Tinnitus in urban settings: insights into lifestyle and medical factors from the Hamburg City Health Study

Abstract Purpose Tinnitus is a common and multifactorial auditory condition associated with considerable psychosocial burden. Evidence regarding its relationship with demographic, lifestyle, and medical factors remains inconsistent. This study aimed to determine the prevalence and correlates of tinnitus in an urban Western European population, focusing on lifestyle, socioeconomic, and clinical characteristics within the Hamburg City Health Study (HCHS). Methods We conducted a population-based cross-sectional analysis of data from 14,355 participants aged 45-74 years enrolled in the HCHS. Tinnitus status was defined by self-reported medical diagnosis. For statistical analyses we fitted age- and sex-adjusted logistic regression models with tinnitus status as the binary outcome. Odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) were derived from the model coefficients. Associations were examined across domains including demographics, comorbidities, medication, subjective hearing difficulties, and environmental noise exposure. Results The lifetime self-reported physician-diagnosed tinnitus was 19.3%. Male sex, older age, previous ENT surgery, sensorineural and conductive hearing loss, antidepressant use, night-shift work, sleep apnea, carotid stenosis, migraines, and shingles were associated with tinnitus. Participants with tinnitus reported greater hearing difficulties, more pronounced social consequences of hearing problems, and higher perceived environmental noise exposure. No relevant associations were observed for income, education, alcohol consumption, or occupational noise exposure. Conclusion Tinnitus in urban populations is linked to auditory and psychological comorbidities and perceived environmental noise, but not to traditional socioeconomic factors. These findings highlight the multifactorial nature of tinnitus and emphasize the need for integrated medical, audiological, and psychosocial management approaches.