Prevalence and Predictors of Hearing Loss Among Farmworkers in the Mexico-US Border Region: A Cross-Sectional Study with National Health and Nutrition Examination Survey Comparison

OBJECTIVES: To estimate the prevalence and predictors of audiometrically measured hearing loss among farmworkers in the Mexico-US border region and compare outcomes with Latino adults from a national survey. DESIGN: Cross-sectional study with National Health and Nutrition Examination Survey (NHANES) comparison. Farmworkers (n = 113) completed otoscopy, tympanometry, air conduction audiometry, and a brief questionnaire. Audiometric outcomes were restricted to participants with ≥1 normal tympanogram. High-frequency hearing loss was >25 dB HL at 4 or 8 kHz in either ear; World Health Organization (WHO) hearing loss was better-ear PTA >25 dB HL across 0.5 to 4 kHz. NHANES comparison included Latino adults ≥18 years with valid audiometry from 2015 to 2016 and 2017 to March 2020 (n = 5046). We compared prevalence (χ²/Fisher), estimated crude odds ratios (ORs), and fit logistic regression adjusting for age and sex. RESULTS: Among farmworkers (mean age 49.0 yrs), 63% had high-frequency hearing loss and 59% self-reported fair/poor hearing. Self-report (fair/poor) was associated with higher odds of high-frequency hearing loss (OR = 3.2, 95% confidence interval [CI] = 1.4 to 7.2). In multivariable models, age (OR = 1.07 per year, 95% CI = 1.04 to 1.11), male sex (OR = 3.53, 1.26 to 9.87), and greater perceived noise exposure (OR = 1.33, 1.02 to 1.73) were associated with higher odds of high-frequency hearing loss; hearing protection use was not. High-frequency hearing loss prevalence was higher in farmworkers than NHANES Latinos (62.5% versus 42.2%; χ²(1) = 17.2, p < .001; OR = 2.29, 1.53 to 3.42). The association persisted after age adjustment (OR = 1.83, 1.10 to 3.05) and remained elevated but not statistically significant after additional adjustment for sex due to wider CIs (OR = 2.23, 0.95 to 5.24). CONCLUSIONS: Farmworkers carry a high burden of high-frequency hearing loss. A one-item self-report question can help triage on-site audiometric testing. Findings support employer provision and fit-training of hearing protection and community-based hearing conservation efforts targeting high-noise tasks.