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Original research
Socio-economic disparity in the global burden of occupational noise-induced hearing loss: an analysis for 2017 and the trend since 1990
  1. Hongjie Zhou1,
  2. Yu Zhou1,
  3. Huina Zhang2,
  4. Aiqing Yu1,
  5. Bo Zhu1,
  6. Lei Zhang1
  1. 1 Department of occupational health, Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou, Zhejiang, China
  2. 2 Department of Ophthalmology, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
  1. Correspondence to Dr Lei Zhang, Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou, Zhejiang, China; leizhanghz{at}


Objectives To evaluate socio-economic disparity in the global burden of occupational noise-induced hearing loss (ONIHL) using disability-adjusted life-years (DALYs).

Methods The numbers of DALYs due to ONIHL, age-standardised DALY rates and national human development index (HDI) data from 1990 to 2017 were collected. The relationship between the age-standardised DALY rates and the 2017 HDI was analysed. A concentration index (CI) and a relative index of inequality (RII) were calculated to evaluate the trend in socio-economic disparity in the burden of ONIHL for the period 1990–2017.

Results From 1990 to 2017, the global DALYs due to ONIHL increased from 3.3 to 6.0 million, with the highest growth occurring in low-income countries (110.7%). Age-standardised DALY rates due to ONIHL were negatively associated with the HDI (β = −0.733, p<0.001), and these rates were significantly higher in countries with a lower HDI. From 1990 to 2017, the trend in between-country inequality was flat with little fluctuation, the CIs stayed near −0.17, and the RIIs remained near 0.35.

Conclusions Over the past few decades, low-income countries have experienced the most rapid growth in DALYs worldwide. A widening socio-economic disparity has persisted in the global burden of ONIHL, with a higher burden in lower socio-economic countries. These data suggest that more prevention programmes and healthcare services should be provided for developing countries.

  • quality of life
  • noise
  • occupational health practice

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  • Contributors LZ and HZ planned the study, HZ contributed to data collection, data preparation and data analysis. YZ, HZ and AY contributed to interpretation of the data and drafting the manuscript. All authors contributed to the interpretation of results and revision of the manuscript critically for important intellectual content.

  • Funding This work is supported by The Medical and Health Science and Technology Programme of Zhejiang Province (Grant No. 2020359541); National Natural Science Foundation of China (Grant No. 81900906); Zhejiang Provincial Natural Science Foundation of China (Grant No. LQ19H120006).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.