{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:23:39Z","timestamp":1791206619168,"version":"4.1.0"},"reference-count":60,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Whether exposure to air pollution is associated with developing sensorineural hearing loss (SHL) remains controversial. Using data from the National Health Insurance Research Database, we recruited a total of 75,767 subjects aged older than 20 years with no history of SHL from 1998 to 2010, and they were followed up until SHL was observed, they withdrew from the National Health Insurance program, or the study ended. The subjects were evenly exposed to low-level, mid-level, and high-level carbon monoxide (CO) and nitrogen dioxide (NO2). The incidence rate ratio of SHL for patients exposed to high-level CO was 1.24 (95% confidence interval (CI) = 1.14\u20131.36). The NO2 pollutants increased the incidence rate ratios of SHL in mid-level NO2 and high-level NO2 exposures by 1.10 (95% CI = 1.10\u20131.32) and 1.36 (95% CI = 1.24\u20131.49) times, respectively. The adjusted hazard ratio (adj. HR) of SHL in patients exposed to high-level CO was 1.45 (95% CI = 1.31\u20131.59), relative to that of patients exposed to low-level CO. Compared to patients exposed to low-level NO2, patients exposed to mid-level NO2 (adj. HR = 1.40, 95% CI = 1.27\u20131.54) and high-level NO2 (adj. HR = 1.63, 95% CI = 1.48\u20131.81) had a higher risk of developing SHL. The increased risk of SHL following the increased concentrations of air pollutants (CO and NO2) was statistically significant in this study. In conclusion, the subjects\u2019 exposure to air pollution exhibited a significantly higher risk of developing SHL in Taiwan.<\/jats:p>","DOI":"10.3390\/ijerph17061969","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T08:20:44Z","timestamp":1584519644000},"page":"1969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Increased Risk of Sensorineural Hearing Loss as a Result of Exposure to Air Pollution"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4453-0068","authenticated-orcid":false,"given":"Kuang-Hsi","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Medical Research, Tungs\u2019 Taichung Metroharbor Hospital, Taichung 43503, Taiwan"},{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan"},{"name":"General Education Center, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 35664, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-1207","authenticated-orcid":false,"given":"Stella Chin-Shaw","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung Metroharbor Hospital, Taichung 43503, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Yin","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus), Kaohsiung 84001, Taiwan"},{"name":"Department of Chinese Medicine, E-DA Hospital, Kaohsiung 82445, Taiwan"},{"name":"Department of Chinese Medicine, E-DA Cancer Hospital, Kaohsiung 82445, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruey-Hwang","family":"Chou","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan"},{"name":"Center for Molecular Medicine, China Medical University Hospital, Taichung 40402, Taiwan"},{"name":"Department of Biotechnology, Asia University, Taichung 41354, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hueng-Chuen","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Tungs\u2019 Taichung Metroharbor Hospital, Taichung 43503, Taiwan"},{"name":"Department of Pediatrics, Department of Medical Research, Tungs\u2019 Taichung Metroharbor Hospital, Taichung 43503, Taiwan"},{"name":"Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 35664, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5301-2345","authenticated-orcid":false,"given":"Frank Cheau-Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9071-475X","authenticated-orcid":false,"given":"Yi-Chao","family":"Hsu","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 252, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Xing, D.F., Xu, C.D., Liao, X.Y., Xing, T.Y., Cheng, S.P., Hu, M.G., and Wang, J.X. 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