased globally.5,6 A greater number of people are expected to develop hearing loss at some point in their lives. Most people born in this century are expected to live 100 years or longer.7 As a result, hearing loss may become a major public health challenge in the future. The determination of the exact prevalence of hearing loss is the first step in public health decision-making. According to results of a questionnaire, the prevalence of hearing loss in South Korea is 11.9%.8 However, no large study incorporating audiometric data has been conducted in South Korea. The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing population study that started in 1998. Examinations to detect diseases of the ear, nose, and throat, including audiological testing and otologic examinations, have been conducted since 2010. The collected information regarding hearing loss will be useful in making decisions about public health screening, prevention of hearing loss, and hearing rehabilitation. In the present study, we aimed to determine the prevalence of hearing loss in the South Korean population and to understand the correlation between aging, sex, and hearing loss prevalence through the analysis of the KNHANES data. We studied not only hearing loss in speech-relevant frequencies, but also high-frequency hearing loss that often precedes hearing loss at speechrelevant frequencies and is more susceptible to ototoxic factors such as noise, ototoxic drugs, and aging. Jun et al.: Prevalence of Hearing Loss in South Korea
TABLE I. Demographic Characteristics of Participants in the Korea National Health and Nutrition Examination Survey (KNHANES). Period of Survey (years)
Total number of participants Sex Male Female Mean age 6 SD Age range
2010–2012
18,650
hearing. The definition of moderate-to-profound hearing loss that we used was similar to one previously described for speechand high-frequency hearing loss. In particular, our classification is similar to the hearing impairment classification of the World Health Organization, with the exception that thresholds at 3 KHz were added when calculating PTA.1
8171 (49.9%)
Statistical Analysis
10479 (50.1%)
All data were analyzed using the survey sample weights assigned to represent the Korean population. We estimated the prevalence and standard error (SE) of unilateral, bilateral, and overall (unilateral or bilateral) hearing loss in the speech-relevant frequencies. The prevalence and SE of unilateral, bilateral, and overall hearing loss by sex and age group were estimated separately. Logistic regression was used to compare the prevalence of hearing loss according to sex and age groups. We calculated the ORs and 95% confidence interval for sex and age groups. The mean and SEs of PTA of speechrelevant frequencies by age groups were estimated. Differences among the age groups for PTA of speech-relevant frequencies were tested using one-way analysis of variance. Statistical analyses were performed using the survey procedure instructions for the SAS 9.3 software (SAS Institute; Cary, NC). P values < 0.05 were considered statistically significant.
46.86 6 18.92 12–97 years
SD 5 standard deviation.
MATERIALS AND METHODS Study Population The KNHANES is an ongoing cross-sectional survey of the general population of South Korea. KNHANES V (2010–2012) is the fifth such survey and contains data from the years 2010 to 2012. KNHANES V used a rolling sample design so that the samples from each year were independent and represented the whole South Korean population. KNHANES V included 11,520 South Korean households. Pure-tone audiometric data were collected for 3 years, from 2010 to 2012.
RESULTS Audiometric Measurement Pure-tone audiometric testing was conducted using a SA 203 audiometer (Entomed; Malm€ o, Sweden). Testing was conducted in a soundproof booth inside a mobile bus reserved for the KNHANES. Otolaryngologists, who had been trained to operate the audiometer, provided instructions to participants and obtained the recordings. All audiometric testing was performed under the supervision of an otolaryngologist. Only air conduction thresholds were measured. Supra-auricular headphones were used in a soundproof booth. The otolaryngologist provided basic instructions to the participant regarding the automated hearing test. Automated testing was programmed according to a modified Hughson-Westlake procedure; it used a single pure tone of 1 to 2 seconds. The lowest level at which the subject responds to 50% of the pure tone was set as the threshold. The automated hearing test involving air-conducted pure tone stimuli showed good test–retest reliability and validity, comparable to the manual pure-tone audio test.9–12 Participants responded by pushing a button when they heard a tone. The results were automatically recorded. All participants were aged 12 years. The frequency ranges tested were 0.5, 1, 2, 3, 4, and 6 kHz.
Definition of Hearing Loss We defined two types of hearing loss for this study. Speech-relevant frequency hearing loss was defined as the pure-tone averages (PTA) of frequencies at 0.5, 1, 2, 3, and 4 kHz at a threshold of 25 decibel hearing level (dBHL). Highfrequency hearing loss was defined as the PTA of frequencies at 3, 4, and 6 kHz at a threshold of 25 dBHL. Moderateto-profound hearing loss was defined as PTA at 40 dBHL hearing level in both speech-relevant frequency and highfrequency hearing loss. We categorized hearing loss as unilateral or bilateral. We defined unilateral hearing loss as hearing loss at a threshold of 25 dBHL in the ear with worse hearing, and bilateral hearing loss as hearing loss at 25 dBHL in the ear with better
Laryngoscope 125: March 2015
The total number of participants in the KNHANES from 2010 to 2012 was 18,650. The mean age of the population was 46.86 6 18.92 years. There were 8,171 male participants (49.9%) and 10,479 female participants (50.1%) (Table I). The prevalence of hearing loss in speech-relevant frequencies in the South Korean population was 9.31% for unilateral hearing loss and 13.42% for bilateral hearing loss. The overall prevalence of hearing loss (unilateral or bilateral) was 22.73% (Table II). The prevalence of unilateral and bilateral hearing loss at high frequencies was 12.38% for unilateral hearing loss and 24.47% for bilateral hearing loss. The overall prevalence of hearing loss (unilateral or bilateral) was 36.85% (Table II). All types of hearing loss, except for unilateral moderate-to-profound hearing loss in speech frequencies, were more prevalent in men than in women (Table III). Men had a greater risk for all types of hearing loss than women (Table IV). The prevalence of bilateral hearing loss increased with age. The prevalence of unilateral hearing loss was highest in participants aged 60 to 69 years for speech-relevant frequencies and in those aged 50 to 59 years for high frequencies. However, the prevalence of unilateral hearing loss decreased in participants aged > 69 years (Table V). The ORs associated with age in bilateral hearing loss for speech and high frequencies were 1.123 and 1.125, respectively. The mean hearing thresholds in the left ear were slightly worse than the mean hearing thresholds in the right ear. The difference between ears was not significant for speech-relevant frequencies (P value 5 0.0569), but was significant for high frequencies (P value < 0.0001)
DISCUSSION To our knowledge, this is the first report regarding the prevalence of various types of hearing loss and risk Jun et al.: Prevalence of Hearing Loss in South Korea
691
TABLE II. The Prevalence of Hearing Loss in South Korea. Hearing Loss in Speech Frequencies (%)
Total (N 5 16,850)
SE of Percent
Hearing Loss in High Frequencies (%)
SE of Percent
Unilateral hearing loss
2018 (9.31)
0.35
2348 (12.38)
0.37
Moderate-to-profound hearing loss Bilateral hearing loss
1425 (5.98) 3501 (13.42)
0.25 0.35
1943 (9.02) 5966 (24.47)
0.29 0.45
Moderate-to-profound hearing loss
1217 (4.45)
0.18
3275 (12.80)
0.33
All hearing loss (unilateral or bilateral)
5519 (22.73)
0.50
8314 (36.85)
0.56
Moderate-to-profound hearing loss (unilateral or bilateral)
2642 (10.43)
0.33
5218 (21.82)
0.44
SE 5 standard error.
factors contributing to hearing loss in the South Korean population. The overall prevalence of hearing loss was 22.73% in participants aged 12 to 97 years. There was a higher prevalence of hearing loss in male and older participants in high frequencies compared with speechrelevant frequencies. These results are consistent with previous studies.2,4,13,14 Men have a higher risk than women for developing hearing loss.2,4,15,16 In the present study, men had higher rates of hearing loss than women for all types of hearing loss except unilateral moderateto-profound hearing loss. There was no significant difference between men and women with regard to unilateral moderate-to-profound hearing loss in speech frequencies. Generally, a weaker association was found in men having unilateral hearing loss compared with bilateral hearing loss. The explanation for the increased prevalence of hearing loss in men may be due to their greater likelihood of exposure to ototoxic insult, such as from occupational and recreational noise and lifestyle factors (smoking and alcohol consumption). Most explanations pertain to extrinsic factors, although there have been
studies of intrinsic factors contributing to the different rate of hearing loss in men and women. Otoacoustic emissions were decreased in men compared with women.17,18 Otoacoustic emissions decreased to a greater extent with age in male mice compared with female mice in a study using a mouse model of aging.19 Estrogen has been suggested as an otoprotective hormone. One study reported that women showed an elevated hearing threshold following hysterectomy and oophorectomy.20 The results of this and other studies suggest that the differences in hearing loss according to sex might be partly due to intrinsic factors. Aging is a well-known risk factor contributing to hearing loss. The prevalence of unilateral and bilateral hearing loss showed different patterns. In cases of bilateral hearing loss, the prevalence of hearing loss at both speech-relevant and high frequencies increased according to the age group. The prevalence of unilateral hearing loss presented a different pattern—an increase up to a certain age group and then a decrease. The prevalence of hearing loss in speech-relevant frequencies increased
TABLE III. Comparison of the Prevalence of Hearing Loss Between Men and Women. n 5 18,650
Men (%)
SE of Percent
Women (%)
SE of Percent
P Value
Speech frequency Unilateral hearing loss Moderate-to-profound hearing loss (unilateral) Bilateral hearing loss Moderate-to-profound hearing loss (bilateral) All hearing loss (unilateral or bilateral) Moderate-to-profound hearing loss (unilateral or bilateral)
949 (9.99)
0.46
1,069 (8.63)
0.41
0.0073
705 (6.32) 1,872 (15.11)
0.34 0.47
720 (5.64) 1,629 (11.73)
0.30 0.41
0.0786
Rhinological and Otological Society, Inc.
The Prevalence of Hearing Loss in South Korea: Data From a Population-Based Study Hyung J. Jun, MD, PhD; Soon Y. Hwang, PhD; Soo H. Lee, MD; Ji E. Lee, MS; Jae-Jun Song, MD, PhD; Sungwon Chae, MD, PhD Objectives/Hypothesis: In the present study, we aimed to determine the prevalence of hearing loss in the South Korean population and to understand the correlation between aging, sex, and hearing loss prevalence through the analysis of data collected from the Korea National Health and Nutrition Examination Survey (KNHANES). Study Design: Cross-sectional epidemiological study. Methods: The KNHANES is an ongoing population study that started in 1998. Examinations to detect diseases of the ear, nose, and throat, including audiological testing and otologic examinations, have been conducted since 2010. We included a total of 18,650 participants in the KNHANES, from 2010 to 2012, in the present study. Pure-tone audiometric testing was conducted in participants aged 12 years. The frequencies tested were 0.5, 1, 2, 3, 4, and 6 kHz. Results: The prevalence of hearing loss in speech-relevant frequencies in the South Korean population was 9.31% for unilateral hearing loss and 13.42% for bilateral hearing loss. The overall hearing loss (unilateral or bilateral) was 22.73%. Male and older participants were more often affected by hearing loss than female and younger participants. High-frequency hearing loss appeared earlier than hearing loss at speech-relevant frequencies, and unilateral hearing loss showed a weaker correlation with aging than bilateral hearing loss. Conclusion: The prevalence of hearing loss in South Korea was higher in men and older participants according to the data collected from the KNHANES. The patterns of hearing loss differed between hearing loss at speech-relevant frequencies and at high frequencies. Key Words: hearing loss, prevalence. Level of Evidence: 2b. Laryngoscope, 125:690–694, 2015
INTRODUCTION Hearing loss is the most common sensory impairment.1 Hearing loss can interfere with the ability to understand speech sounds, leading to difficulties in communication and learning, reduced work productivity, and social isolation. Furthermore, hearing loss can prevent language acquisition in cases of congenital and childhood-onset hearing loss. Any pathologic condition in the auditory pathway (middle ear, cochlea, auditory nerve, brainstem, and auditory cortex in the brain) can cause hearing loss. Various risk factors for hearing loss include noise exposure, gender, ototoxic medications, and aging. Aging is a well-known risk factor that contributes to hearing loss.2–4 Age-related hearing loss, which begins in the third decade of life, initially involves sounds at high frequencies. As the expected lifespans have
From the Department of Otolaryngology–Head and Neck Surgery (H.J.J., S.H.L., J.E.L., J-J.S., S.C.); and the Department of Medical Statistics (S.Y.H.), Korea University College of Medicine, Seoul, Republic of Korea. Editor’s Note: This Manuscript was accepted for publication August 11, 2014. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Sungwon Chae, MD, PhD, Department of Otolaryngology–Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Seoul, South Korea. E-mail: [email protected] DOI: 10.1002/lary.24913
Laryngoscope 125: March 2015
690
increased, aging populations have increased globally.5,6 A greater number of people are expected to develop hearing loss at some point in their lives. Most people born in this century are expected to live 100 years or longer.7 As a result, hearing loss may become a major public health challenge in the future. The determination of the exact prevalence of hearing loss is the first step in public health decision-making. According to results of a questionnaire, the prevalence of hearing loss in South Korea is 11.9%.8 However, no large study incorporating audiometric data has been conducted in South Korea. The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing population study that started in 1998. Examinations to detect diseases of the ear, nose, and throat, including audiological testing and otologic examinations, have been conducted since 2010. The collected information regarding hearing loss will be useful in making decisions about public health screening, prevention of hearing loss, and hearing rehabilitation. In the present study, we aimed to determine the prevalence of hearing loss in the South Korean population and to understand the correlation between aging, sex, and hearing loss prevalence through the analysis of the KNHANES data. We studied not only hearing loss in speech-relevant frequencies, but also high-frequency hearing loss that often precedes hearing loss at speechrelevant frequencies and is more susceptible to ototoxic factors such as noise, ototoxic drugs, and aging. Jun et al.: Prevalence of Hearing Loss in South Korea
TABLE I. Demographic Characteristics of Participants in the Korea National Health and Nutrition Examination Survey (KNHANES). Period of Survey (years)
Total number of participants Sex Male Female Mean age 6 SD Age range
2010–2012
18,650
hearing. The definition of moderate-to-profound hearing loss that we used was similar to one previously described for speechand high-frequency hearing loss. In particular, our classification is similar to the hearing impairment classification of the World Health Organization, with the exception that thresholds at 3 KHz were added when calculating PTA.1
8171 (49.9%)
Statistical Analysis
10479 (50.1%)
All data were analyzed using the survey sample weights assigned to represent the Korean population. We estimated the prevalence and standard error (SE) of unilateral, bilateral, and overall (unilateral or bilateral) hearing loss in the speech-relevant frequencies. The prevalence and SE of unilateral, bilateral, and overall hearing loss by sex and age group were estimated separately. Logistic regression was used to compare the prevalence of hearing loss according to sex and age groups. We calculated the ORs and 95% confidence interval for sex and age groups. The mean and SEs of PTA of speechrelevant frequencies by age groups were estimated. Differences among the age groups for PTA of speech-relevant frequencies were tested using one-way analysis of variance. Statistical analyses were performed using the survey procedure instructions for the SAS 9.3 software (SAS Institute; Cary, NC). P values < 0.05 were considered statistically significant.
46.86 6 18.92 12–97 years
SD 5 standard deviation.
MATERIALS AND METHODS Study Population The KNHANES is an ongoing cross-sectional survey of the general population of South Korea. KNHANES V (2010–2012) is the fifth such survey and contains data from the years 2010 to 2012. KNHANES V used a rolling sample design so that the samples from each year were independent and represented the whole South Korean population. KNHANES V included 11,520 South Korean households. Pure-tone audiometric data were collected for 3 years, from 2010 to 2012.
RESULTS Audiometric Measurement Pure-tone audiometric testing was conducted using a SA 203 audiometer (Entomed; Malm€ o, Sweden). Testing was conducted in a soundproof booth inside a mobile bus reserved for the KNHANES. Otolaryngologists, who had been trained to operate the audiometer, provided instructions to participants and obtained the recordings. All audiometric testing was performed under the supervision of an otolaryngologist. Only air conduction thresholds were measured. Supra-auricular headphones were used in a soundproof booth. The otolaryngologist provided basic instructions to the participant regarding the automated hearing test. Automated testing was programmed according to a modified Hughson-Westlake procedure; it used a single pure tone of 1 to 2 seconds. The lowest level at which the subject responds to 50% of the pure tone was set as the threshold. The automated hearing test involving air-conducted pure tone stimuli showed good test–retest reliability and validity, comparable to the manual pure-tone audio test.9–12 Participants responded by pushing a button when they heard a tone. The results were automatically recorded. All participants were aged 12 years. The frequency ranges tested were 0.5, 1, 2, 3, 4, and 6 kHz.
Definition of Hearing Loss We defined two types of hearing loss for this study. Speech-relevant frequency hearing loss was defined as the pure-tone averages (PTA) of frequencies at 0.5, 1, 2, 3, and 4 kHz at a threshold of 25 decibel hearing level (dBHL). Highfrequency hearing loss was defined as the PTA of frequencies at 3, 4, and 6 kHz at a threshold of 25 dBHL. Moderateto-profound hearing loss was defined as PTA at 40 dBHL hearing level in both speech-relevant frequency and highfrequency hearing loss. We categorized hearing loss as unilateral or bilateral. We defined unilateral hearing loss as hearing loss at a threshold of 25 dBHL in the ear with worse hearing, and bilateral hearing loss as hearing loss at 25 dBHL in the ear with better
Laryngoscope 125: March 2015
The total number of participants in the KNHANES from 2010 to 2012 was 18,650. The mean age of the population was 46.86 6 18.92 years. There were 8,171 male participants (49.9%) and 10,479 female participants (50.1%) (Table I). The prevalence of hearing loss in speech-relevant frequencies in the South Korean population was 9.31% for unilateral hearing loss and 13.42% for bilateral hearing loss. The overall prevalence of hearing loss (unilateral or bilateral) was 22.73% (Table II). The prevalence of unilateral and bilateral hearing loss at high frequencies was 12.38% for unilateral hearing loss and 24.47% for bilateral hearing loss. The overall prevalence of hearing loss (unilateral or bilateral) was 36.85% (Table II). All types of hearing loss, except for unilateral moderate-to-profound hearing loss in speech frequencies, were more prevalent in men than in women (Table III). Men had a greater risk for all types of hearing loss than women (Table IV). The prevalence of bilateral hearing loss increased with age. The prevalence of unilateral hearing loss was highest in participants aged 60 to 69 years for speech-relevant frequencies and in those aged 50 to 59 years for high frequencies. However, the prevalence of unilateral hearing loss decreased in participants aged > 69 years (Table V). The ORs associated with age in bilateral hearing loss for speech and high frequencies were 1.123 and 1.125, respectively. The mean hearing thresholds in the left ear were slightly worse than the mean hearing thresholds in the right ear. The difference between ears was not significant for speech-relevant frequencies (P value 5 0.0569), but was significant for high frequencies (P value < 0.0001)
DISCUSSION To our knowledge, this is the first report regarding the prevalence of various types of hearing loss and risk Jun et al.: Prevalence of Hearing Loss in South Korea
691
TABLE II. The Prevalence of Hearing Loss in South Korea. Hearing Loss in Speech Frequencies (%)
Total (N 5 16,850)
SE of Percent
Hearing Loss in High Frequencies (%)
SE of Percent
Unilateral hearing loss
2018 (9.31)
0.35
2348 (12.38)
0.37
Moderate-to-profound hearing loss Bilateral hearing loss
1425 (5.98) 3501 (13.42)
0.25 0.35
1943 (9.02) 5966 (24.47)
0.29 0.45
Moderate-to-profound hearing loss
1217 (4.45)
0.18
3275 (12.80)
0.33
All hearing loss (unilateral or bilateral)
5519 (22.73)
0.50
8314 (36.85)
0.56
Moderate-to-profound hearing loss (unilateral or bilateral)
2642 (10.43)
0.33
5218 (21.82)
0.44
SE 5 standard error.
factors contributing to hearing loss in the South Korean population. The overall prevalence of hearing loss was 22.73% in participants aged 12 to 97 years. There was a higher prevalence of hearing loss in male and older participants in high frequencies compared with speechrelevant frequencies. These results are consistent with previous studies.2,4,13,14 Men have a higher risk than women for developing hearing loss.2,4,15,16 In the present study, men had higher rates of hearing loss than women for all types of hearing loss except unilateral moderateto-profound hearing loss. There was no significant difference between men and women with regard to unilateral moderate-to-profound hearing loss in speech frequencies. Generally, a weaker association was found in men having unilateral hearing loss compared with bilateral hearing loss. The explanation for the increased prevalence of hearing loss in men may be due to their greater likelihood of exposure to ototoxic insult, such as from occupational and recreational noise and lifestyle factors (smoking and alcohol consumption). Most explanations pertain to extrinsic factors, although there have been
studies of intrinsic factors contributing to the different rate of hearing loss in men and women. Otoacoustic emissions were decreased in men compared with women.17,18 Otoacoustic emissions decreased to a greater extent with age in male mice compared with female mice in a study using a mouse model of aging.19 Estrogen has been suggested as an otoprotective hormone. One study reported that women showed an elevated hearing threshold following hysterectomy and oophorectomy.20 The results of this and other studies suggest that the differences in hearing loss according to sex might be partly due to intrinsic factors. Aging is a well-known risk factor contributing to hearing loss. The prevalence of unilateral and bilateral hearing loss showed different patterns. In cases of bilateral hearing loss, the prevalence of hearing loss at both speech-relevant and high frequencies increased according to the age group. The prevalence of unilateral hearing loss presented a different pattern—an increase up to a certain age group and then a decrease. The prevalence of hearing loss in speech-relevant frequencies increased
TABLE III. Comparison of the Prevalence of Hearing Loss Between Men and Women. n 5 18,650
Men (%)
SE of Percent
Women (%)
SE of Percent
P Value
Speech frequency Unilateral hearing loss Moderate-to-profound hearing loss (unilateral) Bilateral hearing loss Moderate-to-profound hearing loss (bilateral) All hearing loss (unilateral or bilateral) Moderate-to-profound hearing loss (unilateral or bilateral)
949 (9.99)
0.46
1,069 (8.63)
0.41
0.0073
705 (6.32) 1,872 (15.11)
0.34 0.47
720 (5.64) 1,629 (11.73)
0.30 0.41
0.0786
