Use of Personal Listening Devices and Knowledge/Attitude for Greater Hearing Conservation in College Students: Data Analysis and Regression Model Based on 1009 Respondents

"It's about wanting to disappear from the world… " - an interpretative phenomenological analysis on the meaning of music and hearing-related risks

PURPOSE

To explore the role and meaning of music in adolescents' lives and the adolescents' ways of understanding how music listening can impact hearing-health.

METHODS

Open-ended interviews and Interpretative Phenomenological Analysis (IPA). The analysis involves both individual and more generalized investigations based on the contributions from seven participants.

FINDINGS

The findings show that music is an integrated and habitual aspect of the adolescents' daily lives, used as a tool for emotion regulation, cognitive enhancement, and creating personal space where one can be free from outside criticisms and distractions. There is a preference for music listening in headphones which creates a more intense and private experience. There are varying levels of awareness of the potential hearing-health risks, but the profound meaning of music for their well-being often overshadows any concerns.

CONCLUSIONS

Despite awareness of potential hearing-health risks, the adolescents prioritize the immediate emotional and cognitive benefits of music. Technological advancements and increased social media interactions contribute to a trend towards more personalized music listening. These insights call for more complex intervention strategies and models for health promotion which account for the positive aspects of music listening, instead of merely focusing on the potential risks of loud music.

Recreational noise induced hearing loss: South African undergraduate students' perspectives

Background

Recreational noise-induced hearing loss (NIHL) is an increasing public health concern among young adults who frequently use personal listening devices (PLDs) at high volumes for extended periods. Despite this, awareness of NIHL risks remains low, particularly among university students in South Africa.

Objective

This study aimed to assess undergraduate students' awareness of recreational NIHL, examining their earphone use habits, volume preferences, preventive behaviors, and associations between demographic variables and NIHL awareness.

Methods

A cross-sectional survey was conducted with 154 undergraduate students at a large urban South African university. Quantitative data on listening habits, NIHL awareness, and preventive behaviors were collected and analysed using descriptive including thematic analysis and inferential statistics such as Chi-square tests to examine associations between variables.

Results

Most participants (67.5%) reported daily earphone use, often at moderate (48.1%) or high (33.8%) volumes. Awareness of NIHL was low, with only 9.7% of students feeling very informed. Inferential analysis revealed significant associations between NIHL awareness and age (χ 2 = 12.67, p < 0.05), as well as year of study (χ 2 = 10.89, p < 0.05), with older students and those in upper academic years (third year or beyond) showing greater awareness. Preventive behaviors were inconsistent; 46.1% of students reported lowering volume, while 13.0% took no preventive measures. Further analysis revealed that students who preferred high volumes were more likely to adopt preventive measures, while those who preferred low volumes often took no action, perceiving their existing habits as safe. Thematic analysis identified concerns about hearing health, barriers to safe listening, influence of social norms, and misconceptions about ear health.

Conclusion

The findings highlight a high prevalence of potentially unsafe listening behaviors and low NIHL awareness among South African university students. Recommendations include university-based hearing health programs, leveraging social media for outreach, integrating education into first-year curricula, and promoting affordable protective options, and social media campaigns targeting safe listening practices. These measures could help foster safer listening habits and reduce NIHL risk within this vulnerable population.

The Role of a Smartphone Application in Monitoring the Risk of Hearing Loss Associated with Personal Listening Devices in Young Adults

Background Exposure to loud music has been reported to affect high-frequency hearing thresholds in adults. This study aimed to use a mobile application to assess the risk of hearing loss associated with personal listening devices (PLDs) in young adults. Methods A cross-sectional study was conducted on 99 healthy iPhone Operating System (iOS) smartphone users aged 17 to 31 years. Based on their weekly, monthly, 6-month, and annual listening data from the "Health" application, participants were classified into at-risk or non-risk groups. Six individuals in the at-risk group underwent audiological assessments. The Speech, Spatial, and Qualities of Hearing Scale (SSQ) was given to all participants. SSQ scores were compared between groups using the Mann-Whitney U test. The correlation between average PLD sound levels and SSQ scores was analyzed using the Spearman's test. Results The weekly, monthly, 6-month, and annual listening data showed that 16, 14, 12, and 12 participants were at risk, respectively. All six participants who underwent audiological assessment exhibited normal hearing thresholds. However, a pattern of decline at high frequencies was noted. A significant difference was found between the groups in terms of overall SSQ score (z = -2.74, P = 0.00), speech perception score (z = -3.25, P = 0.00), and hearing quality score (z = -2.01, P = 0.04) based on the 6-month and annual listening data. A weak positive correlation was found between the SSQ scores across all subscales and monthly sound-level data. Exposure duration was negatively correlated with speech perception (r = -0.32, P < 0.05), spatial perception (r = -0.26, P < 0.05), and overall score (r = -0.29, P < 0.05) in weekly data, as well as with hearing quality (r = -0.21; P < 0.05) and overall score (r = -0.21, P < 0.05) in annual data. Conclusions The immediate effects of loud music exposure were absent; however, prolonged exposure resulted in reduced speech perception and hearing-quality levels. Data from the iOS "Health" application indicated that some individuals were at risk of hearing loss, suggesting the need to modify their listening habits to prevent long-term decline in hearing function.

Hearing thresholds at conventional and extended high frequencies in young personal listening devices' users: A pilot study

<b>Introduction:</b> The exposure to unsafe sound levels is considered a risk factor for developing noise-induced hearing loss (NIHL). Personal listening devices (PLDs) represent a common source of recreational noise among young adults. First changes of NIHL could be detected at extended high frequencies (EHFs).<b>Aim:</b> This pilot study aimed to analyze hearing thresholds at conventional frequencies (CFs) and EHFs in young adults due to the PLD use.<b>Methods:</b> Hearing thresholds of 114 otologically normal adults aged 18 to 30 years unexposed to occupational noise were assessed using conventional and extended high-frequency audiometry. Data on PLD use, leisure time noise exposure, health and lifestyle, were acquired using a questionnaire.<b>Results:</b> Differences in hearing thresholds were found at CFs but not at EHFs according to the listening frequency (daily vs less frequent listening); duration of one PLD use of more than 30 minutes; and total listening time ≥7 hours/week. Only the highest frequency was affected by loud volume listening.<b>Conclusions:</b> Changes in hearing thresholds were found at CFs, whereby long duration, high volume and daily use were associated with lower hearing thresholds in otologically healthy adults.

Prevalence of High Frequency Noise-Induced Hearing Loss Among Medical Students Using Personalized Listening Devices

The misuse of personalized listening devices (PLDs) resulting in noise-induced hearing loss (NIHL) has become a public health concern, especially among youths, including medical students. The occupational use of PLDs that produce high-intensity sounds amplifies the danger of cochlear deterioration and high-frequency NIHL especially when used in noisy environments. This study aims to evaluate the incidence and trends of NIHL among medical students using PLDs. Background/Objectives: The purpose of this study is to assess the prevalence of high-frequency NIHL among PLD-using medical students. Methods: A semi-structured questionnaire covering details on PLD usage, exposure to noisy environments, and hearing difficulties was used to gather the data required. Conventional pure-tone audiometry with extended high-frequency audiometry was preceded by routine clinical evaluation using tuning fork tests and otoscopic examination for hearing loss assessment and to rule out middle-ear pathology. Hearing impairment was determined and categorized according to the Goodman and Clark classification system (250 Hz to 8000 kHz). SPSS version 21 was used in the analysis of the frequency data collected. Results: Out of 100 participants, using conventional PTA, 33% were found to have hearing loss, with 42.9% of males and 23.5% of females affected. Bilateral hearing loss was seen in 36.4% of the cases. Left-sided hearing loss was found to be more common (28%). The duration of usage of PLD had a significant correlation with hearing loss with a p-value < 0.0001. Hearing thresholds were significantly elevated at 16 kHz and 18 kHz in both the right and left ear. Conclusions: The high prevalence of PLD misuse among medical students is a major risk factor for NIHL. To help combat chronic hearing loss, students need to be educated about safe listening levels that can prevent further damage to the cochlea and auditory system.

From sound waves to molecular and cellular mechanisms: Understanding noise‑induced hearing loss and pioneering preventive approaches (Review)

Noise-induced hearing loss (NIHL) is a significant and urgent global public health concern, arising from prolonged exposure to elevated levels of noise. This auditory impairment harms delicate inner ear structures, particularly the essential hair cells transmitting auditory signals to the brain. Recognized by the World Health Organization as a major contributor to worldwide hearing loss, NIHL requires a comprehensive examination of its molecular and cellular mechanisms. Animal models emerge as indispensable tools for unraveling these intricacies, allowing researchers to simulate and study the impact of noise exposure on auditory structures, shedding light on the interplay of oxidative stress, inflammation and immune responses-crucial factors in NIHL progression. The present review focuses on elucidating the molecular mechanisms of NIHL, with a specific emphasis on findings derived from animal models, alongside the exploration of thorough preventive strategies, including protective measures and probing potential interventions. Understanding the molecular underpinnings not only provides insight into targeted treatment approaches, but also unlocks pathways for exploring and implementing preventive actions. This approach not only deepens the current comprehension of NIHL, but also has the potential to influence the shaping of public health policies, offering a nuanced perspective on this prevalent auditory disorder.

New Paradigm of Music Listening: Hearing Protection Perceptions and Treatment Decision-Making Among Music Venue Attendees

OBJECTIVE

Investigate the prevalence of hearing protection (HP) use and behavioral motivations and barriers among adults attending music venues.

STUDY DESIGN

Cross-sectional online survey study.

SETTING

Noise exposure levels at popular social music venues often exceed national guidelines.

METHODS

Surveys were distributed on online music communities. Respondents (n = 2352) were asked about demographics, HP use at music venues, knowledge about noise exposure impact, and perceptions of HP use. Data were characterized through descriptive statistics. Multivariable regression analysis explored differences in knowledge and perception between HP users and nonusers.

RESULTS

In this cohort (mean age 29 ± 7 years, 61% male), HP users were significantly more aware of the impact of music venues on hearing (P < .01), believed their hearing ability had decreased after attending music venues (P < 0.01), and believed HP could protect from hearing loss (P < .01) than non-HP users. HP nonusers most frequently cited never considering HP (14.45%) and apathy about it affecting music quality (12.71%). Common sources of HP information were recommended by a friend/peer. Multivariable regression analysis accounting for demographics, medical history, and attendance characteristics found belief that HP use at music venues could protect from hearing loss (β = 0.64, 95% confidence interval [CI] = [0.49-0.78]) and HP use (β = 1.73, 95% CI = [1.47-1.98]) were significantly associated with increased subjective enjoyment while wearing HP.

CONCLUSION

HP users and nonusers have significantly different perceptions of HP use and its impact. Our findings have implications for understanding motivations and barriers related to HP use and developing strategies to promote HP use at music venues.

Hearing Care: Safe Listening Method and System for Personal Listening Devices

Excessive use of Personal Listening Devices (PLDs) and prolonged exposure to noise from loud music create many potential risks associated with hearing loss. To this end, the World Health Organization has published Recommendation ITU-T H.870 in 2019, which provides adults and children with a set of recommendations for sound dosage and operating times needed to avoid potential hearing risks. Some studies have investigated noise exposure of related applications for listening safety, resulting in some related recommendations and applications; however, these studies often do not pay attention to measurement error, which is important for human real noise exposure estimation to avoid hearing loss. This paper proposes a method for calculating noise exposure that can accurately calculate the actual noise sound-pressure level (SPL) and PLD dosage based on the WHO-ITU standard. We develop a calculation method and design a listening system that includes (i) a Safe Listening Personal Listening Device (SL-PLD) that can measure the listening dose in real time and control the output volume effectively, (ii) a Safe Listening Application (SL-APP) for assisting the SL-PLD to check the listening status in real time and provide alerts. Our experimental results show that (i) the proposed noise calculation method can reach 0.88 dB deviation under the 76 dB reference SPL and 98.8% accuracy, as compared to the SoundCheck tool measurement, (ii) the proposed SL-PLD controls the SPL output effectively as the dose increases, and (iii) the SL-APP determines the dosage usage and will provide a warning when the dosage exceeds a preset value. Therefore, users can adjust their listening behavior for more secure listening by using our methods and applications.

Attitudes towards Safe Listening Measures in Entertainment Venues: Results from an International Survey among Young Venue-Goers

BACKGROUND

Sustained exposure to excess noise in recreational settings is among the main causes of hearing loss among young adults worldwide. Within a global effort to develop standards for safe listening in entertainment venues, this study aims at identifying modifiable factors (knowledge, attitudes, and beliefs), which can hinder or facilitate the acceptance of safe listening measures in public venues among young venue-goers.

METHODS

An online questionnaire was developed inspired by the Health Belief Model. It was divided into five sections: (i) socio-demographics (ii) listening habits, (iii) experiences with loud music, (iv) knowledge, attitudes, and beliefs, and (v) willingness to change. Participants were recruited through social media.

RESULTS

2264 individuals aged 16-35 completed the questionnaire. Most visited entertainment venues relatively infrequently, with the majority of them only visiting once per month or less. Nevertheless, most reported having experienced the negative consequences of listening to loud music. Overall, most people were favorable towards preventive measures, especially quiet areas.

CONCLUSION

Our findings stress the urge to address the issue of safe listening in public venues and support an approach based on the introduction of standards. Moreover, they provide us with information on key factors to be considered when introducing and communicating preventive measures in public entertainment venues.

Analysis of the Actual One-Month Usage of Portable Listening Devices in College Students

Although contemporary researchers are concerned about overexposure of portable listening devices (PLD) for adolescents and young adults who often prefer listening to music at high levels for a long time, many of these studies have focused on either comparing sound pressure levels of various kinds of earphones or evaluating the recognition of noise-included hearing loss and listening habits through surveys. Further still, current criteria were developed for occupational noise-induced hearing loss, so there are only a few published guidelines for hearing insults due to recreational noise exposure. The present study, therefore, measures actual listening levels and PLD time in college students using a real-time measurement system and applying that gathered scientific data to the internationally recommended noise exposure standards. Thirty-four college students were asked to listen to music similar to their daily lifestyles for 4-weeks. After installing the application, the Google account that linked to the user's mobile phone was logged into the server communication. When a subject listened to music, the average and maximum listening levels and listening time could then be recognized as his or her Google account ID and stored in the database for analysis. User data was measured at 1-s intervals and delivered to the main server system every 5 s. The data were analyzed as LZeq for mean levels and LCpeak for maximum levels, and also for PLD use time. The mean of the preferred listening level was 68-70 dB SPL for 4 weeks with long enough break times. That is, the listening levels of college students were not high enough to induce instant hearing loss when they used PLD. However, there was a large individual difference in the listening levels and use times. When applied to three recommended noise exposure criteria, the number of exceeded subjects also differed from 0 to 56.72% depending on the criterion. We thus suggest that appropriate and standardized criteria for music-induced hearing loss might be proposed for recreational PLD users.

Health Education Intervention on Hearing Health Risk Behaviors in College Students

Young people, like college students, are at risk of hearing loss from prolonged and excessive exposure to loud sounds. However, behavioral interventional studies on them are inadequate. This study explored the application of a health belief model to the health education intervention on college students for improving hearing health knowledge, health belief, and hearing behaviors. From November 2017 to September 2018, a cluster randomized controlled trial was conducted, enrolling 830 college students, with 419 in the intervention group and 411 in the control group. The intervention group received a 3-month hearing health education, while the control group received no intervention. The information of hearing health knowledge, health belief, and hearing behaviors were collected using hearing health questionnaires before the intervention, after the intervention, and 3 months after the intervention cessation. The intervention significantly improved hearing health knowledge, health belief, perceived severity, and self-efficacy in female students, and effectively reduced the frequency of using headphones per day, duration of using headphones each time, and proportion of using headphones at high volume in female students, and reduced the behaviors of sleeping with headphones listening in females and males. Therefore, this study confirms the effectiveness of health belief model-based intervention for changing hearing loss-related risk behaviors.

Personal Music Players Use and Other Noise Hazards among Children 11 to 12 Years Old

Exposure to loud music-due to widespread personal music players (PMPs) and noisy leisure activities-are major risk factors for noise induced hearing loss (NIHL) in adolescents. However, there is little evidence of the impact of noise on the hearing of younger children. This study aimed to explore an association between PMP use and hearing, and to identify other sources of noise among children. The study sample consisted of 1032 children aged 11-12 years old. Hearing thresholds were determined from 0.5 to 8 kHz. PMP use and other noise exposures were evaluated using a survey. We found that 82% of the children had a PMP, and 78% were exposed to noise when playing computer games. An audiometric notch was documented in 1.3% of the children. Only 11.5% of the children ever used hearing protection while engaged in noisy activities. We found no convincing evidence of an association between PMP use and hearing thresholds, although our results suggest that tinnitus may be an early sign of NIHL in young children. The study shows a need to provide children, their parents, and educators with knowledge of how to take care of hearing, including how to avoid and minimize noise exposure.

Topic Modeling for Analyzing Patients' Perceptions and Concerns of Hearing Loss on Social Q&A Sites: Incorporating Patients' Perspective

Hearing loss is the most common human sensory deficit, affecting normal communication. Recently, patients with hearing loss or at risk of hearing loss are increasingly turning to the online health community for health information and support. Information on health-related topics exchanged on the Internet is a useful resource to examine patients' informational needs. The ability to understand the patients' perspectives on hearing loss is critical for health professionals to develop a patient-centered intervention. In this paper, we apply Latent Dirichlet Allocation (LDA) on electronic patient-authored questions on social question-and-answer (Q&A) sites to identify patients' perceptions, concerns, and needs on hearing loss. Our results reveal 21 topics, which are both representative and meaningful, and mostly correspond to sub-fields established in hearing science research. The latent topics are classified into five themes, which include "sudden hearing loss", "tinnitus", "noise-induced hearing loss", "hearing aids", "dizziness", "curiosity about hearing loss", "otitis media" and "complications of disease". Our topic analysis of patients' questions on the topic of hearing loss allows achieving a thorough understanding of patients' perspectives, thereby leading to better development of the patient-centered intervention.