Recreational Noise Exposure Research Articles

Noise levels at baseball stadiums and the spectators' attitude to noise.

Background:Many public health professionals have expressed concern that regular participation in recreational settings with high noise levels might induce hearing loss. This study measures the noise levels in a baseball stadium and analyzes baseball fans’ attitude of effect of recreational noise exposure on their hearing.Methods:In the baseball stadium, noise levels from the beginning to the end of four games were measured in four seating sections, the red, blue, navy, and outfield sections using a sound level meter. For the survey sample, 344 randomly selected participants who visited the stadium and/or were baseball fans completed a 16-question survey on their noise exposure during the game and on the potential risk of hearing loss.Results:The LAeq average of the 16 measures produced 91.7 dBA, showing a significantly high noise level in the red and navy sections. As a function of frequency by LZeq analysis, the noise levels of low frequencies between 0.05 and 1 kHz were significantly higher than other frequencies except for the outfield section, but the levels abruptly decreased above 1 kHz. Despite the very high noise levels, 70% of the respondents preferred sitting in either the red or the navy section to be closer to the cheerleaders and to obtain a good view. Most respondents reported that they did not consider wearing earplugs, and one-third experienced hearing muffled speech after the game. Notably, they agreed that an information announcement regarding loud noise and hearing protection was needed at the stadium.Conclusions:We conclude that the noise levels in baseball stadiums are high enough to cause hearing damage and/or tinnitus later when applying a rule of 85 dB LAeq for 8 hours with a 3-dB exchange rate. We expect these results to improve public education regarding safe noise exposure during popular sports activities.

A preliminary study on time-compressed speech recognition in noise among teenage students who use personal listening devices

Objective: To compare speech perception obtained with different time compression rates in teenagers that do or do not use personal listening devices (PLDs).Design: Teenagers in a high school were recruited to complete questionnaires reporting their recreational noise exposure using PLDs. The dose of individual recreational noise exposure was calculated. The individuals with the most and least doses of recreational noise were selected and grouped into PLD users and non-PLD users. Normal rate and time-compressed (60% and 70%) speech recognition in quiet and noisy conditions was measured.Study sample: PLD user and non-PLD user group each included 20 participants.Results: ANOVA analysis showed that the effect of group, background, compression rate, and interactions between any two factors are significant. Post hoc analysis showed that the speech recognition scores with normal rate in quiet and noise and those obtained from time-compressed speech in the quiet condition were not significantly different between PLD users and non-PLD users. However, differences in the time-compressed speech recognition scores (60% and 70%) in noisy conditions between the two groups were statistically significant.Conclusions: The fast-speed speech recognition in noise decreased significantly in PLD users compared with that in non-PLD users selected by extreme entertainment exposure.

No Reliable Association Between Recreational Noise Exposure and Threshold Sensitivity, Distortion Product Otoacoustic Emission Amplitude, or Word-in-Noise Performance in a College Student Population.

The purpose of this study was to evaluate the relationship between recreational sound exposure and potentially undiagnosed or subclinical hearing loss by assessing sound exposure history, threshold sensitivity, distortion product otoacoustic emission (DPOAE) amplitudes, and performance on the words-in-noise (WIN) test. Survey data were collected from 74 adult participants (14 male and 60 female), 18 to 27 years of age, recruited via advertisements posted throughout the University of Florida campus. Of these participants, 70 completed both the survey and the additional functional test battery, and their preferred listening level was measured in a laboratory setting. There were statistically significant relationships between hearing thresholds and DPOAE amplitude. In contrast, performance on the WIN was not reliably related to threshold sensitivity within this cohort with largely normal hearing. The two most common exposures included bars or dance clubs, followed by music player use. There were no statistically significant relationships between individual or composite measures of recreational sound exposure, including preferred listening level, years of music player use, number of reported sound exposures, previous impulse noise exposure, or previous noise-induced change in hearing, and functional measures including threshold, DPOAE amplitude, and WIN measures. Some subjects were highly consistent in listening level preferences, while others were more variable from song to song. No reliable relationships between common recreational sound exposure or previous noise-induced changes in hearing were found during analysis of threshold sensitivity, DPOAE amplitude, or WIN performance in this cohort. However, the study sample was predominantly female and Caucasian, which limits generalizability of the results.

Effects of Recreational Noise on Threshold and Suprathreshold Measures of Auditory Function.

Noise exposure that causes a temporary threshold shift but no permanent threshold shift can cause degeneration of synaptic ribbons and afferent nerve fibers, with a corresponding reduction in wave I amplitude of the auditory brainstem response (ABR) in animals. This form of underlying damage, hypothesized to also occur in humans, has been termed synaptopathy , and it has been hypothesized that there will be a hidden hearing loss consisting of functional deficits at suprathreshold stimulus levels. This study assessed whether recreational noise exposure history was associated with smaller ABR wave I amplitude and poorer performance on suprathreshold auditory test measures. Noise exposure histories were collected from 26 men and 34 women with hearing thresholds ≤ 25 dB hearing loss (HL; 250 Hz to 8 kHz), and a variety of functional suprathreshold hearing tests were performed. Wave I amplitudes of click-evoked ABR were obtained at 70, 80, 90, and 99 dB (nHL) and tone-burst evoked ABR were obtained at 90 dB nHL. Speech recognition performance was measured in quiet and in competing noise, using the Words in Noise test, and the NU-6 word list in broadband noise (BBN). In addition, temporal summation to tonal stimuli was assessed in quiet and in competing BBN. To control for the effects of subclinical conventional hearing loss, distortion product otoacoustic emission amplitude, an indirect measure of outer hair cell integrity, was measured. There was no statistically significant relationship between noise exposure history scores and ABR wave I amplitude in either men or women for any of the ABR conditions. ABR wave I amplitude and noise exposure history were not reliably correlated with suprathreshold functional hearing tests. Taken together, this study found no evidence of noise-induced decreases in ABR wave I amplitude or signal processing in noise in a cohort of subjects with a history of recreational noise exposure.

Hidden Hearing Loss? No Effect of Common Recreational Noise Exposure on Cochlear Nerve Response Amplitude in Humans.

This study tested hypothesized relationships between noise exposure and auditory deficits. Both retrospective assessment of potential associations between noise exposure history and performance on an audiologic test battery and prospective assessment of potential changes in performance after new recreational noise exposure were completed.Methods: 32 participants (13M, 19F) with normal hearing (25-dB HL or better, 0.25–8 kHz) were asked to participate in 3 pre- and post-exposure sessions including: otoscopy, tympanometry, distortion product otoacoustic emissions (DPOAEs) (f2 frequencies 1–8 kHz), pure-tone audiometry (0.25–8 kHz), Words-in-Noise (WIN) test, and electrocochleography (eCochG) measurements at 70, 80, and 90-dB nHL (click and 2–4 kHz tone-bursts). The first session was used to collect baseline data, the second session was collected the day after a loud recreational event, and the third session was collected 1-week later. Of the 32 participants, 26 completed all 3 sessions.Results: The retrospective analysis did not reveal statistically significant relationships between noise exposure history and any auditory deficits. The day after new exposure, there was a statistically significant correlation between noise “dose” and WIN performance overall, and within the 4-dB signal-to-babble ratio. In contrast, there were no statistically significant correlations between noise dose and changes in threshold, DPOAE amplitude, or AP amplitude the day after new noise exposure. Additional analyses revealed a statistically significant relationship between TTS and DPOAE amplitude at 6 kHz, with temporarily decreased DPOAE amplitude observed with increasing TTS.Conclusions: There was no evidence of auditory deficits as a function of previous noise exposure history, and no permanent changes in audiometric, electrophysiologic, or functional measures after new recreational noise exposure. There were very few participants with TTS the day after exposure - a test time selected to be consistent with previous animal studies. The largest observed TTS was approximately 20-dB. The observed pattern of small TTS suggests little risk of synaptopathy from common recreational noise exposure, and that we should not expect to observe changes in evoked potentials for this reason. No such changes were observed in this study. These data do not support suggestions that common, recreational noise exposure is likely to result in “hidden hearing loss”.

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.

Epidemiology of firearm and other noise exposures in the United States.

Identify contemporary noise exposures and hearing protection use among adults. Cross-sectional analysis of national health survey. Adult respondents in the 2014 National Health Interview Series hearing survey module were analyzed. Potentially harmful exposures to occupational and recreational noises in the past 12 months were extracted and quantified. Patterns of hearing protection use also were analyzed. Among 239.7 million adults, "loud" and "very loud" occupational noise exposures were reported by 5.3% and 21.7%, respectively. Of those exposed to "loud" or "very loud" sounds at work, only 18.7% and 43.6%, respectively, always used hearing protection. A total of 38.2% (1.9 million) of those with "very loud" occupational exposures never used hearing protection. Frequent (> 10/year) "loud" and "very loud" recreational noise exposures were reported by 13.9% and 21.1%, respectively, most commonly to lawn mowers (72.6% and 55.2%, respectively). When exposed to recreational "loud/very loud" noise, only 11.4% always used hearing protection, whereas 62.3% (6.3 million) never used any protection. Lifetime exposure to firearm noise was reported by 36.6% of adults, 11.5% of whom had used firearms in the prior 12 months. Of those, only 58.5% always used hearing protection, whereas 21.4% (7.4 million) never used hearing protection. Substantial noise exposures with potentially serious long-term hearing health consequences frequently are occurring in occupational and recreational settings, and with the use of firearms. Only a minority of those exposed consistently are using hearing protection. Healthcare providers should actively identify and encourage the use of hearing protection with those patients at risk. 4. Laryngoscope, 127:E340-E346, 2017.

Short-term effects of simultaneous cardiovascular workout and personal music device use on the outer hair cell function of young adults

Background: Recreational noise exposure, including personal music device use (PMD), has become a growing public health concern, as it may potentially result in the development of hearing difficulties.Objectives: The aim of the study was to determine the differential impact and short-term effects of simultaneous cardiovascular workout and PMD use on the outer hair cell (OHC) function of young adults.Method: A quantitative research approach was followed. In this study a pre-test post-test approach was used and twelve subjects participated in three 1 h testing conditions with altered variables including: (i) exposure to PMD use in isolation, (ii) exposure to cardiovascular workout in isolation, and (iii) simultaneous exposure to the latter mentioned. Distortion product otoacoustic emissions (DPOAEs) were conducted pree and post exposure for each testing condition as primary indicator of cochlear responses. The process consisted of a cycling procedure through the preset stimulus frequency sequence, measuring the 2f₁—f₂ (75—70 dBSPL) and constructing a plot of DPOAE levels as a function offrequency.Results: Individual testing conditions did not result in statistically significant changes of the DPOAE response, however a significantly different profile in the DPOAE response level increase/decrease for the higher frequencies (6—8 kHz) was obtained when comparing the different sessions. Exposure to cardiovascular workout condition in isolation indicated a clear trend of an increased DPOAE response level between the pre-exposure and post exposuretesting from 2 kHz to 8 kHz with a maximum increase at 6 kHz. Both the music-only condition and the combined condition resulted in a clear trend of decreased DPOAE response amplitudes between the pre-exposure and post-exposure testing for the higher frequencies.Conclusion: Findings support the notion of a clear effect of cardiovascular workout with and without music exposure on the OHC function at higher test frequencies, as measured by DPOAEs. Decreased DPOAE amplitudes between 2 kHz and 8 kHz were observed with music exposure and the opposite effect was observed for cardiovascular workout in isolation.

Exposure of Pupils to Recreational Noise from Portable Listening Devices and Possible Preventive Measures

Background and Objectives: Exposure to recreational noise is becoming increasingly important due to a change in leisure behavior amongst children and adolescents. The aim of this pilot study was to assess exposure of 6th grade pupils to recreational noise from portable listening devices (PLD). Furthermore, preventive measures to reduce recreational noise exposure should be identified. Methods: In "Ohrkan Kids", 38 Bavarian pupils aged 11 to 14 were interviewed regarding their music listening behavior using a standardized questionnaire. In addition, measurements of commonly used volume settings on the children's portable listening devices were carried out. Furthermore, the German Social Accident Insurance (DGUV), health insurance companies as well as health and education ministries of the German federal states were surveyed regarding their activities in the prevention of recreational noise exposure. Results: Based on the questionnaire data for weekly usage, 10 out of 31 children (32.3%) exceeded the upper exposure value of 85 dB recommended by labor protection law. Taking actually measured values, 9 out of 31 children (29%) exceeded this level. The DGUV and some federal states carry out specific projects for the prevention of recreational noise exposure. Conclusion: The large number of children with hazardous music consumption indicates that measures for the prevention of noise-induced hearing loss are already required for 11 to 14 year olds. To maximize the number of children addressed, age-appropriate and target-group-specific preventive measures are needed. As there are only few studies which examined the effectiveness of awareness campaigns for the prevention of recreational noise, any future prevention projects should be evaluated with an increased focus on estimating their effectiveness.

The Effect of Earplugs in Preventing Hearing Loss From Recreational Noise Exposure: A Systematic Review.

The prevalence of hearing loss among children and adolescents is rising dramatically, caused mainly by increased exposure to recreational noise. To present a systematic overview of the effectiveness of wearing earplugs to music venues, such as nightclubs and concert halls, to prevent hearing loss and tinnitus directly after exposure. PubMed, EMBASE, and the Cochrane Library databases were searched for articles from database inception to June 22, 2015, using the keywords music and earplugs and all synonyms. Titles, abstracts, and full text of retrieved articles were screened for eligible articles. The directness of evidence (relevance of the assessed articles) and risk of bias of eligible articles were assessed. For the included articles, the study characteristics and data on our outcomes of interest (hearing loss and tinnitus) were extracted. Data analysis occurred from June 22 to July 3, 2015. Of 228 articles screened, 4 were eligible for critical appraisal. After critical appraisal, 2 studies with a high directness of evidence and low or moderate risk of bias remained for data extraction. Only 1 of these articles was a randomized clinical trial, which found significantly lower postconcert differences in thresholds and a lower proportion of threshold shifts in the group using earplugs compared with the unprotected group. In the other study, only 3 individuals wore earplugs, and no significant differences were found between the 2 groups. The available evidence on the effectiveness of earplugs in preventing hearing damage directly after recreational music exposure is scarce. Only 1 well-conducted randomized clinical trial was found, which showed that wearing earplugs to concerts is effective in reducing postconcert threshold shifts. There is a need for further research on this topic to strengthen the level of evidence. Physicians should promote awareness on the risks of recreational noise and recommend the use of earplugs among their patients who visit music venues.

Distortion product otoacoustic emissions in college music majors and nonmusic majors.

The presence and absence of distortion product otoacoustic emissions (DPOAEs) as well as DPOAE amplitudes were compared between college music majors and a control group of nonmusic majors. Participants included 28 music majors and 35 nonmusic majors enrolled at a university with ages ranging from 18-25 years. DPOAEs and hearing thresholds were measured bilaterally on all the participants. DPOAE amplitudes were analyzed at the following f2 frequencies: 1,187 Hz, 1,500 Hz, 1,906 Hz, 2,531 Hz, 3,031 Hz, 3812 Hz, 4,812 Hz, and 6,031 Hz. Significantly more music majors (7/28) than nonmusic majors (0/35) exhibited absent DPOAEs for at least one frequency in at least one ear. Both groups of students reported similar histories of recreational and occupational noise exposures that were unrelated to studying music, and none of the students reported high levels of noise exposure within the previous 48 h. There were no differences in audiometric thresholds between the groups at any frequency. At DPOAE f2 frequencies from 3,031 Hz to 6,031 Hz, nonsignificantly lower amplitudes of 2-4 dB were seen in the right ears of music majors versus nonmajors, and in the right ears of music majors playing brass instruments compared to music majors playing nonbrass instruments. Given the greater prevalence of absent DPOAEs in university music majors compared to nonmusic majors, it appears that early stages of cochlear damage may be occurring in this population. Additional research, preferably longitudinal and across multiple colleges/universities, would be beneficial to more definitively determine when the music students begin to show signs of cochlear damage, and to identify whether any particular subgroups of music majors are at a greater risk of cochlear damage.

Survey of recreational noise exposure through the use of personal music players in young Nigerian adults

Background: Personal music players (PMPs) are widely used among young adults of Nigeria, but information on knowledge about their usage and effect on hearing health has not been studied in Nigeria. Objectives: The aim of the study was to determine the pattern of usage, knowledge and attitude towards loud sound output from PMPs among young Nigerian adults. Methods: This was a prospective, observational survey. Subjects were recruited from a cross-section of undergraduate students of Obafemi Awolowo University, Ile-Ife. A structured questionnaire that detailed the type and usage of PMPs was administered. Subjects were also asked about episode of adverse hearing effects and the attitude of the respondents to issue of recreational noise and hearing loss. Results: There were 985 respondents, comprising 594 (60.3%) males and 391 (39.7%) females. Of the 985 students, 967 (98.2%) admitted listening to music on PMPs. The mean age of the student was 24.4 (6.0) years, with 891 (92.1%) of the 967 using earphones while listening to music. Mobile phones were the most common PMPs being used by 768 (79.3%) of the respondents. Five hundred and thirty (54.8%) were listening to music for more 1 h per day and 536 (55.4%) were listening to music for more than 3 days per week. Further, 502 (52.3%) were listening to music at the level of loudness, which was self-assessed to be high volume. Conclusions: Mobile phones are the most common PMPs in the present study population and most of the respondent were listening to music at the level of loudness that should call for concern.

Hearing in young adults. Part II: The effects of recreational noise exposure.

Great concern arises from recreational noise exposure, which might lead to noise-induced hearing loss in young adults. The objective of the current study was to evaluate the effects of recreational noise exposure on hearing function in young adults. A questionnaire concerning recreational noise exposures and an audiological test battery were completed by 163 subjects (aged 18-30 years). Based on the duration of exposure and self-estimated loudness of various leisure-time activities, the weekly and lifetime equivalent noise exposure were calculated. Subjects were categorized in groups with low, intermediate, and high recreational noise exposure based on these values. Hearing was evaluated using audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). Mean differences in hearing between groups with low, intermediate, and high recreational noise exposure were evaluated using one-way analysis of variance (ANOVA). There were no significant differences in hearing thresholds, TEOAE amplitudes, and DPOAE amplitudes between groups with low, intermediate, or high recreational noise exposure. Nevertheless, one-third of our subjects exceeded the weekly equivalent noise exposure for all activities of 75 dBA. Further, the highest equivalent sound pressure levels (SPLs) were calculated for the activities visiting nightclubs or pubs, attending concerts or festivals, and playing in a band or orchestra. Moreover, temporary tinnitus after recreational noise exposure was found in 86% of our subjects. There were no significant differences in hearing between groups with low, intermediate, and high recreational noise exposure. Nevertheless, a long-term assessment of young adults’ hearing in relation to recreational noise exposure is needed.

The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults.

Excessive recreational noise exposure in young adults might result in noise-induced hearing loss (NIHL) and tinnitus. Inducing behavioral change in young adults is one of the aims of a hearing conservation program (HCP). The goal of the current study was to evaluate the effect of a hearing education program after 6 months in young adults in relation to knowledge regarding their individual hearing status. The results of a questionnaire regarding the weekly equivalent recreational noise exposure, attitudes and beliefs toward noise, and hearing loss and hearing protector devices (HPDs) were compared between both sessions. Seventy-eight young adults completed the questionnaire concerning recreational noise exposure, youth attitude to noise scale (YANS), and beliefs about hearing protection and hearing loss (BAHPHL). Their hearing status was evaluated based on admittance measures, audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). The main analysis consisted of a mixed model analysis of variance with dependent variables of either the noise exposure or the scores on (subscales of) YANS and BAHPHL. The independent variables were hearing status and session one versus session two. There was a significant decrease in recreational noise exposure and several (sub) scales of YANS and BAHPHL between both the sessions. This behavioral change resulted in a more frequent use of HPDs in 12% of the participants. However, the behavioral change was not completely related to the knowledge of young adults’ individual hearing status. To prevent hearing damage in young people, investing in HCPs is necessary, apart from regulating sound levels and its compliance at various leisure-time activities. Also, the long-term effect of HCPs and their most cost-efficient repetition rates should be further investigated.

Changes in distortion product otoacoustic emission components after music exposure.

Young adults experience some type of recreational noise exposure on a daily basis; this includes using personal music (PM) systems with earphones. In most cases, this exposure is intermittent and the short-term effects of this exposure on the auditory system are becoming better understood. The purpose of this study was to examine the effects of one hour of music exposure using a PM system on distortion product otoacoustic emission (DPOAE) absolute levels and generator and characteristic frequency (CF) component levels. Young adults (n = 101) between 18-30 years with normal hearing participated listened to one hour of music through earphones. A second group of young adults (n = 21) served as controls and did not listen to music, but sat in the sound-treated room for one hour. Otoscopy, tympanometry, and a hearing screening (≤20 dB HL at 0.5, 1, 2, and 4 kHz) were completed in a randomly determined test ear. Preferred listening level, in dBA, was obtained and DPOAEs (2f1-f2) were measured between 1 and 6 kHz with stimulus levels fixed at L1,L2 = 55,40 dB SPL. Absolute DPOAE levels, along with generator and CF components levels were measured before and after each participant listened to one hour of music at their preferred level in a quiet setting. For data analyses, absolute DPOAE and generator and CF component levels were collapsed into 1/3rd octave bands centered around 1, 1.5, 2, 3, 4, and 6 kHz. Mean preferred listening level was 57.8 dBA, with males having a higher mean level of 61.1 dBA compared with females who had a mean level of 55.7 dBA. Females and males had negligible mean changes in absolute DPOAE levels at 1, 1.5, and 2 kHz, but males had 0.4-1 dB mean decreases after music at 3, 4, and 6 kHz compared to females, although not statistically significant. For DPOAE generator component data, females had small mean decreases for the two lower frequencies whereas males had mean decreases of 0.4-0.8 dB at 3, 4, and 6 kHz. Because of missing data, analyses of the CF component were limited, although females had small mean decreases at four frequencies while males had small mean decreases at two frequencies. There was no effect of listening to music on changes in DPOAEs but control participants had strong reliability (i.e., little or no change) after sitting in quiet for one hour. Young adults listened to music well below what would be considered hazardous. Because of the lower listening levels, DPOAEs showed very little change after music. Although there were no significant short-term changes in DPOAEs after music, the cumulative effect of this noise exposure is still unknown.

Noise-induced hearing loss

Noise-induced hearing loss is the permanent hearing impairment that results from prolonged exposure to high levels of noise. Hearing loss caused by recreational and occupational noise exposure is the second-most-common cause of sensorineural hearing loss after presbycusis. Noise exposure is a potentially avoidable cause of deafness and the World Health Organisation recommends integrating elements of prevention, diagnosis, education, hearing promotion and conservation into primary care.

Effectiveness of a preventive campaign for noise-induced hearing damage in adolescents

ObjectivesMany studies have documented a high incidence of hearing loss and tinnitus in adolescents after recreational noise exposure. The prevalence of noise-induced symptoms is in contradiction to the low preventive use of hearing protection. The effects of preventive campaigns on the attitudes toward noise in young people are under debate. The aim of the present study is to investigate whether a preventive campaign can alter attitudes toward noise in adolescents and whether this results in an increase of hearing protection use in this population. MethodsA cohort of 547 Flemish high school students, aged 14 to 18 years old, completed a questionnaire prior to and after a governmental campaign focusing on the harmful effects of recreational noise and the preventive use of hearing protection. At both occasions the attitudes toward noise and toward hearing protection were assessed by use of the youth attitudes toward noise scale (YANS) and the beliefs about hearing protection and hearing loss (BAHPHL), respectively. These questionnaires fit into the model of the theory of planned behavior which provides a more clear insight into the prediction of a certain behavior and the factors influencing that behavior. ResultsThe score on the YANS and the BAHPHL decreased significantly (p<0.001) implying a more negative attitude toward noise and a more positive attitude toward hearing protection. The use of hearing protection increased significantly from 3.6% prior to the campaign to 14.3% (p=0.001) post campaign in students familiar with the campaign. ConclusionsMeasurable alteration of all the variables in the theory of planned behavior caused an increase of the intentions to use hearing protection as well as the actual use of hearing protection. The present study shows the usefulness of the theory of planned behavior to change and guide adolescents’ preventive actions toward noise damage. In addition, preventive campaigns can establish attitude and behavioral adjustments. However, the long term effects of preventive campaigns should be investigated in future research.

Construction and validation of questionnaire to assess recreational noise exposure in university students.

Recreational noise exposure and its impact on hearing is a problem to which increasing attention is being paid. In Spanish, it is necessary to have a reliable and valid instrument that is capable of describing the extent of noise exposure. The aim was to create and validate an instrument to determine listening habits and levels of recreational noise exposure in young people. We performed a transversal questionnaire validation study using university students. We assessed the validity of the content and appearance of the "Recreational Hearing Habits Questionnaire" (CHAR in Spanish) through experts' judgment. Then we piloted the administration of semantic adaptation with 30 students. Finally, the instrument was applied to 335 Chilean university students, obtaining with these indicators that demonstrated convergent validity of the construct, criterion and reliability. We used exploratory and confirmatory factor analysis, as well as correlation and agreement tests. It was confirmed that 14 questions in the questionnaire have a good item-test correlation, having also a factorial structure that indicates the existence of three-dimensions. The questionnaire has good internal consistency and convergent validity with the Noise Exposure Questionnaire. In addition, the score obtained in the CHAR is a predictor of the presence of notch at frequencies of 4 kHz in the right ear and 6 kHz in the left. The CHAR is useful for determining listening habits and thereby recreational noise exposure, indicating good psychometric properties.

A case-study on the continuous use of an in-ear dosimetric device

In order to further understand the combined effects of occupational and recreational noise exposure with regards to noise induced hearing loss (NIHL), an in-ear dosimeter prototype meant for continuous use was developed. The device acts as a hearing protection device (HPD) and can measure and log effective in-ear sound pressure level as well as unprotected levels. To enable its continuous use, this HPD is also equipped with a bypass feature for “transparent” hearing, input for music or communication devices and interfaces with Android smartphones. The proposed device allows for the implementation of an algorithm accounting for the auditory fatigue recovery rate, providing a true representation of the current accumulated noise dose. This allows for 24 h dosimetry and avoids having the user manually reset the dose back to 0% on the next day and thus assuming complete fatigue recovery has occurred. This paper details the proposed recovery algorithm, presents collected field data, and discusses the benefits as well as real-world challenges of using such a device.

The prevalence and characteristics of tinnitus in the youth population of the United States

To evaluate the prevalence, characteristics, and associated risk factors of tinnitus in U.S. adolescents. Cross-sectional analyses of U.S. representative demographic and audiometric data, the National Health and Nutrition Examination Survey (NHANES) 2005 to 2008. The study population consisted of 3,520 individuals aged 12 to 19 years with complete tinnitus-related data. Tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 minutes during the preceding 12 months. In addition, we defined a chronic tinnitus subgroup as being bothered by tinnitus for more than 3 months. Demographic and other data regarding tinnitus, smoking, body mass index (BMI), anemia, hypertension, history of ear infections, tympanostomy tube placement, otoscopy, tympanometry and hearing thresholds, history of firearm use, and recreational and occupational exposure to noise were extracted and analyzed. Overall, tinnitus lasting 5 minutes or more in the preceding 12 months was reported by 7.5% of the 12- to 19-year-old population. This represents about 2.5 million adolescents in the United States. The prevalence of chronic tinnitus was 4.7%, corresponding to about 1.6 million adolescents in the United States. Multivariable-adjusted analysis revealed that both overall and chronic tinnitus were associated with female gender, low income, exposure to passive smoking, type A tympanogram, and occupational and recreational noise exposure. History of ≥ 3 ear infections and history of tympanostomy tube placement were associated only with overall tinnitus. Tinnitus afflicts a substantial portion of the youth population. Further investigation of the association between tinnitus and the identified risk factors is warranted.