Objectives This study aimed to investigate the association between working behaviors and sensorineural hearing loss (SNHL).

Methods A cross-sectional analysis was conducted (N=90 286) to assess the association between working behaviors (including shift work, night shift work and physically demanding work) and the occurrence (yes/no), laterality (unilateral/bilateral), and severity (mild/severe) of SNHL. A prospective analysis was conducted to explore the association between new-onset SNHL and working behaviors (N=8341). Multivariable logistic regression and Cox regression models were performed. Subgroup analyses were further carried out, stratified by age, sex, and chronotype. Furthermore, a polygenic risk score (PRS) was calculated to assess the influence of genetic susceptibility on the relationship.

Results Cross-sectional analysis indicated that shift work, night shift work and physically demanding work were all associated with an increased risk of SNHL (all P<0.05). These working behaviors were also associated with increased severity of SNHL (all P<0.05) and a higher likelihood of bilateral SNHL (all P<0.05). In prospective studies, the trends were generally consistent with the aforementioned results. Furthermore, the relationship between night shift work and SNHL was particularly pronounced among individuals with morning chronotype (P-interaction=0.007), or with ≤5 years noisy work environments (P-interaction=0.026). Importantly, regardless of the level of genetic risk of PRS, a positive association remained between night shift work and physically demanding work with SNHL.

Conclusions Both cross-sectional and prospective analysis indicated that shift work, night shift work, and physically demanding work were associated with increased risk of occurrence, laterality and severity of SNHL, regardless of PRS for SHNL.

Key terms cohort study; night shift work; physically demanding work; sensorineural hearing loss; shift work; working behavior

• Supplementary material