Newborn screening is the practice of testing every newborn for certain harmful or potentially fatal conditions, such as hearing loss and certain genetic, endocrine, and metabolic disorders that typically are not otherwise apparent at birth. Newborn screening in the United States began in the 1960s. Universal newborn screening has become a well-established, state-based, public health system involving education, screening, diagnostic follow-up, treatment and management, and system monitoring and evaluation. Each year, >98% of approximately 4 million newborns in the United States are screened. Through early identification, newborn screening provides an opportunity for treatment and significant reductions in morbidity and mortality.

The Noise Control Act of 19721 directed the Environmental Protection Agency (EPA) to protect the health and welfare of Americans from unregulated noise and formed the EPA Office of Noise Abatement and Control (ONAC). In 1974, ONAC recommended an equivalent sound exposure level of 70 decibels over a 24-hour period to protect the public from hearing loss.2 At that time, ONAC also recommended levels regarding interference or annoyance of 55 and 45 decibels for outside and inside activities, respectively. In 1982, ONAC was defunded, transferring the primary responsibility of regulating noise to state and local governments. An analysis of 491 U.S. noise ordinances in 20163 revealed most communities used multiple standards to regulate noise exposure including nuisance, zoning, audibility decibel levels, time of day and distance.

For nearly five decades, the Centers for Disease Control and Prevention (CDC) has | researched noise-induced hearing loss (NIHL) in the workplace and disseminated that | research through the National Institute for Occupational Safety and Health (NIOSH) to | prevent occupational hearing loss.In 2015, CDC received inquiries from the public and the | medical community about NIHL in non-workplace settings. To address these issues, CDC | formed an unfunded intra-agency workgroup within the National Center for Environmental | Health (NCEH). This small workgroup, comprised of audiologists, scientists, and health | educators from NCEH, NIOSH, and the National Center on Birth Defects and Development | Disorders, gathers evidence and creates educational resources to increase awareness and | promote the prevention of NIHL from exposures at home and in the community

Nearly one in four (24.4%) U.S. adults aged 20-69 years show evidence of noise-induced hearing loss (1). Among those reporting exposure to noise outside of work, 19.9% showed possible noise-induced hearing loss. Exposure to non-job-related noise can be substantial (2). Loud music from personal listening devices and entertainment venues might place more than 1 billion teenagers and young adults at risk for hearing loss worldwide (3). Early noise exposure might increase the risk for age-related hearing loss later in life (4). CDC analyzed data from the 2022 FallStyles survey (conducted by Porter Novelli via the Ipsos' KnowledgePanel) on U.S. adult perceptions regarding preventing hearing loss from amplified music at venues or events. More than one half of U.S. adults agreed with one or more of the following protective actions: limiting sound levels, posting warning signs, and using hearing protection when music at such events reaches potentially hazardous levels. Hearing and other health professionals can make use of existing materials available from the World Health Organization (WHO), CDC, and other professional organizations to raise awareness about noise risks and promote protective behaviors.

Almost all noise-induced hearing loss (NIHL) is preventable. However, once acquired, NIHL is permanent and irreversible. In addition to hearing loss, evidence shows that prolonged or repeated exposure to high levels of noise is associated with other health effects, such as heart disease, hypertension, and insomnia. 1 The World Health Organization (WHO) 2 and the United Nations Environmental Programme (UNEP) 3 attest that exposure to loud sounds (noises) adversely affects the lives of millions of people at home, at work, and in the community. If just 20% of NIHL was prevented among working-age individuals, $123 billion could be obtained from increased earnings, an economic impact excluding costs associated with health care, special education, and reduced quality of life. 4 Noise is the most common modifiable environmental cause of hearing loss among young and middle-aged adults, and the most common self-reported cause of hearing loss among men. 5

Almost all noise-induced hearing loss (NIHL) is preventable. However, once acquired, NIHL is permanent and irreversible. In addition to hearing loss, evidence shows that prolonged or repeated exposure to high levels of noise is associated with other health effects, such as heart disease, hypertension, and insomnia. 1 The World Health Organization (WHO) 2 and the United Nations Environmental Programme (UNEP) 3 attest that exposure to loud sounds (noises) adversely affects the lives of millions of people at home, at work, and in the community. If just 20% of NIHL was prevented among working-age individuals, $123 billion could be obtained from increased earnings, an economic impact excluding costs associated with health care, special education, and reduced quality of life. 4 Noise is the most common modifiable environmental cause of hearing loss among young and middle-aged adults, and the most common self-reported cause of hearing loss among men. 5

Loud restaurant noise can be a barrier to communication and enjoyment of a dining experience and might increase the risk for adverse health effects among patrons and employees. In addition to adversely affecting the subjective quality of the dining experience, environments that require a person to raise their voice to be understood an arm's length distance suggest an ambient sound level sufficient to create a risk for noise-induce hearing loss.

Noise-induced hearing loss (NIHL) is a substantial, often unrecognized, health problem. Various learning environments and activities in school settings are loud. Researchers have reported the prevalence of NIHL among U.S. adolescents ranging between 12.8% and 17.5%, suggesting that one in every six to eight middle and high school students (aged 12-19 years) has measurable hearing loss likely resulting from excessive noise exposure (1). Evidence suggests that even mild levels of hearing loss negatively affect auditory perception and cognitive skills.* CDC analyzed data from a sample of 817 youths aged 12-17 years who responded to the web-based YouthStyles survey in 2020. The survey measured the frequency of exposure to loud noise in school settings, the provision of hearing protection devices (HPDs) during exposure, and whether prevention techniques were part of their educational curriculum. Approximately three in four teenage students reported being exposed to loud sound at school, and nearly one half (46.5%) of respondents reported exposure to loud sounds at school on a regular basis. A majority of students (85.9%) reported that their school did not provide HPDs during classes or activities where they were exposed to loud sounds, and seven out of 10 reported they were never taught how to protect their hearing. Increasing youth's awareness about the adverse health effects of excessive noise exposure and simple preventive measures to reduce risk can help prevent or reduce NIHL. Health care providers and educators have resources and tools available to prevent NIHL among school-aged children. Increased efforts are needed to promote prevention.

Hearing loss (HL) is the third most common chronic physical condition in the United States. Obesity has become an increasingly important public health concern, as the prevalence in children, adolescents and adults has increased over the past few decades. The objectives of this study is to investigate whether obesity is associated with audiometric notches indicative of noise-induced hearing loss (NIHL), speech frequency hearing loss (SFHL), and high frequency hearing loss (HFHL) in adolescent participants of the National Health and Nutrition Examination Survey 2007-2010. The prevalence of overall audiometric notches in the adolescent population was 16.0% with higher prevalence in females than males. The prevalence of SFHL and HFHL were higher in males than females (SFHL, 7.3% vs. 5.4%, respectively; and HFHL 14.3% vs. 8.1%, respectively). Obese adolescents had a higher adjusted OR to have audiometric notches (OR = 1.93; 95% CI: 1.33-2.81) and HFHL (OR = 1.95; 95% CI: 1.19-3.21). Continued preventative efforts towards reducing obesity might also help to reduce the risk for HL and NIHL.

Tens of millions of U.S. residents have a range of adverse health outcomes caused by noise exposure (1). During 2011-2012, 21 million U.S. adults who reported no exposure to loud or very loud noise at work exhibited hearing damage suggestive of noise-induced hearing loss (2). In addition to the known risk for hearing damage, nonauditory adverse health outcomes and health risks from excessive environmental sound exposure can include effects on the cardiovascular system, metabolism, blood pressure, body weight, cognition, sleep, mental health, quality of life, and overall well-being (1,3,4). CDC analyzed a representative sample of the U.S. adult population (aged >/=18 years) from a 2018 national marketing survey (50 states and the District of Columbia) that included questions about use of hearing protection devices (HPDs) (e.g., ear plugs or ear muffs) during recreational exposure to loud athletic and entertainment events; approximately 8% of respondents reported consistent use of an HPD at these types of events. Among those adults more likely to wear an HPD, 63.8% had at least some college education, and 49.1% had higher income levels. Women and older adults were significantly less likely to use HPDs. These findings suggest a need to strengthen a public health focus on the adverse health effects of excessive noise exposure at home and in recreational settings as well as a need for continued efforts to raise public awareness about the protective value of HPDs.

BACKGROUND: Depression is a common and significant health problem. Hearing loss is the third most common chronic physical condition in the USA and might be a factor in depression. To determine whether hearing loss is associated with depressive symptoms in US adults ages 20-69 years. METHODS: National Health and Nutrition Examination Survey (NHANES) data (2011-2012) were used to assess the potential relationship between hearing loss and depression, in adults (20-69 years) who answered the Patient Health Questionnaire (PHQ-9) depression screening module, with pure tone audiometry measurements, and complete information on the co-variates data (n = 3316). The degree of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were defined as slight/mild hearing loss 26-40 dB; moderate/worse hearing loss 41 dB by pure tone audiometry examination. RESULTS: Moderate/worse HFHL was statistically significantly associated with depressive symptoms (OR 1.54, 95% CL 1.04-2.27) when the analyses were conducted among all participants. Further stratification by gender and age groups found that moderate/worse HFHL (OR 3.85, 95% CL 1.39-10.65) and moderate/worse SFHL (OR 5.75, 95% CL 1.46-22.71) were associated with depressive symptoms in women ages 52-69 years. CONCLUSIONS: Moderate/worse speech frequency and HFHL are associated with depression in women ages 52-69 years, independent of other risk factors. Hearing screenings are likely to reduce delays in diagnosis and provide early opportunities for noise prevention counseling and access to hearing aids. Health professionals should be aware of depressive signs and symptoms in patients with hearing loss.

The article discusses the relationship between exposure to hazardous substances in the environment and their impact on human health and how to protect public health. Topics mentioned include a hearing loss campaign launched by the U.S. Centers for Disease Control and Prevention in February 2017, the National Health and Nutrition Examination Survey, and the 1999 Guidelines for Community Noise by the World Health Organization.

Globally, one in three adults has some level of measurable hearing loss, and 1.1 billion young persons are at risk for hearing loss attributable to noise exposure. Although noisy occupations such as construction, mining, and manufacturing are primary causes of hearing loss in adults, nonoccupational noise also can damage hearing. Loud noises can cause permanent hearing loss through metabolic exhaustion or mechanical destruction of the sensory cells within the cochlea. Some of the sounds of daily life, including those made by lawn mowers, recreational vehicles, power tools, and music, might play a role in the decline in hearing health. Hearing loss as a disability largely depends on a person's communication needs and how hearing loss affects the ability to function in a job. The loss of critical middle and high frequencies can significantly impair communication in hearing-critical jobs (e.g., law enforcement and air traffic control).

The Centers for Disease Control and Prevention (CDC) has conducted more than 40 years of research, providing guidelines to help reduce risks of noise-induced hearing loss in the workplace. In 2015, CDC received public and medical community inquiries on the topic of hearing loss related to noise in non-occupational settings. In 2016, the 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. In response to the information gap about the effect of noise in homes and communities, CDC instigated research efforts and participated in activities to raise awareness that excessive exposure to loud sounds outside of the working environment can cause permanent hearing damage, which can occur any time in life. Noise-induced hearing loss is a preventable health condition that can be avoided by using relatively easy measures.

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 available data collected both by questionnaire and audiometric tests of adult participants aged 20-69 years in the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to determine the presence of audiometric notches indicative of noise-induced hearing loss. Prevalence of both unilateral and bilateral audiometric notches and their association with sociodemographics and self-reported exposure to loud noise were calculated. RESULTS: Nearly one in four adults (24%) had audiometric notches, suggesting a high prevalence of noise-induced hearing loss. The prevalence of notches was higher among males. Almost one in four U.S. adults who reported excellent or good hearing had audiometric notches (5.5% bilateral and 18.0% unilateral). Among participants who reported exposure to loud noise at work, almost one third had a notch. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Noise-induced hearing loss is a significant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss.

Two to three infants per 1,000 live births are born deaf or hard of hearing. When left undetected, a hearing loss can delay a child's speech and language development. Approximately 40% of young adults with hearing loss identified during childhood reported experiencing at least one limitation in daily functioning. A total of 41 states, Guam, and the District of Columbia have passed statutes or regulatory guidance related to the identification of deaf and hard of hearing infants. All U.S. jurisdictions also have now established Early Hearing Detection and Intervention (EHDI) programs. These programs represent an evidence-based public health approach that connects public health and clinical preventive services to address the needs of infants who are deaf and hard of hearing. With support from public health agencies at both the jurisdictional and federal levels, EHDI programs help ensure that infants are screened for hearing loss and receive recommended follow-up through active tracking, surveillance, and coordination with clinical service providers and families.

Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed.

Identifying and treating children with congenital hearing loss during the first few months of life is a relatively new concept. To assist states in the development of statewide Early Hearing Detection and Intervention programs, the federal government provides grants and/or cooperative agreements to almost all states and has established "National Goals, Program Objectives and Performance Measures" to guide the development and implementation of those systems. This article reviews the history of newborn hearing screening programs in the United States, summarizes the content of legislation and regulations passed by states related to universal newborn hearing screening, and describes how well each National Goal has been addressed. Although substantial progress has been made in the percentage of infants screened for hearing loss before hospital discharge, significant improvement is needed with respect to the availability of pediatric audiologists, implementation of effective tracking and data management systems, program evaluation and quality assurance, availability of appropriate early intervention programs, and linkages with medical home providers.