{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:16:21Z","timestamp":1789186581812,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T00:00:00Z","timestamp":1571270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["K01- ES028750-01; P30 ES020957"],"award-info":[{"award-number":["K01- ES028750-01; P30 ES020957"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. We enrolled firefighters from Michigan, with at least 5 years of continuous service. The hearing handicap inventory for adults (HHIA) was used to determine the difficulty in hearing perceived by the firefighters and the tinnitus functional index (TFI) was used to determine the severity of tinnitus. Self-perceived hearing handicap was reported by 36% of the participants, while tinnitus was reported by 48% of the participants. The TFI survey indicated that 31% perceived tinnitus as a problem. More importantly, self-perceived hearing handicap was significantly associated with the incidence of tinnitus in firefighters, suggesting a potential link between occupational exposure to ototraumatic agents and tinnitus in firefighters.<\/jats:p>","DOI":"10.3390\/ijerph16203958","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T11:07:59Z","timestamp":1571310479000},"page":"3958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Tinnitus and Self-Perceived Hearing Handicap in Firefighters: A Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Samson","family":"Jamesdaniel","sequence":"first","affiliation":[{"name":"Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA"},{"name":"Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem G.","family":"Elhage","sequence":"additional","affiliation":[{"name":"Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Rosati","sequence":"additional","affiliation":[{"name":"Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samiran","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7173-4333","authenticated-orcid":false,"given":"Bengt","family":"Arnetz","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Blessman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,17]]},"reference":[{"key":"ref_1","unstructured":"Blackwell, D.L., Lucas, J.W., and Clarke, T.C. (2014). Summary health statistics for US adults: National Health Interview Survey, 2012, Vital Health Statistics."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1080\/15459620701880659","article-title":"Perception and attitudes of firefighters on noise exposure and hearing loss","volume":"5","author":"Hong","year":"2008","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.disamonth.2013.01.003","article-title":"Chemical exposure and hearing loss","volume":"59","author":"Campo","year":"2013","journal-title":"Dis. Mon."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3766\/jaaa.25.1.2","article-title":"Underlying mechanisms of tinnitus: Review and clinical implications","volume":"25","author":"Henry","year":"2014","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.amjmed.2010.02.015","article-title":"Prevalence and characteristics of tinnitus among US adults","volume":"123","author":"Shargorodsky","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1097\/MAO.0000000000000312","article-title":"Willingness-to-accept Gamma knife radiosurgery for tinnitus among career San Francisco firefighters","volume":"35","author":"Pross","year":"2014","journal-title":"Otol. Neurotol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2134\/jeq2004.1630","article-title":"Heavy metals in an urban watershed in southeastern Michigan","volume":"33","author":"Murray","year":"2004","journal-title":"J. Environ. Qual."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00003446-199012000-00004","article-title":"The Hearing Handicap Inventory for Adults: Psychometric adequacy and audiometric correlates","volume":"11","author":"Newman","year":"1990","journal-title":"Ear Hear"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/00003446-199110000-00009","article-title":"Test-retest reliability of the hearing handicap inventory for adults","volume":"12","author":"Newman","year":"1991","journal-title":"Ear Hear"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/AUD.0b013e31822f67c0","article-title":"The tinnitus functional index: Development of a new clinical measure for chronic, intrusive tinnitus","volume":"33","author":"Meikle","year":"2012","journal-title":"Ear Hear"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.heares.2015.06.004","article-title":"Tinnitus Functional Index: Development, validation, outcomes research, and clinical application","volume":"334","author":"Henry","year":"2016","journal-title":"Hear Res."},{"key":"ref_12","first-page":"377","article-title":"Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development","volume":"10","author":"Bibas","year":"2016","journal-title":"Front. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1053\/ajot.2000.9871","article-title":"Tinnitus and insomnia","volume":"21","author":"Folmer","year":"2000","journal-title":"Am. J. Otolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.heares.2015.08.014","article-title":"Tinnitus and anxiety disorders: A review","volume":"333","author":"Pattyn","year":"2016","journal-title":"Hear Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/AUD.0000000000000045","article-title":"Socio-demographic, health, and tinnitus related variables affecting tinnitus severity","volume":"35","author":"Hoekstra","year":"2014","journal-title":"Ear Hear"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Castellanos, M.J., and Fuente, A. (2016). The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review. Int J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13121223"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7205\/MILMED-D-10-00353","article-title":"Self-reported tinnitus and ototoxic exposures among deployed Australian Defence Force personnel","volume":"176","author":"Kirk","year":"2011","journal-title":"Mil. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1289\/ehp.1104863","article-title":"Environmental cadmium and lead exposures and hearing loss in US adults: The National Health and Nutrition Examination Survey, 1999 to 2004","volume":"120","author":"Choi","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.toxlet.2018.05.004","article-title":"Chronic lead exposure induces cochlear oxidative stress and potentiates noise-induced hearing loss","volume":"292","author":"Jamesdaniel","year":"2018","journal-title":"Toxicol. Lett."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1038\/jes.2014.72","article-title":"Hearing among male firefighters: A comparison with hearing data from screened and unscreened male population","volume":"25","author":"Kang","year":"2015","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neuroscience.2019.03.021","article-title":"Overview: Hearing loss, tinnitus, hyperacusis, and the role of central gain","volume":"407","author":"Roberts","year":"2019","journal-title":"Neuroscience"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/2165079916629975","article-title":"Double Jeopardy: Hearing Loss and Tinnitus Among Noise-Exposed Workers","volume":"64","author":"Hong","year":"2016","journal-title":"Workplace Health Saf."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/20\/3958\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:27:14Z","timestamp":1760189234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/20\/3958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,17]]},"references-count":22,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2019,10]]}},"alternative-id":["ijerph16203958"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16203958","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,17]]}}}