{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:12:13Z","timestamp":1756858333763,"version":"3.44.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Secondhand smoke (SHS) exposure has been implicated as a risk factor for hearing loss. However, there is a relative paucity of inconsistent findings with limited frequency-specific details. The goal of this study is to better characterize the relationship between SHS exposure and hearing loss among adult nonsmokers in the U.S.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Study design<\/jats:title>\n<jats:p>Cross-sectional.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Setting<\/jats:title>\n<jats:p>2015-2016 NHANES cycle.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Patients<\/jats:title>\n<jats:p>1644 nonsmokers between ages 20 and 69 and without diabetes, stroke, or heart disease.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Intervention<\/jats:title>\n<jats:p>Serum cotinine level (ng\/ml) indicated SHS exposure.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Main outcome measures<\/jats:title>\n<jats:p>Outcomes were hearing thresholds at low-frequencies and high-frequencies as well as hearing loss defined by hearing threshold 20 dB in the better ear. Linear regressions between hearing thresholds and SHS exposure stratified by Body Mass Index (BMI) category and controlled for\u00a0socio-demographic\u00a0variables. Logistic regression modeling hearing loss by SHS exposure controlled for the same.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec007\">\n<jats:title>Results<\/jats:title>\n<jats:p>SHS exposure was associated with elevated hearing thresholds at low-frequencies (\u03b2\u2009=\u20090.47, p\u2009=\u2009.03) only in the obese (BMI 30) population. SHS exposure was associated with greater odds of hearing loss (Odds Ratio: 1.17, 95% Confidence Interval: 1.06\u20131.29, p\u2009=\u2009.005) and demonstrated a dose-response relationship.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec008\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>While SHS exposure was associated with hearing loss and showed a dose-response relationship, its relationship with hearing thresholds was not demonstrated across all hearing frequencies or BMI categories. Additional research is needed to establish the clinical significance of these findings and clarify the role of obesity in this relationship.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0331105","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T17:41:11Z","timestamp":1756834871000},"page":"e0331105","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the association between secondhand smoke exposure and hearing loss among U.S. nonsmokers"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4437-0249","authenticated-orcid":true,"given":"Aashish","family":"Batheja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-2075","authenticated-orcid":true,"given":"Daniel H.","family":"Coelho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"issue":"10","key":"pone.0331105.ref001","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/j.amjmed.2020.03.049","article-title":"Cigarette Smoking, Smoking Cessation, and Risk of Hearing Loss in Women","volume":"133","author":"BM Lin","year":"2020","journal-title":"Am J Med"},{"issue":"2","key":"pone.0331105.ref002","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/MAO.0b013e318192483c","article-title":"Risk Factors for Hearing Loss in US Adults: Data From the National Health and Nutrition Examination Survey, 1999 to 2002","volume":"30","author":"Y Agrawal","year":"2009","journal-title":"Otol Neurotol"},{"issue":"21","key":"pone.0331105.ref003","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1001\/jama.279.21.1715","article-title":"Cigarette smoking and hearing loss: the epidemiology of hearing loss study","volume":"279","author":"KJ Cruickshanks","year":"1998","journal-title":"JAMA"},{"issue":"7","key":"pone.0331105.ref004","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1001\/archoto.2011.109","article-title":"Secondhand smoke and sensorineural hearing loss in adolescents","volume":"137","author":"AK Lalwani","year":"2011","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"1","key":"pone.0331105.ref005","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ijporl.2013.10.016","article-title":"Dose passive smoking induce sensorineural hearing loss in children?","volume":"78","author":"HS Talaat","year":"2014","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"pone.0331105.ref006","article-title":"Maternal prenatal smoking and hearing loss among adolescents","volume":"1","author":"M Weitzman","year":"2013","journal-title":"JAMA Otolaryngol Neck Surg"},{"issue":"4","key":"pone.0331105.ref007","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s10162-014-0461-0","article-title":"Cigarette smoking, passive smoking, alcohol consumption, and hearing loss","volume":"15","author":"P Dawes","year":"2014","journal-title":"J Assoc Res Otolaryngol"},{"issue":"1","key":"pone.0331105.ref008","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1136\/tc.2010.035832","article-title":"Secondhand smoke exposure and the risk of hearing loss","volume":"20","author":"DA Fabry","year":"2011","journal-title":"Tob Control"},{"issue":"8","key":"pone.0331105.ref009","doi-asserted-by":"crossref","first-page":"685","DOI":"10.3766\/jaaa.16161","article-title":"Effects of Secondhand Smoke Exposure on Hearing and Auditory Evoked Potentials, ABR and AMLR in Young Adults","volume":"29","author":"I Ramkissoon","year":"2018","journal-title":"J Am Acad Audiol"},{"issue":"1","key":"pone.0331105.ref010","doi-asserted-by":"crossref","first-page":"5746","DOI":"10.1038\/s41598-018-24166-9","article-title":"Chronic cigarette smoke exposure drives spiral ganglion neuron loss in mice","volume":"8","author":"ST Paquette","year":"2018","journal-title":"Sci Rep"},{"key":"pone.0331105.ref011","doi-asserted-by":"crossref","first-page":"33071","DOI":"10.1038\/srep33071","article-title":"Secondhand Smoke is Associated with Hearing Threshold Shifts in Obese Adults","volume":"6","author":"Y-Y Lin","year":"2016","journal-title":"Sci Rep"},{"key":"pone.0331105.ref012","volume-title":"Secondhand Smoke Exposure Among Nonsmoking Adults: United States, 2015-2018","author":"DJ Brody","year":"2021"},{"key":"pone.0331105.ref013","volume-title":"World report on hearing","year":"2021"},{"key":"pone.0331105.ref014","author":"National Center for Health Statistics","year":"2023"},{"key":"pone.0331105.ref015","unstructured":"Centers for Disease Control and Prevention. 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