Air Pollution Exposure and the Relative Risk of Sudden Sensorineural Hearing Loss in Taipei

Chun Gu Cheng, Yu Hsuan Chen, Shang Yih Yen, Hui Chen Lin, Hung Che Lin, Kuei Ru Chou, Chun An Cheng

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


(1) Background: The etiologies of sudden sensorineural hearing loss (SSHL) remain unclear. The level of mean particulate matter with a diameter of 2.5 µm or less (PM2.5) was not associated with SSHL, but the maximum PM2.5 level exhibited a negative association with SSHL in Korea. Exposure to nitrogen dioxide (NO2 ) for 2 weeks increased the risk of SSHL. The lag effects of SSHL after air pollution exposure were limited. We aimed to evaluate the association of SSHL with air pollution exposure to determine whether air pollution exposure caused delayed effects. (2) Methods: This observational study used inpatient data obtained from electronic health records at the TriService General Hospital from 2011 to 2019. The data of all SSHL patients were retrieved. The air quality dataset from Songshan station from 2011 to 2019 was used. The main outcomes were the relative risks (RRs) of SSHL associated with PM2.5, O3, and NO2 exposures within 1 month. The relationships between these factors were examined using distributed lag nonlinear time series models. (3) Results: The RR of SSHL associated with PM2.5 exposure was 1.195 (95% confidence interval (C.I.: 1.047–1.363) for a 10 unit increase at a lag of 7 days. The RR of SSHL associated with O3 exposure was 1.14 (95% C.I.: 1.003–1.3) for a 10 unit increase at a lag of 9 days. The RR of SSHL associated with NO2 exposure was 1.284 (95% C.I.: 1.05–1.57) for a 10 unit increase at a lag of 23 days. (4) Conclusions: In our study, SSHL was confirmed to be associated with air pollution exposure with a lag effect. We discussed possible mechanisms to explore possible biological hypotheses and support further research. Large-scale studies including participants with other ethnicities and causal relationships are needed to confirm our findings.

Original languageEnglish
Article number6144
JournalInternational journal of environmental research and public health
Issue number10
Publication statusPublished - May 1 2022


  • air pollution
  • lag effect
  • sudden sensorineural hearing loss

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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