LCQ19: Ear and hearing care
***************************
Question:
A study has pointed out that 24 per cent of young people worldwide, when using personal audio devices, listen to music at unsafe sound levels, which may lead to a decrease in hearing acuity in the long run. Moreover, the World Health Organization (WHO) has earlier on recommended governments of various countries to implement integrated ear and hearing care through a strengthened health system, so as to overcome the challenges in hearing health. In this connection, will the Government inform this Council:
(1) whether it knows the respective current numbers and percentages of those persons with hearing problems in various groups (i.e. children, adolescents, adults and elderly persons) in Hong Kong;
(2) of the number of persons who sought consultation in each of the past five years at clinics under the Hospital Authority due to their hearing problems, together with a breakdown by the aforesaid groups;
(3) of the support provided by the Government for the groups of children and adolescents with hearing problems, and the respective annual numbers of persons in these two groups who received the relevant support services, in the past five years;
(4) as it is learnt that personal audio devices remain popular, whether the Government has assessed the numbers of children and adolescents in Hong Kong who may develop hearing problems in future; if so, of the details; if not, whether it will consider conducting such assessment in future; and
(5) whether it will consider, by drawing reference from the WHO's recommendations, implementing ear and hearing care measures (e.g. conducting hearing screening, and stepping up the prevention and management of ear diseases); if so, of the details; if not, the reasons for that?
Reply:
President,
In consultation with the Education Bureau (EDB), the Labour and Welfare Bureau (LWB), the Department of Health (DH), the Census and Statistics Department (C&SD) and the Hospital Authority (HA), the reply to various parts of the question raised by the Hon Chan Hoi-yan is as follows:
(1) According to a territory-wide survey conducted by the C&SD on persons with disabilities and chronic diseases in 2019/20, it was estimated that there were 47 900 persons with hearing difficulty in 2020. "Persons with hearing difficulty" were respondents who reported "a lot of difficulty" in hearing or "cannot hear at all" in the long term when using a hearing aid if necessary. Figures by age group are set out in the table below:
| Age group | Persons with hearing difficulty | ||
| Number of persons | Percentage | Rate# | |
| Aged below 15 | 300 | 0.7 | § |
| Aged 15 – 29 | 400 | 0.9 | § |
| Aged 30 – 64 | 7 600 | 16.0 | 0.2 |
| Aged 65 or above | 39 500 | 82.4 | 2.9 |
| Total* | 47 900 | 100.0 | 0.6 |
§Less than 0.05.
*Due to rounding of figures in the table, sub-items may not add up to the total figure.
(2) Over the past five years, the numbers of attendances for Audiology Outpatient Services of the HA are set out in the table below:
| Age group | Year | |||||
| 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 | Total | |
| Aged below 18 | 10 670 | 10 387 | 9 911 | 8 558 | 8 978 | 48 504 |
| Aged 18 – 64 | 40 471 | 42 848 | 39 419 | 38 949 | 45 096 | 206 783 |
| Aged 65 – 79 | 23 351 | 26 781 | 26 707 | 29 724 | 37 838 | 144 401 |
| Aged 80 or above | 12 051 | 13 962 | 14 440 | 14 923 | 18 509 | 73 885 |
| Total | 86 544 | 93 978 | 90 477 | 92 154 | 110 421 | 473 574 |
(3) In respect of children aged under 12 who are suspected to have development problems, the Child Assessment Service (CAS) of the DH provides comprehensive assessment (including hearing assessment). Interim support services would be provided for parents in need, such as talks, workshops and parental training courses, etc. in order to help them understand their children's conditions, so that better care and early intervention could be given accordingly. Children and adolescents with suspected hearing problems will be referred to the Ear, Nose, Throat (ENT) Specialist Out-patient Clinics of the HA for further assessment and follow-up. Audiologists and audiology technicians will provide hearing tests and treatment services in a timely manner based on the diagnosis of ENT specialists and the patients' needs. The Child Assessment Centres will also refer the pre-school children to the Social Welfare Department (SWD) and deliver the report to the EDB for follow-up.
The SWD provides subventions to a non-governmental organisation to operate Multi-service Centres for Hearing Impaired Persons (MSC) which provide various support services for persons with hearing impairment (including children and youth), including casework and counselling, sign language interpretation and training, audiological and speech therapy etc., to enhance their communication ability and assist them to live independently in the community. Over the past five years, the numbers of cases of the MSCs (including children and youth) are set out in the table below:
| 2017-18 | 2018-19 | 2019-20 | 2020-21 | 2021-22 |
| 871 | 883 | 912 | 839 | 941 |
Besides, the SWD provides subvented pre-school rehabilitation services for children from birth to six years old who have not yet started primary school and are assessed with hearing impairment. Such services are provided by the Early Education and Training Centres, Integrated Programmes in Kindergarten-cum-Child Care Centres, Special Child Care Centres and On-site Pre-School Rehabilitation Services. Pre-school rehabilitation services designed for children with hearing impairment include more intensive aural, pronunciation and language training to assist them to make use of their residual hearing as far as possible in order to learn to communicate in oral language in their early development stage. Sign language training is also provided based on the need of individual child. Over the past five years, the numbers of children with hearing impairment who received subvented pre-school rehabilitation services are set out in the table below:
| 2017-18 | 2018-19 | 2019-20 | 2020-21 | 2021-22 |
| 374 | 396 | 434 | 441 | 466 |
In addition, the EDB has all along been providing hearing aids as well as hearing aid fitting and related follow-up services free of charge to students in need of hearing aids. The EDB will also, subject to the assessment and recommendations of specialists and the consent of parents, refer students who have severe or profound hearing impairment or those who have inadequate speech ability owing to hearing impairment to the school for children with hearing impairment for receiving education services with intensive support. Other students with hearing impairment will be arranged to study in ordinary schools. Over the past five school years, the numbers of students with hearing impairment enrolled in the school for children with hearing impairment and public sector ordinary schools are set out in the table below:
| School year | 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 |
| School for children with hearing impairment | 84 | 64 | 71 | 63 | 57 |
| Ordinary schools | 690 | 670 | 700 | 650 | 640 |
The EDB has also been encouraging schools to adopt a 3-Tier Intervention Model under the Whole School Approach (WSA) to provide support according to the needs of students with special educational needs, including students with hearing impairment. Under the WSA, the Student Support Team, teaching staff, student guidance personnel, social workers, school-based educational psychologists, school-based speech therapists, etc. provide school-based support services to students with hearing impairment in different professional domains. Moreover, the EDB has been providing public sector ordinary schools with additional resources, professional support and teacher training. The EDB has also facilitated schools' implementation of school-based support programmes through conducting school visits regularly and organising seminars and workshops from time to time. Schools may also apply for the Top-up Fund for students with hearing impairment to procure wireless transmission systems for enhancing their speech perception effectiveness. If students still have adaptation, learning or communication difficulties after receiving school-based support, subject to parents' consent and assessment of the EDB, the Enhanced Support Service for Students with hearing impairment will be arranged to provide them with additional support.
(4) and (5) The DH has been providing health promotion and disease prevention services, including hearing health services, through its Family Health Service (FHS), Student Health Service (SHS), and Elderly Health Service to the public at different critical stages of life. This is in line with the recommendations of the World Health Organization on the prevention of hearing loss through public health and clinical interventions implemented across the life course.
The Maternal and Child Health Centres (MCHCs) of the FHS would provide Automated Otoacoustic Emission hearing screening test to those newborns who have not been screened in their birthing hospital. Babies suspected to have hearing impairment will be referred to relevant specialist for further assessment and follow-up. The MCHCs are also committed to increasing the vaccination coverage rates of the Hong Kong Childhood Immunisation Programme, which helps reduce infectious diseases, including otitis media and other common diseases that cause hearing loss.
The SHS provides preliminary hearing screening for Primary One and Secondary Two students who attend the annual health check or other students with suspected hearing problems identified during the annual health check. If necessary, the DH will arrange students to undergo further hearing test at the Special Assessment Centre to confirm the nature and severity of their hearing impairment. The students concerned would be triaged according to their needs or referred to various service agencies such as ENT clinics of the HA and the Educational Audiology Service Section of the EDB for follow-up and intervention provided by relevant professionals. Over the past five years (2017/18 to 2021/22 school years), about 2 per cent to 2.5 per cent of the screened students were referred for further assessment and follow-up.
As for preventive measures, the SHS has been providing health information on hearing to students, parents, and teachers, including advice to prevent hearing loss in children and adolescents due to the use of electronic devices, such as listening at no more than 60 per cent of the audio devices' maximum volume for less than a cumulative of 60 minutes a day. The SHS has also provided health advice on choosing earphones via the webpage, produced different videos on preventive measures to protect hearing for students, parents, and teachers, and encouraged them to seek medical advice if hearing loss or ear problem is suspected for early detection and treatment to prevent the problem from worsening.
Ends/Wednesday, January 18, 2023
Issued at HKT 19:10
Issued at HKT 19:10
NNNN