Use Of Earplugs Research Articles

The effect of sleep quality on patients in a coronary care unit

Background: Patients in coronary care units (CCUs) are at risk of sleep deprivation. This study investigated the effects of ear plugs, eye masks and both together on the sleep quality of patients in a CCU. Materials and methods: This randomised-controlled trial was conducted on 90 patients in Imam Khomeini Hospital in Jiroft. Patients were randomly assigned to three groups: eye mask (group 1), ear plugs (group 2), and both together (group 3). Using the Verran and Snyder-Halpern Sleep Scale, perception of patients' sleep with and without intervention were evaluated. This tool consists of 16 items grouped into three main subscales: disturbance, effectiveness, and supplementation. Results: The mean length of time patients slept for was 6.34±1.2 hours. In group 1, the quality of sleep improved significantly in relation to disturbance and effectiveness. In group 2, all three subscales showed significant improvements. In group 3, which used the eye mask and ear plugs together, only the disturbance subscale showed significant improvement. Conclusion: The use of ear plugs and eye masks is an easy and cheap method of improving the quality of sleep in CCU patients. Nurses should consider these devices for reducing environmental factors that disturb the sleep of CCU patients.

Investigation of cortical and subcortical plasticity following short-term unilateral auditory deprivation in normal hearing adults

There is growing evidence that auditory stimulation or deprivation can induce physiological and perceptual changes in the auditory system of normal hearing adults. The present study investigated cortical (hemispheric asymmetry) and subcortical (acoustic reflex threshold) changes in 11 normal hearing adults after 7 days of continuous unilateral earplug use (around 30 dB of attenuation at the high frequencies). The results revealed: (a) a decrease in high frequency acoustic reflex thresholds of around 7 dB in the ear that had been plugged and (b) no change in hemispheric asymmetry. The change in acoustic reflex is consistent with subcortical plasticity. It is unclear if homoeostatic plasticity preserved the normal hemispheric asymmetry or if this is the result of the experimental paradigm.

Do Snoring Sounds Arouse the Snorer?

Respiratory cycle-related electroencephalographic (EEG) changes (RCREC), especially in delta and sigma frequencies, are thought to reflect subtle, breath-to-breath inspiratory microarousals that are exacerbated in association with increased work of breathing in obstructive sleep apnea (OSA). We wondered whether snoring sounds could create these microarousals, and investigated whether earplugs, anticipated to alter snoring perception, might affect RCREC. Randomized controlled trial. An accredited, academic sleep laboratory. Adults (n = 400) referred for suspected OSA. Subjects were randomly assigned to use earplugs or not during a night of diagnostic polysomnography. Two hundred three of the participants were randomized to use earplugs. Earplug use was associated with lower RCREC in delta EEG frequencies (0.5-4.5 Hz), although not in other frequencies, after controlling for potential confounds (P = 0.048). This effect of earplug use was larger among men in comparison with women (interaction term P = 0.046), and possibly among nonobese subjects in comparison with obese subjects (P = 0.081). However, the effect of earplug use on delta RCREC did not differ significantly based on apnea severity or snoring prominence as rated by sleep technologists (P > 0.10 for each). This randomized controlled trial is the first study to show that perception of snoring sounds, as modulated by earplugs, can influence the cortical EEG during sleep. However, the small magnitude of effect, lack of effect on RCREC in EEG frequencies other than delta, and absence of effect modulation by apnea severity or snoring prominence suggest that perception of snoring is not the main explanation for RCREC.

Efficacy of Commercial Earplugs in Preventing Water Intrusion during Swimming

To evaluate and compare the efficacy of commercially available earplugs in preventing water intrusion in healthy individuals. Experimental study. Tertiary care medical center. Ten subjects (20 ears) were assessed. After insertion of the earplugs, subjects underwent 3 standardized head-wetting protocols, including (1) surface swimming for 10 minutes, which entailed no head submersion and moderate splashing; (2) head submersion at a 90-cm depth for 20 seconds with their head upright; and (3) head submersion at a 90-cm depth with head tilted 90 degrees left and then tilted 90 degrees right for 10 seconds on each side to apply vertical pressure. Color change of a wetness indicator was used to determine water intrusion after each protocol. The same protocol was repeated for all 9 earplugs. Water intrusion was observed in 44%, 67%, and 88% of ears after surface swimming, horizontal submersion, and vertical submersion, respectively. The results revealed a significant difference in the waterproofing qualities of the various types of earplugs. The soft silicone type (Pillow Soft) earplug had the lowest rate of water penetration during all 3 protocols (P < .001). The difference between the most effective earplugs, Pillow Soft and Aquaseal, were only significant during the horizontal submersion protocol (P = .008). Water intrusion occurred even with the use of earplugs. The intrusion was more significant with horizontal or vertical head submersion. The soft silicone Pillow Soft earplug was the most effective earplug for preventing water intrusion in surface swimming.

Use of Reference Ear Plug to improve accuracy of lateral cephalograms generated from cone-beam computed tomography scans

ObjectiveThe purpose of this study was to evaluate the effectiveness of the use of Reference Ear Plug (REP) during cone-beam computed tomography (CBCT) scan for the generation of lateral cephalograms from CBCT scan data.MethodsTwo CBCT scans were obtained from 33 adults. One CBCT scan was acquired using conventional methods, and the other scan was acquired with the use of REP. Virtual lateral cephalograms created from each CBCT image were traced and compared with tracings of the real cephalograms obtained from the same subject.ResultsCBCT scan with REP resulted in a smaller discrepancy between real and virtual cephalograms. In comparing the real and virtual cephalograms, no measurements significantly differed from real cephalogram values in case of CBCT scan with REP, whereas many measurements significantly differed in the case of CBCT scan without REP.ConclusionMeasurements from CBCT-generated cephalograms are more similar to those from real cephalograms when REP are used during CBCT scan. Thus, the use of REP is suggested during CBCT scan to generate accurate virtual cephalograms from CBCT scan data.

Efficacy of Commercial Earplugs in Preventing Water Exposure

Objective: 1) To evaluate and compare the efficacy of commercially available earplugs in preventing water intrusion in healthy individuals. 2) To be able to provide an evidence-based recommendation for use of ear plugs in patients with tympanostomy tubes to prevent otorrhea. Method: Nine ear plugs were inserted in random order in ears of 10 healthy subjects. Three standardized head wetting protocols were instructed: surface swimming, upright head submersion to apply horizontal pressure, and 90 degrees tilted head submersion to apply vertical pressure. Color change in moisture indicator was evaluated after each protocol. Results: Water penetration was observed in 44%, 67%, and 88% of ears after surface swimming, horizontal submersion, ad vertical submersion, respectively. The results showed a significant difference in the waterproofing qualities of the various types of earplugs. Pillow Soft Silicone Earplugs had the lowest rate of water penetration in all 3 protocols ( P &lt; .001). There was no significant difference between the 2 waterproof earplugs Pillow Soft and Aquaseal, during surface swimming and vertical submersion protocols. However, Pillow Soft was significantly more effective comparing to Aquaseal with horizontal submersion protocol ( P = .008). Conclusion: Commercially available ear plugs are not as protective against water intrusion as generally expected. Water exposure is recommended to be limited in patients with tympanostomy tubes. Pillow Soft was the most effective method of ear sealant compared to other commercially available earplugs.

Delirium in Critically Ill Patients

Delirium is commonly observed in critically ill patients and is associated with negative outcomes. The pathophysiology of delirium is not completely understood. However, alterations to neurotransmitters, especially acetylcholine and dopamine, inflammatory pathways and an aberrant stress response are proposed mechanisms leading to intensive care unit (ICU) delirium. Detection of delirium using a validated delirium assessment tool makes early treatment possible, which may improve prognosis. Patients at high risk of delirium, especially those with cognitive decline and advanced age, should be identified in the first 24 hours of admission to the ICU. Whether these high-risk patients benefit from haloperidol prophylaxis deserves further study. The effectiveness of a multicomponent, non-pharmacological approach is shown in non-ICU patients, which provides proof of concept for use in the ICU. The few studies on this approach in ICU patients suggest that the burden of ICU delirium may be reduced by early mobility, increased daylight exposure and the use of earplugs. In addition, the combined use of sedation, ventilation, delirium and physical therapy protocols can reduce the frequency and severity of adverse outcomes and should become part of routine practice in the ICU, as should avoidance of deliriogenic medication such as anticholinergic drugs and benzodiazepines. Once delirium develops, symptomatic treatment with antipsychotics is recommended, with haloperidol being the drug of first choice. However, there is limited evidence on the safety and effectiveness of antipsychotics in ICU delirium.

Characteristics of Noise Exposure During Solitary Trumpet Playing

The objectives of this investigation were to quantify noise exposures generated during a 1 hr trumpet practice session and to determine whether distortion-product otoacoustic emissions (DPOAEs) are affected by such exposure, to describe the distribution of intensity levels and temporal characteristics of noise produced by trumpet practice, and to determine the effect of earplug use on generated noise levels and DPOAEs. In experiment 1, eight college-age trumpeters underwent an otoscopic inspection, tympanometry, and pure-tone threshold testing. Using a Grason-Stadler 60 DPOAE system, DPOAEs were recorded just before a 1 hr practice session, at 2 min after the practice session, 4 min after the session, and at 4 min intervals thereafter for a total period of 1 hr. A Hewlett-Packard 3569A Real-Time Frequency Analyzer was used to integrate noise levels to assess the overall level of exposure averaged over the course of the hour. In experiment 2, seven different trumpeters participated in two data-collection sessions. The main difference between the sessions was that subjects wore E.A.R. earplugs during session 2. All other design parameters were similar to those of experiment 1. Noise levels generated during the practice sessions resulted in average Leqs of 95.96, 96.6, and 96.43 dB SPL. A sound-distribution analysis revealed that noise levels exceeded 85 dB for an average of 43.73 min per session. Mean Leq values did not change when subjects wore earplugs (96.6 dB SPL versus 96.43 dB SPL.) Predictions (ISO 1999) of the increased risk of hearing loss that trumpeters would experience at 40, 50, and 60 years of age were made and indicated that trumpeters are at a significantly increased risk of hearing loss over that contributable to age alone. This increased risk is apparent with as little as 1 hr of exposure per day and suggests that 60-year-old male and female musicians exposed to trumpet noise for 4 hr per day for 40 years would be 85% and 300%, respectively, more likely to have hearing loss than their peers with negative noise exposure histories. Statistically significant decreases in DPOAE amplitudes from the prenoise exposure collection point to the 2 min post exposure point were observed only when subjects were not wearing earplugs during their practice session. Recovery of DPOAEs to baseline level varied in form for four test frequencies. During solitary play, trumpeters generate noise levels that temporarily decrease DPOAE amplitudes and that by themselves have the potential to result in permanent noise-induced hearing loss. Trumpeters who practice/perform over a period of years should be concerned about the implications of their craft on their hearing and should be offered personalized hearing conservation programs. The use of earplugs offers a practical and cost-effective means of hearing protection and, for this group of trumpeters, did not lead to an increase in playing level.

Reversible Induction of Phantom Auditory Sensations through Simulated Unilateral Hearing Loss

Tinnitus, a phantom auditory sensation, is associated with hearing loss in most cases, but it is unclear if hearing loss causes tinnitus. Phantom auditory sensations can be induced in normal hearing listeners when they experience severe auditory deprivation such as confinement in an anechoic chamber, which can be regarded as somewhat analogous to a profound bilateral hearing loss. As this condition is relatively uncommon among tinnitus patients, induction of phantom sounds by a lesser degree of auditory deprivation could advance our understanding of the mechanisms of tinnitus. In this study, we therefore investigated the reporting of phantom sounds after continuous use of an earplug. 18 healthy volunteers with normal hearing wore a silicone earplug continuously in one ear for 7 days. The attenuation provided by the earplugs simulated a mild high-frequency hearing loss, mean attenuation increased from <10 dB at 0.25 kHz to >30 dB at 3 and 4 kHz. 14 out of 18 participants reported phantom sounds during earplug use. 11 participants presented with stable phantom sounds on day 7 and underwent tinnitus spectrum characterization with the earplug still in place. The spectra showed that the phantom sounds were perceived predominantly as high-pitched, corresponding to the frequency range most affected by the earplug. In all cases, the auditory phantom disappeared when the earplug was removed, indicating a causal relation between auditory deprivation and phantom sounds. This relation matches the predictions of our computational model of tinnitus development, which proposes a possible mechanism by which a stabilization of neuronal activity through homeostatic plasticity in the central auditory system could lead to the development of a neuronal correlate of tinnitus when auditory nerve activity is reduced due to the earplug.

Using impulsive peak insertion loss of hearing protectors with impulsive damage risk criteria

Impulsive noise presents special challenges for hearing conservation. The scientific community continues to search for an impulsive noise exposure criterion which accurately assesses the hearing damage risk for both short and long duration impulses. Other factors, such as the use of hearing protectors, earmuffs and earplugs, also affect the hearing damage risk but the current criteria do not address methods for using the attenuation of hearing protectors in impulsive noise. The relatively new ANSIS12.42-2010 “Methods for the Measurement of Insertion Loss of Hearing Protection Devices in Continuous or Impulsive Noise using Microphone-in-Real-Ear or Acoustic Test Fixture Procedures” describes methods for measuring the peak insertion loss of a hearing protector in impulsive noise. This paper will describe a method to apply the peak insertion loss data to impulsive noise damage risk criteria for an estimate of allowable impulsive noise exposure when using hearing protection.

Survey on individual occupational health protection behaviors of welding workers using theory of reasoned action

To apply theory of reasoned action at survey on welding workers occupational health protection behaviors and explore related influencing factors. nine companies were randomly selected from areas with many welding works in Zhejiang Province. All welding workers were surveyed using a questionnaire based on theory of reasoned action. 10.06%, 26.80% and 37.50% of the respondents never or seldom used eyeshade, mask and earplug, respectively. After controlling the socio-demographic factors, welding workers' behavioral belief was correlated with the behaviors of eyeshade-mask and earplug use (χ(2) = 31.88, 18.77 and 37.77, P < 0.01). the subjective norm of company was correlated with all protection behaviors (χ(2) = 20.60, 10.98 and 19.86, P < 0.01), the subjective norm of colleague was correlated with mask and earplug use, (χ(2) = 27.43, 36.39, P < 0.01), and the subjective norm of family was correlated with mask use (χ(2) = 5.73, P < 0.05). Theory of reasoned action is suitable for welding worker occupational health related behaviors. It is useful to improve occupational health education, to effectively select health education objective and to tailor health education contents.

The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients

IntroductionThis study hypothesised that a reduction of sound during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, does the use of earplugs during the night improve the quality of sleep in the ICU?MethodsA randomized clinical trial included adult intensive care patients in an intervention group of 69 patients sleeping with earplugs during the night and a control group of 67 patients sleeping without earplugs during the night. The researchers were blinded during data collection. Assignment was performed by an independent nurse researcher using a computer program. Eligible patients had an expected length of stay in the ICU of more than 24 hours, were Dutch- or English-speaking and scored a minimum Glasgow Coma Scale of 10. Delirium was assessed using the validated NEECHAM scale, sleep perception was reported by the patient in response to five questions.ResultsThe use of earplugs during the night lowered the incidence of confusion in the studied intensive care patients. A vast improvement was shown by a Hazard Ratio of 0.47 (95% confidence interval (CI) 0.27 to 0.82). Also, patients sleeping with earplugs developed confusion later than the patients sleeping without earplugs. After the first night in the ICU, patients sleeping with earplugs reported a better sleep perception.ConclusionsEarplugs may be a useful instrument in the prevention of confusion or delirium. The beneficial effects seem to be strongest within 48 hours after admission. The relation between sleep, sound and delirium, however, needs further research.Trial registrationCurrent Controlled Trials ISRCTN36198138

An objective comparison of leakage between commonly used earplugs

ObjectiveWe sought to determine the efficacy of commonly used earplugs using an anatomically correct ear model. MethodsThe total volume and rate of water that leaked past the earplug and subsequent defect in the tympanic membrane over separately measured 30, 60, 120, and 180-second intervals were recorded. Scenarios tested included a control with no earplug, custom molded earplug (Precision Laboratories, Orlando, FL), Mack's plug (Warren, MI), Doc's plug (Santa Cruz, CA), and cotton balls coated with petroleum jelly. ResultsAll plugs tested resulted in less leakage at all time points when compared with no plug (P < .05). At 30 seconds, the custom molded, Mack's and Doc's plugs all showed significantly less leakage when compared with the cotton ball coated with petroleum jelly (P < .05). At 60, 120, and 180 seconds, Mack's, Doc's, and the cotton plugs all showed significantly less leakage compared with the customized plug (P < .05). At 120 and 180 seconds, Mack's plugs had significant less leakage than the cotton plug (P < .05). Among the types of plugs, the molded variety (Mack's) showed the least volume and lowest leakage rate (f4,45 = 94 [P < .001]). In addition, Doc's and cotton balls coated with petroleum jelly were more effective than the customized earplugs. ConclusionsIf the clinician feels that middle ear and external canal water exposure should be minimized, then use of earplugs, particularly the moldable variety, merits further consideration.

A Qualitative Study of Earplug Use as a Health Behavior: The Role of Noise Injury Symptoms, Self-efficacy and an Affinity for Music

The use of earplugs in loud music venues is confined to a small minority who wish to avoid hearing damage from excessive noise exposure. Using the framework of the health belief model (HBM), structured interviews were held with 20 earplug-wearing clubbers. Qualitative analysis revealed the HBM constructs relevant to understanding this group's motivation to protect their hearing. Personal experience of noise injury symptoms was the most common cue triggering earplug use. Awareness of the benefits of earplugs and appreciation of the long-term implications of hearing damage, affinity for music and high self-efficacy were also key variables underlying this health behaviour.

Symphony orchestra musicians′ use of hearing protection and attenuation of custom-made hearing protectors as measured with two different real-ear attenuation at threshold methods

Despite a high level of sound exposure and a fairly large selection of earplugs available, musicians have often been reported to use personal hearing protectors only seldom. For better hearing conservation, it is important to identify and eliminate the causes for the low motivation to use hearing protection. We explored the usage rate of custom-molded musician's earplugs (ER-15) among 15 symphony orchestra musicians with a questionnaire, and measured the attenuation properties of their earplugs with a Real-Ear Attenuation at Threshold (REAT) procedure in a sound field. Earplug use was found to be low, and the musicians reported that earplugs hampered listening to their own and their colleagues' playing; earplugs affected either timbre or dynamics, or both. Additionally, several reasons related to discomfort of use were itemized, but the musicians who consistently used their earplugs did so in spite of problems with use. The REAT values obtained in sound field were relatively close to the manufacturer's nominal specifications, being 13.7 dB, on average. In the frequency range studied (0.125-8 kHz), individual variation in REAT was, however, up to 15 dB across the measured frequencies. Fluctuation in attenuation might be related to low use of hearing protectors, and REAT measured at fixed center frequencies may be too robust a method to uncover it. We therefore tested 10 additional subjects to find out whether a sweeping signal used in Bιkιsy audiometry would bring more detailed information on earplug attenuation. Mean attenuation was found to be somewhat closer to the nominal attenuation of the ER-9 and ER-15 earplugs up to about 1 kHz, whereas REAT measurements in sound field revealed more even attenuation at frequencies between 1 and 6 kHz. No significant association was found between earplug attenuation properties and earplug use. It was concluded that support and determination to get accustomed to hearing protector use are important factors in hearing conservation.

Decompression syndrome, ear-plug and barotrauma

Sir, We read with great interest the paper by Phatak et al. which was published in Jul-Sep issue of your journal.[1] They described a severe case of decompression sickness in a breath-hold diver in India. After stating that no formal education was given to divers regarding diving diseases and preventive measures in India, they imply that diving injuries can be prevented with proper education and training. We hope that this case will ignite a discussion of the problems of divers in India. The authors also recommend that “divers should use ear-plugs for protection from barotrauma”. We think that a general recommendation of the use of ear-plugs for divers may be harmful and a clear explanation of how and when to use ear-plugs during diving is required. Since regular (solid) ear-plugs will totally obstruct external ear cannel, a closed space will be created between the ear-plug and tympanic membrane. As other air-filled spaces in the body, this “new” closed space will be subjected to pressure alterations during diving. The air between the ear-plug and tympanic membrane will shrink during decent according to Boyle's law and either the ear-plug will move toward the tympanic membrane or the tympanic membrane will burst to equalize the pressure inside this space and environment. Ear-plugs may be used during swimming to protect the ear canal from water but it is not recommended during diving because of the increased risk of barotrauma as explained above. There are commercially available ear-plugs that allow the air to vent, so called “vented” ear-plugs. It is suggested that since vented ear-plugs allow pressure equalization, they may be used in divers to prevent ear squeeze. However, if the hole in the vented ear-plug is closed by ear wax, there is a risk of barotrauma. Furthermore, the data on the effectiveness and safety of vented ear-plugs is anecdotal and no clinical trial has been reported yet. In conclusion, considering that there is no formal education for divers in India, recommendations to the diving community should be made by being cautious. Solid (non-vented) ear-plugs are not recommended for diving.

Effect of Musician’s Earplugs on Sound Level and Spectrum During Musical Performances

In this study, change in A-weighted and 1/3-octave sound pressure levels (SPLs) was used to assess the influence of wearing earplugs by musicians on their musical performances. Seven soloists and 3 music assembles performed 4 pieces of music with musician’s earplugs donned and doffed. They used silicon custom moulded earplugs with acoustic filters designed to attenuate sound by 9, 15 or 25 dB. Results showed that the use of earplugs affected the sound level and the spectrum of played sounds. This effect was the greatest for brass players. The difference between SPLs in high-frequency 1/3-octave bands and A-weighted SPLs with and without earplugs exceeded 5 and 15 dB, respectively. Similar changes for woodwind, percussion and string instruments were less noticeable than for brass instruments; they were more than 5 dB for 1/3-octave spectra and no more than 2 dB for A-weighted SPL.

Hearing impairment among workers exposed to excessive levels of noise in ginning industries

Cotton ginning workers have a risk of hearing loss due to excessive noise levels at the workplace environment. In this study, estimates of typical sound levels prevailing at the workplace environment and its effects on hearing ability of the exposed workers were made among cotton ginning workers. Data on self-reported health status was collected by a questionnaire survey at 10 cotton ginning industries located at Jalgaon district of Maharashtra state, India. The cotton ginning workers were exposed to continuous noise levels between 89 and 106 dBA. The hearing ability of the subjects was accessed by pure tone audiometry. The results of audiometry show mild, moderate and moderately severe degree of hearing impairment among the cotton ginning workers. The data generated during the study show that hearing loss was significantly associated with period of exposure to the workplace noise (P <0.0001). The prevalence of audiometric hearing impairment defined as a threshold average greater than 25 dB hearing level was 96% for binaural low-frequency average, 97% for binaural mid frequency average and 94% for binaural high-frequency average in the cotton ginning workers. We recommend the compulsory use of personal protective equipment like ear plug by the cotton ginning workers at the workplace environment. A regular maintenance of ginning and pressing machineries will avoid the emission of excessive noise at the workplace environment of cotton gins. A regular periodic medical examination is necessary to measure the impact of workplace noise on the health of cotton ginning workers.

Prospective, randomized controlled assessment of the short‐ and long‐term efficacy of a hearing conservation education program in Canadian elementary school children

To assess the efficacy of a hearing conservation program in changing acoustic risk-taking and hearing conservation behaviors in elementary school children. Prospective, randomized, mixed design controlled study. Participants were grade-six students from 16 Vancouver School Board schools. Differences between the intervention and control group responses on a behavioral questionnaire were measured at baseline, and then at 2 weeks and 6 months after administration of a hearing conservation program (Sound Sense™). The intervention resulted in significant interactions for improved earplug use at dances (P = .019), rock concerts (P = .001), with percussion musical instruments (P = .002), and electric guitars (P = .028) at 2 weeks postintervention relative to baseline. Improvements in children's earplug use at dances (P = .041), rock concerts (P = .0024), and with power lawn mowers (P = .043) at 6 months postintervention relative to baseline were also observed. Behavior in the intervention group compared to control group improved in earplug use with any "other noises" at 2 weeks (P = .001), and 6 months (P = .022) relative to baseline. There was a tendency in the intervention group to reduce the duration of use of personal music devices at 2 weeks and 6 months after the hearing conservation program, which was nonsignificant. The Sound Sense™ hearing conservation program improved earplug use practices in elementary school children in the short and long term. The development, implementation and evaluation of a community-based health promotion project around hearing loss can serve as a tremendous opportunity for students to develop their knowledge and skills in health advocacy.

Hearing protection for clubbers is music to their ears

while it is difficult to promote the use of hearing protectors in noisy workplaces and leisure settings, some nightclub attendees choose to wear earplugs when exposed to loud music. This qualitative study investigated the perceptions of clubbers about the advantages and disadvantages of earplug use in nightclubs. Such first-hand information could potentially be used to educate non-wearers about the features of different earplug types, the experience of wearing earplugs and their relative merits. structured telephone interviews were conducted with 20 regular clubbers who wear different types of earplugs at nightclubs. Participants were asked about their experience of wearing earplugs and, in particular, what they perceive to be the advantages and disadvantages of earplugs. participants' responses revealed that cheaper foam earplugs are considered less satisfactory than more expensive earplugs, which are relatively discreet and comfortable, facilitate communication with others, create minimal music distortion and, in some cases, improve music sound quality. In terms of effectiveness, all types of earplugs were considered beneficial in reducing the after-effects of loud music and providing hearing protection. the perceived advantages of earplugs, which are often not recognised by non-earplug wearers, should be communicated in order to encourage the use of earplugs among clubbers.