{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:59:53Z","timestamp":1790319593584,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Occupational exposure to sustained high\u2010noise levels in intensive care units (ICUs) could pose significant auditory health risks for healthcare professionals.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n This investigation evaluates the prevalence and characteristics of hearing impairment among nursing staff working in an intensive care unit (ICU) versus non\u2010ICU environments within Chinese healthcare facilities.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n A cross\u2010sectional study was conducted at a hospital in Chongqing, China. Participants underwent comprehensive audiological assessments including pure\u2010tone audiometry (PTA) and Chinese digits\u2010in\u2010noise (DIN) (testing for speech reception thresholds (SRT)). Statistical analyses employed univariate and multivariate logistic regression models to identify independent predictors of hearing impairment.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 93 registered nurses (45 ICU and 48 non\u2010ICU) were included in the final analysis. ICU nurses demonstrated significantly worse hearing thresholds compared to non\u2010ICU counterparts, particularly at high frequencies (4\u20138\u2009kHz). Approximately 20% of ICU nurses exhibited hearing loss (>\u200925\u2009dB HL) at high frequencies, compared to 10% in non\u2010ICU settings. Working in ICU environments (adjusted OR\u2009=\u20092.82, 95% CI: 1.25\u20136.35), working 50\u201360\u2009h per week (adjusted OR\u2009=\u20094.15, 95% CI: 1.18\u201314.60), and working more than 60\u2009h per week (adjusted OR\u2009=\u20095.85, 95% CI: 1.55\u201322.10) emerged as significant independent predictors of hearing impairment. Speech reception thresholds were significantly poorer among ICU nurses (\n p<\/jats:italic>\n \u2009<\u20090.05), with PTA thresholds showing a strong correlation with SRT performance (\n r<\/jats:italic>\n \u2009=\u20090.824,\n p<\/jats:italic>\n \u2009<\u20090.001). Multiple regression analysis identified 2\u2009kHz as the most critical frequency contributing to speech understanding in noise for both groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study provides compelling evidence of elevated hearing impairment risk among ICU nurses compared to non\u2010ICU nursing staff in China. These findings highlight the urgent need for targeted occupational health interventions and hearing conservation programmes for nursing staff working in high\u2010noise environments.<\/jats:p>\n <\/jats:sec>\n \n Relevance to Clinical Practice<\/jats:title>\n This study emphasises the necessity of targeted occupational health measures for ICU nurses, particularly those with prolonged working hours. Clinical protocols should prioritise monitoring high\u2010frequency hearing thresholds and incorporating speech\u2010in\u2010noise assessments to detect functional deficits. Furthermore, implementing workload management strategies is essential to mitigate the dose\u2013response risk of noise exposure and preserve nurses' long\u2010term auditory health.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nicc.70697","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:18:28Z","timestamp":1790317108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational Hearing Loss in the Intensive Care Unit: A Comparative Study Between ICU and Non\u2010ICU Nursing Staff"],"prefix":"10.1111","volume":"31","author":[{"given":"Ziwei","family":"Song","sequence":"first","affiliation":[{"name":"Acoustics Research Unit School of Architecture, University of Liverpool Liverpool UK"},{"name":"School of Design and Humanities Chongqing University of Science & Technology Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0328-9175","authenticated-orcid":false,"given":"Pyoung Jik","family":"Lee","sequence":"additional","affiliation":[{"name":"Acoustics Research Unit School of Architecture, University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Bin","sequence":"additional","affiliation":[{"name":"Nanchuan District People's Hospital Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6515-8058","authenticated-orcid":false,"given":"Thomas","family":"Hampton","sequence":"additional","affiliation":[{"name":"Department of Eye and Vision Sciences, Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK"},{"name":"NHS University Hospitals of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"1","key":"e_1_2_15_2_1","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1186\/s12889-024-19006-7","article-title":"Association Between Exposure to Metalworking Fluid Aerosols, Occupational Noise and Chronic Kidney Disease: A Cross\u2010Sectional Study in China","volume":"24","author":"Zhou L.","year":"2024","journal-title":"BMC Public Health"},{"issue":"2","key":"e_1_2_15_3_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1136\/oemed-2018-105269","article-title":"Tunnel Driving Occupational Environment and Hearing Loss in Train Drivers in China","volume":"76","author":"Peng Y.","year":"2019","journal-title":"Occupational and Environmental Medicine"},{"issue":"9","key":"e_1_2_15_4_1","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1136\/oem.59.9.634","article-title":"Occupational Exposure to Noise and the Attributable Burden of Hearing Difficulties in Great Britain","volume":"59","author":"Palmer K. T.","year":"2002","journal-title":"Occupational and Environmental Medicine"},{"issue":"1","key":"e_1_2_15_5_1","doi-asserted-by":"crossref","DOI":"10.1186\/s43163-025-00790-x","article-title":"Role of Occupational Factors in Noise\u2010\u0131nduced Hearing Loss: A Single\u2010Center Real\u2010World Data Study","volume":"41","author":"Aliyeva A.","year":"2025","journal-title":"Egyptian Journal of Otolaryngology"},{"issue":"1","key":"e_1_2_15_6_1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1186\/s12888-023-04722-y","article-title":"Association Between Long Working Hours and Mental Health Among Nurses in China Under COVID\u201019 Pandemic: Based on a Large Cross\u2010Sectional Study","volume":"23","author":"Che H. W.","year":"2023","journal-title":"BMC Psychiatry"},{"issue":"1","key":"e_1_2_15_7_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s40557-016-0140-1","article-title":"The Association Between Long Working Hours and Hearing Impairment in Noise Unexposed Workers: Data From the 5th Korea National Health and Nutrition Examination Survey (KNHANES 2010\u20132012)","volume":"28","author":"Park J.\u2010W.","year":"2016","journal-title":"Annals of Occupational and Environmental Medicine"},{"issue":"1","key":"e_1_2_15_8_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s12889-023-17618-z","article-title":"The Sound of Safety: Exploring the Determinants of Prevention Intention in Noisy Industrial Workplaces","volume":"24","author":"Jo H.","year":"2024","journal-title":"BMC Public Health"},{"issue":"10","key":"e_1_2_15_9_1","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.jdent.2012.06.006","article-title":"General Dental Practitioners and Hearing Impairment","volume":"40","author":"Messano G. A.","year":"2012","journal-title":"Journal of Dentistry"},{"issue":"1","key":"e_1_2_15_10_1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1186\/s12912-024-01896-y","article-title":"\u201cTo Do or Not to Do\u201d, Male Nurses' Experiences of Providing Intimate Care to Female Patients in China, a Constructivist Grounded Theory Study","volume":"23","author":"Lyu X.\u2010C.","year":"2024","journal-title":"BMC Nursing"},{"issue":"4","key":"e_1_2_15_11_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3390\/audiolres15040091","article-title":"Associations Between Occupational Noise Exposure, Aging, and Gender and Hearing Loss: A Cross\u2010Sectional Study in China","volume":"15","author":"Wang Y.","year":"2025","journal-title":"Audiology Research"},{"issue":"3","key":"e_1_2_15_12_1","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1097\/AUD.0000000000001160","article-title":"Diotic and Antiphasic Digits\u2010In\u2010Noise Testing as a Hearing Screening and Triage Tool to Classify Type of Hearing Loss","volume":"43","author":"De Sousa K. C.","year":"2022","journal-title":"Ear and Hearing"},{"issue":"7","key":"e_1_2_15_13_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3109\/14992027.2016.1172269","article-title":"Development and Validation of a Smartphone\u2010Based Digits\u2010In\u2010Noise Hearing Test in South African English","volume":"55","author":"Potgieter J.\u2010M.","year":"2016","journal-title":"International Journal of Audiology"},{"issue":"2","key":"e_1_2_15_14_1","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1097\/AUD.0000000000000775","article-title":"Improving Sensitivity of the Digits\u2010In\u2010Noise Test Using Antiphasic Stimuli","volume":"41","author":"De Sousa K. C.","year":"2020","journal-title":"Ear and Hearing"},{"issue":"1","key":"e_1_2_15_15_1","doi-asserted-by":"crossref","first-page":"7359","DOI":"10.1038\/s41598-024-57944-9","article-title":"Assessing the Accuracy and Reliability of Application\u2010Based Audiometry for Hearing Evaluation","volume":"14","author":"Lee S. Y.","year":"2024","journal-title":"Scientific Reports"},{"issue":"16","key":"e_1_2_15_16_1","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1002\/sim.1047","article-title":"A Solution to the Problem of Separation in Logistic Regression","volume":"21","author":"Heinze G.","year":"2002","journal-title":"Statistics in Medicine"},{"issue":"1","key":"e_1_2_15_17_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12960-024-00898-w","article-title":"Feminization of the Health Workforce in China: Exploring Gendered Composition From 2002 to 2020","volume":"22","author":"Li M.","year":"2024","journal-title":"Human Resources for Health"},{"key":"e_1_2_15_18_1","volume-title":"ISO 7029 Acoustics\u2010Statistical Distribution of Hearing Thresholds Related to Age and Gender","author":"ISO","year":"2017"},{"issue":"2","key":"e_1_2_15_19_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.7874\/jao.2015.19.2.91","article-title":"Hearing Thresholds for a Geriatric Population Composed of Korean Males and Females","volume":"19","author":"Bahng J.","year":"2015","journal-title":"Journal of Audiology & Otology"},{"issue":"4","key":"e_1_2_15_20_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3109\/1651386X.2011.631285","article-title":"WHO Ear and Hearing Disorders Survey in Four Provinces in China","volume":"9","author":"Bu X.","year":"2011","journal-title":"Audiological Medicine"},{"issue":"123","key":"e_1_2_15_21_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4103\/nah.nah_83_24","article-title":"Effect of the Levels and Sources of Noise on the Sleep Quality of Conscious Patients in Emergency Intensive Care Unit","volume":"26","author":"Yang J.","year":"2024","journal-title":"Noise & Health"},{"issue":"1","key":"e_1_2_15_22_1","doi-asserted-by":"crossref","first-page":"10858","DOI":"10.1038\/s41598-025-94365-8","article-title":"Noise and Sound in the Intensive Care Unit: A Cohort Study","volume":"15","author":"Tahvili A.","year":"2025","journal-title":"Scientific Reports"},{"key":"e_1_2_15_23_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.apacoust.2022.109037","article-title":"Acoustic Environments of Intensive Care Units During the COVID\u201019 Pandemic","volume":"199","author":"Song Z.","year":"2022","journal-title":"Applied Acoustics"},{"issue":"2","key":"e_1_2_15_24_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/nicc.12490","article-title":"Effect of Noise and Light Levels on Sleep of Intensive Care Unit Patients","volume":"26","author":"Bani Younis M.","year":"2021","journal-title":"Nursing in Critical Care"},{"issue":"5","key":"e_1_2_15_25_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/01.NAJ.0000446780.99522.90","article-title":"Noise in the ICU","volume":"114","author":"Stafford A.","year":"2014","journal-title":"American Journal of Nursing"},{"issue":"6","key":"e_1_2_15_26_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/BF01694709","article-title":"Noise in the ICU","volume":"19","author":"Balogh D.","year":"1993","journal-title":"Intensive Care Medicine"},{"issue":"10","key":"e_1_2_15_27_1","article-title":"Study on Noise Induced Deafness in Five Metals Factory","volume":"11","author":"Cai Y.","year":"2005","journal-title":"Hebei Medicine"},{"issue":"2","key":"e_1_2_15_28_1","first-page":"9","article-title":"Study on Noise Induced Deafness in Linen Textile Factory","volume":"26","author":"Tu B.","year":"2000","journal-title":"Gong Ye Wei Sheng Yu Zhi Ye Bing"},{"issue":"9","key":"e_1_2_15_29_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-039576","article-title":"Occupational Noise\u2010Induced Hearing Loss in China: A Systematic Review and Meta\u2010Analysis","volume":"10","author":"Zhou J.","year":"2020","journal-title":"BMJ Open"},{"issue":"3","key":"e_1_2_15_30_1","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.joto.2021.01.001","article-title":"Sensorineural Hearing Dysfunction After Discharge From Critical Care in Adults: A Retrospective Observational Study","volume":"16","author":"Fujiwara T.","year":"2021","journal-title":"Journal of Otology"},{"issue":"4","key":"e_1_2_15_31_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1080\/14992020500057731","article-title":"Screened and Unscreened Hearing Threshold Levels for the Adult Population: Results From the Nord\u2010Tr\u00f8ndelag Hearing Loss Study Niveles de Umbrales Auditivos Tamizados y no Tamizados en la poblaci\u00f3n Adulta. Resultados del Estudio Nord\u2010Tr\u00f8ndeIag Sobre Hipoacusias","volume":"44","author":"Engdahl B.","year":"2005","journal-title":"International Journal of Audiology"},{"issue":"10","key":"e_1_2_15_32_1","doi-asserted-by":"crossref","first-page":"798","DOI":"10.12788\/jhm.2826","article-title":"Sound and Light Levels Are Similarly Disruptive in ICU and Non\u2010ICU Wards","volume":"12","author":"Jaiswal S. J.","year":"2017","journal-title":"Journal of Hospital Medicine"},{"issue":"3","key":"e_1_2_15_33_1","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1097\/AUD.0000000000001154","article-title":"The Associations of Hearing Sensitivity and Different Cognitive Functions With Perception of Speech\u2010In\u2010Noise","volume":"43","author":"Merten N.","year":"2022","journal-title":"Ear and Hearing"},{"issue":"2","key":"e_1_2_15_34_1","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/AUD.0000000000000753","article-title":"The Association Between Physiological Noise Levels and Speech Understanding in Noise","volume":"41","author":"Stiepan S.","year":"2020","journal-title":"Ear and Hearing"},{"issue":"10","key":"e_1_2_15_35_1","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1080\/14992027.2019.1622042","article-title":"Improving the Efficiency of the Digit Triplet Test Using Digit Scoring With Variable Adaptive Step Sizes","volume":"58","author":"Denys S.","year":"2019","journal-title":"International Journal of Audiology"},{"issue":"1","key":"e_1_2_15_36_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14992020400050004","article-title":"Development and Validation of an Automatic Speech\u2010In\u2010Noise Screening Test by Telephone","volume":"43","author":"Smits C.","year":"2004","journal-title":"International Journal of Audiology"},{"issue":"5","key":"e_1_2_15_37_1","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/AUD.0000000000000282","article-title":"Using the Digits\u2010In\u2010Noise Test to Estimate Age\u2010Related Hearing Loss","volume":"37","author":"Koole A.","year":"2016","journal-title":"Ear and Hearing"},{"issue":"4","key":"e_1_2_15_38_1","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1044\/jshr.3904.714","article-title":"Frequency Importance Functions for Words, Sentences, and Continuous Discourse","volume":"39","author":"DePaolis R. A.","year":"1996","journal-title":"Journal of Speech, Language, and Hearing Research"},{"key":"e_1_2_15_39_1","doi-asserted-by":"crossref","DOI":"10.1017\/S0142716425000049","article-title":"Reliability and Validity Assessment of Working Memory Measurements","volume":"46","author":"Liu K.","year":"2025","journal-title":"Applied PsychoLinguistics"},{"key":"e_1_2_15_40_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2021.725080","article-title":"French Version of the Antiphasic Digits\u2010In\u2010Noise Test for Smartphone Hearing Screening","volume":"9","author":"Ceccato J.\u2010C.","year":"2021","journal-title":"Frontiers in Public Health"},{"issue":"3","key":"e_1_2_15_41_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.2486\/indhealth.39.250","article-title":"Long Working Hours and Subjective Fatigue Symptoms","volume":"39","author":"Park J.","year":"2001","journal-title":"Industrial Health"},{"key":"e_1_2_15_42_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.5271\/sjweh.2985","article-title":"The Impact of Junior Doctors' Worktime Arrangements on Their Fatigue and Well\u2010Being","volume":"36","author":"Tucker P.","year":"2010","journal-title":"Scandinavian Journal of Work, Environment & Health"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70697","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.70697","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:18:35Z","timestamp":1790317115000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.70697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/nicc.70697"],"URL":"https:\/\/doi.org\/10.1111\/nicc.70697","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"2026-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70697"}}