Noise exposure and dizziness in middle-aged adults: a nationally representative study

Abstract

Background: Dizziness is a common and multifactorial neurological symptom whose environmental determinants remain incompletely understood. Although noise exposure is well established as a cause of hearing loss, its potential relationship with dizziness has been insufficiently investigated at the population level. Objective: To evaluate associations between everyday noise exposure and dizziness in middle-aged adults and to examine whether such associations are more detectable among individuals with normal audiometric hearing. Methods: We analyzed nationally representative data from adults aged 40-59 years participating in KNHANES. Noise exposure was assessed using workplace noise exposure and earphone use duration in noisy environments. Associations with dizziness were evaluated using survey-weighted logistic regression models under three exposure specifications: (1) categorical exposure, (2) continuous exposure using log-transformed earphone duration, and (3) joint exposure categories defined as combinations of workplace noise exposure (yes vs. no) and earphone use duration (none, <= 120 min/day, >120 min/day). Models were fully adjusted for demographic, behavioral, cardiometabolic, and psychological factors. Parallel analyses were conducted among participants with normal audiometric hearing. Results: In the overall population, associations under categorical and continuous exposure specifications were modest and not consistently statistically significant. Under the joint exposure specification, participants with both workplace noise exposure and earphone use >120 min per day showed higher odds of dizziness (OR 5.03, 95% CI 1.35-19.05), whereas single-exposure categories showed more modest associations. Associations were more pronounced among adults with normal audiometric hearing, with a significant trend observed across increasing earphone exposure levels. Conclusion: Noise exposure was associated with dizziness-related symptoms at the population level, with more pronounced patterns observed under joint exposure conditions and in individuals with normal audiometric hearing. Further studies are needed to determine whether this association reflects specific vestibular disorders.