Elevated lead levels as a risk factor for pediatric sensorineural hearing loss.

Area of Science:

• Environmental Health
• Pediatric Health
• Audiology

Background:

• Pediatric lead exposure persists despite the 1978 US ban on lead paint.
• The CDC's 2021 reference value for blood lead levels is 3.5 μg/dL, as even low levels are harmful.
• Neurologic effects of pediatric lead exposure are known, but the link to hearing loss is less studied.

Purpose of the Study:

• To investigate the association between pediatric lead exposure and sensorineural hearing loss (SNHL).

Main Methods:

• Utilized the TriNetx Analytics Network, querying de-identified electronic health records of over 78 million patients.
• Identified pediatric patients (≤18 years) with blood lead levels ≥3.5 μg/dL and a control group (<3.5 μg/dL).
• Excluded participants with congenital cytomegalovirus, inner ear malformations, or noise-induced hearing loss.

Main Results:

• Children with elevated blood lead levels (≥3.5 μg/dL) showed a 2.83% SNHL diagnosis rate.
• The control group (no elevated lead levels) had a 2.32% SNHL diagnosis rate.
• Elevated lead levels correlated with a 1.22 relative risk for SNHL (95% CI: 1.21-1.23, p=0.005).

Conclusions:

• Pediatric patients with blood lead levels ≥3.5 μg/dL were 1.22 times more likely to have SNHL.
• This study is the largest to examine lead exposure and SNHL using the CDC's current reference value.
• Clinicians should consider this association and refer children for audiology evaluations.