Music-induced Hearing Loss Research Articles

A Survey on Knowledge, Attitude & Practice of Yakshagana Mela Artists Towards Music-Induced Hearing Loss.

Yakshagana is a type of folk-art theatre portraying mythological and historical stories. It includes artists who play predominantly percussion instruments besides cymbals and harmonium. Professional musicians exposing themselves to deafening sounds are prone to develop noise-induced complications. [1] One such professional in the coastal districts of Karnataka state is a Yakshagana himmela (backstage) artist. There is no reported literature concerning these artists' hearing health and problems. Hence, the proposed study was aimed at developing, validating and assessing the Knowledge, Attitude and Practice (KAP )of Yakshagana Mela artists towards Music-Induced Hearing Loss (MIHL), a possible risk factor of their profession. This study was carried out on 139 yakshagana mela artists with a mean age of 41.63 years. It was conducted in two phases. In the first phase, an expert committee discussion was conducted to verify, modify and validate the questionnaire. The second phase included the administration of the developed questionnaire on the artists. The sum scores for each domain of KAP were computed. Scores above 80% were defined as good knowledge, practice, and a positive attitude. The findings of the study revealed that more than half of the participants demonstrated inadequate knowledge (63.3%) and negative attitude (63.7%), but a fair level of practice (65.4%). From the outcome of the present study, it can be inferred that in spite of being in a profession with a high risk of MIHL, the participants considered hearing health as their least priority. The study illustrates the need for initiating hearing and conservation programs to improve awareness & combat music induced hearing loss in this population.

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.

Toward Music-Related Sound Control and Hearing Conservation in the Leisure Soundscape

Music-Induced Hearing Loss (MIHL) affects both musicians and participants of leisure soundscapes. Noise Risk Assessment and Hearing Conservation Program have been practised in the manufacturing and construction industries; however, these are rarely implemented in Cultural and Creative Industries (CCI) that are also exposed to excessive sound levels. This paper includes an example from the Rainforest World Music Festival, Malaysia where data were collected from 2015 to 2017, through sound pressure level (SPL) measurements, semi-structured interviews (60 participants) and a survey (1,194 respondents). Despite SPL measurements showing levels exceeding the recommended noise limit, the study reported a majority of 68% perceived the loudness of the music festival as "perfect" whilst 21% as "loud but acceptable". In leisure soundscapes, sounds are featured aural products in demand and encapsulated in cultural meanings with voluntary listening behaviours. Thus, some of the existing guidelines in occupational noise exposure may not be transferable. As recommendations, it is essential for an extensive study on the development of a focused framework to incorporate music-related sound control and hearing conservation in reducing the risk of MIHL while preserving the social-cultural value, creativity in arts and rewards in the hearing experience of a leisure soundscape.

Music listening habits of adolescents in a South Indian city

Objective: Universal access to personal music listening devices has attracted many adolescents to listen to music. However, risky music listening behavior can lead to music-induced hearing loss, becoming a major social and public health problem. We aimed to investigate music listening habits in three groups of adolescents based on age, learn the differences in music listening habits among the groups, if any, and assess their knowledge regarding loud music-induced hearing loss. Materials and method: A total of 300 adolescents aged 13-20 years studying in various schools and colleges of a South Indian city completed a questionnaire to understand music listening habits and knowledge regarding loud music-induced hearing loss. Based on age and education level, they were divided into three groups of 100 each [high school(HS): 13-16 years, pre-university(PU): 16-17 years, and undergraduate(UG) level: 18-20 years]. Results: Duration and frequency of music listening, usage of the device, and accessory were similar among the three groups. However, across the age, there is a difference in the loudness in music listening (younger HS and PU groups frequently used loud volume) and the awareness about the damage caused to hearing due to loud music (younger HS group was least aware). A reduced hearing was reported by 17% of the UG group as opposed to 4% of the HS group. Conclusion: With the use of earphones and loud volume, younger adolescents are at greater risk for music-induced hearing loss than older adolescents. This group, if educated, is ready to accept modifications in listening behaviors that are hearing protective. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 882-894

Hearing loss and mental health issues in amateur and professional musicians

Musicians are at risk of developing music-induced hearing loss (MIHL) and also exhibit increased prevalence of depression, anxiety, and stress. However, the relationship between hearing loss and mental health issues in musicians has not yet been explored. This study conducted a cross-sectional analysis of 32 professional and 35 amateur musicians recruited from local bands and orchestras. KUDUwave software was used to obtain their overall hearing thresholds for both ears over three frequency ranges: 0.5 to 4, 6 to 8, and 9 to 16 kHz. Participants also completed a demographic questionnaire that contained questions related to musical exposure, type of music exposed, years of practice, and so on, and the DASS-21 questionnaire, which assesses the presence of depression, anxiety, and stress symptoms. Professional musicians had significantly greater music exposure compared with amateur musicians, but their hearing thresholds were not significantly different from amateur musicians in 0.5–4, 6–8, or 9–16 kHz frequency ranges. Professional musicians experienced greater symptoms of anxiety compared with amateur musicians, and this occurred independently of their hearing status. Further longitudinal studies are required to explore the causative factors resulting in increased mental health issues in professional musicians and what potential interventions may be implemented to address anxious symptomology in this population.

A Comparison of the Digits-in-Noise Test and Extended High Frequency Response between Formally Trained Musicians and Non-Musicians

Background and Aim: Musical training has been hypothesised to result in enhanced Speech Perception in Noise (SPIN) abilities, but prolonged exposure to music also increases the risk for Music-Induced Hearing Loss (MIHL). The Signal-to-Noise Ratios (SNR) and the Extended High Frequency (EHF) thresholds between formally trained musicians and non- musicians were compared to determine the effect of musical training on musicians’ SPIN and hearing abilities. Methods: This cross-sectional study included 40 musicians and 39 non-musicians 18–30 years, with mean age (SD) 22.43(2.71) years. EHF audiometry and the Digits-in-Noise (DIN) test were conducted via a smartphone. Results: Differences found between the two groups regarding the DIN test and EHF thresholds were statistically insignificant. Musicians displayed early signs of MIHL as the musicians reported significantly more (p=0.004) instances of tinnitus than non-musicians. A statistically significant correlation was found only for the non-musician group between the 12.5 kHz threshold left and the SNR obtained in the diotic listening condition (rs=-0.465; p=0.003). Conclusion: The results suggested that musicians did not display a significant advantage for SPIN and did not appear to have significantly poorer EHF hearing sensitivity. However, slight trends were noticeable in the musicians which gravitated more towards studies that found enhanced SPIN abilities and elevated EHF thresholds in the musician population. In the future, it may be useful to include additional speech tests (open-set) alongside the DIN test (closed-set). The present study suggests that EHF audiometry may be used for the early detection of MIHL. Keywords: Music; audiometry; hearing loss; noise-induced; pitch discrimination; sound localization

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.

A Systematic Literature Review of Music Induced Hearing loss

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Personal Listening Device Use Habits, Listening Belief, and Perceived Change in Hearing Among Adolescents

PurposeThis study aimed to identify personal listening device (PLD) usage habits, listening belief, and perceived change in hearing, and to investigate how the variables related to perceived change in hearing among adolescents. MethodsThe participants were 183 middle school students and 233 high school students from Ulsan. Data were collected by self-reported questionnaires from August 1, 2019, to October 22, 2019, and analyzed with descriptive statistics, χ2 test, Mann–Whitney U test, and hierarchical multiple logistic regression. ResultsMost students started to use PLDs from elementary school, and mean preferred listening level was 70.13 dB. Mean perceived susceptibility to music-induced hearing loss (MIHL) and perceived barriers to prevent MIHL were 5.18 and 3.40, respectively. Perceived change in hearing was reported on 14.2% of middle school students and 32.2% of high school students, and as the average score of perceived barriers to prevent MIHL increases by one point, the odds of decrease in hearing increase by 2.05 times (p < .001) and 1.35 times (p < .05), respectively. ConclusionConsidering that most adolescents are exposed to PLD in elementary schools and about a quarter experienced a decrease in hearing after PLD use, educational programs on hearing conservation are required to start as early as in schools. Particularly, knowledge and skills to overcome barriers to prevent MIHL should be emphasized in educational programs.

Young Adults’ Knowledge and Attitudes Regarding “Music” and “Loud Music” Across Countries: Applications of Social Representations Theory

Exposure to loud music, especially by young people, has significantly increased in recent years as a result of (a) advancements in technology in terms of personal music players and smart mobile phones, and (b) streaming of music through these devices. The World Health Organization (WHO) estimates that some 1.1 billion teenagers and young adults are at risk of developing hearing loss due to exposure to recreational noise such as music. It is suggested that knowledge and attitude of young adults toward music has bearing upon their music listening habits and thereby influences who is at risk of developing music induced hearing loss. Hence, researchers from various fields have tried to understand the knowledge and attitude of young adults regarding loud music. However, there is some criticism of attitude studies as there is little relation between expressed attitude and behavior. Some recent studies have explored the social representations of music and loud music using the Social Representations Theory (SRT). It has been suggested that social representation is more fundamental than attitude (or in other words social representation informs attitude), hence, it has a better relation to behavior. The current paper: (1) provides an overview of studies on knowledge and attitude of young adults toward loud music, (2) discusses the limitations of attitude theories and introduces SRT, and (3) provides a summary of social representation studies on “music” and “loud music” in young adults from different countries.

Awareness, attitudes, and beliefs about music-induced hearing loss: Towards the development of a health communication strategy to promote safe listening

Objective: Worldwide, 1.1 billion young people are at risk of developing hearing loss due to unsafe listening. The World Health Organization plans a global health campaign to promote behavior change. In an effort to develop effective evidence-based interventions, this study identifies modifiable factors that influence listening habits.Methods: Online survey among 1019 individuals aged 18–35. The questionnaire was based on theories of behavior change.Results: Individuals not contemplating change showed a lack of knowledge, tended not to feel particularly at risk, and did not see the benefits of preventive measures. Conversely, those considering a change perceived more barriers (e.g., lack of information on how to act,). Self-efficacy was shown to play an ambivalent role.Conclusion: Four factors that can be influenced by a health communication intervention were identified: risk perception, perceived safe listening level due to a lack of symptoms, knowledge, and perceived benefits and barriers, in particular perceived loss of pleasure.Practice implications: The first aspects can be influenced through health communication interventions. Influencing the perceived loss of pleasure additionally requires an analysis of competing pressures. To support and not exceedingly burden the individual, we further suggest to address environmental aspects (e.g., policies).

Awareness of Musicians on Ear Protection and Tinnitus: A Preliminary Study

Music induced hearing loss (MIHL) is linked to chronic, extended exposure, and progress at a rate proportionate to exposure conditions. The aim was to document hearing deterioration; awareness of ear protection devices (EPDs); presence of tinnitus, measurement of temporary threshold shift. Thirty-four musicians filled a questionnaire regarding: years of experience, instrument/splayed, hours of music exposure per week with/without amplification, through earphones and speakers, use of EPDs and tinnitus. Hearing screening in five subjects was done before and after one hour and ten minutes of practice session. Among the participants, 8.8% reported hearing deterioration subjectively and 38.2% reported unilateral intermittent tinnitus, 79.4% lacked awareness about EPDs and 21.6 % were aware but never used them. Mean for temporary threshold shift at 500 Hz and 1 KHz was 5dB HL and 10dBHL at 2 KHz. Musicians are at risk for hearing problems, but the awareness on auditory damage is limited, hence conservative measures must be taken for their well being.

Effects of Including Information about Hidden Hearing Loss in an Adopt-A-Band Program on College Band Members' Attitudes toward Healthy Hearing Behaviors.

Young musicians may be at risk for developing cochlear synaptopathy (CS), or hidden hearing loss (HHL), that could lead to permanent music-induced hearing loss (MIHL). Patients with CS often complain of tinnitus and/or difficulty understanding speech in noisy situations, even though traditional audiometric testing indicates normal hearing. The aim of this article was to determine the effects of including information about HHL on an Adopt-A-Band program involving college band members' concern about and self-efficacy toward the prevention of MIHL. We conducted a single-blinded, randomized clinical trial. Forty-eight band members participated in this study. Band members were randomly assigned to two Adopt-A-Band presentations, one with and one without information on HHL. Including information about HHL had no effect on these band members' concerns about and self-efficacy toward the prevention of MIHL. However, the Adopt-A-Band program resulted in significantly increased concern for MIHL by 39.5% ( p < 0.0001, 95% confidence interval [CI]: 25-54.2), self-efficacy in its prevention by 79.1% ( p < 0.0001, 95% CI: 66.9-91.2), and plans to use musicians' earplugs while playing by 67.4% ( p < 0.0001, 95% CI: 53.4-81.45). Although inclusion of information about HHL did not have a significant effect, the Adopt-A-Band program, in general, significantly increased the immediate intent of these students to practice healthy hearing behaviors. Future research is needed to determine the long-term effects of using the Adopt-A-Band program with university marching bands' use of healthy hearing behaviors.

Expert Listening beyond the Limits of Hearing: Music and Deafness

Attitudes to the relationship between music and deafness suffer from two related misconceptions: the enduring assumption that hearing is central to musical experience in conjunction with an extreme impression of deafness as total aural loss; and, more recently, the tendency to reduce deaf listening to tactility, as narratives about inborn sensory acuities among the deaf proliferate in the popular imaginary. Increasingly, deafness symbolizes a set of sensory polarities that obscure an intrinsic diversity of musical experiences from which musicology stands to gain, a diversity that encompasses members of Deaf culture and non-culturally deaf people alike, and that is signaled through the person-centered compound “d/Deaf.” My article builds on recent music scholarship on disability to offer a pluralistic understanding of music and deafness. Beginning with Scottish deaf percussionist Evelyn Glennie, I investigate a range of d/Deaf accounts of music, including those of Deaf sign language users, hearing aid wearers, and cochlear implant recipients, and of people with music-induced hearing loss. Deafness resists automatic entry points into music, unsettling any straightforward hierarchy of the senses. Deaf people reflect on the musical status of aurality in markedly different ways, just as they offer a complex understanding of vision and touch. For instance, vision is a highly versatile listening strategy and is often more reliable than vibration; touch is feasible because of its contextual dependence on visual cues, and is further tied to a set of material and environmental variables. Ultimately, I argue that d/Deaf listeners enrich customary notions of musical expertise: deafness belongs in musicology as a diverse set of experiences within the full spectrum of listening.

Music-induced Hearing Loss in Children, Adolescents, and Young Adults: A Systematic Review and Meta-analysis.

Exposure to loud music has increased significantly because of the current development of personal music players and mobile phones. The aim of this study was to provide an overview of music-induced hearing loss and its symptoms in children. The search was performed in the databases Embase, Medline (OvidSP), Web-of-science, Scopus, Cinahl, Cochrane, PubMed publisher, and Google Scholar. Only articles written in English were included. Articles describing hearing levels and music exposure in children were used, published from 1990 until April 2015. The quality of the studies was assessed on reporting, validity, power, and the quality of audiometric testing. Data of each publication was extracted into spreadsheet software and analyzed using best evidence synthesis. The prevalence of increased hearing levels (>15 dB HL) was 9.6%, and high-frequency hearing loss was found in 9.3%. The average hearing thresholds were 4.79 dB HL at low frequencies (0.5, 1, and 2 kHz) and 9.54 dB HL at high frequencies (3, 4, and 6 kHz). Most studies reported no significant association between pure-tone air thresholds and exposure to loud music. However, significant changes in hearing thresholds and otoacoustic emissions, and a high tinnitus prevalence suggest an association between music exposure and hearing loss in children.

Music-Induced Hearing Loss: What Do College Students Know?

Music-Induced Hearing Loss: What Do College Students Know?

Hearing Loss, Earplug Use, and Attitudes to Hearing Protection Among Non-Orchestral Ensemble Musicians

Music-induced hearing loss and its prevention amongst professional musicians has been researched extensively, but there has been less attention on musicians playing in non-orchestral ensembles. This study’s aim was to survey musicians from brass, pipe, concert or wind, and jazz big bands regarding their perceived risk of music-induced hearing damage, rates of self-reported hearing loss, and use of earplugs and acoustic screens while playing in ensemble. A questionnaire was administered to 257 Australian band musicians and the data were compared to responses obtained previously from 367 orchestral musicians. The results showed that band and orchestral musicians had similar rates of self-reported hearing loss, but band musicians were significantly less likely to perceive risk or use protective equipment when compared to orchestral musicians. Amongst the band types, pipe band musicians had the highest incidence of hearing loss, greatest awareness of risk, and highest rates of earplug and screen use. In contrast, brass band musicians demonstrated poor risk awareness and a reluctance to use protective equipment. These results suggest that a band-specific approach to hearing conservation is needed to develop appropriate and effective strategies that account for the widely differing cultures and work practices of the various non-orchestral ensembles.

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.

Hearing loss from the overuse of portable listening devices (PLDs), such as MP3 players or iPods, is of great concern in the popular media. This review aims to discuss the current state of scientific knowledge about music-induced hearing loss from PLD use. This report evaluates the literature on the risk to hearing from PLD use, the individual and psychological factors that influence PLD usage, and strategies for reducing exposure to music through PLDs. Specific interventions are reviewed, and several recommendations for designing interventions and for individual intervention in clinical practice are presented. Clinical recommendations suggested include the “80–90 rule” and the use of isolator-style earphones to reduce background noise.

Short-term music-induced hearing loss after sound exposure to discotheque music: The effectiveness of a break in reducing temporary threshold shift

Objective: To investigate the effect of a break in music exposure on temporary threshold shifts. Design: A cross-over design where subjects are exposed to dance music for either two hours consecutively, or exposed to two hours of dance music with a one-hour break in between. Outcome measure was the change in hearing threshold, measured in 1-dB steps at different time points after ending the music. Study sample: Eighteen normal-hearing subjects participated in this study. Results: Changes in pure-tone threshold were observed in both conditions and were similar, regardless of the break. Threshold shifts could be averaged for 1000, 2000, and 4000 Hz. The shift immediately after the ending of the music was 1.7 dB for right ears, and 3.4 dB for left ears. The difference between left and right ears was significant. One hour after the exposure, right ears were recovered to baseline conditions whereas left ears showed a small but clinically irrelevant remaining shift of approximately 1 dB. Conclusions: The advice to use chill-out zones is still valid, because this helps to reduce the duration to the exposure. This study does not provide evidence that a rest period gives an additional reduction of temporary threshold shifts.

Self-report and long-term field measures of MP3 player use: How accurate is self-report?

Objective: This study was designed to evaluate the usage patterns of portable listening device (PLD) listeners, and the relationships between self-report measures and long-term dosimetry measures of listening habits. Design: This study used a descriptive correlational design. Study sample: Participants (N = 52) were 18–29 year old men and women who completed surveys. A randomly assigned subset (N = 24) of participants had their listening monitored by dosimetry for one week. Results: Median weekly noise doses reported and measured through dosimetry were low (9–93%), but 14.3% of participants reported exceeding a 100% noise dose weekly. When measured by dosimetry, 16.7% of participants exceeded a 100% noise dose weekly. The self-report question that best predicted the dosimetry-measured dose asked participants to report listening duration and usual listening level on a visual-analog scale. Conclusions: This study reports a novel dosimetry system that can provide accurate measures of PLD use over time. When not feasible, though, the self-report question described could provide a useful research or clinical tool to estimate exposure from PLD use. Among the participants in this study, a small but substantial percentage of PLD users incurred exposure from PLD use alone that increases their risk of music-induced hearing loss.