The hearing-acuity testing was per-
formed in such a fashionas to provide a
modified screeningof hearing. This max-
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jmized efficiency, to allow for inclusion
of the largest number of children, but
also gave a sense of the severity of any
hearing loss observed, because theact-
ual thresholds were obtained at 500 Hz,
1000 Hz, 2000 Hz, and 4000 Hz.If a child
showed any abnormalities in hearing, at
any frequency, then impedancetesting
was also performed. In a group session
the pediatric nurse practitioner instructed and encouragedall the children
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to signify each time that they heard the
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their hands or dropped objects into a cup
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7
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stimulus tone. For impedance audiom-
etry, the children were required tosit
the normal! range. Hearingloss in one or
two ears was observed in 66 (50.4%} of
the children. Of those children with
hearing loss, losses for 48 wereclassified
in the mild-hearing-loss range; 12, children had hearing thresholds in the worse
ear ranging from 40 dB to 55 dB (moder-
still, as for a regular ear examination.
Abnormalities were defined as: (1} tym-
panogramswith pressurepeaks thatfell
in the negative range beyond - 100mm
H,0,(2] flat tympanograms, and (3) hear-
ing thresholds of 30 dB or greater in one
or two ears. Hearing thresholds at 500 Hz
were eliminated from this study, because
abnormally elevated thresholds there were
obtained in 56% of the children, and it
was often the only abnormal frequency —
ate loss); 4 had moderate-to-severe loss-
es; and 2 had thresholds poorer than 70
dB in the worse ear. Abnormal tympanograms were observed in one or both ears
for 59 {89%} of the children with hearing
loss (Figure 1}. Summaries of abnormalities in hearing and tympanometry,relative to the ages of the children tested, are
shown in Tables 1 and 2, respectively.
A comparison was made of data obtained for the children born to parents
whohad been exposed to radiation, and
the children born to nonexposedparents.
suggesting that environmental-noise
contamination, not impaired hearing
among those children, caused those abnormal results.
FINDINGS
Of the 131 children — 66 boys, 65 girls—
who ranged in age from 3 years to 18
years (mean = 9.3 years}, 63 were offspring of parents who had been exposed
to radiation, while 68 were the children
of nonexposed parents.
Of those 131, 65 had hearing within
Of those with normal hearing, 32 were
children of parents who had been exposed to radiation, while 33 were children of nonexposed parents. Unilateral
hearing loss was observed in 14 of the ex-
Table 1. Audiometric hearing findings (by age) for 131 Marshallese children.
Age in Years
Children with abnormal
findings in 1] ear
Children with abnormal
findings in 2 ears
Total
3-6
a)
10-12
9
9
8
8
(34]
9
3
(32)
17
11
{66}
2
1k
27
13+
(Total)
Children with abnormal
findings in | ear
Children with abnormal
findings in 2 ears
Total
_———
VOL. 42 NO. 8
7-9
5
recorded in 17 children of the exposed
group, and in 15 of the nonexposed
(Figure 2). Chi square revealed no signifi-
cant interactionsrelative to the exposed
and nonexposed groups for either
unilateral or bilateral hearing losses. Of
those children with abnormal tympanograms, 29 were from the exposed group
and 30 were from the nonexposed group.
The test of chi square revealed independence of the two groups.
DISCUSSION
Our evaluation of the hearing and tym-
panometric testing of 131 Marshallese
children revealed a high rate of abnormalities. In 1982, Dungy et al. noted
ear/hearing abnormalities in 11.4% of
513 Marshallese children examined.’
They described acute and chronic purulent and serousotitis media and ear-canal
foreign bodies, and they postulated an
increased risk attributable to the large
amountof time the children spent swim-
ming in the warm tropical lagoons.
That study lends support to our concerns about hearing and middle-ear function among this group of children. We
found 50.4% of the children in our study
to have unilateral or bilateral hearing
Table Tympanometric findings (by age) for 66 Marshallese children with hearing loss.
3-6
posed group, and in 20 of the nonexposed
group. Bilateral hearing losses were
ae
eePernaanneeN
eee gO Raia
hearing test. For hearing acuity testing,
Sa ee
in their native language to undergo the
Age in Years
10-12
13+
(Total)
10
7
4
3
17
8
5
3
97
1
9
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