{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:45:49Z","timestamp":1760060749209,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Hearing loss (HL) causes numerous challenges for individuals. N,N-diethyl-meta-toluamide (DEET) is a common ingredient in insect repellants and some sunscreens. M-(diethylcarbamoyl) benzoic acid (DCBA) is a DEET metabolite measured in the urine of National Health and Nutrition Examination Survey participants. This study examines potential associations between HL and urinary DCBA in U.S. adults. Speech-frequency hearing loss (SFHL) was defined as an average hearing threshold above 25 dB across four frequencies (0.5, 1, 2, and 4 kHz). In comparison, high-frequency hearing loss (HFHL) was based on the average threshold above 25 dB at three higher frequencies (3, 4, and 6 kHz) in the better hearing ear. Hearing loss severity was categorized as normal (\u226425 dB), mild (26\u201340 dB), and moderate or worse (\u226541 dB). Higher DCBA exposure was significantly associated with increased odds of high-frequency hearing loss (HFHL). Participants in the highest exposure quartile had greater odds of HFHL (aOR = 2.34; 95% CI: 1.14\u20134.81), with a dose\u2013response trend (p &lt; 0.05) confirmed in sensitivity analyses controlling for chronic conditions and inflammation. Multinomial models further showed elevated odds of both slight\/mild (aOR = 2.15; 95% CI: 1.05\u20134.42) and moderate\/worse HFHL (aOR = 2.84; 95% CI: 1.10\u20137.37), supporting the robustness of the association. To our knowledge, this is the first report of HL being associated with a DEET metabolite in a nationally representative cross-sectional sample.<\/jats:p>","DOI":"10.3390\/toxics13090801","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:08:03Z","timestamp":1758542883000},"page":"801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["DEET Metabolite and Hearing Loss in United States Adults"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5837-350X","authenticated-orcid":false,"given":"Rae T.","family":"Benedict","sequence":"first","affiliation":[{"name":"Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-3720","authenticated-orcid":false,"given":"Gregory M.","family":"Zarus","sequence":"additional","affiliation":[{"name":"Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Scinicariello","sequence":"additional","affiliation":[{"name":"Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry G.","family":"Abadin","sequence":"additional","affiliation":[{"name":"Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Attanasio","sequence":"additional","affiliation":[{"name":"Department of Biology, Georgia State University, Atlanta, GA 30303, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,20]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021). 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