{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:54:57Z","timestamp":1790934897462,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100024253","name":"Western Australian Future Health and Innovation Fund, Government of Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024253","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the associations between major modifiable risk factors and hearing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This serial cross\u2010sectional study was conducted within the National Health and Nutrition Examination Survey 1999\u20132020 in the United States. Associations were assessed using modified Poisson regression and within\u2010sample population attributable fraction (PAF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight thousand seven hundred and seventy adults aged 40\u201385\u2009years were included in the analyses, the mean (SD) age was 58.0 (11.7) years, with 4002 men (45.6%). Hearing loss was associated with low educational attainment with prevalence ratio 1.23, 95% confidence interval (1.15, 1.31); low income 1.11 (1.04, 1.19); diabetes 1.10 (1.03, 1.18); HDL\u2010C dyslipidaemia 1.13 (1.06, 1.21); obesity 1.08 (1.01, 1.15) and tobacco use 1.11 (1.04, 1.19). Within our analysis, over 25% of hearing loss cases were attributed to modifiable risk factors, with low education or income, HDL\u2010C dyslipidaemia, obesity and tobacco use being the leading contributors, though relative rankings varied slightly in survey\u2010weighted analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hearing promotion policies should prioritise related modifiable factors to reduce the burden of hearing loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70153","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:10:22Z","timestamp":1785546622000},"page":"929-937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modifiable Risk Factors and Hearing Loss: The National Health and Nutrition Examination Survey 1999\u20132020"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-8863","authenticated-orcid":false,"given":"Yulu","family":"Zheng","sequence":"first","affiliation":[{"name":"Centre for Precision Health Edith Cowan University  Joondalup WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0461-0024","authenticated-orcid":false,"given":"Tingting","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Research Center Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5694-2441","authenticated-orcid":false,"given":"Zhiyuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Centre for Precision Health Edith Cowan University  Joondalup WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8320-0417","authenticated-orcid":false,"given":"Yahong","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Science Edith Cowan University  Joondalup WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2105-4537","authenticated-orcid":false,"given":"Zheng","family":"Guo","sequence":"additional","affiliation":[{"name":"Centre for Precision Health Edith Cowan University  Joondalup WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0252-154X","authenticated-orcid":false,"given":"Xingang","family":"Li","sequence":"additional","affiliation":[{"name":"Nutrition and Innovation Research Institute Edith Cowan University  Joondalup WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000325"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.101717"},{"key":"e_1_2_13_4_1","unstructured":"WHO \u201cWHO: 1 in 4 People Projected to Have Hearing Problems by 2050 \u201daccessed March 2 2021 https:\/\/www.who.int\/news\/item\/02\u201003\u20102021\u2010who\u20101\u2010in\u20104\u2010people\u2010projected\u2010to\u2010have\u2010hearing\u2010problems\u2010by\u20102050."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25927"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnz009"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz103.182"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.2513"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu094"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.7874\/kja.2013.17.2.45"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz023"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.3144"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010031030"},{"key":"e_1_2_13_14_1","first-page":"1","article-title":"National Health and Nutrition Examination Survey: Analytic Guidelines, 1999\u20102010","volume":"161","author":"Johnson C. 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