Lisa Aarhus

• Aarhus, Lisa; Skare, Øivind; Nordby, Karl-Christian; Gulsvik, Anne Kristine; Vikjord, Sigrid Anna Aalberg & Hedman, L. [Show all 7 contributors for this article] (2025). Occupation and 11-year lung function decline in the HUNT Study. Occupational Medicine. ISSN 0962-7480. 74(9), p. 676–683. doi: 10.1093/occmed/kqae115. Full text in Research Archive Show summary

  Background: The association between occupational titles and lung function has mostly been examined through cross-sectional studies. Preventive measures are expected to mitigate adverse effects; hence, updated estimates are necessary. Aims: To study change in lung function measured by spirometry across occupations. Methods: This population-based prospective cohort study comprised 5618 working adult participants of the Trøndelag Health Study (HUNT3, 2005–07), Norway. Among these, 3800 individuals (43% men, mean age 42 years, range 20–55) also attended HUNT4 (2017–19). We analysed longitudinal decline in forced expiratory volume in 1 second (FEV1 ) z-score during the 11-year follow-up by occupation (white-collar workers as reference category), in mixed models, adjusting for age, sex and smoking. We assessed the prevalence of self-reported respiratory symptoms and disease in the working population in HUNT4 (n = 32 124) and HUNT3 (n = 32 070). Results: Compared with white-collar workers, agricultural workers and ‘drivers and mobile plant operators’, had larger declines in FEV1 z-score during follow-up. In sex-stratified analyses, men defined as agricultural workers and ‘drivers and mobile plant operators’ had larger declines than white-collar workers. Among women, who were underrepresented in many blue-collar jobs, workers classified as ‘machine operators and assemblers’ experienced greater declines. In the working population in HUNT4, the prevalence of respiratory symptoms in connection with work was 8%, and lower among white-collar workers (6%) than blue-collar workers (14%). Conclusions: Although certain workers in Norway remain at risk for occupational lung function decline, there were modest differences between occupations. The findings encourage continuous efforts to implement preventive measures in high-risk jobs.

• Engdahl, Bo Lars & Aarhus, Lisa (2024). Prevalence and predictors of self-reported hearing aid use and benefit in Norway: the HUNT study. BMC Public Health. 24(1). doi: 10.1186/s12889-024-17852-z. Full text in Research Archive Show summary

  Background Knowledge on hearing aid use and benefit is important to ensure appropriate and effective treatment. We aimed to assess prevalence and predictors of hearing aid use and benefit in Norway, as well as possible birth cohort changes. Methods We analyzed two large cross-sectional, population-based hearing surveys of 63,182 adults in 1996–1998 and 2017–2019 (the HUNT study). We used multivariable regression models to examine independent predictors of hearing aid use and benefit, including demography, hearing-related variables, known risk factors for hearing loss and birth cohort. Results The nationally weighted hearing aid use in the adult population increased from 4.2% in 1997 to 5.8% in 2018. The use among individuals with disabling hearing loss (≥ 35 dB HL) increased from 46.3% to 64.4%. Most users reported some (47%) or great (48%) help from their hearing aids. In addition to the level of hearing loss and birth cohort, factors associated with hearing aid use included lower age, tinnitus, childhood-onset hearing loss, higher education, marriage, having children, being exposed to occupational noise or impulse noise, recurrent ear infections, and head injury. In addition to the level of hearing loss, factors related to hearing aid benefit included younger age, female gender, and higher income. Being bothered by tinnitus reduced the benefit. Conclusion Our study shows an increase in self-reported hearing aid usage over time in Norway, with lower adoption rates and perceived benefits observed among the elderly. The results suggest that having a spouse and children positively influences the adoption of hearing aids. These findings emphasize the necessity of customized strategies to address demographic disparities and the need for innovative enhancements in hearing rehabilitation programs.

• Jørgensen, Astrid; Engdahl, Bo Lars; Bratsberg, Bernt Magne; Mehlum, Ingrid Sivesind; Hoffman, Howard J. & Aarhus, Lisa (2024). Hearing Loss and Annual Earnings Over a 20-Year Period: The HUNT Cohort Study. Ear and Hearing. ISSN 0196-0202. 46(1), p. 121–127. doi: 10.1097/AUD.0000000000001554. Full text in Research Archive Show summary

  Objectives: The association between hearing loss and income has only been examined in cross-sectional studies. We aim to study annual increase in earnings over 20 years, comparing people with and without hearing loss. Design: We used data from a population-based hearing study in Norway (The Trøndelag Health Study, 1996–1998), including 14,825 persons (46.2% men, mean age at baseline 30.6 years, age range 20 to 40 years). Hearing loss was defined as the pure-tone average threshold of 0.5 to 4 kHz in the better hearing ear ≥20 dB HL (n = 230). Annual earnings were assessed from 1997 to 2017. Longitudinal analyses were performed with linear mixed models adjusted for age, sex, and education. Results: People without hearing loss at baseline (before age 40) had a greater annual increase in earnings over a 20-year follow-up period compared with people with hearing loss. For people with normal hearing, annual earnings over 20 years increased by 453 Euro (EUR) (95% confidence interval [CI] = 384 to 522) or 13.2% more per year than for people with hearing loss, adjusted for age and sex. The difference in annual earnings over 20 year was greater among women (462 EUR, 95% CI = 376 to 547) than men (424 EUR, 95% CI = 315 to 533), greater among younger than older adults, and greater among lower than higher educated persons. When including adjustment for education in the model, in addition to age and sex, the difference in annual earnings over 20 years between persons with and without hearing loss was reduced (337 EUR, 95% CI = 269 to 405). Conclusions: The results from this large population-based study indicates that people with hearing loss experience lower long-term earnings growth compared with people with normal hearing. The findings highlight the need for increased interventions in the workplace for people with hearing loss.

• Molaug, Ina Charlotte; Aarhus, Lisa; Mehlum, Ingrid Sivesind; Stokholm, Zara Ann; Kolstad, Henrik A. & Engdahl, Bo Lars (2023). Occupational noise exposure and tinnitus: the HUNT Study. International Journal of Audiology. ISSN 1499-2027. doi: 10.1080/14992027.2023.2211735. Full text in Research Archive Show summary

  Objective: We aimed to assess the association between occupational noise exposure and tinnitus. Further, to assess whether the association depends on hearing status. Design: In this cross-sectional study, tinnitus (>1 h daily) was regressed on job exposure matrix (JEM)-based or self-reported occupational noise exposure, adjusted for confounders. Study sample: The 14,945 participants (42% men, 20–59 years) attended a population-based study in Norway (HUNT4, 2017-2019). Results: JEM-based noise exposure, assessed as equivalent continuous sound level normalised to 8-h working days (LEX 8 h), over the working career or as minimum 5 years ≥85 dB) was not associated with tinnitus. Years of exposure ≥80 dB (minimum one) was not associated with tinnitus. Self-reported high noise exposure (>15 h weekly ≥5 years) was associated with tinnitus overall and among persons with elevated hearing thresholds (prevalence ratio (PR) 1.3, 1.0–1.7), however not statistically significantly among persons with normal thresholds (PR 1.1, 0.8–1.5). Conclusions: Our large study showed no association between JEM-based noise exposure and tinnitus. This may to some extent reflect successful use of hearing protection. High self-reported noise exposure was associated with tinnitus, but not among normal hearing persons. This supports that noise-induced tinnitus to a large extent depends on audiometric hearing loss

• Aarhus, Lisa; Molaug, Ina Charlotte & Engdahl, Bo Lars (2023). No accelerated 20-year hearing decline after occupational noise exposure has ceased: The HUNT study. American Journal of Industrial Medicine. ISSN 0271-3586. 67(1), p. 10–17. doi: 10.1002/ajim.23543. Full text in Research Archive Show summary

  Objectives It has been suggested that noise exposure can accelerate hearing decline after the noise exposure has ceased. We aimed to assess long-term hearing decline in persons with and without prior occupational noise exposure. Methods We conducted a population-based longitudinal study in Norway using the Trøndelag Health Study (HUNT) from 1996 to 1998 (baseline) and from 2017 to 2019 (follow-up). The sample included 1648 participants with baseline age ≥55 years (42% men, mean age 60 years) and <5 years occupational noise exposure after baseline. We analyzed the association between occupational noise exposure before baseline and mean hearing decline between 1998 and 2018 (20-year decline) at each frequency, adjusted for age, sex, education, and impulse noise exposure before baseline. Results Occupational noise exposure before baseline (N = 603) was associated with baseline hearing loss, but not with later accelerated 20-year decline, at any frequency. Noise-exposed persons had less subsequent 20-year decline at 3 kHz than did nonexposed. Restricting the noise-exposed group to persons who also had a baseline Coles notch (hearing thresholds at 3, 4, or 6 kHz of 10 dB or more compared with thresholds at 1 or 2 kHz and 6 or 8 kHz; N = 211), the exposed group showed less 20-year decline at both 3 and 4 kHz, as well as less accelerated 20-year decline at 8 kHz, compared with the nonexposed. Conclusion Our large long-term longitudinal study shows no increased risk of continuing hearing decline after occupational noise exposure has ceased. The finding supports a conclusion that ear damage stops when the noise exposure is ended.

• Moradi, Shahram; Engdahl, Bo Lars; Johannessen, Aud; Selbæk, Geir; Aarhus, Lisa & Haanes, Gro Gade (2023). Hearing loss, hearing aid use, and subjective memory complaints: Results of the HUNT study in Norway. Frontiers in Neurology. 13. doi: 10.3389/fneur.2022.1094270. Full text in Research Archive Show summary

  Objective. To study the association between hearing loss severity, hearing aid use, and subjective memory complaints in a large cross-sectional study in Norway. Methods. Data were drawn from the fourth wave of the Trøndelag Health Study (HUNT4 Hearing, 2017–2019). Hearing threshold was defined as the pure tone average of 0.5, 1, 2 and 4 kHz in the better ear. The participants were divided into five groups: normal hearing or slight/mild/moderate/severe hearing loss. Subjective self-reported short-term and long-term memory complaints was measured by the nine-item Meta-Memory Questionnaire (MMQ). The sample included 20,092 individuals (11,675 women, mean age 58,3 years) who completed both hearing and MMQ tasks. Multivariate analysis of variance (adjusted for covariates of age, sex, education, and health cofounders) was used to evaluate the association between hearing status and hearing aid use (in the hearing-impaired groups) and long-term and short-term subjective memory complaints. Results. Multivariate analysis of variance, followed by univariate ANOVA and pairwise comparisons showed that hearing loss was associated only with more long-term subjective memory complaints and not with short-term subjective memory complaints. In the hearing-impaired groups, the univariate main effect of hearing aid use was only observed for subjective long-term memory complaints and not for subjective short-term memory complaints. Similarly, the univariate interaction of hearing aid use and hearing status was significant for subjective long-term memory complaints and not for subjective short-term memory complaints. Pairwise comparisons, however, revealed no significant differences between hearing loss groups with respect to subjective long-term complaints. Conclusion. This cross-sectional study indicates an association between hearing loss and subjective long-term memory complaints, but not with subjective short-term memory complaints. In addition, an interaction between hearing status and hearing aid use for subjective long-term memory complaints was observed in hearing-impaired groups, which calls for future research to examine the effects of hearing aid use on different memory systems.

• Moradi, Shahram; Engdahl, Bo Lars; Johannessen, Aud; Selbæk, Geir; Aarhus, Lisa & Haanes, Gro Gade (2023). Hearing loss, hearing aid use, and performance on the Montreal cognitive assessment (MoCA): findings from the HUNT study in Norway. Frontiers in Neuroscience. ISSN 1662-4548. 17. doi: 10.3389/fnins.2023.1327759. Full text in Research Archive Show summary

  Purpose. To evaluate the associations between hearing status and hearing aid use and performance on the Montreal Cognitive Assessment (MoCA) in older adults in a cross-sectional study in Norway. Methods. This study utilized data from the fourth wave of the Trøndelag Health Study (HUNT4, 2017–2019). Hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz (or PTA4) in the better hearing ear were used to determine participants’ hearing status (normal hearing [PTA4 hearing threshold, ≤ 15 dB], or slight [PTA4, 16–25 dB], mild [PTA4, 26–40 dB], moderate [PTA4, 41–55 dB], or severe [PTA4, ≥ 56 dB] hearing loss). Both standard scoring and alternate MoCA scoring for people with hearing loss (deleting MoCA items that rely on auditory function) were used in data analysis. The analysis was adjusted for the confounders age, sex, education, and health covariates. Results. The pattern of results for the alternate scoring was similar to that for standard scoring. Compared with the normal-hearing group, only individuals with moderate or severe hearing loss performed worse in the MoCA. In addition, people with slight hearing loss performed better in the MoCA than those with moderate or severe hearing loss. Within the hearing loss group, hearing aid use was associated with better performance in the MoCA. No interaction was observed between hearing aid use and participants’ hearing status with performance on the MoCA test. Conclusion. While hearing loss was associated with poorer performance in the MoCA, hearing aid use was found to be associated with better performance in the MoCA. Future randomized control trials are needed to further examine the efficacy of hearing aid use on the MoCA performance. When compared with standard scoring, the alternate MoCA scoring had no effect on the pattern of results.

• Aarhus, Lisa; Sand, Morten & Engdahl, Bo Lars (2023). COPD and 20-year hearing decline: The HUNT cohort study. Respiratory Medicine. ISSN 0954-6111. 212. doi: 10.1016/j.rmed.2023.107221. Full text in Research Archive Show summary

  Background We aimed to assess the association between chronic obstructive pulmonary disease (COPD) and long-term hearing decline. A further aim was to study sex differences. Methods Population-based cohort study in Norway (the HUNT study) with baseline measurements in 1996–1998 and follow-up in 2017–2019. The sample included 12,082 participants (43% men, mean age at follow-up 64 years). We used multiple linear regression to assess the association between COPD (minimum one registered ICD-10 code with emphysema or other COPDs during follow-up) and 20-year hearing decline in the low/mid/high frequency area (0.25–0.5/1–2/3-8 kHz). We adjusted for age, sex, education, smoking, noise exposure, ear infections, hypertension and diabetes. Results Persons registered with COPD (N = 403) had larger 20-year hearing decline at low frequencies (1.5 dB, 95% confidence interval (CI) 0.6–2.3) and mid frequencies (1.2 dB, 95% CI 0.4–2.1), but not at high frequencies. At high frequencies, the association was stronger and statistically significant only among women (1.9 dB, 95% CI 0.6–3.2). Persons registered with both COPD and respiratory failure (N = 19) had larger 20-year hearing decline at low and mid frequencies: 7.4 dB (95% CI 3.6–11.2) and 4.5 dB (95% CI 0.7–8.4), respectively. Conclusion Our large cohort study shows an association between COPD and increased long-term hearing decline. Women seem to be more susceptible to COPD-related hearing loss at high frequencies. The findings support that COPD can affect the cochlear function.

• Molaug, Ina Charlotte; Engdahl, Bo Lars; Degerud, Eirik Magnus Meek; Mehlum, Ingrid Sivesind & Aarhus, Lisa (2022). Occupation and 20-year hearing decline: findings from The HUNT Study. Occupational Medicine. ISSN 0962-7480. 72(9), p. 622–628. doi: 10.1093/occmed/kqac085. Full text in Research Archive Show summary

  Background: Studies show that certain occupations are associated with an increased risk of hearing loss. However, many studies are cross-sectional, and the few longitudinal studies are mostly small or focus on only one occupation. Aims: We aimed to quantify the long-term hearing decline among workers in different occupations and assess whether the change differs between the occupations. Methods: The study population was 4525 adults who participated in two population-based health studies in Norway, HUNT2 1996-1998 and HUNT4 2017-2019. Linear regression models assessed the association between occupations (clerks as reference) and 20-year hearing decline (hearing thresholds at 3-6 kHz, averaged over both ears) from HUNT2 to HUNT4. Models were adjusted for age, sex, recurrent ear infections, smoking and ear pathology. Results: Among the participants (40% men), the mean age at HUNT2 was 31.2 ± 5.4 years (range 20-39) and the average 20-year hearing decline was 11.3 ± 9.8 dB. Occupations that were associated with larger hearing decline included other craft and related trades workers (3.9 dB, 95% confidence interval [CI] 0.2-7.7) and building frame and related trades workers (3.4 dB, 95% CI 1.3-5.4). Among occupations with larger hearing decline, a higher proportion of the workers reported exposure to noise. Conclusions: This large longitudinal study shows a larger long-term hearing decline among building frame workers and craft and related trades workers. Differences between occupations were modest, which may indicate successful preventive measures in Norway during the last two decades.

• Jørgensen, Astrid Ytrehus; Engdahl, Bo Lars; Mehlum, Ingrid Sivesind & Aarhus, Lisa (2022). Weaker association between hearing loss and non-employment in recent generations. The HUNT cohort study. International Journal of Audiology. ISSN 1499-2027. p. 1–8. doi: 10.1080/14992027.2022.2045367. Full text in Research Archive Show summary

  Objectives To examine the prevalence of hearing loss (HL) among employed persons, the association between HL and non-employment, assessing whether this has changed over the last two decades. To identify susceptible groups for HL-related work problems and examine the association between HL and co-worker relations. Design Cross-sectional analyses of working-age participants (20–66 years). HL was defined as the pure-tone average threshold of 0.5–4 kHz in the better hearing ear: 20–34 dB (mild) or ≥35 dB (disabling). Associations were assessed with logistic regression. Study sample Data from two waves of the Trøndelag Health Study (HUNT): HUNT2 1996–1998 (N = 38,603), HUNT4 2017–2019 (N = 19,614). Results The nationally weighted prevalence of HL among employees was 5.8%. HL was associated with non-employment, more strongly in HUNT2 (odds ratio (OR) 2.2, 95% confidence interval (CI) 2.0–2.4) than HUNT4 (OR 1.9, CI 1.7–2.1). HL was not associated with poorer co-worker relations. The association between HL and non-optimal work performance was stronger among white-collar workers than blue-collar workers. Conclusions Our study shows that HL is common in the employed population. It also indicates a weakened association between HL and non-employment in recent generations. White-collar workers appear to be more vulnerable to HL-related work problems than blue-collar workers.

• Jørgensen, Astrid Ytrehus; Aarhus, Lisa; Engdahl, Bo Lars; Bratsberg, Bernt Magne; Skirbekk, Vegard Fykse & Mehlum, Ingrid Sivesind (2022). Hearing loss, sick leave, and disability pension. Findings from the HUNT follow-up study. BMC Public Health. 22(1). doi: 10.1186/s12889-022-13760-2. Full text in Research Archive Show summary

  Background Evidence on the association between hearing loss and sick leave or disability pension is to a great extent based on few cross-sectional studies and remains unclear. We aim to assess the associations in a long-term follow-up population study. Methods We used baseline data from a large population-based hearing study in Norway, the HUNT Hearing study (1996–1998). The sample included 21 754 adults (48.5% men, mean age at baseline 36.6 years). We used register data on sick leave and disability pension (1996–2011). Cox regression was used to assess the association between hearing loss at baseline (Pure tone average/PTA 0.5–4 kHz > 20 dB) and time to first physician-certified sick leave episode, as well as time to first disability pension payment. Results Hearing loss at baseline (yes/no) was weakly associated with time to first physician-certified sick leave episode: Hazard ratio (HR) 1.2 (95% confidence interval (CI) 1.1–1.3). Restricting the exposed group to people with both hearing loss and tinnitus, the HR was slightly increased: 1.3 (95% CI 1.1–1.6). Hearing loss in 1996–1998 was also associated with time to first received disability pension: HR 1.5 (95% CI 1.3–1.8). Stronger associations were found for disabling hearing loss (PTA > 35). Restricting the exposure to hearing loss and tinnitus, the HR was increased: 2.0 (95% CI 1.4–2.8). Conclusions This large population-based cohort study indicates that hearing loss is associated with increased risk of receiving disability pension, especially among younger adults and low educated workers. Hearing loss was weakly associated with sick leave.

• Kolasa, Sylwia Katarzyna; Bogen, Bård Erik; Nilsen, Roy Miodini; Nordahl, Stein Helge Glad; Goplen, Frederik Kragerud & Engdahl, Bo Lars [Show all 12 contributors for this article] (2022). Hearing threshold and physical performance in older people: a cross-sectional study from the HUNT4 cohort. European Geriatric Medicine. ISSN 1878-7649. 14, p. 165–172. doi: 10.1007/s41999-022-00713-6. Full text in Research Archive Show summary

  Purpose: To evaluate the association between increased hearing loss and reduced physical performance in older people. Methods: Cross-sectional population-based study using data from the fourth wave of the Trøndelag Health Survey (HUNT4) in Norway. Data were obtained from the subproject HUNT4 Hearing which collected audiometric data of people > 70 years (N = 13,197). Analyses were performed on all participants who had completed audiometry and measured balance using the Short Physical Performance Battery (SPPB), which was scored from 0 (worst score) to 12. The hearing threshold was expressed as a pure tone average (PTA). Associations between the hearing threshold for the best and worst ear and physical performance were analyzed by linear regression models adjusted for age, sex, education, diabetes, and cardiovascular disease. Hearing threshold was indicated with steps of 10 dB. Results: Of 13,197 eligible participants, 4101 who completed audiometry and SPPB (52.3% women. mean age 76.3 years) were included. The analyses revealed an association between reduced SPPB and increased hearing threshold in the best ear (b = − 0.296; 95% CI − 0.343 to − 0. 249; P < 0.001) and the worst ear (b = − 0.229; 95% CI − 0.270 to − 0.189; P < 0.001). Conclusions: In this population study, we found that the increased hearing threshold was associated to reduced physical performance as measured by SPPB. The association seemed to be strongest for the best ear. The association between hearing threshold and physical performance illustrates the importance of assessing physical performance in people with hearing loss to prevent the risk of falls and disability. The underlying causes of the associations between hearing loss and poorer physical performance are not fully understood and should be further investigated. Level of evidence: Level 3.

• Molaug, Ina Charlotte; Engdahl, Bo Lars; Mehlum, Ingrid Sivesind; Stokholm, Zara Ann; Kolstad, Henrik & Aarhus, Lisa (2022). Quantitative levels of noise exposure and 20-year hearing decline: findings from a prospective cohort study (the HUNT Study). International Journal of Audiology. ISSN 1499-2027. 63(1), p. 40–48. doi: 10.1080/14992027.2022.2143432. Full text in Research Archive Show summary

  Objective We aimed to assess the association between occupational noise exposure and long-term hearing decline. Design This prospective cohort study used linear regression to investigate the association between occupational noise exposure and 20-year hearing decline, adjusted for important confounders. Study sample The Norwegian cohort (N = 4,448) participated in two population-based health studies with pure-tone audiometry; HUNT2 1996–1998 and HUNT4 2017–2019. Exposure assessments included a quantitative job exposure matrix (JEM) and questionnaires. Results The participants (40.2% men, 20–39 years at baseline) had a mean 20-year decline (3–6 kHz) of 11.3 ± 9.8 decibels (dB). There was a positive association between 20-year logarithmic average noise level (JEM-based, LEX,20y) and 20-year hearing decline among men. Compared with no exposure ≥80 dB during follow-up, minimum 5 years of exposure ≥85 dB (JEM-based) predicted 2.6 dB (95% CI: 0.2–5.0) larger 20-year decline for workers aged 30–39 years at baseline, and −0.2 dB (95% CI: −2.2 to 1.7) for workers aged 20–29 years. Combining JEM information with self-reported noise exposure data resulted in stronger associations. Conclusion This large longitudinal study shows an association between JEM-based noise exposure level and increased 20-year hearing decline among men. Contrary to expectations, the associations were weaker among younger workers, which might reflect a latency period.

• Engdahl, Bo Lars & Aarhus, Lisa (2022). Cohort difference in the association between use of recreational firearms and hearing loss: findings from the HUNT study. International Journal of Audiology. ISSN 1499-2027. doi: 10.1080/14992027.2022.2050822. Full text in Research Archive Show summary

  Objectives:The risk of noise injury from recreational firearm use is well known. Despite preventive meas-ures it is uncertain whether it has become less harmful. We assessed whether the association betweenrecreational firearm use and hearing has changed during the last two decades.Design:We used a repeated cross-sectional design and determined hearing thresholds by pure-tone audi-ometry. Frequency-specific associations between recreational firearm use and hearing thresholds wereassessed by multivariate linear regression stratified by sex and adjusted for age and other covariates.Study sample:Two cross-sectional population-based cohorts 20 years apart (1998 and 2018) comprised 27,580(53% women, mean age 53 years) and 26,606 individuals (56% women, mean age 54 years), respectively.Results:Recreational firearm use was reported by 28% in 1998 and 30% in 2018. The proportion thatreported wearing hearing protection increased. Exposure to recreational firearms was associated with ele-vated thresholds at 3-6 kHz in both cohorts. The association increased with the number of lifetime shots.The associations increased by age and were substantially smaller in the most recent cohort.Conclusions:Analyses of two cohorts revealed a reduction in the association between recreational fire-arm use and hearing over 20years, coinciding with the introduction of hearing preservation measures

• Engdahl, Bo Lars; Stigum, Hein & Aarhus, Lisa (2021). Explaining better hearing in Norway. A comparison of two cohorts 20 years apart - the HUNT study. BMC Public Health. 21. doi: 10.1186/s12889-021-10301-1. Full text in Research Archive Show summary

  Background The hearing function at a given age seems to have improved in more recent born cohorts in industrialized countries. But the reasons for the improvement have not yet been explained. Methods We investigated the extent to which better hearing in Norway is attributed to modifiable risk factors by using representative demographic and audiometric data from two cohorts of the Trøndelag Health Study, HUNT2 (1996–1998) and HUNT4 (2017–2019). We estimated natural indirect effects using causal inference methods in order to assess whether cohort improvement in hearing thresholds (HTs) was mediated by occupational noise exposure, recurrent ear infections, smoking and education. Results The improvement in HTs from HUNT2 to HUNT4 was 2.8 and 3.0 dB at low respectively high frequencies. Together all risk factors mediated this improvement by 0.8 dB (95% CI 0.7–0.9) and 0.8 dB (95% CI 0.7–0.9) respectively, corresponding to mediated proportions of 27 and 28%. Substantial mediation was specifically found for occupational noise in men and recurrent ear infections in women (mediated proportions of 11 and 17% at high frequencies, respectively). Conclusions Increased education, less occupational noise exposure, ear infections and smoking contributed considerably to better hearing in Norway the last two decades.

• Bast-Pettersen, Rita; Nordby, Karl-Christian; Wastensson, Gunilla & Aarhus, Lisa (2021). Tremor measurements in a 22-year cohort study of workers exposed to hand-held vibrating tools. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 94, p. 1049–1059. doi: 10.1007/s00420-020-01612-8. Full text in Research Archive Show summary

  Objectives The objectives of this cohort study were to evaluate possible long-term effects of occupational exposure to hand-arm vibration (HAV) in terms of increased tremor. The aims were to evaluate whether exposure during follow-up, baseline hand-arm vibration syndrome (HAVS), baseline manual dexterity or current medical conditions or life-style habits might be associated with increased tremor. A further aim was to compare two different activation conditions: postural vs rest tremor. Methods Forty men (current age: 60.4 years) who had previously worked as manual workers in a specialized engineering and construction company enrolled in the study. Their hand functions had been examined in 1994. At the baseline examination, 27 had been diagnosed with HAVS, while 13 were not exposed. The follow-up examination in 2016–2017 comprised the CATSYS Tremor Pen® for measuring postural and rest tremor and the Grooved Pegboard Test for assessing manual dexterity. Blood samples were taken for assessing biomarkers that might have impact on tremor. Results Neither cumulative exposure to HAV during follow-up nor HAVS at baseline were associated with increased tremor. A test for manual dexterity at baseline was significantly associated with increased tremor (Tremor Intensity) at follow-up. Blood markers of current medical conditions and tobacco consumption were associated with increased tremor. Rest tremor frequency was higher than postural tremor frequency (p < 0.001). Conclusions The main findings of this 22-year cohort study were no indications of long-term effects on tremor related to HAV exposure and previous HAVS status. However, baseline manual dexterity was significantly associated with increased tremor at follow-up. Activation conditions (e.g., hand position) are important when testing tremor.

• Engdahl, Bo Lars & Aarhus, Lisa (2021). Personal music players and hearing loss. The HUNT Cohort Study. Trends in Hearing (Trends). 25, p. 1–11. doi: 10.1177/23312165211015881. Full text in Research Archive Show summary

  It is unclear whether the current average use of personal music players (PMPs) including mobile phones has affected hearing in the general population. The association between the use of PMPs and hearing loss was assessed in a large population cross-sectional and follow-up study with the following distribution: cross-sectional (2018): n = 26,606, 56% women, mean age 54 years and 20-year follow-up (baseline 1998): n = 12,115, 57% women, mean age at baseline 43 years. Hearing threshold was determined as pure-tone average over the frequencies 3, 4, and 6 kHz. We used linear regression to assess relationships between hearing threshold and PMP use (yes), duration (1–2/2–6/>6 h per week), or sound volume (low/medium/high), with nonuse as reference. The PMP use increased from 8% in 1998 to 30% in 2018. Compared with nonusers, neither use nor duration was related to hearing threshold. As to sound volume, listening at low levels was associated with better thresholds (−2.5 dB [−4.1 to −0.8]), while listening at high levels was associated with worse thresholds (1.4 dB [0.1 to 2.8]). We adjusted for age, sex, baseline hearing threshold, education, noise exposure, ear infections, head injury, and daily smoking. The association with sound volume was nearly twice as strong when adjusting for hearing threshold at baseline. Accordingly, the possibility of reverse causality was reduced although not eliminated by the follow-up design. This large population study showed no association between normal PMP use and 20-year progression in hearing; however users listening to high levels increased their hearing threshold.

• Aarhus, Lisa & Engdahl, Bo Lars (2020). Occupational noise exposure and asymmetric hearing loss: Results from the HUNT population study in Norway. American Journal of Industrial Medicine. ISSN 0271-3586. 63(6), p. 535–542. doi: 10.1002/ajim.23105. Full text in Research Archive Show summary

  BACKGROUND: A large population study with adequate data on confounders is required to determine whether asymmetric hearing loss (AHL) is associated with occupational noise exposure. METHODS: We performed a cross-sectional population study in Norway (the Health Investigation in Nord-Trøndelag: HUNT) with 24 183 participants, using pure-tone audiometry and questionnaires. AHL was defined as a difference in hearing threshold between the right and left ears of greater than or equal to 15 dB for the pure-tone average of 0.5 to 2 or 3 to 6 kHz. RESULTS: The mean age of the participants was 53 years (range, 19-99); 53% were women. The prevalence of AHL in this general Norwegian population was 6% for the 0.5 to 2 kHz range and 15% for 3 to 6 kHz. In unadjusted regression models, subjects reporting prolonged occupational noise exposure to high-level noise sources (N = 1652) had a higher risk of AHL at 3 to 6 kHz than those reporting no prior exposure (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.75-2.25). After adjustment for age and sex, OR was 1.08; (95% CI, 0.95-1.24). After additional adjustment for head trauma, ear infections, blasting or shooting (all associated with AHL), smoking, and diabetes, OR was 1.00 (95% CI, 0.87-1.16). No association between occupational noise and right-ear hearing threshold advantage (left-right ear difference) was observed after adjustment for confounders. CONCLUSION: Our study suggests that AHL is relatively common in the general population, especially at the high-frequency range in men and elderly subjects. Our study showed no relation between occupational noise exposure and AHL after confounder adjustment.

• Aarhus, Lisa; Kjærheim, Kristina; Heikkinen, Sanna; Martinsen, Jan Ivar; Pukkala, Eero & Selander, Jenny [Show all 10 contributors for this article] (2020). Occupational noise exposure and vestibular schwannoma. A case-control study in Sweden. American Journal of Epidemiology. ISSN 0002-9262. 189(11), p. 1342–1347. doi: 10.1093/aje/kwaa091. Full text in Research Archive Show summary

  It has been suggested that the association between self-reported occupational noise exposure and vestibular schwannoma (VS) found in several studies, represents recall bias. Therefore, we aim to study the relation in a large case-control study using occupational noise measurements. We performed a case-control study from Sweden of 1913 VS cases diagnosed in 1961-2009 and 9566 age- and sex-matched population controls. We defined occupational history by linkage to national censuses from 1960, 1970, 1980, and 1990. We estimated occupational noise exposure for each case and control using a job-exposure matrix (JEM). There was no association between occupational noise exposure and VS. Among subjects assessed as ever exposed to occupational noise levels ≥85 dB (214 cases and 1142 controls), the odds ratio for VS per five years of exposure was 1.02 (95% confidence interval 0.90-1.17). Workers with noise levels of 85 dB or higher for at least 15 years (5-year latency period), showed no increased risk of VS (odds ratio 0.98, 0.73-1.31) compared to those who had never been exposed to noise levels of 75 dB or higher. To conclude, our large study does not support an association between occupational noise exposure and VS.

• Mehlum, Ingrid Sivesind & Aarhus, Lisa (2020). Occupational noise. A determinant of social inequalities in health. In Theorell, Töres (Eds.), Handbook of Socioeconomic Determinants of Occupational Health. From Macro-level to Micro-level Evidence. Springer Nature. ISSN 9783030314378. p. 195–205. doi: 10.1007/978-3-030-31438-5_2. Full text in Research Archive Show summary

  Occupational noise exposure is common in many workplaces and a well-known cause of noise-induced hearing loss and related to tinnitus and hyperacusis (hypersensitivity to sound), as well as other health outcomes, such as distress, hypertension, and occupational injuries. Hearing loss and many health conditions are more frequent in lower socioeconomic groups. Loud occupational noise is generally also more common among blue-collar workers, while white-collar workers are virtually unexposed. Therefore, occupational noise exposure would seem like a plausible cause of socioeconomic inequalities in hearing and other health outcomes; in other words, occupational noise could be a mediator (intermediate variable) between socioeconomic position and health. However, hardly any studies have investigated the impact of occupational noise exposure on social inequalities in hearing, and none seems to have studied its impact on other health outcomes. One study found that the association between socioeconomic position and hearing loss was reduced after controlling for occupational noise exposure, suggesting that occupational noise to a considerable extent could explain the association between occupation and hearing loss. There is a lack of studies addressing the impact of occupational noise exposure on social inequalities in health; thus, more studies specifically designed to investigate this topic are needed.

• Engdahl, Bo Lars; Strand, Bjørn Heine & Aarhus, Lisa (2020). Better hearing in Norway. A comparison of two HUNT Cohorts 20 years apart. Ear and Hearing. ISSN 0196-0202. 42(1), p. 42–52. doi: 10.1097/AUD.0000000000000898. Full text in Research Archive Show summary

  Objective: To obtain updated robust data on a age-specific prevalence of hearing loss in Norway and determine whether more recent birth cohorts have better hearing compared with earlier birth cohorts. Design: Cross-sectional analyzes of Norwegian representative demographic and audiometric data from the Nord-Trøndelag Health Study (HUNT)—HUNT2 Hearing (1996–1998) and HUNT4 Hearing (2017–2019), with the following distribution: HUNT2 Hearing (N=50,277, 53% women, aged 20 to 101 years, mean = 50.1, standard deviation = 16.9); HUNT4 Hearing (N=28,339, 56% women, aged 19 to 100 years, mean = 53.2, standard deviation = 16.9). Pure-tone hearing thresholds were estimated using linear and quantile regressions with age and cohort as explanatory variables. Prevalences were estimated using logistic regression models for different severities of hearing loss averaged over 0.5, 1, 2, and 4 kHz in the better ear (BE PTA4). We also estimated prevalences at the population-level of Norway in 1997 and 2018. Results: Disabling hearing loss (BE PTA4 ≥ 35 dB) was less prevalent in the more recent born cohort at all ages in both men and women (p < 0.0001), with the largest absolute decrease at age 75 in men and at age 85 in women. The age- and sex-adjusted prevalence of disabling hearing loss was 7.7% (95% confidence interval [CI] 7.5 to 7.9) and 5.3% (95% CI 5.0 to 5.5) in HUNT2 and HUNT4, respectively. Hearing thresholds were better in the more recent born cohorts at all frequencies for both men and women (p < 0.0001), with the largest improvement at high frequencies in more recent born 60- to 70-year old men (10 to 11 dB at 3 to 4 kHz), and at low frequencies among the oldest. Conclusions: The age- and sex-specific prevalence of hearing impairment has decreased in Norway from 1996–1998 to 2017–2019.

• Aarhus, Lisa; Homøe, Preben & Engdahl, Bo Lars (2019). Otitis media in childhood and disease in adulthood: A 40-year follow-up study. Ear and Hearing. ISSN 0196-0202. 41(1), p. 67–71. doi: 10.1097/AUD.0000000000000729. Full text in Research Archive Show summary

  Objectives: The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood. Design: Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses. Results: The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking. Conclusion: Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.

• Aarhus, Lisa; Veiersted, Kaj Bo; Nordby, Karl-Christian & Bast-Pettersen, Rita (2019). Neurosensory component of hand-arm vibration syndrome: a 22-year follow-up study. Occupational Medicine. ISSN 0962-7480. 69(3), p. 215–218. doi: 10.1093/occmed/kqz029. Full text in Research Archive Show summary

  Knowledge about the long-term course of the neurologic component of hand–arm vibration syndrome (HAVS) is scarce. To study the course and prognostic factors of the neurosensory component of HAVS over a period of 22 years. Forty male sheet metal workers, with a mean age of 60 (range 45–78) years at follow-up, were examined with a test battery in 1994 and 2017. At baseline, the sample comprised 27 workers with HAVS symptoms and 13 workers without HAVS symptoms. Among the 27 workers, 25 workers reported work-related hand–arm vibration during follow-up (mean 3639 h). In 2017, the mean time since vibration stopped was 8.4 years. Among the 27 workers with HAVS in 1994, no overall statistically significant change was observed in hand numbness (Stockholm Workshop Scale), shoulder/arm pain (pain scale) or finger pain from 1994 to 2017. However, vibration exposure during follow-up was associated with increased finger pain. Cotinine, carbohydrate-deficient transferrin, glycosylated haemoglobin and folate were not associated with changes in neurosensory symptoms or manual dexterity (Grooved Pegboard) from 1994 to 2017. A diagnosis of HAVS in 1994 did not predict poor hand strength 22 years later. Isolated hand numbness (without white finger attacks) was more common at baseline than at follow-up. This 22-year follow-up study indicates a tendency towards irreversibility of hand numbness and finger pain in workers with HAVS. Continued vibration exposure seems to predict increased finger pain. Our findings highlight the importance of HAVS prevention.

• Idstad, Mariann; Tambs, Kristian; Aarhus, Lisa & Engdahl, Bo Lars (2019). Childhood sensorineural hearing loss and adult mental health up to 43 years later. Results from the HUNT study. BMC Public Health. 19. doi: 10.1186/s12889-019-6449-2. Full text in Research Archive Show summary

  Background: Hearing loss is a global public health problem putting millions of people at risk of experiencing impediments in communication and potentially impaired mental health. Many studies in this field are based on small, cross sectional samples using self-report measures. The present study aims to investigate the association between childhood sensorineural hearing loss and mental health in adult men and women longitudinally in a large cohort with a matched control group, and hearing is measured by pure-tone audiometry. Studies of this kind are virtually non-existing. Methods: The present study combines data from two large studies; the School Hearing Investigation in Nord-Trøndelag (SHINT) carried out yearly from 1954 to 1986, and the second wave of the Nord-Trøndelag Health Study (HUNT 2) conducted from 1995 to 1997. The participants were 7, 10 or 13 years during the SHINT, and between 20 and 56 years old during HUNT 2. The total sample consisted of 32,456 participants (of which 32,104 in the reference group). Participants with a sensorineural hearing loss in SHINT of 41 dB or more were classified with moderate-severe hearing loss (N = 66), 26–40 dB as mild (N = 66) and 16–25 dB as slight (N = 220). Mental health in adulthood was measured in HUNT 2 by symptoms of anxiety and depression, subjective well-being, and self-esteem. The association between childhood sensorineural hearing loss and adult mental health was tested by means of ANOVA. Results: There was a significant relation between slight childhood sensorineural hearing loss and lowered subjective well-being in women (B = −.25, p = 0.038). Further investigation of the results revealed a significant association between slight hearing loss and symptoms of anxiety and depression (B = .30, p = 0.054) and between mild hearing loss and lowered self-esteem (B = .63, p = 0.024) among women aged 20–39 years. There were no significant relations between childhood sensorineural hearing loss and any of the three mental health outcomes among men. Conclusions: This study suggests that women with slight or mild sensorineural hearing loss from childhood experience elevated levels of symptoms of anxiety and depression, lowered subjective well-being and lowered self-esteem. However, the results should be interpreted with caution due to a lack of power in some analyses.

• Aarhus, Lisa; Stranden, Einar; Nordby, Karl-Christian; Thornér, Elin Einarsdóttir; Olsen, Raymond & Ruud, Bjørn [Show all 7 contributors for this article] (2018). Vascular component of hand-arm vibration syndrome: A 22-year follow-up study. Occupational Medicine. ISSN 0962-7480. 68(6), p. 384–390. doi: 10.1093/OCCMED/KQY085. Full text in Research Archive Show summary

  Background Vibration-induced white finger (VWF) is often assessed using the Stockholm Workshop Scale (SWS) and cold challenge plethysmography. However, long-term longitudinal studies using both methods are scarce. Aims To study the long-term course and prognostic factors of VWF assessed with the SWS and photoplethysmography (PPG), and to examine the effects of lifestyle on PPG score, regardless of VWF status. Methods Forty male construction workers were examined with a test battery and clinical examination in 1994 and 2016/17. Results At baseline, the sample comprised 27 workers with, and 13 without, symptoms of hand-arm vibration syndrome (HAVS). Thirty-five workers reported vibration exposure during follow-up. The mean age of the workers was 60 years (45–78) at follow-up. The paired t-test showed that PPG scores deteriorated from 1994 to 2017 in the 27 workers with HAVS in 1994 (mean difference 2.7 min, 95% confidence interval (CI) 0.2–5.2). However, there was no statistically significant change in SWS scores in these workers over time. Smoking and age were associated with PPG score deterioration. Vibration exposure during follow-up predicted SWS score deterioration: 1000 h of exposure predicted a deterioration stage of 0.09 (95% CI 0.03–0.16). Analysis of all 40 workers showed that 2017 PPG scores were associated with positive serum cotinine and self-reported smoking during follow-up. Conclusions Whereas age and smoking predicted a PPG deterioration, continued vibration exposure predicted worsening of white finger symptoms. The association of PPG score and smoking should be considered in diagnostic and prognostic factor evaluations.

• Aarhus, Lisa & Mehlum, Ingrid Sivesind (2017). Arbeidsmedisinsk pasientutredning i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(14-15). doi: 10.4045/tidsskr.16.0652. Full text in Research Archive Show summary

  BAKGRUNN: De arbeidsmedisinske sykehusavdelingene og Statens arbeidsmiljøinstitutt etablerte et felles, anonymt utredningsregister i 2009. Formålet var å få bedre oversikt over arbeidsmedisinsk pasientutredning i Norge, inkludert endring i arbeidsrelatert eksponering og sykdom over tid. MATERIALE OG METODE: Utredende lege fyller ut et skjema etter pasientkonsultasjonen, hvorpå dette registreres elektronisk. Artikkelen bygger på analyse av registrerte pasientutredninger i perioden 2010-15. RESULTATER: Det var registrert 8 775 pasientutredninger. Flest menn ble utredet (75 %), og vanligste aldersgruppe var 50-69 år (52 %). Vanligste eksponering var irritanter/allergener (18 %) og organiske løsemidler (15 %), som ble registrert i henholdsvis noe økende og noe minkende grad i perioden. Industri og bergverksdrift toppet bransjestatistikken (30 %). Vanligste symptomorgan var lunger/luftveier (57 %), med astma, kols og lungekreft som hyppigste diagnoser. Andelen saker som ble vurdert å ha sannsynlig eller mulig arbeidsrelasjon, holdt seg stabil på rundt henholdsvis 40 % og 23 %. 16 % av pasientene mottok sykepenger, 10 % arbeidsavklaringspenger og 13 % uførepensjon på undersøkelsestidspunktet. FORTOLKNING: Arbeidsrelatert sykdom har store konsekvenser for enkeltmennesker og samfunn. Utredningsregisteret gir en god oversikt over pasientutredningen ved de arbeidsmedisinske avdelingene i Norge og kan avdekke endringer i arbeidsrelatert eksponering og sykdom over tid. Slik kan registeret bidra til målrettet forebyggende innsats.

• Engdahl, Bo Lars; Aarhus, Lisa; Lie, Arve & Tambs, Kristian (2015). Cardiovascular risk factors and hearing loss: The HUNT study. International Journal of Audiology. ISSN 1499-2027. 54(12), p. 958–966. doi: 10.3109/14992027.2015.1090631. Full text in Research Archive Show summary

  Objective: The purpose of the present paper was to examine the association between prospectively and cross-sectionally assessed cardiovascular risk factors and hearing loss. Design: Hearing was assessed by pure-tone average thresholds at low (0.25–0.5 kHz), middle (1–2 kHz), and high (3–8 kHz) frequencies. Self-reported or measured cardiovascular risk factors were assessed both 11 years before and simultaneously with the audiometric assessment. Cardiovascular risk factors were smoking, alcohol use, physical inactivity, waist circumference, body mass index, resting heart rate, blood pressure, triglycerides, total serum cholesterol, LDL cholesterol, HDL cholesterol, and diabetes. Study sample: A population-based cohort of 31 547 subjects. Results: After adjustment for age, sex, level of education, income, recurrent ear infections, and noise exposure, risk factors associated with poorer hearing sensitivity were smoking, diabetes, physical inactivity, resting heart rate, and waist circumference. Smoking was only associated with hearing loss at high frequencies. The effects were very small, in combination explaining only 0.2–0.4% of the variance in addition to the component explained by age and the other cofactors. Conclusion: This cohort study indicates that, although many cardiovascular risk factors are associated with hearing loss, the effects are small and of doubtful clinical relevance.

• Aarhus, Lisa; Tambs, Kristian; Nafstad, Per; Bjørgan, Eskil & Engdahl, Bo Lars (2015). Childhood sensorineural hearing loss: effects of combined exposure with aging or noise exposure later in life. European Archives of Oto-Rhino-Laryngology. ISSN 0937-4477. doi: 10.1007/s00405-015-3649-y. Full text in Research Archive
• Aarhus, Lisa; Engdahl, Bo Lars; Tambs, Kristian; Kvestad, Ellen & Hoffman, Howard J (2015). Association Between Childhood Hearing Disorders and Tinnitus in Adulthood. JAMA Otolaryngology - Head and Neck Surgery. ISSN 2168-6181. 141(11), p. 983–989. doi: 10.1001/jamaoto.2015.2378. Full text in Research Archive
• Aarhus, Lisa; Tambs, Kristian & Engdahl, Bo Lars (2015). No association between time of onset of hearing loss (Childhood versus adulthood) and self-reported hearing handicap in adults. American Journal of Audiology. ISSN 1059-0889. 24(4), p. 549–556. doi: 10.1044/2015_AJA-15-0038. Full text in Research Archive
• Aarhus, Lisa; Tambs, Kristian; Hoffman, Howard J & Engdahl, Bo Lars (2015). Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study. European Archives of Oto-Rhino-Laryngology. ISSN 0937-4477. doi: 10.1007/s00405-015-3764-9. Full text in Research Archive
• Aarhus, Lisa; Tambs, Kristian; Kvestad, Ellen & Engdahl, Bo Lars (2015). Childhood Otitis Media: A Cohort Study with 30-Year Follow-Up of Hearing (The HUNT Study). Ear and Hearing. ISSN 0196-0202. 36(3), p. 302–308. doi: 10.1097/AUD.0000000000000118. Full text in Research Archive
• Aarhus, Lisa; Kvestad, Ellen; Tambs, Kristian & Engdahl, Bo Lars (2012). Aldersrelatert hørselstap: en kort oppsummering av resultater fra Hørselsundersøkelsen i Nord-Trøndelag. Norsk Epidemiologi. ISSN 0803-2491. 22(2), p. 175–176. doi: 10.5324/nje.v22i2.1563. Full text in Research Archive

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• Larssen-Aas, Kari & Aarhus, Lisa (2025). I desse yrka er det risiko for å utvikle kols. https://forskning.no/. Full text in Research Archive
• Kvestad, Ellen & Aarhus, Lisa (2025). Snuoperasjon om snus. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(7). doi: 10.4045/tidsskr.25.0266. Full text in Research Archive
• Larssen-Aas, Kari & Aarhus, Lisa (2024). Flere yngre med nedsatt hørsel bruker høreapparat. https://forskning.no/. Full text in Research Archive
• Larssen-Aas, Kari & Aarhus, Lisa (2024). Hørselsskader på jobb: – Dette er gode nyheter. https://forskning.no/. Full text in Research Archive
• Aarhus, Lisa & Mehlum, Ingrid Sivesind (2019). Utredning av unge med arbeidsrelatert sykdom. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(12). doi: 10.4045/tidsskr.19.0187. Full text in Research Archive Show summary

  BAKGRUNN: De arbeidsmedisinske sykehusavdelingene og Statens arbeidsmiljøinstitutt (STAMI) etablerte et felles, anonymt pasientutredningsregister i 2009. Denne rapporten beskriver de vanligste diagnoser, yrker og eksponeringsfaktorer hos den yngste pasientgruppen. Dette vil spesielt avspeile eksponering i dagens moderne arbeidsliv og således fremskaffe viktig kunnskap med henblikk på målrettet forebyggende arbeid. MATERIALE OG METODE: Vi har foretatt en deskriptiv analyse av 910 utredninger av pasienter i aldersgruppen 20–29 år utført ved en arbeidsmedisinsk poliklinikk i Norge i perioden 2010–17. RESULTATER: Utredninger av pasienter i aldersgruppen 20–29 år utgjorde 914 (8 %) av totalt 11 969 registrerte pasientutredninger. Vi ekskluderte fire deltakere som manglet data på kjønn. I aldersgruppen var det 498 (55 %) menn, sammenliknet med 75 % menn i totalmaterialet. Hyppigste diagnoser var astma (187/910, 21 %), kontakteksem (184/910, 20 %) og rhinitt (73/910, 8 %). Den hyppigste eksponeringsfaktoren var irritanter/allergener (469/910, 52 %). De vanligste yrkene var frisør (159/910, 17 %) og maler/lakkerer (46/910, 5 %). Hos kvinner dominerte frisøryrket (154/412, 37 %), mens maler/lakkerer (35/498, 7 %) og elektriker (25/498, 5 %) dominerte hos menn.

• Aarhus, Lisa; Tambs, Kristian; Kvestad, Ellen & Engdahl, Bo Lars (2014). Childhood otitis media: A cohort study with 30-year follow-up of hearing. Full text in Research Archive
• Engdahl, Bo Lars; Aarhus, Lisa; Krog, Norun Hjertager; Kvestad, Ellen; Idstad, Mariann & Tambs, Kristian (2014). The Nord-Trøndelag Hearing Loss Study – main results. Full text in Research Archive
• Aarhus, Lisa; Engdahl, Bo Lars & Tambs, Kristian (2014). Adult outcomes for children with hearing loss. Full text in Research Archive
• Aarhus, Lisa (2014). Hørsel i barndommen og senere i livet. Full text in Research Archive
• Jørgensen, Astrid Ytrehus & Aarhus, Lisa (2025). Hearing loss and work participation: A longitudinal population study. Universitetet i Oslo. ISSN 9788234805417. Full text in Research Archive Show summary

  People with hearing loss who are in employment may experience challenges, such as difficulties with verbal communication and high levels of fatigue after work. Since hearing loss presents challenges at work, it is important to raise awareness and put emphasis on support. The aim of this PhD project was to examine the relationship between hearing loss and work participation by studying several factors, including employment, sick leave, disability pension, and income. Previous research has largely been based on cross-sectional studies. This study used data from a large Health Study in Trøndelag (HUNT) and Statistics Norway (SSB). By using data from both HUNT2 (1996-1998) and HUNT4 (2017-2019), it was possible to use a study design with longitudinal follow-up of each participant. The study showed a nationally weighted prevalence of hearing loss among employed persons of 5.8%. Hearing loss was associated with marked higher odds of non-employment, more strongly in 1998 (odds ratio (OR) 2.3, 95% confidence interval (CI) 2.1-2.4) than in 2018 (OR 1.9, CI 1.7-2.1). A weak association between hearing loss and sick leave (Hazard ratio (HR) 1.2 (95 (CI) 1.1-1.3)) and a somewhat stronger association between hearing loss and disability pension (HR 1.5 (95% CI 1.3-1.8)) was found. For both outcomes, the association was stronger for individuals with both hearing loss and tinnitus. People with hearing loss had a lower annual income increase compared to those with normal hearing. Over a 20-year period, the annual earnings of those with normal hearing increased by 453 Euro (EUR) (95% Confidence interval (CI) 384 – 522) or 13.2% more per year than for people with hearing loss. For both disability pension and annual income, the association was stronger among younger than older adults. Over the coming decades, as the aging population is increasing, it is expected that the number of people with hearing loss will increase. Knowledge about hearing loss in the workplace provides important information to employers and public decision-makers regarding the planning of support for hearing-impaired individuals at work.

• Molaug, Ina Charlotte & Aarhus, Lisa (2024). Occupational noise exposure and ear disease. A population-based longitudinal study. Statens arbeidsmiljøinstitutt og Universitetet i Oslo. ISSN 9788234805066. Full text in Research Archive
• Aarhus, Lisa; Engdahl, Bo Lars; Tambs, Kristian & Nafstad, Per (2016). Follow-up of childhood hearing disorders: hearing loss, tinnitus and dizziness in adulthood. Universitetet i Oslo. ISSN 9788283331455. Full text in Research Archive

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