Recent prevalence estimates indicate that in 2015 almost half a billion people—about 6.8% of the world’s population—had disabling hearing loss and that prevalence numbers will further increase. The World Health Organization (WHO) currently estimates that at least 34 million children under the age of 15 have disabling hearing loss. Based on a 2012 WHO report, approximately 7.5 million of these children were under the age of 5 years. This review article focuses on the importance of high-quality newborn and infant hearing screening (NIHS) programs as one strategy to ameliorate disabling hearing loss as a global health problem. Two WHO resolutions regarding the prevention of deafness and hearing loss have been adopted urging member states to implement screening programs for early identification of ear diseases and hearing loss in babies and young children. The effectiveness of these programs depends on factors such as governmental mandates and guidance; presence of a national committee with involvement of professionals, industries, and stakeholders; central oversight of hearing screening; clear definition of target parameters; presence of tracking systems with bi-directional data transfer from screening devices to screening centers; accessibility of pediatric audiological services and rehabilitation programs; using telemedicine where connectivity is available; and the opportunity for case discussions in professional excellence circles with boards of experts. There is a lack of such programs in middle- and low-income countries, but even in high-income countries there is potential for improvement. Facing the still growing burden of disabling hearing loss around the world, there is a need to invest in national, high-quality NIHS programs.
The spectral properties of click- and tone-evoked otoacoustic emission (OAE) under ipsilateral simultaneous tonal masking conditions as well as the changes of click-evoked OAE under ipsilateral forward masking by clicks were studied in normal-hearing subjects. It was found that (i) transiently evoked OAE (TEOAE) spectra consist of a number of peaks individual to the subject and distributed along a sufficiently wide cochlear region; (ii) each spectral peak is excited only when the stimulus energy was concentrated within the frequency range covering the frequency of the particular peak; (iii) different TEOAE spectral peaks can be masked independently under simultaneous tonal masking conditions; (iv) the TEOAE tuning curve shape is more closely related to the spectrum of TEOAE but not to that of the stimulus; (v) forward masking of TEOAE generation is most pronounced during the first few milliseconds after masker click onset and become significantly smaller with the longer latency. It is suggested that: (i) TEOAE is generated by a number of local generators individually distributed along the cochlear partition within a sufficiently wide region and characterized by different power; (ii) possible efferent effects in the ipsilateral TEOAE suppression are negligible as compared to the TEOAE reduction of exclusively cochlear origin.
The European multicenter project named GUARD involved nine centers and aimed to assess potential changes in auditory function as a consequence of exposure to low-intensity electromagnetic fields (EMFs) produced by GSM cellular phones. Participants were healthy young adults without any evidence of hearing or ear disorders. Auditory function was assessed immediately before and after exposure to EMFs, and only the exposed ear was tested. The procedure was conducted twice in a double blinded design, once with a genuine EMF exposure and once with a sham exposure (at least 24 h apart). Tests for assessment of auditory function were hearing threshold level (HTL), transient otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR). The exposure consisted of speech at a typical conversational level delivered via an earphone to one ear, plus genuine or sham EMF exposure. The EMF exposure used the output of a software-controlled consumer cellular phone at full power for 10 min. A system of phone positioning that allowed participants to freely move their heads without affecting exposure was used. Analysis of the data showed there were no effects of exposure to GSM mobile phone signals on the main measures of the status of the auditory system.