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8.2.3. Hearing loss

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8.2.3. Hearing loss Introduction


Hearing impairment is the most frequent sensory deficit in humans. It affects more than 250 million people in the world. Consequences of hearing impairment include inability to interpret speech sounds, often producing a reduced ability to communicate, delay in language acquisition, economic and educational disadvantage, social isolation and stigmatisation. It may be worsened by some medical conditions such as hypothyroidism, diabetes, and possibly hyperlipidemia, among others. Data Sources


Studies of hearing loss occurrence have been carried out in relatively few Countries in the world (see a list of studies with their basic features in Mathers et al, 2003). In Europe, surveys have been carried out in representative population samples of Denmark, Finland, Italy, Sweden and United Kingdom (Davis, 1989; Fortnum and Davis, 1997; Johansson and Arlinger, 2003; Karlsmose et al, 1999; Quaranta et al, 1996; Uimonen et al, 1999). Self-reported data on hearing problems have been also collected in several EU Member States by means of EU Labour Force Survey (LFS) carried out in 2002 and the EU SILC carried out in 2004. The results obtained with these two surveys have been analysed in a Report published in 2007 (APPLICA et al, 2007).




There is a diversity of definitions of hearing impairment, thus, comparison among studies is difficult. WHO has classified hearing impairment according to the hearing threshold average of pure tones of four frequencies: 0.5, 1, 2, and 4 kHz (WHO, 1997). The different grades of hearing impairment and their impact in performance are presented in Table 8.4. Available data have been elaborated by WHO to obtain comparable estimates of hearing loss. While the prevalence of slight impairment (26-40dBHL) has been estimated, it has been assumed to result in negligible disability and it has not been considered in the estimation of the burden of disability for hearing loss due to ageing or noise exposure, which excludes hearing loss due to congenital causes, infectious diseases, other diseases or injury (adult-onset hearing loss, ICD-10 codes H90-H91) (WHO, 2002).


Table 8.4. WHO grades of hearing impairment
 Data description


Prevalence of congenital permanent childhood hearing loss (≥ 40 dB hearing loss in the ear) has been estimated as 0.1% in a study carried out in the Trent Region (UK) during the years 1985-1993 on a population sample ob about 553000 children aged 0-9 years (Fortnum and Davis, 1997).


Data available from the other surveys in EU Member States were interpolated to obtain comparable estimates according to the WHO definitions of severity (Mathers et al, 2003). The results obtained are shown in Table 8.5. An additional study carried out in 590 randomly selected Swedish subjects aged from 20 to 80 years (Johansson and Arlinger, 2003) showed that 16.9% subjects showed no hearing impairment (≥25 dB HL), 7.7% showed35 dB HL, 3.3% showed45 dB HL, and 0.2% showed65 dB HL. Hearing loss appeared generally similarly distributed between genders in United Kingdom, Italy and Sweden (Odds Ratios males/females in the range 0.9-1.2), with some evidence of increased prevalence in Italian men associated with manual occupations with greater noise exposure. In Denmark and Finland, the prevalence of slight to moderate hearing loss was more marked in men (Odd Ratios males/females in the range 1.5-2.3). Prevalence of adult onset hearing loss of at least moderate severity in the age group 15-19 year has been estimated to be 0.1 to 0.2%.


Table 8.5. Estimated prevalence of adult onset hearing loss for adults aged 15 years and over


The leading causes of adult-onset hearing loss are presbycusis (age related hearing loss) followed by

noise-induced hearing loss.


From these data, age-standardized prevalence and hearing loss was estimated to be 3.3% (males) and 2.8% (females) in the WHO EUR-A epidemiological region (where most population is from 18 EU Member States, Croatia and EFTA Countries) as well as in the WHO EUR-B1 epidemiological region (to which Bulgaria, Poland, Romania, Slovakia and Turkey belong) (Mathers et al, 2003).

The burden of disability due to hearing loss has been estimated to amount, in 2001, to 4.6 YLD/1000 (males) and 4.3 YLD/1000 (females) in the WHO EURO A and to 3.3 YLD/1000 (males and females) in the WHO EURO B1 (WHO, 2002). References


Davis AC (1989): The prevalence of hearing impairment and reported hearing disability among adults in Great Britain. International J Epidemiology. 1989;18:911-91


European Union Statistics on Income and Living Conditions (EU-SILC) (2004): Database available at:


European Union Statistics on Income and Living Conditions (EU-SILC) (2007): Men and women with disabilities in the eu: statistical analysis of the LFS ad hoc module and the EU-SILC. On line publication available at:


Fortnum H, Davis A (1997): Epidemiology of permanent childhood hearing impairment in Trent

Region, 1985-1993. British Journal of Audiology 31(6):409-46.


Johansson MSK, Arlinger SD (2003): Prevalence of hearing impairment in a population in Sweden. International J Audiology. 2003;42:18-28


Karlsmose B, Lauritzen T, Parving A (1999): Prevalence of hearing impairment and subjective hearing problems in a rural Danish population aged 31-50 years. British Journal of Audiology



Mathers C, Smith A, Concha M (2003): Global burden of hearing loss in the year 2000 (on-line publication available at:


UK Office of National Statistics (ONS) dataset available online at:


Quaranta A, Assennato G, Sallustio V (1996): Epidemiology of hearing problems among adults in Italy. Scandinavian Audiology 1996;Supplement 42:9-13


Uimonen S, Huttunen K, Jounio-Ervasti K, Sorri M (1999): Do we know the real need for hearing rehabilitation at the population level? Hearing impairments in the 5- to 75-year-old crosssectional Finnish population. British Journal of Audiology 33(1):53-9.


WHO (1997): Report on the First Informal Consultation on Future Programme Developments for the Prevention of Deafness and Hearing Impairment. (WHO/PDH/97.3.) Geneva: WHO


WHO (2002): The World Health Report (on-line publication available at Acronyms



Hearing Loss


WHO’s International Classification of Functioning, Disability, and Health (2001).


EU Labour Force Survey


long standing health problem or disability


Minimum European Health Module


European Statistical System


Disability and Social Integration


European Health Survey System