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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    ABSTRACT: BackgroundHearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth.MethodsA cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20–64 years participating in Statistics Sweden’s annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis.ResultsHearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference.ConclusionsHearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women.
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