Assessment of Safe Listening Intentional Behavior Toward Personal Listening Devices in Young Adults

Awareness, attitudes and perceptions of students towards leisure noise in Durban, South Africa

BACKGROUND

 Young adults are exposed to high noise levels in leisure venues, which increases their risk of hearing loss, and can affect their quality of life.

OBJECTIVES

 The aim of this study was to describe the young adults' awareness, attitudes and perceptions towards leisure noise at a university in South Africa.

METHOD

 A descriptive cross-sectional study design with quantitative methods of data was considered for this study. Students from first to fourth years in the Education Department of a local university in Durban, South Africa, who were aged 18 years old - 25 years old were invited to participate in an online survey.

RESULTS

 Of the 462 participants, most had a general awareness on noise and hearing loss but lacked knowledge on the negative effect of loud noise, with 95.2% using personal listening devices, followed by visiting restaurants and gyms, and 48.3% being unsure if noise can damage hearing permanently. They were unaware of methods to reduce their exposure to noise. A significant relationship between awareness of noise and attitudes (p = 0.029) indicated that the higher the level of awareness regarding leisure noise, the better their attitude and behaviour, thus the lower the risk of hearing loss.

CONCLUSION

 The results highlight the need for implementing the World Health Organization (WHO) noise regulations and providing education for this age group to prevent irreversible hearing loss through exposure to leisure noise.Contribution: A national study is recommended to increase research evidence.

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.

Associations Between Recreational Noise Exposure and Hearing Function in Adolescents and Young Adults: A Systematic Review

PURPOSE

There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults.

METHOD

A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure.

RESULTS

Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range.

CONCLUSIONS

There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25114193.

The development and evaluation of an online hearing loss prevention program

Recent studies underline the need for research on approaches to encouraging healthy listening habits. This study aims to develop and evaluate an online hearing loss prevention program; and examine its influence on the participants' use of hearing protection, hearing loss prevention knowledge, attitude towards noise, and program useability and adherence. The study was conducted in the county of Västra Götaland, Sweden, from March through October 2021. The program included four modules focused on hearing and hearing loss prevention and was accessible to the participants for four weeks. In total, 75 participants completed the program which was evaluated using the Youth Attitude to Noise Scale and four additional self-designed questionnaires. The questionnaires were deployed before and immediately after program completion. The findings indicate that the program may influence the participants' attitudes toward noise and the use of hearing protection. The participants who completed the program perceived high useability and increased hearing loss prevention knowledge. This program is most needed to promote healthy hearing. Future studies should target specific groups with this program and evaluate its long-term effects.

Understanding Hearing Health: A Cross-Sectional Study of Determinants in a Metropolitan Area

Hearing health prevention has emerged as a significant public health concern worldwide. With nearly two and a half billion people experiencing some degree of hearing loss, and around seven hundred million requiring medical intervention, the impact on global health is substantial. The economic burden is equally substantial, with estimated health costs reaching 980 billion dollars in the United States alone. To shed light on this issue, we conducted a survey-based cross-sectional study involving 1150 individuals. Utilizing multiple linear regression across three models, we aimed to explore the association between demographic variables and knowledge, attitude, and behaviors related to hearing health. In Model I, we observed a correlation between knowledge and several factors, including age, smoking habits, marital status, and education. In Model II, attitudes were found to associate with non-smoking habits, education, and knowledge. Model III revealed a statistically significant correlation between behaviors and age, gender, parenthood, knowledge, and attitudes. These findings emphasize the importance of targeted public health programs aimed at improving behaviors among the general population. Such interventions can be both effective and relatively inexpensive. By addressing these determinants, we can enhance overall hearing health in the community. Our study contributes valuable information about the knowledge, attitudes, and behaviors related to hearing health in the general population. Understanding these factors is crucial in developing evidence-based strategies to promote hearing health and prevent hearing loss effectively. As we continue to work towards better hearing health, the findings from this study can serve as a cornerstone for informed decision-making and successful intervention implementation.

Influence of music on the hearing and mental health of adolescents and countermeasures

This review elaborates on the influence of music on the psychological well-being of adolescents, covering the potential advantages, drawbacks, and necessary strategic interventions associated with music exposure. Initially, we characterize music and delve into a multifaceted classification system. Music, as a pervasive art form, is categorized based on regional and national parameters, and it also distinguishes through the assorted genres and traits. The mental well-being of adolescents is significantly influenced by music through mechanisms such as the facilitation of emotional expression and regulation, fortification of social bonds and the sense of belonging, as well as the fostering of creativity and cognitive development. Nonetheless, music, if misused or associated with inappropriate content, could elicit a spectrum of issues ranging from auditory impairment, diversion of attention, addiction tendencies, to the induction of negative emotions. To counteract these potential hazards, we propose several mitigation strategies including the selection of appropriate music styles, the establishment of a wholesome music environment, the promotion of the constructive role of music education, and fostering active participation in music activities among the youth. In conclusion, we underscore the necessity of a collaborative endeavor from all sectors of society to ensure a healthy music environment for the youth, which in turn would enhance the positive influence of music on the mental health development of this population.

Personal Listening Device Use and Attitude to Noise in Relation to Depression and Anxiety among Medical Students

Background

High levels of environmental noise may lead to psychological symptoms. The present study has hypothesized that personal listening device (PLD) use and a negative attitude to noise are significantly related to anxiety and/or depression.

Methods

This is a cross-sectional study conducted on 431 six-grade students (35% male) at the Faculty of Medicine, University of Belgrade. All students completed the questionnaires related to socio-demographic data, noise/music exposure habits, behaviors related to PLD use, tinnitus, headaches, consumption of alcohol, coffee, energy drinks and cigarettes, YANS (Youth Attitude to Noise Scale), CES-D (The Center for Epidemiologic Studies Depression), and GAD-7 (Generalised Anxiety Disorder Assessment - 7 item scale) questionnaires.

Results

There were 396 (91.9%) of investigated students who used PLD, with more frequent use among girls compared to boys (95.0% and 86.8%, respectively; p = 0.002). We found no significant relationship between the frequency of PLD use and depression and anxiety. However, continuous daily PLD use longer than 1 hour was significantly and positively related to depression (p = 0.006). Students with depression had a lower total YANS score compared to those without depression, indicating a more negative attitude toward noise (p = 0.042). Students with no difficulties to concentrate in noise and with a positive attitude to daily noises had about 37% lower chance to suffer from depression and anxiety, respectively.

Conclusions

PLD use is common among medical students and may be associated with their mental health. Longer than 1 hour of continuous daily use of PLD may be positively related to depression. We also found a significant relationship between difficulties concentrating in noisy environments and depression, and between negative attitudes to daily noises and anxiety.

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.

Relating Factors and Trends in Hearing Device Adoption Rates to Opportunities for Hearing Health Care Providers

As with many professions, audiology is continuing to evolve. More specifically in terms of hearing device technology, we see evolution in remote accessibility to providers, public knowledge of devices, and services provided by hearing care professionals. Each of these topics plays a role in an individual's decision to pursue any sort of hearing care services. Given the variety of new devices soon coming to the market (over-the-counter devices), it is important for the audiologist to understand patient motivators and how they have a great impact on both the practice of audiology as well as the patient's overall satisfaction. The goal of this article is to investigate the MarkeTrak 2022 data to determine the trends in adoption and use of hearing aids as well as examine predictive factors that can be used to better understand hearing aid adoption.

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.

Sound-level Monitoring Earphones With Smartphone Feedback as an Intervention to Promote Healthy Listening Behaviors in Young Adults

OBJECTIVES

More than a billion adolescents and youngsters are estimated to be at risk of acquiring recreational noise-induced hearing loss (RNIHL) due to the unsafe use of personal audio systems. RNIHL is preventable; therefore, the present study aimed to determine (i) the accuracy and reliability of dbTrack (Westone) sound-level monitoring earphones and (ii) the effect of sound-level monitoring earphones with smartphone feedback and hearing-health information as an intervention to promote healthy listening behaviors in young adults.

DESIGN

The study consisted of two phases: the first phase investigated the accuracy and reliability of dbTrack sound-level monitoring earphones. Accuracy was determined by comparing earphone measurements to sound level meter measurements. Intradevice reliability was determined by comparing earphone measurements during test-retest conditions. Nineteen participants were recruited through convenience sampling to determine within-subject reliability by comparing in-ear sound levels measured by the earphones during test-retest conditions. For the second phase of the study, a single-group pretest-posttest design was utilized. Forty participants, recruited through snowball sampling, utilized the sound-level monitoring earphones with the accompanying dbTrack smartphone application for 4 weeks. The application's smartphone feedback was disabled during the first 2 weeks (pretest condition) and enabled during the last 2 weeks (posttest condition). Average daily intensities, durations, and sound dosages measured during pre- and posttest conditions were compared.

RESULTS

Phase 1 dbTrack earphone measurements were within 1 dB when compared with sound level meter measurements. Earphones were also within 1 dB in repeated measures across earphones and across participants. Phase 2 posttest average daily intensity decreased by 8.7 dB (18.3 SD), duration decreased by 7.6 minutes (46.6 SD), and sound dose decreased by 4128.4% (24965.5% SD). Differences in intensity and sound dose were significantly lower with a small and medium effect size, respectively.

CONCLUSIONS

This study's preliminary data indicate that dbTrack (Westone) sound-level monitoring earphones with a calibrated in-ear microphone can reliably and accurately measure personal audio systems sound exposure. Preliminary results also suggest that feedback on sound exposure using the accurate sound-level monitoring earphones with the accompanying dbTrack application can potentially promote safe listening behavior in young adults and reduce the risk of acquiring an RNIHL.

Associations between adolescents' earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students

Few epidemiological studies have examined the relationship between earphone usage and hearing loss in adolescents. This study identified the prevalence of hearing loss in South Korean adolescents using representative national survey data and evaluated the relationship between earphone usage in a noisy environment and hearing loss. This study analyzed 532 subjects (12-19 years) who participated in a 2012 national survey and completed health and noise environment exposure questionnaires and pure tone audiometry (PTA) test. Hearing loss was defined as an average hearing threshold of 26 Decibel-A (dBA) or higher in PTA. The relationship between earphone usage and hearing loss was analyzed using a hierarchical logistic regression model. Adolescents who were exposed to high noise levels via headphones in a noisy environment had a hearing loss prevalence of 22.6% and adolescents who used earphones 80 minutes or more per day on average had the hearing loss prevalence of 22.3%. The results of the logistic regression analysis revealed that adolescents who used earphones in a noisy environment had a 4.5-fold higher risk of hearing loss and an 8.4 times higher risk of having a subjective hearing problem than those who did not use earphones (prevalence odds ratio (pOR) = 4.54, 95% confidence interval (CI): 1.35-15.24; pOR = 8.39, 95% CI: 1.12-62.83, respectively). Additionally, adolescents who used earphones more than 80 minutes per day in a noisy environment had a 4.7 times higher risk of hearing loss than those who used them less than 80 minutes per day (pOR = 4.68, 95% CI: 1.08-20.22). Longitudinal studies are needed to provide evidence of causality between earphone usage and hearing loss.