Hearing Difficulty Is Associated With Injuries Requiring Medical Care

Objective: Injuries are responsible for 11% of global disability-adjusted life years. Hearing difficulty may be a modifiable risk factor for injury. The primary aim was to determine whether subjective hearing difficulty is associated with increased incidence of injuries (all-type, workplace, and nonworkplace) serious enough to require health care among Americans aged 18 years and older. The secondary aim was to determine whether hearing difficulty is associated with increased use of health care for injuries. Design: The analysis was performed using data from the 1999 to 2012 Medical Expenditure Panel Surveys–Household Component (MEPS-HC). Multivariable estimates are generalizable to the American noninstitutionalized adult population in 2006. Hearing difficulty was determined by computer-assisted personal interview. The primary outcome was number of separate injuries requiring health care (emergency department visits, hospital inpatient admissions, or medical office visits) during the follow-up period. Crude injury incidence rates were calculated with 95% confidence intervals (CIs). Multivariable negative binomial regression was performed to determine the relative incidence rate of injuries among the group reporting hearing difficulties relative to the group reporting no difficulty in hearing, adjusting for relevant confounders. Variance estimates were adjusted to take into account the complex sample design. Results were stratified by sex. Results: Of the 121,453 participants in MEPS-HC panels 6-16, 107,352 (88.4%) had complete data and were included in the analysis. The average follow-up was 1.27 years. Seven thousand six hundred and twenty-four participants (7.1%) reported hearing difficulty at baseline. During the follow-up period, 10,727 participants (10.0%) had one or more injuries. In multivariable analyses, hearing difficulty was significantly associated with increased incidence of all-type (males: incidence rate ratio [IRR] 1.31, 95% CI 1.18–1.45, p value < 0.001; females: IRR 1.21, 95% CI 1.07–1.36, p value < 0.001), workplace (males: IRR 1.42, 95% CI 1.16–1.75, p value 0.001; females: IRR 1.61, 95% CI 1.12–2.31, p value 0.010), and nonworkplace injuries (males: IRR 1.24, 95% CI 1.09–1.42, p value 0.001; females: IRR 1.17, 95% CI, 1.02–1.34, p value 0.023). In multivariable analyses, hearing difficulty was associated with increased incidence of emergency department use in males (IRR 1.36, 95% CI 1.13–1.62, p value 0.001) and medical office visits in females (IRR 1.52, 95% CI 1.12–2.05, p value 0.007). Conclusions: The study results suggest the need to investigate the mechanisms underlying the measured associations so that efforts may be directed toward reducing the risk of injury for individuals with hearing difficulties.