{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T23:16:05Z","timestamp":1756682165128},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2011,6,8]],"date-time":"2011-06-08T00:00:00Z","timestamp":1307491200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hearing impairment negatively impacts students' development of academic, language and social skills. Even minimal unilateral hearing loss can hinder educational performance. We investigated the prevalence of ear diseases among secondary school students in the city of Xi'an, China in order to provide a foundation for evidence-based hearing healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A stratified random sampling survey was conducted in 29 secondary schools. Demographics and medical histories were collected, and otologic examinations were performed. Questionnaires were administered to assess insomnia, academic stress and use of portable audio devices. Logistic regression analysis was used to identify factors associated with hearing impairment, and the association of sensorineural hearing loss with insomnia, academic stress and the use of portable audio devices was analyzed with the chi-square test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The percentage of students with some form of ear disease was 3.32%. External ear disease, middle ear disease and sensorineural hearing loss occurred in 1.21%, 0.64% and 1.47% of the students, respectively. Boys had a relatively higher prevalence of ear disease than girls. According to our survey, the prevalence of sensorineural hearing loss increased significantly among the students with insomnia and extended use of portable audio devices, but not among those with elevated levels of academic stress. Hearing aids and surgical treatment were needed in 1.47% and 0.89% of the students, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a high prevalence of ear disease among secondary school students, and this should be given more attention. Insomnia and the excessive use of portable audio devices may be related to adolescent sensorineural hearing loss. It is important to establish and comply with an evidence-based preventive strategy.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2458-11-445","type":"journal-article","created":{"date-parts":[[2011,6,8]],"date-time":"2011-06-08T06:29:42Z","timestamp":1307514582000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ear diseases among secondary school students in Xi'an, China: The role of portable audio device use, insomnia and academic stress"],"prefix":"10.1186","volume":"11","author":[{"given":"Yang","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zonghua","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengzhi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhua","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2011,6,8]]},"reference":[{"key":"3186_CR1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1542\/peds.74.2.206","volume":"74","author":"FH Bess","year":"1984","unstructured":"Bess FH, Tharpe AM: Unilateral hearing impairment in children. Pediatrics. 1984, 74: 206-216.","journal-title":"Pediatrics"},{"key":"3186_CR2","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/00003446-199810000-00001","volume":"19","author":"FH Bess","year":"1998","unstructured":"Bess FH, Dodd-Murphy J, Parker RA: Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status. Ear Hear. 1998, 19: 339-354. 10.1097\/00003446-199810000-00001.","journal-title":"Ear Hear"},{"key":"3186_CR3","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1001\/archotol.130.5.524","volume":"130","author":"JE Lieu","year":"2004","unstructured":"Lieu JE: Speech-language and educational consequences of unilateral hearing loss in children. Arch Otolaryngol Head Neck Surg. 2004, 130: 524-530. 10.1001\/archotol.130.5.524.","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"3186_CR4","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.ijporl.2009.10.013","volume":"74","author":"M Khairi Md Daud","year":"2010","unstructured":"Khairi Md Daud M, Noor RM, Rahman NA, Sidek DS, Mohamad A: The effect of mild hearing loss on academic performance in primary school children. Int J Pediatr Otorhinolaryngol. 2010, 74: 67-70. 10.1016\/j.ijporl.2009.10.013.","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"3186_CR5","unstructured":"Primary ear and hearing care training resource advanced level. [http:\/\/www.who.int\/entity\/pbd\/deafness\/activities\/hearing_care\/advanced.pdf]"},{"key":"3186_CR6","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1053\/j.semperi.2009.12.009","volume":"34","author":"KR White","year":"2010","unstructured":"White KR, Forsman I, Eichwald J, Munoz K: The evolution of early hearing detection and intervention programs in the United States. Semin Perinatol. 2010, 34: 170-179. 10.1053\/j.semperi.2009.12.009.","journal-title":"Semin Perinatol"},{"key":"3186_CR7","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/S0033-3506(96)80092-8","volume":"110","author":"I Morioka","year":"1996","unstructured":"Morioka I, Luo WZ, Miyashita K, Takeda S, Wang YX, Li SC: Hearing impairment among young Chinese in a rural area. Public Health. 1996, 110: 293-297. 10.1016\/S0033-3506(96)80092-8.","journal-title":"Public Health"},{"key":"3186_CR8","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/S0033-3506(98)00218-2","volume":"112","author":"O Kaewboonchoo","year":"1998","unstructured":"Kaewboonchoo O, Morioka I, Miyashita K, Takeda S, Wang YX, Li SC: Hearing impairment among young Chinese in an urban area. Public Health. 1998, 112: 143-146. 10.1016\/S0033-3506(98)00218-2.","journal-title":"Public Health"},{"key":"3186_CR9","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1093\/her\/cyq091","volume":"26","author":"I Vogel","year":"2011","unstructured":"Vogel I, Brug J, Van der Ploeg CP, Raat H: Adolescents risky MP3-player listening and its psychosocial correlates. Health Educ Res. 2011, 26: 254-264. 10.1093\/her\/cyq091.","journal-title":"Health Educ Res"},{"key":"3186_CR10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/sleep\/34.1.25","volume":"34","author":"T Test","year":"2011","unstructured":"Test T, Canfi A, Eyal A, Shoam-Vardi I, Sheiner EK: The influence of hearing impairment on sleep quality among workers exposed to harmful noise. Sleep. 2011, 34: 25-30.","journal-title":"Sleep"},{"key":"3186_CR11","first-page":"460","volume":"28","author":"M Que","year":"2007","unstructured":"Que M, Tao FB, He CY, Zhang LH, Zhu P: Study on the relationship between mental health and overweight, obesity, different sex among junior middle school students. Zhonghua Liu Xing Bing Xue Za Zhi. 2007, 28: 460-463.","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"3186_CR12","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s00787-005-0460-0","volume":"14","author":"H Lazaratou","year":"2005","unstructured":"Lazaratou H, Dikeos DG, Anagnostopoulos DC, Sbokou O, Soldatos CR: Sleep problems in adolescence. A study of senior high school students in Greece. Eur Child Adolesc Psychiatry. 2005, 14: 237-243. 10.1007\/s00787-005-0460-0.","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"3186_CR13","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.anl.2010.02.007","volume":"37","author":"H Yaman","year":"2010","unstructured":"Yaman H, Guclu E, Yilmaz S, Ozturk O: Myringosclerosis after tympanostomy tube insertion: relation with tube retention time and gender. Auris Nasus Larynx. 2010, 37: 676-679. 10.1016\/j.anl.2010.02.007.","journal-title":"Auris Nasus Larynx"},{"key":"3186_CR14","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/S0165-5876(01)00616-4","volume":"62","author":"SM Zakzouk","year":"2002","unstructured":"Zakzouk SM, Hajjaj MF: Epidemiology of chronic suppurative otitis media among Saudi children--a comparative study of two decades. Int J Pediatr Otorhinolaryngol. 2002, 62: 215-218. 10.1016\/S0165-5876(01)00616-4.","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"3186_CR15","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1001\/jama.2010.1124","volume":"304","author":"J Shargorodsky","year":"2010","unstructured":"Shargorodsky J, Curhan SG, Curhan GC, Eavey R: Change in prevalence of hearing loss in US adolescents. JAMA. 2010, 304: 772-778. 10.1001\/jama.2010.1124.","journal-title":"JAMA"},{"key":"3186_CR16","doi-asserted-by":"publisher","first-page":"e39","DOI":"10.1542\/peds.2010-0926","volume":"127","author":"E Henderson","year":"2011","unstructured":"Henderson E, Testa MA, Hartnick C: Prevalence of noise-induced hearing-threshold shifts and hearing loss among US youths. Pediatrics. 2011, 127: e39-46. 10.1542\/peds.2010-0926.","journal-title":"Pediatrics"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-445.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2458-11-445\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-445.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T07:40:49Z","timestamp":1686123649000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/1471-2458-11-445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,6,8]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["3186"],"URL":"https:\/\/doi.org\/10.1186\/1471-2458-11-445","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,6,8]]},"assertion":[{"value":"23 February 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"445"}}