Global Burden and Future Projections of Occupational Noise Exposure-related Hearing Loss : An Age-Period-Cohort and ARIMA Modeling Study Based on GBD Data (1990-2021)

Objectives: To quantify the global burden of occupational noise-induced hearing loss (ONHL) from 1990 to 2021 by sex, age, and Socio-demographic Index (SDI), and to project its future trends through 2035. Methods: Data on disability-adjusted life years (DALYs), age-standardized DALY rates (ASDRs), and summary exposure values (SEVs) of ONHL were extracted from the GBD 2021 study. Joinpoint regression was used to estimate annual percent changes in ASDRs. An age-period-cohort model assessed the effects of age, period, and cohort. Autoregressive integrated moving average (ARIMA) models forecasted DALY trends from 2025 to 2035. Results: Globally, ONHL-related DALYs increased from 3.84 million in 1990 to 7.85 million in 2021, with the highest relative increases in low- and middle-SDI regions. Males consistently had higher burden than females. DALYs peaked in midlife (ages 50-59), while age-specific DALY rates peaked at older ages (60-74). APC analysis revealed significant age effects across all SDI levels, while period and cohort effects were limited. ARIMA models predicted that global ONHL DALYs would reach 9.65 million by 2035, a 22.97% increase from 2021, with largest increases expected in those aged 55-59. Conclusions: Occupational noise–induced hearing loss remains a growing global public health challenge, particularly among male workers in lower-SDI regions. Continued increases are projected over the next decade. These results underscore the urgent need for strengthened hearing conservation strategies and targeted prevention policies to reduce ONHL burden worldwide.