Despite the significance of hearing impairment, recent, accurate estimates of the magnitude of the problem in the United States and its distribution in the population are lacking. Agrawal et al probed databases on Americans over the past 20 years and found that hearing loss is more prevalent among US adults than previously reported: 16% of Americans aged 20 to 69 years had hearing loss, corresponding to 29 million Americans. Alarmingly, in the youngest age group (20-29 years), 8.5% already exhibited hearing loss. Prevalence appears to be accelerating particularly in this age group, possibly due to the increasing use of personal listening devices. Male subjects were 5.5-fold more likely to have hearing loss, while whites were at a 3.3-fold increased risk. The authors also observed that increases in hearing loss prevalence occurred earlier among participants with cigarette smoke exposure and cardiovascular risks, as well as with noise exposure.