{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:01:05Z","timestamp":1792216865726,"version":"4.4.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>High-intensity noise is associated with noise-induced hearing loss (NIHL). There is also evidence that noise exposure is related to cognitive impairment. This research aimed to analyze the associations and potential pathways of cumulative noise exposure (CNE), hearing loss and cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 560 research subjects were included in this research from May 2021 to April 2022 in western China. The demographic features, occupational features, and CNE were investigated and examined. Hearing loss was evaluated according to the National standard GB\/T 7583\u20131987 of China. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Structural equation modeling (SEM) was used to analyze the potential pathways and specific effect sizes of CNE, hearing loss and cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the research subjects was 34.3 (SD, 9.89). Men accounted for 96.4% (540\/560) and women accounted for 3.6% (20\/560). A total of 62.3% (349\/560) held a college degree or above. The regression analysis showed that high dose CNE was related to MMSE (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.069 (\u22121.539, \u22120.600)) and MoCA (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.040 (\u22121.726, \u22120.355)) scores. The monaural threshold weighted value of the right ear (MTWV<jats:sub>R<\/jats:sub>) greater than 40\u202fdB was associated with both MMSE (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.183 (\u22122.033, \u22120.333)) and MoCA (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.420 (\u22122.647, \u22120.193)) scores. The monaural threshold weighted value of the left ear (MTWV<jats:sub>L<\/jats:sub>) greater than 40\u202fdB was also associated with MMSE (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.540 (\u22122.389, \u22120.690)) and MoCA (<jats:italic>\u03b2<\/jats:italic>\u202f=\u202f\u22121.685 (\u22122.915, \u22120.456)) scores. The SEM result (Model C) showed that the standard effect of CNE- hearing loss path, CNE-MMSE path, and hearing loss-MMSE path were 0.142 (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), \u22120.151 (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and \u22120.030 (<jats:italic>p<\/jats:italic>\u202f=\u202f0.376). The Model D showed that the standard effect of CNE- hearing loss path, CNE- MoCA path, and hearing loss- MoCA path were 0.143 (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), \u22120.048 (<jats:italic>p<\/jats:italic>\u202f=\u202f0.267), and\u202f\u2212\u202f0.050 (<jats:italic>p<\/jats:italic>\u202f=\u202f0.047). The CNE had only a direct effect on the MMSE score. Conversely, the CNE had only an indirect effect on the MoCA score, while hearing loss was borderline associated with MoCA. The total effects of CNE on MMSE and MoCA scores were \u22120.151 and \u22120.007, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Job-related noise exposure is not only associated with NIHL but also with early cognitive impairment in occupational groups. However, there is not enough evidence indicating that NLHL mediates the associations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1455340","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T06:52:03Z","timestamp":1739947923000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Noise exposure, hearing loss and cognitive impairment: a cross-sectional study based on an occupational health surveillance cohort in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Lei","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shushan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajia","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.smrv.2006.09.001","article-title":"Environmental noise, sleep and health","volume":"11","author":"Muzet","year":"2007","journal-title":"Sleep Med Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1289\/ehp.1103448","article-title":"Transportation noise and blood pressure in a population-based sample of adults","volume":"120","author":"Dratva","year":"2012","journal-title":"Environ Health Perspect"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"9145","DOI":"10.3390\/ijerph18179145","article-title":"Effects of exposure to road, railway, airport and recreational Noise on blood pressure and hypertension","volume":"18","author":"Petri","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1177\/1351010X18756800","article-title":"Effects of low-frequency noise on human cognitive performances in laboratory","volume":"25","author":"Rossi","year":"2018","journal-title":"Building Acoustics"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1121\/1.5147125","article-title":"Annoyance at the point of emission versus immission for impulsive noises at train passings","volume":"148","author":"Huth","year":"2020","journal-title":"J Acoust Soc Am"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"190","DOI":"10.4103\/nah.NAH_3_18","article-title":"The interactive effect of occupational noise on attention and short-term memory: a pilot study","volume":"20","author":"Monteiro","year":"2018","journal-title":"Noise Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1051\/aacus\/2021057","article-title":"Influence of road traffic noise peaks on reading task performance and disturbance in a laboratory context","volume":"6","author":"Lavandier","year":"2022","journal-title":"Acta Acustica"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"320","DOI":"10.4103\/1463-1741.165057","article-title":"Noise 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Neurophysiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/s0896-6273(03)00033-3","article-title":"Hippocampal place cells acquire location-specific responses to the conditioned stimulus during auditory fear conditioning","volume":"37","author":"Moita","year":"2003","journal-title":"Neuron"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"102","DOI":"10.3389\/fncel.2018.00102","article-title":"Septal and hippocampal neurons contribute to auditory relay and fear conditioning","volume":"12","author":"Xiao","year":"2018","journal-title":"Front Cell Neurosci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jns.2016.07.049","article-title":"Effects of chronic noise on mRNA and protein expression of CRF family molecules and its relationship with p-tau in the rat prefrontal cortex","volume":"368","author":"Gai","year":"2016","journal-title":"J Neurol 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A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2721","DOI":"10.20043\/j.cnki.MPM.202212301","article-title":"Preliminary discussion and application of occupation-related cumulative noise exposure assessment method","volume":"50","author":"Jing","year":"2023","journal-title":"Modern Preven Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1001\/jamaoto.2017.2513","article-title":"Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis","volume":"144","author":"Loughrey","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"150","DOI":"10.3109\/00206099209072910","article-title":"Left-right asymmetries in hearing threshold levels in three age groups of a random population","volume":"31","author":"Piril\u00e4","year":"1992","journal-title":"Audiology"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1097\/00003446-199310000-00003","article-title":"Factors affecting laterality of standard threshold shift in occupational hearing conservation programs","volume":"14","author":"Simpson","year":"1993","journal-title":"Ear Hear"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e627","DOI":"10.1097\/mao.0000000000001908","article-title":"Hearing loss asymmetry due to chronic occupational Noise exposure","volume":"39","author":"Sturman","year":"2018","journal-title":"Otol Neurotol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1002\/ajim.23105","article-title":"Occupational noise exposure and asymmetric hearing loss: results from the HUNT population study in Norway","volume":"63","author":"Aarhus","year":"2020","journal-title":"Am J Ind Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1136\/oemed-2018-105041","article-title":"Patterns and trends in OSHA occupational noise exposure measurements from 1979 to 2013","volume":"76","author":"Sayler","year":"2019","journal-title":"Occup Environ Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1002\/ajim.22827","article-title":"Hearing loss among older construction workers: updated analyses","volume":"61","author":"Dement","year":"2018","journal-title":"Am J Ind Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1002\/ajim.4700200407","article-title":"Occupational hearing loss in New York dairy farmers","volume":"20","author":"Marvel","year":"1991","journal-title":"Am J Ind Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1017\/s1041610212001068","article-title":"The Montreal cognitive assessment is superior to the mini-mental state examination in detecting patients at higher risk of dementia","volume":"24","author":"Dong","year":"2012","journal-title":"Int Psychogeriatr"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1017\/s1041610218001370","article-title":"Is the Montreal cognitive assessment (MoCA) screening superior to the mini-mental state examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly?","volume":"31","author":"Pinto","year":"2019","journal-title":"Int Psychogeriatr"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e743","DOI":"10.1093\/geront\/gny126","article-title":"Can MoCA and MMSE be interchangeable cognitive screening tools? 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