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J Am Acad Audiol 2019; 30(07): 619-633
DOI: 10.3766/jaaa.17140
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Assessment of Recreational Noise–Induced Hearing Loss from Exposure through a Personal Audio System—iPod Touch

Kamakshi V. Gopal
*   Department of Audiology and Speech-Language Pathology, University of North Texas, Denton, TX
,
Liana E. Mills
*   Department of Audiology and Speech-Language Pathology, University of North Texas, Denton, TX
,
Bryce S. Phillips
*   Department of Audiology and Speech-Language Pathology, University of North Texas, Denton, TX
,
Rajesh Nandy
†   Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
› Author Affiliations
Further Information

Publication History

02 April 2018

06 April 2018

Publication Date:
25 May 2020 (online)

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Abstract

Background:

Recreational noise–induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss.

Purpose:

Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels.

Research Design:

This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups.

Study Sample:

A total of 40 adults, aged 18–31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females.

Data Collection and Analysis:

Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500–8000 Hz, extended high-frequency pure tones between 9–12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA.

Results:

Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels.

Conclusions:

These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage.

Key Words

iPod - personal audio systems - pure-tone thresholds - recreational noise–induced hearing loss - temporary threshold shift

This investigation was supported by a grant from the Texas Speech-Language-Hearing Foundation.


 

  • REFERENCES

  • Balanay JAG, Kearney GD. 2015; Attitudes toward noise, perceived hearing symptoms, and reported use of hearing protection among college students: influence of youth culture. Noise Health 17: 394-405
    CrossrefPubMedGoogle Scholar
  • Bhagat SP, Davis AM. 2008; Modification of otoacoustic emissions following ear-level exposure to MP3 player music. Int J Audiol 47: 751-760
    CrossrefPubMedGoogle Scholar
  • Bulbul SF, Muluk NB, Çakir EP, Tufan E. 2009; Subjective tinnitus and hearing problems in adolescents. Int J Pediatr Otorhinolaryngol 73: 1124-1131
    CrossrefPubMedGoogle Scholar
  • Chung JH, Des Roches CM, Meunier J, Eavey RD. 2005; Evaluation of noise-induced hearing loss in young people using a web-based survey technique. Pediatrics 115: 861-867
    CrossrefPubMedGoogle Scholar
  • Danhauer JL, Johnson CE, Byrd A, DeGood L, Meuel C, Pecile A, Koch LL. 2009; Survey of college students on iPod use and hearing health. J Am Acad Audiol 20: 5-27
    Article in Thieme ConnectPubMedGoogle Scholar
  • Danhauer JL, Johnson CE, Dunne AF, Young MD, Rotan SN, Snelson TA, Stockwell JS, McLain MJ. 2012; Survey of high school students’ perceptions about their iPod use, knowledge of hearing health, and need for education. Lang Speech Hear Serv Sch 43: 14-35
    CrossrefPubMedGoogle Scholar
  • Degeest S, Corthals P, Vinck B, Keppler H. 2014; Prevalence and characteristics of tinnitus after leisure noise exposure in young adults. Noise Health 16: 26
    CrossrefPubMedGoogle Scholar
  • Derebery MJ, Vermiglio A, Berliner KI, Potthoff M, Holguin K. 2012; Facing the music: pre- and postconcert assessment of hearing in teenagers. Otol Neurotol 33: 1136-1141
    CrossrefPubMedGoogle Scholar
  • Dillon H. 2012. Electroacoustic performance and measurement. In Hearing Aids. Sydney: NY: Boomerang Press; Thieme; 81-126
    Google Scholar
  • Eldredge DH, Mills JH, Bohne BA. 1973; Anatomical, behavioral, and electrophysiological observations on chinchillas after long exposures to noise. Adv Otorhinolaryngol 20: 64-81
    PubMedGoogle Scholar
  • Feder K, Marro L, Keith SE, Michaud DS. 2013; Audiometric thresholds and portable digital audio player user listening habits. Int J Audiol 52: 606-616
    CrossrefPubMedGoogle Scholar
  • Figueiredo RR, de Azevedo AA, de Oliveira PM, Pereira S, Amorim V, Rios AG, Baptista V. 2011; Incidence of tinnitus in MP3 player users. Braz J Otorhinolaryngol 77: 293-298
    CrossrefPubMedGoogle Scholar
  • Fligor BJ. 2009; a Personal listening devices and hearing loss: seeking evidence of a long-term problem through a successful short-term investigation. Noise Health 11: 129-131
    CrossrefPubMedGoogle Scholar
  • Fligor BJ. 2009; b Risk for noise-induced hearing loss from use of portable media players: a summary of evidence through 2008. Perspect Audiol 5: 10-20
    Google Scholar
  • Fligor BJ. 2011 Recreational NIHL: a summary of the evidence. http://www.audiologyonline.com/articles/recreational-nihl-summary-evidence-800 . Accessed October 15, 2016
    PubMedGoogle Scholar
  • Fligor BJ, Cox LC. 2004; Output levels of commercially available portable compact disc players and the potential risk to hearing. Ear Hear 24: 513-527
    Google Scholar
  • Fligor BJ, Levey S, Levey T. 2014; Cultural and demographic factors influencing noise exposure estimates from use of portable listening devices in an urban environment. J Speech Lang Hear Res 57: 1535-1547
    CrossrefPubMedGoogle Scholar
  • Gilles A, De Ridder D, Van Hal G, Wouters K, Punte AK, Van de Heyning P. 2012; Prevalence of leisure noise-induced tinnitus and the attitude toward noise in university students. Otol Neurotol 33: 899-906
    CrossrefPubMedGoogle Scholar
  • Gilles A, Van Hal G, De Ridder D, Wouters K, Van de Heyning P. 2013; Epidemiology of noise-induced tinnitus and the attitudes and beliefs towards noise and hearing protection in adolescents. PLoS One 8 (e70297) 1-8
    Google Scholar
  • Goggin LS, Eikelboom RH, Edwards GS, Maric V, Anderson JR, Sander PB, James MA, Ricciardo PM, Broeze C, Atkins L, Rajan GP. 2008; Noise levels, hearing disturbances, and use of hearing protection at entertainment venues. Aust New Zealand J Audiol 30: 50-58
    Google Scholar
  • Gopal KV, Chesky K, Beschoner EA, Nelson PD, Stewart BJ. 2013; Auditory risk assessment of college music students in jazz band-based instructional activity. Noise Health 15: 246-252
    CrossrefPubMedGoogle Scholar
  • Haahr M. 2016 Random.org: true random number generator. Randomness and Integrity Services Ltd. http://www.random.org . Accessed October 12, 2016
    PubMedGoogle Scholar
  • Hammershøi D. 2007 Manikin for assessment of MP3 player exposure. 19th International Congress on Acoustics. Aalborg, Denmark. September 2–7, 2007
    PubMed
  • Hanson DR, Fearn RW. 1975; Hearing acuity in young people exposed to pop music and other noise. Lancet 306: 203-205
    CrossrefPubMedGoogle Scholar
  • Henderson D, Bielefeld EC, Harris KC, Hu BH. 2006; The role of oxidative stress in noise-induced hearing loss. Ear Hear 27: 1-19
    PubMedGoogle Scholar
  • Henderson E, Testa MA, Hartnick C. 2011; Prevalence of noise-induced hearing-threshold shifts and hearing loss among US youths. Pediatrics 127: e39-e46
    CrossrefPubMedGoogle Scholar
  • Hodgetts WE, Rieger JM, Szarko RA. 2007; The effects of listening environment and earphone style on preferred listening levels of normal hearing adults using an MP3 player. Ear Hear 28: 290-297
    CrossrefPubMedGoogle Scholar
  • Hodgetts W, Szarko R, Rieger J. 2009; What is the influence of background noise and exercise on the listening levels of iPod users?. Int J Audiol 48: 825-832
    CrossrefPubMedGoogle Scholar
  • Holland III NV. 2008; Sound pressure levels measured in a university concert band: a risk of noise-induced hearing loss?. Update Appl Res Music Educ 27: 3-8
    Google Scholar
  • Hoover A, Krishnamurti S. 2010; Survey of college students’ MP3 listening: habits, safety issues, attitudes, and education. Am J Audiol 19: 73-83
    CrossrefPubMedGoogle Scholar
  • Jiang W, Zhao F, Guderley N, Manchaiah V. 2016; Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: a systematic review. Int J Audiol 55: 197-205
    CrossrefPubMedGoogle Scholar
  • Keith SE, Michaud DS, Chiu V. 2008; Evaluating the maximum playback sound levels from portable digital audio players. J Acoust Soc Am 123: 4227-4237
    CrossrefPubMedGoogle Scholar
  • Keppler H, Dhooge I, Vinck B. 2015; Hearing in young adults. Part II: the effects of recreational noise exposure. Noise Health 17: 245-252
    CrossrefPubMedGoogle Scholar
  • Kim MG, Hong SM, Shim HJ, Kim YD, Cha CI, Yeo SG. 2009; Hearing threshold of Korean adolescents associated with the use of personal music players. Yonsei Med J 50: 771-776
    CrossrefPubMedGoogle Scholar
  • Kujawa SG, Liberman MC. 2009; Adding insult to injury: cochlear nerve degeneration after “temporary” noise-induced hearing loss. J Neurosci 29: 14077-14085
    CrossrefPubMedGoogle Scholar
  • Kumar A, Mathew K, Alexander SA, Kiran C. 2009; Output sound pressure levels of personal music systems and their effect on hearing. Noise Health 11: 132-140
    CrossrefPubMedGoogle Scholar
  • Kumar UA, Deepashree SR. 2016; Personal music systems and hearing. J Laryngol Otology 130: 717-729
    Google Scholar
  • Le Prell CG, Hensley BN, Campbell KCM, Hall III JW, Guire K. 2011; Evidence of hearing loss in a “normally-hearing” college-student population. Int J Audiol 50: S21-S31
    CrossrefPubMedGoogle Scholar
  • Le Prell CG, Dell S, Hensley B, Hall III JW, Campbell KC, Antonelli PJ, Green GE, Miller JM, Guire K. 2012; Digital music exposure reliably induces temporary threshold shift (TTS) in normal hearing human subjects. Ear Hear 33: e44-e58
    CrossrefPubMedGoogle Scholar
  • Le Prell CG, Spankovich C, Lobariñas E, Griffiths SK. 2013; Extended high-frequency thresholds in college students: effects of music player use and other recreational noise. J Am Acad Audiol 24: 725-739
    Article in Thieme ConnectPubMedGoogle Scholar
  • LePage EL, Murray NM. 1998; Latent cochlear damage in personal stereo users: a study based on click-evoked otoacoustic emissions. Med J Aust 169: 588-592
    CrossrefPubMedGoogle Scholar
  • Levey S, Levey T, Fligor BJ. 2011; Noise exposure estimates of urban MP3 player users. J Speech Lang Hear Res 54: 263-277
    CrossrefPubMedGoogle Scholar
  • Liberman MC, Kujawa SG. 2017; Cochlear synaptopathy in acquired sensorineural hearing loss: manifestations and mechanisms. Hear Res 349: 138-147
    CrossrefPubMedGoogle Scholar
  • Lonsbury-Martin BL, Martin GK, Bohne BA. 1987; Repeated TTS exposures in monkeys: alterations in hearing, cochlear structure, and single-unit thresholds. J Acoust Soc Am 81: 1507-1518
    CrossrefPubMedGoogle Scholar
  • McNeill K, Keith SE, Feder K, Konkle ATM, Michaud DS. 2010; MP3 player listening habits of 17 to 23-year-old university students. J Acoust Soc Am 128: 646-653
    CrossrefPubMedGoogle Scholar
  • Montoya FS, Ibargüen AM, Vences AR, del Rey AS, Sanchez Fernandez JM. 2008; Evaluation of cochlear function in normal-hearing young adults exposed to MP3 player noise by analyzing transient evoked otoacoustic emissions and distortion products. Otolaryngol Head Neck Surg 37: 718-724
    Google Scholar
  • Muchnik C, Amir N, Shabtai E, Kaplan-Neeman R. 2012; Preferred listening levels of personal listening devices in young teenagers: self reports and physical measurements. Int J Audiol 51: 287-293
    CrossrefPubMedGoogle Scholar
  • Muhr P, Rosenhall U. 2010; Self-assessed auditory symptoms, noise exposure, and measured auditory function among healthy young Swedish men. Int J Audiol 49: 317-325
    CrossrefPubMedGoogle Scholar
  • National Institute for Occupational Safety and Health (NIOSH) 1998. Occupational Noise Exposure: Revised Criteria 1998. U.S. Department of Health and Human Services; Cincinnati, OH:
    Google Scholar
  • Peng JH, Tao ZZ, Huang ZW. 2007; Risk of damage to hearing from personal listening devices in young adults. J Otolaryngol 36: 179-183
    CrossrefGoogle Scholar
  • Portnuff CD. 2016; Reducing the risk of music-induced hearing loss from overuse of portable listening devices: understanding the problems and establishing strategies for improving awareness in adolescents. Adolesc Health Med Ther 10: 27-35
    Google Scholar
  • Portnuff C, Fligor BJ. 2006. Sound output levels of the iPod and other MP3 players: is there potential risk to hearing?. Paper Presented at Conference on Noise-induced Hearing Loss in Children at Work and Play Cincinnati, OH: . October 19–20, 2006
    Google Scholar
  • Portnuff C, Fligor BJ, Arehart KH. 2013; New measurement techniques for portable listening devices: technical report. J Audio Eng Soc 61 (10) 1-6
    Google Scholar
  • Pugsley S, Stuart A, Kalinowski J, Armson J. 1993; Changes in hearing sensitivity following portable stereo system use. Am J Audiol 2: 64-67
    CrossrefPubMedGoogle Scholar
  • Rawool VW. 2012. Noise control and hearing conservation in nonoccupational settings. In: Rawool VW. Hearing Conservation: In Occupational, Recreational, Educational, and Home Settings. New York, NY: Thieme; 224-241
    Google Scholar
  • Ryan A, Bone RC. 1978; Noise‐induced threshold shift and cochlear pathology in the Mongolian gerbil. J Acoust Soc Am 63: 1145-1151
    CrossrefPubMedGoogle Scholar
  • Ryan A, Kujawa SG, Hammill TL, Le Prell C, Kil J. 2014 Temporary and Permanent Noise-Induced Threshold Shifts [guidelines]. Pharmaceutical Interventions for Hearing Loss. http://hearing.health.mil/EducationAdvocacy/Newsletters.aspx . Accessed July 2016
    PubMedGoogle Scholar
  • Serra MR, Biassoni EC, Richter U, Minoldo G, Franco G, Abraham S, Carignani JA, Joekes S, Yacci MR. 2005; Recreational noise exposure and its effects on the hearing of adolescents. Part I: an interdisciplinary long-term study. Int J Audiol 44: 65-73
    CrossrefPubMedGoogle Scholar
  • Shotland LI. 1996; Dosimetry measurements using a probe tube microphone in the ear canal. J Acoust Soc Am 99: 979-984
    CrossrefPubMedGoogle Scholar
  • Silvestre RAA, Ribas Â, Hammerschmidt R, de Lacerda ABM. 2016; High‐frequency profile in adolescents and its relationship with the use of personal stereo devices. J Pediatr (Rio J) 92: 206-211
    Google Scholar
  • Spankovich C, Griffiths SK, Lobarinas E, Morgenstein KE, De la Calle S, Ledon V, Guercio D, Le Prell CG. 2014; Temporary threshold shift after impulse-noise during video game play: laboratory data. Int J Audiol 53: S53-S65
    CrossrefPubMedGoogle Scholar
  • Sulaiman AH, Husain R, Seluakumaran K. 2013; Evaluation of early hearing damage in personal listening device users using extended high-frequency audiometry and otoacoustic emissions. Eur Arch Otorhinolaryngol 271: 1463-1470
    PubMedGoogle Scholar
  • Torre III P. 2008; Young adults’ use and output level settings of personal music systems. Ear Hear 29: 791-799
    CrossrefPubMedGoogle Scholar
  • Trask DK, Abkas B, Jous N. 2006; R111: listening habits and noise exposure of MP3 player users. Otolaryngol Head Neck Surg 135: P142-P143
    Google Scholar
  • Tronstad TV, Gelderblom FB. 2016; Sound exposure during outdoor music festivals. Noise Health 18: 220-228
    CrossrefPubMedGoogle Scholar
  • Trzaskowski B, Jędrzejczak WW, Piłka E, Cieślicka M, Skarżyński H. 2014; Otoacoustic emissions before and after listening to music on a personal player. Med Sci Monit 20: 1426-1431
    CrossrefPubMedGoogle Scholar
  • Vogel I, Brug J, Hosli EJ, Van Der Ploeg CP, Raat H. 2008; MP3 players and hearing loss: adolescents’ perceptions of loud music and hearing conservation. J Pediatr 152: 400-404
    CrossrefPubMedGoogle Scholar
  • Vogel I, Verschuure H, Van Der Ploeg CPB, Brug J, Raat H. 2010; Estimating adolescent risk for hearing loss based on data from a large school-based survey. Am J Public Health 100: 1095-1100
    CrossrefPubMedGoogle Scholar
  • Vogel I, Brug J, Van Der Ploeg CP, Raat H. 2011; Adolescents risky MP3-player listening and its psychosocial correlates. Health Educ Res 26: 254-264
    CrossrefPubMedGoogle Scholar
  • Washnik NJ, Phillips SL, Teglas S. 2016; Student's music exposure: full-day personal dose measurements. Noise Health 18: 98-103
    CrossrefPubMedGoogle Scholar
  • Williams W. 2005; Noise exposure levels from personal stereo use nivel de expositión a ruido por el uso de estéreos personales. Int J Audiol 44: 231-236
    CrossrefPubMedGoogle Scholar
  • World Health Organization 2015 1.1 Billion People at Risk of Hearing Loss: WHO highlights serious threat posed by exposure to recreational noise. http://www.who.int/mediacentre/news/releases/2015/ear-care/en/ . Accessed October 2015
    PubMedGoogle Scholar
  • Zocoli AM, Morata TC, Marques JM, Corteletti LJ. 2009; Brazilian young adults and noise: attitudes, habits, and audiological characteristics. Int J Audiol 48: 692-699
    CrossrefPubMedGoogle Scholar