Howard Hoffman

National Institutes of Health | NIH · Epidemiology and Statistics Program, Division of Scientific Programs, NIDCD, NIH

Studies have observed neurodevelopmental (ND) challenges among young children perinatally HIV-exposed yet uninfected (CHEU) with in utero antiretroviral (ARV) exposure, without clear linkage to specific ARVs. Atazanavir (ATV) boosted with ritonavir has been a preferred protease inhibitor recommended for pregnant women, yet associations of ATV with...

Background: To collect and compare selected hearing measures in a pilot study of young adults with perinatally-acquired HIV (YAPHIV), and those with perinatal HIV-exposure, who are uninfected (YAPHEU). Setting: Cross-sectional hearing measures in YAPHIV and YAPHEU enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol...

Objective: This study's objective was determining whether gap detection deficits are present in a longstanding cohort of people living with HIV (PLWH) compared to those living without HIV (PLWOH) using a new gap detection modelling technique (i.e. fitting gap responses using the Hill equation and analysing the individual gap detection resulting cu...

Hearing loss is one of the top contributors to years lived with disability and is a risk factor for dementia. Molecular evidence on the cellular origins of hearing loss in humans is growing. Here, we performed a genome-wide association meta-analysis of clinically diagnosed and self-reported hearing impairment on 723,266 individuals and identified 4...

Importance Prenatal smoking is a known modifiable risk factor for stillbirth; however, the contribution of prenatal drinking or the combination of smoking and drinking is uncertain. Objective To examine whether prenatal exposure to alcohol and tobacco cigarettes is associated with the risk of stillbirth. Design, Setting, and Participants The Safe...

We identified associations between cigarette-smoking and taste function in the U.S. NHANES 2013-2014. Adults ≥40 years (n=2849, nearly half former or current smokers) rated whole-mouth and tongue-tip bitter (1mM quinine) and salt (1M NaCl, 0.32 M NaCl) intensities and reported smoking history (pack years, PY), dependence (time to first cigarette, T...

Prenatal exposures to alcohol (PAE) and tobacco (PTE) are known to produce adverse neonatal and childhood outcomes including damage to the developing auditory system. Knowledge of the timing, extent, and combinations of these exposures on effects on the developing system is limited. As part of the physiological measurements from the Safe Passage St...

Objectives To identify associations of self-reported olfactory dysfunction (OD) with attributes of diet quality in a nationally-representative sample of US adults. Methods In this cross-sectional study, we utilized self-reported taste and smell, and dietary data collected from participants 40 years and older (n = 6356) in the NHANES 2011–2014. In...

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews...

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews...

Objective: To determine if middle-aged and aging men and women with HIV disease (HIV+) should be screened for vestibular and oculomotor dysfunction. Methods: Age- and sociodemographically matched HIV+ and HIV- men and women were tested on vestibular evoked myogenic potential (VEMP), bi-thermic caloric testing, Dix-Hallpike maneuvers and saccades...

The most recent WHO estimate suggests that approximately 466 million people (or 6.1% of the world’s population) were living with disabling hearing loss in 2018.3 This estimate is projected to rise to 630 million by 2030 and to over 900 million by 2050. Approximately 90% of people with moderate to profound hearing impairment reside in low- and middl...

Background: Sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality. Although the rate has plateaued, any unexpected death of an infant is a family tragedy thus finding causes and contributors to risk remains a major public health concern. The primary objective of this investigation was to determine patterns of drinking...

Purpose The purpose of this study was to compare Words-in-Noise (WIN) data between young adults with perinatal HIV (PHIV) infection and those with PHIV exposure but uninfected (PHEU) and to evaluate associations between antiretroviral therapy (ART) exposures and WIN data. Method The WIN test and cognitive function were assessed in participants of...

Objectives: Small studies have suggested an association between vertigo and psychiatric comorbidity. The purpose of this study is to evaluate the associations between vertigo and cognitive and psychiatric conditions among a large sample of U.S. children. Methods: We conducted a cross-sectional analysis of the 2012 National Health Interview Surve...

Previous research has shown that genes play a substantial role in determining a person’s susceptibility to age-related hearing impairment. The existing studies on this subject have different results, which may be caused by difficulties in determining the phenotype or the limited number of participants involved. Here, we have gathered the largest sa...

Introduction Although most US adults drink alcoholic beverages, little is known about the association between drinking and taste. We hypothesized that the ability to distinguish differing intensities of bitter and salt solutions would be poorer among drinkers than nondrinkers. Methods We used cross-sectional data from 4990 participants aged 40+ fr...

We examined associations of olfactory dysfunction with anthropometric and cardiometabolic measures in a nationally representative sample of US adults. In the 2013-2014 National Health and Nutrition Examination Survey (NHANES), 3,815 participants, 40 years and older, completed a standardized taste and smell protocol, which consisted of an 8-item odo...

Objectives: To estimate birth prevalence of congenital cytomegalovirus (cCMV) in HIV-exposed uninfected children born in the current era of combination antiretroviral therapy and describe cCMV-related neurodevelopmental and hearing outcomes. Study design: The Surveillance Monitoring for ART Toxicities cohort study follows HIV-exposed uninfected...

Background: In 1989-1991, a population-based cohort of every Missouri birth weighing < 1500 g was identified over a 16-month period. Infants born moderately low birth weight (MLBW, 1500-2499 g) and normal birth weight (NBW, ≥ 2500 g), were matched to < 1500 g infants by delivery date, race, maternal age, and residence. Aims: To compare outcomes...

Objectives: To assess the associations between smell function and adiposity and cardiometabolic measures in a nationally representative sample of US adults. Methods: In the 2013-2014 NHANES, 3527 adults ≥40 years, completed the NHANES Taste and Smell Exam. Smell function was assessed with an 8-item odor identification test. Participants smelled...

Background The prevalence of congenital cytomegalovirus infection (cCMV) at birth is 0.5%–1% in the United States. Most cCMV newborns are asymptomatic at birth with 10%–15% subsequently developing sequelae, such as hearing loss. Higher cCMV prevalence (2.5%–11.4%) is reported in infants born to HIV-infected women, associated with maternal immune su...

Objectives/Hypothesis To investigate factors associated with hearing impairment (HI) in adolescent youths during the period 1966–2010. Study Design Cross‐sectional analyses of US sociodemographic, health, and audiometric data spanning 5 decades. Methods Subjects were youths aged 12 to 17 years who participated in the National Health Examination S...

Introduction: Hearing loss is a worldwide societal and public health concern. Globally, disabling hearing loss affects 538 million adults (men, 12.2%; women, 9.8%). This study examined the prevalence and risk factors associated with deafness or serious difficulty hearing in two nationally representative surveys. Methods: Data were analyzed in 20...

In recent years, there has been increased awareness and prevention efforts toward reducing concussion incidence. Previous research has most often estimated the prevalence of concussions among youth using medical claims data (1–4). In the 2016 National Health Interview Survey (NHIS), parents or guardians answered questions about whether their childr...

Background: Perinatally HIV-exposed but uninfected (HEU) children have elevated risk of late language emergence at age 1 year, with possible links to in utero antiretroviral (ARV) exposure. We investigated possible risks for speech impairments (SI) and language impairments (LI) in preschool monolingual HEU children in the United States. Methods:...

Introduction Population-based studies show inconsistent effects of cigarette smoking on olfactory function. We aimed to identify direct and indirect associations between measures of smoking exposure/nicotine dependence and altered olfaction in a nationally-representative sample of adults. Methods NHANES 2011–2014 (n=7,418) participants (mean age=5...

Background: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years l...

Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study...

In Reply We thank Dr Fuller-Thomson for her suggestion. Prior publications have found associations between hearing impairment (HI) and blood lead levels (BLL) and cadmium.¹,2 If associations exist, it is unknown what proportion of HI in the population may be attributable to lead and/or cadmium or other heavy metals. Heavy metal exposures co-occur w...

Prenatal alcohol exposure (PAE) has been linked to poor pregnancy outcomes, yet there is no recognized standard for PAE assessment, and the specific effects of quantity, frequency, and timing remain largely unknown. The Safe Passage Study was designed to investigate the role of PAE in a continuum of poor peri- and postnatal outcomes.

Introduction: The 2016 National Academies of Sciences report "Hearing Health Care for Adults: Priorities for Improving Access and Affordability" included a call to action for government agencies to strengthen efforts to collect, analyze, and disseminate population-based data on hearing loss in adults. Methods: CDC analyzed the most recent availa...

Objective: Variation in taste perception and exposure to risk factors of taste alterations have been independently linked with elevated adiposity. Using a laboratory database, taste-adiposity associations were modeled and examined for whether taste functioning mediates the association between taste-related risk factors and adiposity. Methods: He...

Errata for corrected authorship, affiliations and funding statements.

Background: The Prenatal Alcohol and Sudden Infant Death Syndrome and Stillbirth Network, known as the "Safe Passage Study," enrolled approximately 12,000 pregnant women from the United States and South Africa and followed the development of their babies through pregnancy and the infant's first year of life to investigate the role of prenatal alco...

Importance: As the US population ages, effective health care planning requires understanding the changes in prevalence of hearing loss. Objective: To determine if age- and sex-specific prevalence of adult hearing loss has changed during the past decade. Design, setting, and participants: We analyzed audiometric data from adults aged 20 to 69 y...

Background Language impairment (LI) risk is increased for perinatally acquired human immunodeficiency virus-infected (PHIV) and perinatally exposed to HIV but uninfected (PHEU) youth. This study evaluates the persistence of LI in these groups. Methods The Clinical Evaluation of Language Fundamentals was repeated on participants of the Pediatric HI...

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in contex...

Supplementary appendix

Objectives/Hypothesis To study the prevalence and usefulness of audiometric notches in the diagnosis of noise‐induced hearing loss (NIHL). Study Design Audiograms and data on noise exposure from 23,297 men and 26,477 women, aged 20 to 101 years, from the Nord‐Trøndelag Hearing Loss Study, 1996–1998. Methods The prevalence of four types of audiome...

Aim: The aim was to examine risk factors for hearing impairment among Hispanic/Latino adults with diabetes. Methods: Findings are based on 3384 participants aged 18–76 years with diagnosed or previously undetected diabetes who completed audiometric testing as part of the Hispanic Community Health Study/Study of Latinos. We defined hearing impairmen...

Objectives: Pressure equalization tube (PET) placement (also referred to as tympanostomy tube placement) is among the most common ambulatory surgical procedures performed on U.S. children. Over twenty years ago, differences by race/ethnicity in the national prevalence of having had PETs placed were documented. Whether these differences persist is...

The purpose of this study was to compare various speech audiometry measures between HIV+ and HIV− adults and to further evaluate the association between speech audiometry and HIV disease variables in HIV+ adults only. Three hundred ninety-six adults from the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS) completed spe...

The U.S. NHANES included chemosensory assessments in the 2011–2014 protocol. We provide an overview of this protocol and 2012 olfactory exam findings. Of the 1818 NHANES participants aged ≥40 years, 1281 (70.5 %) completed the exam; non-participation mostly was due to time constraints. Health technicians administered an 8-item, forced-choice, odor...

Objectives: Falls and fall-related injuries are a major public health concern. HIV-infected adults have been shown to have a high incidence of falls. Identification of major risk factors for falls that are unique to HIV infection or similar to those in the general population will inform development of future interventions for fall prevention. Met...

Study objective: Sleep apnea (SA) may promote hearing impairment (HI) through ischemia and inflammation of the cochlea. Our objective was to assess an independent association between SA and HI in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants. Methods: We used data from the HCHS/SOL, a multicenter population-based s...

Objective: To study national prevalence of dizziness and balance problems in US children and explore associated risk factors and patterns of healthcare utilization. Study design: A multistage, nationally representative, probability sample of children (n = 10 954; aged 3-17 years) was examined based on the 2012 National Health Interview Survey Ch...

Perinatal HIV infection and congenital cytomegalovirus (CMV) infection may increase the risk for hearing loss. We examined 1,435 infants enrolled in the Surveillance Monitoring of ART Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study (PHACS) network, a prospective study of the safety of in utero antiretroviral (ARV) exposures. We det...

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity...

Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generat...

Purpose: To determine whether adults, aged 66-96 years, with exfoliation syndrome (XFS)/exfoliation glaucoma (XFG), or primary open-angle glaucoma (POAG) have poorer hearing than controls of similar age. Methods: Case (XFS/XFG and POAG) and control status was diagnosed in the Reykjavik Glaucoma Studies (RGS) using slit-lamp examination, visual f...

Importance The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies.Objectives To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss.Design, Setting, and Partici...

Chemosensory problems challenge health through diminished ability to detect warning odors, consume a healthy diet, and maintain quality of life. We examined the prevalence and associated risk factors of self-reported chemosensory alterations in 3603 community-dwelling adults (aged 40+ years), from the nationally representative, US National Health a...

Introduction: Mobility is reduced in people with sensory impairments and those with arthritis. The combined impact of these conditions may be underappreciated. This study examines the associations between impairments in vision, hearing, and balance and functional ability in adults with versus without arthritis. Methods: Using National Health and...

The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individua...

Age is typically the most significant determinant of hearing loss (5,6). Among U.S. adults in 2014, self-reported hearing loss was most prevalent among adults aged 70 and over (43.2%), compared with adults aged 40-69 (19.0%) and aged 18-39 (5.5%). Age-related hearing loss is often overlooked due to its deceptively slow progression, lack of attentio...

Background: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 18...

Introduction The US NHANES 2011–2014 protocol includes a taste and smell questionnaire (CSQ) in home-based interviews and brief assessments in mobile exam centers. We report the short- and longer-term test–retest reliability and validity of this protocol against broader chemosensory measures. Methods A convenience sample of 73 adults (age = 39.5 ±...

Nearly 8% of children aged 3-17 years had a communication disorder during the past 12 months. • Children aged 3-6 years, boys, and non-Hispanic black children were more likely than other children to have had any communication disorder. • Approximately 55% of children aged 3-17 years who had any communication disorder received an intervention servic...

Hearing impairment is common in adults, but few studies have addressed it in the US Hispanic/Latino population. To determine the prevalence of hearing impairment among US Hispanic/Latino adults of diverse backgrounds and determine associations with potential risk factors. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a populati...

Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview S...