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. 2023 Jul-Aug;44(4):768-775.
doi: 10.1097/AUD.0000000000001323. Epub 2022 Dec 27.

The Effects of Tinnitus and Tinnitus Annoyance on Need for Recovery After Work: Results of the Netherlands Longitudinal Study on Hearing

Iris A Simons  1   2   3 , Thadé Goderie  1   2   3 , Birgit I Lissenberg-Witte  4 , Niek J Versfeld  1 , Sophia E Kramer  1   2 , Marieke F van Wier  1   2
Affiliations

The Effects of Tinnitus and Tinnitus Annoyance on Need for Recovery After Work: Results of the Netherlands Longitudinal Study on Hearing

Iris A Simons et al. Ear Hear. 2023 Jul-Aug.

Abstract

Objectives: The first aim of this study was to examine the relationship between having tinnitus and the need for recovery after work (NFR). The second aim was to investigate whether the level of tinnitus annoyance is associated with NFR.

Design: Data from the 5- and 10-year follow-up measurement rounds of the Netherlands Longitudinal Study on Hearing (NL-SH) were used in a cross-sectional analyses. The NL-SH is a web-based prospective cohort study and includes participants aged 18 to 70 years at baseline. For this study, we included only participants who worked at least 12 hours/week and were under the age of 65 years. Participants completed questionnaires on demographic, socioeconomic, psychosocial, hearing-related, and work-related characteristics. In addition, participants answered questions about hearing ability and tinnitus and performed an online digit-triplet speech recognition in noise test to measure the speech reception threshold (SRT) in noise. Participants were asked if (1) they suffer from tinnitus and (2) to rate tinnitus annoyance on a 0-100 numeric rating scale. A linear mixed model was used (1) to estimate the overall (i.e., cross-sectional) association between having tinnitus and NFR and (2) to estimate the overall association between the level of tinnitus annoyance and NFR. The models were checked for effect modification and confounding of factors known to be associated with either tinnitus or NFR and available in the NL-SH.

Results: The study sample comprised 770 unique participants in total; 686 and 335 participants at 5- and 10-year follow-up, respectively. Distress, somatization, and self-reported hearing disability appeared to be confounding factors in the analysis of having tinnitus and NFR. After adjusting for these factors, participants with tinnitus had a 2.5% higher NFR (95% confidence interval: -0.9 to 5.9; p = 0.15). In the analysis of tinnitus annoyance and NFR, SRT was an effect modifier. Distress, somatization, depression, and self-reported hearing disability were confounders. After adjustment for effect modification and confounding, tinnitus annoyance was not significantly associated with NFR ( p = 0.79 for tinnitus annoyance).

Conclusions: This study showed that having tinnitus was not associated with a higher NFR. Also, higher levels of tinnitus annoyance were not associated with a higher NFR. NFR was associated with the psychological factors distress, somatization, and depression, which are known to be intricately related to tinnitus. A longitudinal study design is recommended as it can assess the sequence of events, which might help disentangle the association between tinnitus, NFR, and psychological factors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Flow chart of participant numbers after applying inclusion criteria per measurement round. The number of measurements excluded per measurement round are given in the dashed line rectangle. T1 = first included measurement, T2 = second included measurement and 5 years later than T1.
Fig. 2.
Fig. 2.
Estimated mean NFR per tinnitus annoyance category. A higher tinnitus NRS indicates a higher tinnitus annoyance. Model adjusted for the mean distress, mean somatization, mean depression, and mean self-reported hearing disability. NFR indicates need for recovery; NRS, numeric rating scale; SNR, signal-to-noise ratio; SRT, speech reception threshold in noise.
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