Loud Noise Exposure and Acoustic Neuroma
Loud Noise Exposure and Acoustic Neuroma
The results from studies of loud noise exposure and acoustic neuroma are conflicting. A population-based case-control study of 451 acoustic neuroma patients and 710 age-, sex-, and region-matched controls was conducted in Sweden between 2002 and 2007. Occupational exposure was based on historical measurements of occupational noise (321 job titles summarized by a job exposure matrix) and compared with self-reported occupational noise exposure. We also evaluated self-reported noise exposure during leisure activity. Conditional logistic regression was used to estimate odds ratios. There was no statistically significant association between acoustic neuroma and persistent occupational noise exposure, either with or without hearing protection. Exposure to loud noise from leisure activity without hearing protection was more common among acoustic neuroma cases (odds ratio = 1.47, 95% confidence interval: 1.06, 2.03). Statistically significant odds ratios were found for specific leisure activities including attending concerts/clubs/sporting events (odds ratio = 1.82, 95% confidence interval: 1.09, 3.04) and participating in workouts accompanied by loud music (odds ratio = 2.84, 95% confidence interval: 1.37, 5.89). Our findings do not support an association between occupational exposure to loud noise and acoustic neuroma. Although we report statistically significant associations between leisure-time exposures to loud noise without hearing protection and acoustic neuroma, especially among women, we cannot rule out recall bias as an alternative explanation.
Acoustic neuroma (also referred to as vestibular schwannoma) is a benign, usually nonlethal tumor arising from Schwann cells in the vestibulocochlear nerve. This rare tumor accounts for approximately 6% of intracranial tumors, with an incidence rate of 11–13 cases per million per year.
Acoustic neuroma presents either bilaterally in its hereditary form or unilaterally as a sporadic disease. Bilateral acoustic neuroma is a primary manifestation of neurofibromatosis type 2, a highly penetrant autosomal dominant disorder. The etiology of the more common sporadic unilateral form is unknown, although there is evidence of associations with ionizing radiation and occupational exposures, such as mercury. Mobile phone use has also been investigated, but findings are inconclusive.
The 3 previous studies that examined exposure to leisure-time loud noise to determine whether it is associated with acoustic neuroma were substudies within the INTERPHONE Study and, therefore, used identical questions to ascertain exposure, but their results were conflicting. Five previous studies evaluated occupational noise exposure for evidence of association with acoustic neuroma. Three of these studies were substudies within the INTERPHONE Study and were based on self-reported exposure to loud noise. An earlier study had examined self-reported occupations linked to a job exposure matrix (JEM), and a fifth study evaluated census information on occupations linked to a JEM.
The purpose of the present study was to evaluate potential associations between acoustic neuroma and occupational exposure to loud noise, using both self-reported and JEM data. We also examined self-reported leisure-time exposure to loud noise.
Abstract and Introduction
Abstract
The results from studies of loud noise exposure and acoustic neuroma are conflicting. A population-based case-control study of 451 acoustic neuroma patients and 710 age-, sex-, and region-matched controls was conducted in Sweden between 2002 and 2007. Occupational exposure was based on historical measurements of occupational noise (321 job titles summarized by a job exposure matrix) and compared with self-reported occupational noise exposure. We also evaluated self-reported noise exposure during leisure activity. Conditional logistic regression was used to estimate odds ratios. There was no statistically significant association between acoustic neuroma and persistent occupational noise exposure, either with or without hearing protection. Exposure to loud noise from leisure activity without hearing protection was more common among acoustic neuroma cases (odds ratio = 1.47, 95% confidence interval: 1.06, 2.03). Statistically significant odds ratios were found for specific leisure activities including attending concerts/clubs/sporting events (odds ratio = 1.82, 95% confidence interval: 1.09, 3.04) and participating in workouts accompanied by loud music (odds ratio = 2.84, 95% confidence interval: 1.37, 5.89). Our findings do not support an association between occupational exposure to loud noise and acoustic neuroma. Although we report statistically significant associations between leisure-time exposures to loud noise without hearing protection and acoustic neuroma, especially among women, we cannot rule out recall bias as an alternative explanation.
Introduction
Acoustic neuroma (also referred to as vestibular schwannoma) is a benign, usually nonlethal tumor arising from Schwann cells in the vestibulocochlear nerve. This rare tumor accounts for approximately 6% of intracranial tumors, with an incidence rate of 11–13 cases per million per year.
Acoustic neuroma presents either bilaterally in its hereditary form or unilaterally as a sporadic disease. Bilateral acoustic neuroma is a primary manifestation of neurofibromatosis type 2, a highly penetrant autosomal dominant disorder. The etiology of the more common sporadic unilateral form is unknown, although there is evidence of associations with ionizing radiation and occupational exposures, such as mercury. Mobile phone use has also been investigated, but findings are inconclusive.
The 3 previous studies that examined exposure to leisure-time loud noise to determine whether it is associated with acoustic neuroma were substudies within the INTERPHONE Study and, therefore, used identical questions to ascertain exposure, but their results were conflicting. Five previous studies evaluated occupational noise exposure for evidence of association with acoustic neuroma. Three of these studies were substudies within the INTERPHONE Study and were based on self-reported exposure to loud noise. An earlier study had examined self-reported occupations linked to a job exposure matrix (JEM), and a fifth study evaluated census information on occupations linked to a JEM.
The purpose of the present study was to evaluate potential associations between acoustic neuroma and occupational exposure to loud noise, using both self-reported and JEM data. We also examined self-reported leisure-time exposure to loud noise.
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