Loud Music Exposure Research Articles

Causal effects of noise and air pollution on multiple diseases highlight the dual role of inflammatory factors in ambient exposures

BackgroundNoise and air pollution are significant environmental threats with proven adverse health effects. However, the causality between these ambient exposures and disease is still largely unknown. This study aims to provide genetic evidence for this gap and investigates the dual role of inflammatory factors, emphasizing the need for integrated public health strategies. MethodsWe included noise and air pollution as exposures, 91 inflammatory factors as mediators, and 26 diseases as outcomes. We explored causal relationships using Mendelian randomization. To ensure the reliability, we screened single nucleotide polymorphisms (SNPs) closely associated with exposure as instrumental variables (IVs), and assessed the pleiotropy and heterogeneity of these IVs. ResultsOur results suggest that “Hearing difficulty/problems with background noise” increases the risk of hypertension, bronchitis, and menopause; loud music exposure frequency increases the risk of bronchitis; noisy workplace raises the risk of hypertension, coronary heart disease, narcolepsy, and irritable bowel syndrome; NO2 increases the risk of myocardial infarction and chronic heart failure; NOx increases the risk of pneumonia and inflammatory diseases of female pelvic organs; and PM10 increases the risk of myocardial infarction, narcolepsy, and type 2 diabetes; PM2.5–10 increases the risk of developing pneumonia and type 2 diabetes. Furthermore, we found that nine inflammatory factors play a mediating role, of which four play a mediating role in increasing the risk of morbidity and eight play a mediating role in protection against ambient exposures. Finally, we selected SNPs significantly associated with exposure and outcome for enrichment analysis. ConclusionsThis study provides the first genetic evidence linking noise and air pollution to various diseases, highlighting the dual mediating role of inflammatory factors. Our findings align with the “One Health” framework, emphasizing the interconnectedness of environmental and human health. Integrated public health strategies considering these complex biological responses are essential for promoting overall well-being.

Development and Validation of an Efficient and Safe Loud Music Exposure Paradigm.

The purpose of this study was to develop a time-efficient music exposure and testing paradigm that safely creates temporary cochlear dysfunction that could be used in future temporary threshold shift (TTS) studies. A 30-min audio compilation of pop rock music tracks was created. Adult volunteers with normal hearing were then exposed to this music material monaurally through headphones for 30 min at 97 dBA or 15 min at 100 dBA. Levels were measured from the ear of a manikin and are considered to provide an equivalent daily noise dose based on a 3-dB exchange. We assessed the changes in their hearing, by means of distortion product otoacoustic emission (DPOAE) testing, and standard and extended high-frequency pure-tone audiometry before and after exposure. There were 17 volunteers in total. In the first trial, eight volunteers (four females; Mdnage = 31 years [interquartile range, IQR = 4.25]) were included. Although TTS was observed in all eight participants for at least one frequency, a large variation in affected frequencies was observed. To address this issue, the audio material was further remastered to adjust levels across the different frequency bands. Fourteen adults (nine newly recruited and five from the first trial; seven females; Mdnage = 31 years [IQR = 5]) were exposed to the new material. All but two of 17 participants presented clinically significant TTS or decrease in DPOAE amplitude in at least one frequency. Statistically significant average TTS of 7.43 dB was observed at 6 kHz. There were statistically significant average DPOAE amplitude shifts of -2.55 dB at 4 kHz, -4.97 dB at 6 kHz, and -3.14 dB at 8 kHz. No participant presented permanent threshold shift. A monaural music paradigm was developed and shown to induce statistically significant TTS and DPOAE amplitude shifts, without evidence of permanent loss. This realistic and time-efficient paradigm may be considered a viable option for experimental studies of temporary music-induced hearing loss. https://doi.org/10.23641/asha.25016471.

Attitudes towards hearing, hearing loss, and hearing protection in university students

Objective Young adults are at risk for hearing loss caused by exposure to loud music. Intervention at this stage provides opportunities to support lifelong hearing protection use. This study explores attitudes related to hearing, hearing loss, and hearing protection among university students. Design Qualitative interview design, supplemented by quantitative questionnaire data. Study sample 18 university students, aged 18–24 years. Results Students were uncertain about mechanisms of noise-induced hearing loss, did not feel vulnerable to permanent hearing damage from loud music, were unconvinced of hearing protection efficacy, and reported barriers to hearing protection use. Students emphasised the positive effects of loud music and reported an increased likelihood of using hearing protection were it used by peers. Music students appeared more aware of the negative effects of loud music exposure. Students reported conflicting attitudes regarding government regulation of hearing protection use. Conclusion Young adults require education about hearing protection from multiple, credible sources and need to understand the mechanisms behind noise-induced hearing loss in a way that makes it of high personal relevance.

Personal Audio Systems Unsafe At Any Sound

Personal Audio Systems Unsafe At Any Sound

University Marching Band Members' Noise Dosages and Hearing Health-Related Knowledge.

Objectives: (1) To measure sound exposures of marching band and non-marching band students during a football game, (2) to compare these to sound level dose limits set by NIOSH, and (3) to assess the perceptions of marching band students about their hearing health risk from loud sound exposure and their use of hearing protection devices (HPDs). Methods: Personal noise dosimetry was completed on six marching band members and the band director during rehearsals and performances. Dosimetry measurements for two audience members were collected during the performances. Noise dose values were calculated using NIOSH criteria. One hundred twenty-three marching band members responded to a questionnaire analyzing perceptions of loud music exposure, the associated hearing health risks, and preventive behavior. Results: Noise dose values exceeded the NIOSH recommended limits among all six marching band members during rehearsals and performances. Higher sound levels were recorded during performances compared to rehearsals. The audience members were not exposed to hazardous levels. Most marching band members reported low concern for health effects from high sound exposure and minimal use of HPDs. Conclusion: High sound exposure and low concern regarding hearing health among marching band members reflect the need for comprehensive hearing conservation programs for this population.

Distortion product otoacoustic mapping measured pre- and post-loud sound exposures

Objective Sampling distortion product otoacoustic emissions (DPOAEs) at multiple f2/f1 ratios and f2 frequency values produces a DPOAE “map.” This study examined the efficacy of DPOAE mapping compared with pure tone audiometry and standard DPOAEs for detecting noise effects in subjects exposed to loud sound. Design A map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study. Study sample The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure. Results After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations. Conclusions Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive.

Loud Music Listening

Over the past four decades, there has been increasing interest in the effects of music listening on hearing. The purpose of this paper is to review published studies that detail the noise levels, the potential effects (e.g. noise-induced hearing loss), and the perceptions of those affected by music exposure in occupational and non-occupational settings. The review employed Medline, PubMed, PsychINFO, and the World Wide Web to find relevant studies in the scientific literature. Considered in this review are 43 studies concerning the currently most significant occupational sources of high-intensity music: rock and pop music playing and employment at music venues, as well as the most significant sources of non-occupational high-intensity music: concerts, dicotheques (clubs), and personal music players. Although all of the activities listed above have the potential for hearing damage, the most serious threat to hearing comes from prolonged exposures to amplified live music (concerts). The review concludes that more research is needed to clarify the hearing loss risks of music exposure from personal music players and that current scientific literature clearly recognizes an unmet hearing health need for more education regarding the risks of loud music exposure and the benefits of wearing hearing protection, for more hearing protection use by those at risk, and for more regulations limiting music intensity levels at music entertainment venues.

Regulations to reduce risk of hearing damage in concert venues.

In 2015, the World Health Organization (WHO) convened a group of researchers and industry experts to tackle the risk of noise-induced hearing loss from loud music exposure because of personal listening devices and entertainment venues...

Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010.

To investigate factors associated with hearing impairment (HI) in adolescent youths during the period 1966-2010. Cross-sectional analyses of US sociodemographic, health, and audiometric data spanning 5 decades. Subjects were youths aged 12 to 17 years who participated in the National Health Examination Survey (NHES Cycle 3, 1966-1970; n = 6,768) and youths aged 12 to 19 years in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994; n = 3,057) and NHANES (2005-2010; n = 4,374). HI prevalence was defined by pure-tone average (PTA) ≥ 20 dB HL for speech frequencies (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Multivariable logistic models were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Overall speech-frequency HI prevalence was 10.6% (95% CI: 9.7%-11.6%) in NHES, 3.9% (95% CI: 2.8%-5.5%) in NHANES III, and 4.5% (95% CI: 3.7%-5.4%) in NHANES 2005 to 2010. The corresponding high-frequency HI prevalences were 32.8% (95% CI: 30.8%-34.9%), 7.3% (95% CI: 5.9%-9.0%), and 7.9% (95% CI: 6.8%-9.2%). After adjusting for sociodemographic factors, overall high-frequency HI was increased twofold for males and cigarette smoking. Other significant risk factors in NHANES 2005 to 2010 included very low birth weight, history of ear infections/otitis media, ear tubes, fair/poor general health, and firearms use. HI declined considerably between 1966 to 1970 and 1988 to 1994, with no additional decline between 1988 to 1994 and 2005 to 2010. Otitis media history was a significant HI risk factor each period, whereas very low birth weight emerged as an important risk factor after survival chances improved. Reductions in smoking, job-related noise, and firearms use may partially explain the reduction in high-frequency HI. Loud music exposure may have increased, but does not account for HI differences. NA Laryngoscope, 129:1922-1939, 2019.

Social Representation of "Loud Music" in Young Adults: A Cross-Cultural Study.

Exposure to recreational noise, particularly music exposure, is considered one of the biggest public health hazards of our time. Some important influencing factors such as socioeconomic status, educational background, and cross-cultural perspectives have previously been found to be associated with attitudes toward loud music and the use of hearing protection. Although culture seems to play an important role, there is relatively little known about how it influences perceptions regarding loud music exposure in young adults. The present study was aimed to explore cross-cultural perceptions of and reactions to loud music in young adults (18-25 yr) using the theory of social representations. The study used a cross-sectional survey design. The study sample included young adults (n = 534) from five different countries (India, Iran, Portugal, the United States, and the United Kingdom) who were recruited using convenience sampling. Data were collected using a questionnaire. Data were analyzed using a content analysis, co-occurrence analysis, and also χ² analysis. Fairly equal numbers of positive and negative connotations (∼40%) were noted in all countries. However, the χ² analysis showed significant differences between the countries (most positive connotations were found in India and Iran, whereas the most negative connotations were found in the United Kingdom and Portugal) regarding the informants' perception of loud music. The co-occurrence analysis results generally indicate that the category "negative emotions and actions" occurred most frequently, immediately followed by the category "positive emotions and actions." The other most frequently occurring categories included "acoustics," "physical aliment," "location," and "ear and hearing problems." These six categories formed the central nodes of the social representation of loud music exposure in the global index. Although some similarities and differences were noted among the social representations toward loud music among countries, it is noteworthy that more similarities than differences were noted among countries. The study results suggest that "loud music" is perceived to have both positive and negative aspects within society and culture. We suggest that the health promotion strategies should focus on changing societal norms and regulations to be more effective in decreasing the noise- and/or music-induced auditory symptoms among young adults.

Noise-induced hearing loss: a modern epidemic?

Hearing loss is an increasingly common problem in the UK, and noise-induced hearing loss is the second most common acquired cause. There is a greater burden on the younger population, as recreational noise exposure is an important contributor. New damaging hearing behaviours have emerged including loud music exposure at concerts, nightclubs and via personal music players. The mechanism of damage is thought to involve many diverse pathways, which include oxidative damage, mechanical shearing forces and glutamate excitotoxicity. Although no current treatment exists to reverse the damage caused, these pathways can be targeted by agents that are being trialled for use in post-exposure treatment and prevention, with conflicting results. Other preventative strategies are important in addressing damaging hearing behaviours, including 'safe listening' promotion with advocacy materials for young adults, and promoting safe listening devices.

Loud Music Exposure and Cochlear Synaptopathy in Young Adults: Isolated Auditory Brainstem Response Effects but No Perceptual Consequences

Loud Music Exposure and Cochlear Synaptopathy in Young Adults: Isolated Auditory Brainstem Response Effects but No Perceptual Consequences

Loud Music Exposure and Cochlear Synaptopathy in Young Adults: Isolated Auditory Brainstem Response Effects but No Perceptual Consequences.

The purpose of this study was to test the hypothesis that listeners with frequent exposure to loud music exhibit deficits in suprathreshold auditory performance consistent with cochlear synaptopathy. Young adults with normal audiograms were recruited who either did (n = 31) or did not (n = 30) have a history of frequent attendance at loud music venues where the typical sound levels could be expected to result in temporary threshold shifts. A test battery was administered that comprised three sets of procedures: (a) electrophysiological tests including distortion product otoacoustic emissions, auditory brainstem responses, envelope following responses, and the acoustic change complex evoked by an interaural phase inversion; (b) psychoacoustic tests including temporal modulation detection, spectral modulation detection, and sensitivity to interaural phase; and (c) speech tests including filtered phoneme recognition and speech-in-noise recognition. The results demonstrated that a history of loud music exposure can lead to a profile of peripheral auditory function that is consistent with an interpretation of cochlear synaptopathy in humans, namely, modestly abnormal auditory brainstem response Wave I/Wave V ratios in the presence of normal distortion product otoacoustic emissions and normal audiometric thresholds. However, there were no other electrophysiological, psychophysical, or speech perception effects. The absence of any behavioral effects in suprathreshold sound processing indicated that, even if cochlear synaptopathy is a valid pathophysiological condition in humans, its perceptual sequelae are either too diffuse or too inconsequential to permit a simple differential diagnosis of hidden hearing loss.

Effectiveness of Earplugs in Preventing Recreational Noise-Induced Hearing Loss: A Randomized Clinical Trial.

The incidence of hearing loss has risen in past years. Attendance at music festivals and concerts may contribute to this increasing problem. To assess the effectiveness of earplugs in preventing temporary hearing loss immediately following music exposure. A randomized, single-blind clinical trial was conducted on September 5, 2015, at an outdoor music festival in Amsterdam, the Netherlands. Normal-hearing adult volunteers were recruited via social media. An exclusion criterion was the participants' intention to wear earplugs. Of the 86 volunteers assessed, 51 were included in the study. All analyses were performed on an intention-to-treat basis. Participants were randomly assigned to a group using earplugs or an unprotected group during a 4½-hour festival visit. The primary study outcome was a temporary threshold shift (TTS) on the audiogram, primarily for frequencies at 3 and 4 kHz. Secondary study outcomes included distortion product otoacoustic emission (DPOAE) measurements and claims of tinnitus using a questionnaire and tinnitus matching experiments. Of 51 participants included, 25 were randomized to the earplug group and 26 to the unprotected group. Nine in each group (36% and 35%, respectively) were men, and the mean (SD) ages were 27.3 (5.6) years in the earplug group and 27.0 (6.2) years in the unprotected group. Baseline demographics were similar in both groups. The time-averaged, equivalent A-weighted sound pressure level experienced was 100 dBA during the festival. A TTS over frequencies at 3 and 4 kHz after exposure was seen in 4 of 50 ears (8%) in the earplug group compared with 22 of 52 ears (42%) in the unprotected group (P < .001). The relative risk for a TTS after exposure was 5.3 (95% CI, 2.0-14.3) for the unprotected group vs the earplug group. The number needed to treat with earplugs for preventing 1 TTS was 2.9. The DPOAE amplitudes decreased significantly more over the frequencies 2 to 8 kHz in the unprotected group: the mean (SD) decrease in magnitude was 0.6 (2.8) dB in the earplug group vs 2.2 (1.9) dB in the unprotected group (P = .04). Newly induced tinnitus following sound exposure occurred in 3 of the 25 participants (12%) in the earplug group vs 10 of 25 (40%) in the unprotected group (difference, 28%; 95% CI, 3.6%-49.0%; P = .02). Earplug use is effective in preventing temporary hearing loss after loud music exposure. The present randomized clinical trial adds proof to the scarce evidence and knowledge on this topic, which is a growing global problem. trialregister.nl Identifier: NTR5401.

Perception of Changes in Spectrum and Envelope of Musical Signals vs Auditory Fatigue

AbstractThe paper presents results of research on an influence of listening fatigue on the detection of changes in spectrum and envelope of musical samples. The experiment was carried out under conditions which normally exist in a studio or on the stage when sound material is recorded and/or mixed. The equivalent level of presented sound samples is usually 90 dB and this is an average value of sound level existing in control room at various recording activities. Such musical material may be treated as a noise so Temporary Threshold Shift phenomenon may occur after several sessions and this may lead to a listening fatigue effect. Fourteen subjects participated in the first part of the experiment and all of them have the normal hearing thresholds. The stimuli contained the musical material with introduced changes in sound spectrum up to ±6 dB in low (100 Hz), middle (1 kHz) and high frequency (10 kHz) octave bands. In the second part of research five subjects listened to musical samples with introduced envelope changes up to ±6 dB in interval of 1 s. The time of loud music exposure was 60, 90 and 120 minutes and this material was completely different from the tested samples. It turned out that listening to the music with an Leq= 90 dB for 1 hour influences the hearing thresholds for middle frequency region (about 1-2 kHz) and this has been reflected in a perception of spectral changes. The perceived peaks/notches of 3 dB have the detection ability at 70% and the changes of low and high ranges of spectrum were perceived at the similar level. After the longer exposure, the thresholds shifted up to 4.5 dB for the all investigated stimuli. It has been also found that hearing fatigue after 1 hour of a listening influences the perception of envelope which gets worse of 2 dB in comparison to the fresh-ear listening. When time of listening to the loud music increases, the changes in envelopes which can be detected rise to the value of 6 dB after 90-minutes exposure and it does not increase with further prolongation of listening time.

Differential effects of prenatal chronic high-decibel noise and music exposure on the excitatory and inhibitory synaptic components of the auditory cortex analog in developing chicks (Gallus gallus domesticus)

Proper development of the auditory cortex depends on early acoustic experience that modulates the balance between excitatory and inhibitory (E/I) circuits. In the present social and occupational environment exposure to chronic loud sound in the form of occupational or recreational noise, is becoming inevitable. This could especially disrupt the functional auditory cortex development leading to altered processing of complex sound and hearing impairment. Here we report the effects of prenatal chronic loud sound (110-dB sound pressure level (SPL)) exposure (rhythmic [music] and arrhythmic [noise] forms) on the molecular components involved in regulation of the E/I balance in the developing auditory cortex analog/Field L (AuL) in domestic chicks. Noise exposure at 110-dB SPL significantly enhanced the E/I ratio (increased expression of AMPA receptor GluR2 subunit and glutamate with decreased expression of GABA(A) receptor gamma 2 subunit and GABA), whereas loud music exposure maintained the E/I ratio. Expressions of markers of synaptogenesis, synaptic stability and plasticity i.e., synaptophysin, PSD-95 and gephyrin were reduced with noise but increased with music exposure. Thus our results showed differential effects of prenatal chronic loud noise and music exposures on the E/I balance and synaptic function and stability in the developing auditory cortex. Loud music exposure showed an overall enrichment effect whereas loud noise-induced significant alterations in E/I balance could later impact the auditory function and associated cognitive behavior.

Using prophylactic antioxidants to prevent noise-induced hearing damage in young adults: a protocol for a double-blind, randomized controlled trial

BackgroundDuring leisure activities young people are often exposed to excessive noise levels resulting in an increase of noise-induced symptoms such as hearing loss, tinnitus and hyperacusis. Noise-induced tinnitus is often perceived after loud music exposure and provides an important marker for overexposure as a temporary threshold shift that is often not experienced by the individual itself. As oxidative stress plays an important role in the pathogenesis of noise-induced hearing loss, the use of antioxidants to prevent hearing damage has recently become the subject of research.MethodsThis study proposes a randomized, double-blind, placebo-controlled crossover trial to assess the effects of a prophylactic combination of N-acetylcysteine (600 mg) and magnesium (200 mg) prior to leisure noise exposure in young adults. The primary outcome measure is the tinnitus loudness scored by a visual analogue scale (VAS). Secondary outcome measures are the differences in audiological measurements for the antioxidant treatments compared to placebo intake. Audiological testing comprising of pure tone audiometry including frequencies up to 16 kHz, distortion product otoacoustic emissions, transient-evoked otoacoustic emissions and speech-in-noise testing will be performed prior to and within 7 hours after noise exposure. By use of a mixed effects statistical model, the effects of antioxidants compared to placebo intake will be assessed.DiscussionAs adolescents and young adults often do not use hearing protection while being exposed to loud music, the use of preventive antioxidant intake may provide a useful and harmless way to prevent noise-induced hearing damage in this population. Furthermore, when exposed to hazardous noise levels the protection provided by hearing protectors might not be sufficient to prevent hearing damage and antioxidants may provide additive otoprotective effects. Previous research mainly focused on occupational noise exposure. The present study provides a protocol to assess the usefulness of antioxidants during leisure noise activities.Trial registrationThe present protocol is registered at ClinicalTrials.gov: NCT01727492.

A public science experiment on the link (if any) between hearing loss and a lifetime of loud music exposure

It is well known that a lifetime of exposure to loud industrial noise can lead to substantial amounts of hearing damage. The effect of a lifetime of loud music exposure is far less certain, however. To assess if there is such a link, we have launched a public science experiment that combines (a) a questionnaire on the amount of listening to loud music over one's life as well as standard questions on their hearing, and (b) a triple-digit speech-in-noise test specifically crafted for high-frequency hearing losses. The experiment has a dedicated website and takes advantage of the 2013 Centenary of the Medical Research Council to act as a “pull” for the public to participate. Over the 100 years, the MRC has been funding research, there has been revolution after revolution in the technology for music reproduction for the home or stage and in the volumes they can reach. The talk will describe the design of the experiment, the results so far, and our experience-based suggestions for running future web-based, public-science experiments. [Work supported by the Medical Research Foundation, the Medical Research Council, and the Chief Scientist Office, Scotland.]

Hearing and loud music exposure in 14-15 years old adolescents.

Adolescent exposure to loud music has become a social and health problem whose study demands a holistic approach. The aims of the current study are: (1) To detect early noise-induced hearing loss among adolescents and establish its relationship with their participation in musical recreational activities and (2) to determine sound immission levels in nightclubs and personal music players (PMPs). The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs) were classified as: normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3). The musical general exposure (MGE), from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01), in Group 3 compared with Group 2 (P < 0.05) only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01). Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05) and in Group 3 compared with Group 1 (P < 0.05). A significant difference (P < 0.05) was found in Group 1's HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2) dBA and PMPs (82.9-104.6) dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

Hearing and loud music exposure in a group of adolescents at the ages of 14-15 and retested at 17-18.

Young people expose themselves to potentially damaging loud sounds while leisure activities and noise induced hearing loss is diagnosed in increasing number of adolescents. Hearing and music exposure in a group of adolescents of a technical high school was assessed at the ages of: 14-15 (test) and 17-18 (retest). The aims of the current study were: (1) To compare the auditory function between test and retest; (2) to compare the musical exposure levels during recreational activities in test and retest; (3) to compare the auditory function with the musical exposure along time in a subgroup of adolescents. The participants in the test were 172 male; in the retest, this number was reduced to 59. At the test and retest the conventional and extended high frequency audiometry, transient evoked otoacoustic emissions (TEOAEs) and recreational habits questionnaire were performed. In the test, hearing threshold levels (HTLs) were classified as: Normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3); the Musical General Exposure (MGE), categorized in: Low, moderate, high, and very high exposure. The results revealed a significant difference (P < 0.0001) between test and retest in the HTL and global amplitude of TEOAEs in Group 1, showing an increase of the HTL and a decrease TEOAEs amplitude. A subgroup of adolescents, with normal hearing and low exposure to music in the test, showed an increase of the HTL according with the categories of MGE in the retest. To implement educational programs for assessing hearing function, ear vulnerability and to promote hearing health, would be advisable.