Analgesic Use and the Risk of Hearing Loss in Men

Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
The American journal of medicine (Impact Factor: 5). 03/2010; 123(3):231-7. DOI: 10.1016/j.amjmed.2009.08.006
Source: PubMed


Hearing loss is a common sensory disorder, yet prospective data on potentially modifiable risk factors are limited. Regularly used analgesics, the most commonly used drugs in the US, may be ototoxic and contribute to hearing loss.
We examined the independent association between self-reported professionally diagnosed hearing loss and regular use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen in 26,917 men aged 40-74 years at baseline in 1986. Study participants completed detailed questionnaires at baseline and every 2 years thereafter. Incident cases of new-onset hearing loss were defined as those diagnosed after 1986. Cox proportional hazards multivariate regression was used to adjust for potential confounding factors.
During 369,079 person-years of follow-up, 3488 incident cases of hearing loss were reported. Regular use of each analgesic was independently associated with an increased risk of hearing loss. Multivariate-adjusted hazard ratios of hearing loss in regular users (2+ times/week) compared with men who used the specified analgesic <2 times/week were 1.12 (95% confidence interval [CI], 1.04-1.20) for aspirin, 1.21 (95% CI, 1.11-1.33) for NSAIDs, and 1.22 (95% CI, 1.07-1.39) for acetaminophen. For NSAIDs and acetaminophen, the risk increased with longer duration of regular use. The magnitude of the association was substantially higher in younger men. For men younger than age 50 years, the hazard ratio for hearing loss was 1.33 for regular aspirin use, 1.61 for NSAIDs, and 1.99 for acetaminophen.
Regular use of aspirin, NSAIDs, or acetaminophen increases the risk of hearing loss in men, and the impact is larger on younger individuals.

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    • "Further, OTC medications are portrayed as less harmful, not addictive, safe alternatives to prescription medications . Despite the appearance of relative harmlessness, however, serious risks such as hearing loss (Curhan et al., 2010) or liver injury (Larson et al., 2005) are associated with their long-term use. In 2007, for example, the CDC estimated that acetaminophen was the leading cause of over 1600 cases of acute liver failure in the US (Larson et al., 2005). "
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    • " high frequency hearing loss , and alterations of perceived sounds . Salicylates act as com - petitive inhibitors of Cl - anions at the anion - binding site of prestin , the motor protein of the outer hair cell . Reg - ular use of aspirin , non - steroidal antiinflammatory drugs ( NSAIDs ) , and acetaminophen / paracetamol may cause hearing loss ( Curhan et al . , 2010 ) . Aseptic ibuprofen - induced meningitis , often recurrent , may occur with therapeutic doses , especially in patients with an autoimmune connective tissue disorder . It presents as an acute meningeal or meningoencephalopathic syn - drome , sometimes with focal neurologic signs ( Agus et al . , 1990 ) . The cerebrospinal fluid shows e"
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    • "This negative development is particularly pronounced in young people, in agreement with recent audiometric investigations [4,5], and in women [3]. Why the age-specific prevalence would be increasing is unknown, but potential contributing factors are use of personal listening devices [6-8], diabetes [9,10], cardiovascular disease [11,12], common analgesic drugs [13], distress [14,15], and higher demands of communication skills in modern society, which possibly has led to a higher awareness of hearing difficulties [16]. However, other studies indicate that the age-specific prevalence is instead decreasing [17-19], possibly as a result of better medical management of middle-ear disease in childhood [20] and a reduction in occupational noise-induced hearing loss due to the introduction of hearing conservation programs and a decrease of total employment in manufacturing [21]. "
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