Epidemiological investigations of tinnitus

Biswas, Roshni (2021) Epidemiological investigations of tinnitus. PhD thesis, University of Nottingham.

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Subjective tinnitus is defined as the conscious perception of an auditory sensation in the absence of a corresponding external stimulus. Severe tinnitus can significantly affect physical and mental well-being while incurring substantial social and financial costs on the individual and society. Nonetheless, tinnitus research and financial investment are substantially lower than other comparable conditions. Adequate assessment of tinnitus prevalence and investigating tinnitus-related risk factors could help recognise the burden of tinnitus and the need for adequate resource allocation. Understanding the epidemiology of tinnitus is crucial for addressing the population-level questions and identifying and quantifying exposures that predispose an individual to tinnitus.

The objectives of this PhD was to address two major aspects of tinnitus epidemiology: (i) estimating the Pan-European prevalence of tinnitus and (ii) identifying tinnitus-related risk factors and quantifying their association with tinnitus, particularly modifiable lifestyle-related risk factors.

A cross-sectional study using standardised assessment questions across 12 European countries estimated 15% prevalence for any, 6% for bothersome, and 1% for severe tinnitus. Eastern European countries showed a consistently higher prevalence compared to the rest of Europe. A literature search for tinnitus-related risk factors was conducted. Evidence from high-quality analytical studies reported an increased risk of tinnitus in the presence of hearing loss, occupational noise exposure, temporomandibular joint disorders, head injury, and ototoxic medications, and decreased risk in people with diabetes. Meta-analyses conducted mostly on cross-sectional studies, reported significantly increased tinnitus risk for smokers and the obese, but no effect of alcohol consumption. Analysing a real-world prospective cohort dataset, moderate alcohol consumption was observed to reduce the risk of incident tinnitus. Adherence to healthy dietary patterns, namely Dietary Approaches to Stop Hypertension (DASH) pattern and Alternative Mediterranean diet (AMED) diet, increased tinnitus risk. Obesity was observed to have no effect on incident tinnitus.

Around 65 million in the EU28 (including UK) report any tinnitus, 26 million report bothersome tinnitus and 4.4 million report severe tinnitus. Not much is known about the causal risk factors for tinnitus since most data are derived from cross-sectional studies. A meta-analysis on modifiable lifestyle-related risk factors found smoking to be related to tinnitus. In women, healthy diet increased the risk of developing tinnitus, while alcohol consumption in moderation was protective. Obesity did not affect tinnitus risk in women.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Hall, Deborah A.
Akeroyd, Michael A.
Keywords: Tinnitus epidemiology; Risk factors; Lifestyle-related risk factors
Subjects: W Medicine and related subjects (NLM Classification) > WV Otolaryngology
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 65705
Depositing User: Biswas, Roshni
Date Deposited: 04 Aug 2021 04:43
Last Modified: 04 Aug 2023 04:30
URI: https://eprints.nottingham.ac.uk/id/eprint/65705

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