Hearing Threshold of Korean Adolescents Associated with the Use of Personal Music Players

Purpose: Hearing loss can lead to a number of disabilities and can reduce quality of life. Noise-induced hearing losses have become more common among adolescents due to increased exposure to personal music players. We, therefore, investigated the use of personal music player among Korean adolescents and the relationship between hearing threshold and usage pattern of portable music players. Materials and Methods: A total of 490 adolescents were interviewed personally regarding their use of portable music players, including the time and type of player and the type of headphone used. Pure tone audiometry was performed in each subject. Results: Of the 490 subjects, 462 (94.3%) used personal music players and most of them have used the personal music player for 1-3 hours per day during 1-3 years. The most common type of portable music player was the MP3 player, and the most common type of headphone was the earphone (insert type). Significant elevations of hearing threshold were observed in males, in adolescents who had used portable music players for over 5 years, for those over 15 years in cumulative period and in those who had used earphones. Conclusion: Portable music players can have a deleterious effect on hearing threshold in adolescents. To preserve hearing, adolescents should avoid using portable music players for long periods of time and should avoid using earphones

Maximum Sound Output Levels of Pediatric Marketed Headphones: The Development of Healthy Listening Habits in Children

Background: In recent years there has been a growing concern regarding the etiology of pediatric hearing loss. Based on cross-sectional studies of data produced by the National Health and Nutrition Examination Surveys, the incidence of hearing loss in US adolescents (age 12-19 years) has increased from 14.9 to 19.5% from 1988-2006 (Shargorodsky, Curhan, & Eavey, 2010) (Brooks & Chan, 2017). Many individuals suspect the leading contributor of this to be frequent exposure to unsafe listening conditions (Muchnik, Amir, Shabtai, & Kaplan-Neeman, 2012) (Brookhouser, Wothington, & Kelley, 1992). Presently there are no government issued regulations on the maximum sound output levels for headphones sold in the U.S. Though a handful of studies have been conducted to investigate the output levels of commercially available headphones, none have utilized calibrated, scientific equipment or have focused on pediatric headphones specifically. This study looks to measure and analyze the maximum output levels of pediatric headphones to determine if they are capable of reaching levels that may be harmful to a child’s auditory system. Method: Output measurements were obtained in a calibrated sound booth using a Larson Davis sound level meter connected to a preamplifier with one-inch microphone attached. Each headphone under investigation was then connected to the preamplifier with a 500g force placed on top of the earphone to simulate the force of the band against the skull. Using an iPhone X MP3 player, the same song was presented to each headphone. The exact dBA fluctuations were measured throughout the duration of the song via the calibrated sound level meter to ensure that an accurate maximum output level was recorded. The data collected was then analyzed further to determine maximum output levels of each headphone under investigation. Results: Of the sixteen products tests, 88% of them exceeded the World Health Organization (WHO) and the National Institute of Occupational Safety and Health (OSHA) recommended 85dBA safety limit. Additionally, of the twelve products tested which marketed themselves as being volume limiting, only 16.7% of them were able to adhere to their own restrictions. Products ranged from maximum outputs of 114.5 dBA (Elecder- I37 Kids Headphones) to 81.7dBA (AILIHEN-HD50 Kids Headphones). Devices were then categorized based on predicted duration until damage, assuming a steady output at or near the maximum output level obtained. The results of this ranged from upwards of 17.2 hours. All the way down to 32.4 seconds. Lastly, average dBA output levels for each category (high-end, mid-level and low-end) were derived. Results suggest that lower-end devices on average produced greater dBA outputs than did either the mid-level or high-end devices. Conclusion: Pediatric marketed headphones are capable of reaching levels that could result in auditory damage. The results of this study should be used to highlight the importance of not only mandating but strictly enforcing a government issued regulation on maximum sound outputs for pediatric marketed headphones sold in the United States. In addition, further action must be taken to help inform and educate parents about the potential risks the associated with extended headphone usage

Non-linear Distortion against Hearing Loss

Today, an increasing problem is hearing loss caused by increasingly high Sound Pressure Levels (SPL). Extremely loud noises and sounds originating from our environment often cause damage to our ears and result in noise-induced hearing loss (NIHL). There are procedures to increase loudness without increasing the physical, measurable Sound Pressure Level (SPL). Procedures using equal loudness sensitivity curves amplify at different frequencies. It was our intention to create a device that will control volume and clarity to a suitable level without inflicting any damage to the ear since the sound pressure level remains at a lower level. Additionally, our aim was to design a device, that, in contrast with current procedures today, does not weaken or masquerade the sound, does not distort the intricacies of music or alter tonality. Environmental conscious thinking, especially in energy saving, has become increasingly important today. When amplifying sound, we can achieve significant energy savings from utilising a lower Sound Pressure Level (SPL). Our patented method imitates the human ear’s distortion and non-linear behaviour. Any non-linear distorting causes a sense of loudness growth, but the modified sound will become realistic if we come closer to the human ear’s distortion. In our investigations, we conclude that, by setting (or "imitating") an overtone range similar to the human ear’s distortion, we can achieve an increase in loudness in the entire audible frequency spectrum without loss of sound quality. Our prototype was constructed with the ability to carry out a subjective comparative loudness test. The data was collected individually by questionnaire, and later calculated using the arithmetical mean of the answers, with the results given in decibels. An average increment of 2.7 dB was measured electronically based on the 66 completed questionnaires used with the Triode Proof of Concept Model. The results demonstrated that an increase of loudness level can be achieved not only with the currently used Fletcher-Munson curves, but with the help of the procedure found in our study. In the implementation of this unique method, an increase in the sound pressure level can be avoided, and, so, without SPL increases, the subjective loudness of the sound can be increased, ensuring the ear will not be exposed to the adverse consequences of the higher sound pressure level. Our unique equipment and methodology can help reduce hearing damage without the discomfort caused by coloured tones. While further studies and improvements are required, the usability of this method demonstrates its practical applicability. These may include various electronic sound amplifiers in which the method can be used as a sound effect module. However, the most important field now using this method is huge number of media players, as young people commonly use these audio tools. The greatest benefit of this unique approach is therefore a reduction of hearing damage caused by the widespread and reckless use of headphones

The effects of various modes of feedback on preferred iPod listening levels

The current study was conducted in an effort to promote safe listening habits of personal media player device users. Devices such as the iPod are known to have high output capacities well within the range of potentially hazardous sound levels, thus there is a concern that personal listening may pose a risk to hearing. Intuitive and real-time feedback representing the risk of hearing damage based on selected Preferred Listening Levels (PLLs) was provided to subjects they listened to an iPod. Objective: To provide listeners with tools to judge ‘what is too loud’ (and potentially damaging to hearing) so that they may use the knowledge to modify their listening habits to reduce their risk of noise-induced hearing loss. Subjects: Twenty, normal-hearing, young, female subjects participated in the study. Measurements: Ear canal sound level measurements were made of subjects’ PLLs while listening to music in the presence of Visual, Vibro-tactile, and Auditory feedback and no feedback (used as a baseline). PLLs were separated into three sound intensity level categories; “safe” (\u3c85dB SPL), “risky” (≥85dB SPL to \u3c90dB SPL), and “unsafe” (≥90dB SPL), real-time feedback was administered according to the respective sound-level category. Subject’s perceptions regarding influence, effectiveness and acceptability of feedback were also measured. Results: revealed lower PLLs for all feedback conditions relative to the no feedback condition, however only visual feedback resulted in significantly lower preferred listening levels (p\u3c0.05). Visual feedback was shown to have the strongest influence on subjects’ PLLs (p=0.000), and was perceived to be the most effective form of feedback to alert users to potentially hazardous sound levels (p=0.007). No form of feedback was significantly more acceptable to subjects (p=0.098). Conclusions: Results support the implementation of a Visual feedback system (into iPods) to alert users to hazardous PLLs to encourage safe listening habits. However due to general usage trends (iPods frequently being out of sight during use), the use of a multi-modal feedback system is suggested. Auditory and Vibro-tactile feedback could be easily detected even if an iPod is out of sight, could reduce PLLs or at a minimum alert users to attend to the Visual feedback

The Effect of Low Frequency Sound on Listening Level

A listener’s preferred listening level (PLL) for music under headphones has been found to be related to factors such as music genre, external noise, and headphone fit. The purpose of this study was to investigate the relationship between a listener’s PLL and the amount of low frequency sound in music. The study also investigated the relationship between a listener’s PLL, their music preference, and familiarity with the songs used in the experiment. For the study, 44 participants aged 18 to 35 years old with normal hearing were recruited from a university population. Participants completed listening tasks comprised of 16 experimental stimuli representing the pop, rock, and classical genres, as well as a self-selected song of their preference. High-pass filtering with corner frequencies of 100, 173, and 300 Hz was applied to 12 of the stimuli while 4 stimuli remained unfiltered. Participants adjusted the volume setting to their preference for each stimulus. A post-test survey was administered to rate the participants’ familiarity with the songs used in the listening task. A two-way repeated measures ANOVA analysis demonstrated that there were significant differences between the songs (p = 0.009) and the filter settings that removed low frequency sound (p = 0.009), as well as interaction effects between these groups (p = 0.018). A post-hoc analysis revealed that the PLLs for the classical song were significantly lower than the other 3 songs, and only the 300 Hz high-pass filter setting was significantly higher in PLL than the baseline “no filter” setting. No significant correlation was found between participant ranking of song familiarity and volume setting for that song. The use of a preferred or familiar song did not have a significant effect when measuring a listener’s PLL in this study. These results demonstrate that the absence of low frequency sound can lead to an increase in listener PLL for music. However, observations from the data revealed that this trend may not be true for all listeners. The real-implications of these findings suggest that a transducer with poor low-frequency response may lead to higher listener PLLs. Similar future studies should consider other methods to further clarify the influence of low frequency sound on PLL and how other known influences on PLL (i.e., environmental noise) may interact

Developing a Questionnaire to Assess Noise Exposure in Children and Teens

Until recently, children and teenagers were not thought to be an at-risk population for noise induced hearing loss (NIHL). As MP3 players have grown in popularity, there has been an increased awareness of possible noise exposure and hearing loss in children and teens. NIHL is a cumulative hearing loss that is due to repeated exposure to noise. Concerns about NIHL in children and teens are raised due to the opportunities for noise exposure that they may encounter in their daily environments. Children and teens can be exposed to potentially dangerous levels of noise during activities at school, part-time work, recreational activities, and even household chores (e.g. musical instruments, lawn mowers, dirt bikes, and vacuums). The need to identify, diagnose, and treat hearing loss, as close to the onset is crucial, especially for children. Hearing loss in children and teens impacts their speech perception, learning, self-image, and social skills. NIHL is virtually 100 percent preventable; therefore identifying any risk of NIHL as early as possible can stop its progression and severity. The present study attempts to develop a questionnaire to help identify children and teens at highest risk for NIHL. Mandated hearing screenings in schools provide an opportunity to reach those at risk. A noise exposure questionnaire may be a useful companion tool for the hearing screenings. Research about questionnaire development was completed to determine what survey format would be most effective. Items on the questionnaire were selected based on research regarding current concerns of NIHL and sources of noise exposure in children and teens. Five experts in the field of hearing conservation reviewed the questionnaire to address face validity. Comments provided by the experts were taken into consideration and the questionnaire was revised. In the future, a field trial of the questionnaire should be completed in order to correlate the results of the questionnaire to behavioral audiometric test results

Music Intensity in the Ear Canal in Quiet and in Subway Noise Using Four Different Headphones

Background: Noise-induced hearing loss, hearing loss caused by exposure to loud sounds, affects individuals of all ages. One cause of noise-induced hearing loss is listening to music at high intensities on personal listening devices, such as the iPhone. The aim of this study was to compare the intensity of music in the ear canal when presented in quiet at multiple volume settings through 4 different headphone styles (2 over the ear and 2 earbuds) to the intensity of the music in the ear canal when presented in typical subway noise. The results were used to determine recommended listening durations for the iPhone based on earphone style and music intensity in quiet listening environments and on the subway. Method: This study used an iPhone 6s to present a 30 second clip of the 2015 #1 song “Uptown Funk” by Mark Ronson, featuring Bruno Mars (Billboard, 2015). The output of the iPhone was fed to a Zwislocki coupler inserted into the left ear of Knowles Electronic Manikin for Acoustic Research (KEMAR) and RMS sound intensity was measured using a sound level meter. A total of 4 different headphones were used to present the music clip in two conditions (in quiet and in 80dBA of subway noise). The music was played at 4 different iPhone volume settings: 25%, 50%, 75% and 100% of the maximum volume. Measured intensities were then compared to the WHO and EPA allowable listening levels of a 24-hour period in order to determine safe listening duration as a function of music intensity and background noise. Results: In terms of volume setting across all 6 headphone conditions, 25% of maximum volume had recorded peak amplitudes ranging from 52.8dB SPL (Sony ZX series) to 82.6 dB SPL (PowerBeats Plugged) in quiet and 76.4 dB SPL (Beats Studio) to 85.8 dB SPL(Apple EarPods Plugged and Sony ZX Series) in noise. 100% of maximum volume had recorded peak amplitudes ranging from 93.3 dB SPL (PowerBeats Unplugged) to 119.4 dB SPL (Beats Studio) in quiet and 94.3 dB SPL (PowerBeats Unplugged) to 119.4 dB SPL (Beats Studio) in noise. In terms of the difference in dB SPL between quiet and noise conditions, the in-the-ear earbuds had a range from 0 dB SPL (Apple EarPods Plugged at 100% volume) to 30.9 dB SPL (Apple EarPods Unplugged at 25% volume). For the over-the-ear headphones, the differences in dB SPL between the quiet and noise conditions ranges from 0 dB SPL (Beats Studio at 100%) to 33 dB SPL (Sony ZX Series at 25%). Recommended listening durations decreased as volume setting increased, as would be expected. At a volume setting of 25%, listening durations were longest--at least 8 hours for all headphones in quiet or in noise. At a volume setting of 100%, however, listening times decreased, ranging from 1 hour to 14 seconds, depending on headphone. Conclusions: In subway noise, the intensity of the music plus the noise reached potentially damaging levels. Some earphone styles offered more protection from the subway noise than others. For the over-the-ear style, the Beats Studio headphones offered the most protection. Although the SONY headphones provide longer listening durations in the presence of subway noise, especially at 75% and 100% of maximum volume, less of the signal reaching ear level was the desired music. For the in-the-ear style, the PowerBeats, when well-sealed in the ear canal, offered the most protection from the subway noise. The PowerBeats also yield the longer safe listening times. Overall, the over-the-ear style headphones provide more protection and longer listening durations in the presence of subway noise compared to in-the-ear earbuds. This study provides data that could be used to promote awareness regarding the dangers of listening to music at loud intensities for long durations, especially in the presence of background noise

Impact of Educational Program About Earphones Hazards and Healthy Hearing on Knowledge, Perception and Practices of Students in Zagazig University

Background: The potential for hearing loss among younger generations is escalating every year. Likewise, the use of earphones has been thought to degrade a college student’s academic performance. Hearing loss is an issue among the younger age group requires immediate attention. Aim: In light of this, this study was conducted in order to illustrate the impact of educational program about earphones hazards and healthy hearing on knowledge, perception and practices of students in Zagazig University. Design: A quasi-experimental pre/post–test design was adopted to carry out this study. Setting: the study was conducted at faculties affiliated to Zagazig University Subjects: The total number of the randomly selected students was 1532  Tools: data was collected using three tools; tool (I) A self-administered questionnaire entitled data about socio-demographic characteristic, tool (II):A students’ knowledge, perception and practices questionnaire:, and tool (III) hearing loss designed questionnaire. Results: put on show that approximately less than two thirds (64%) of studied students used  earphones, there was a marked improvement in participant’s knowledge, perception and practices regarding earphones hazards and healthy hearing post implementation of educational program, what's more, health problems were declined after implementation of the program,  Conclusion: students had knowledge gaps regarding hazards of earphones and hearing health, the education  program had positive impacts on knowledge, perception  and practices of the studied students. Recommendations: Establishing national campaigns to promote knowledge about the hazards of earphones among adolescents and young adults and raising parents’ awareness through national and social media to shed the light on hearing health. Keywords: Earphones- Hazards- Impact - Students- Knowledge- perception- practices- educational program- Healthy hearing. DOI: 10.7176/JHMN/67-04 Publication date:October 31st 201

Noise-Induced Hearing Loss in Pediatric Patients

The purpose of this study is to examine the hearing tests that are done in the schools in the Philadelphia School District; it will examine the frequencies that are tested, the follow-up procedures for a poor performance in the exam, what barriers exist to follow-up, and educational methods used to prevent excessive noise-level. A previous literature review found that excessive noise was a major cause of hearing loss among school-aged children, and hearing impairment is increasing as a result of voluntary exposure to loud noise (Henderson, Testa, & Hartnick, 2011). Karper (2014) found that teenagers are not being tested at the right frequencies, and Abbasi (2014) found that the screening questions available do not identify which teenagers are at risk for hearing loss. A literature search was done using PubMed using keywords, such as “noise-induced hearing loss in pediatrics.” According to the Pennsylvania School Health Guidelines (2016), a student whose pure-tone threshold hearing test shows a level that is 30 dB or more for two or more tones in either one or both ears, or 35 dB or more for one tone in either ear, will be referred to the family’s provider. If a student fails the hearing screen, a complete ear exam is recommended, and it is the family’s responsibility to schedule this exam and follow up with the family’s provider. This study looks into methods that will ensure proper testing and follow-up with the provider in the West Philadelphia area of the Philadelphia School District. The expectation is that this study will evaluate the process of hearing screenings in schools in The City of Philadelphia, determine appropriate and effective methods of preventing noise-induced hearing loss, and find a way to ensure that all children get the follow-up care that they need. Collaboration between school officials, ENTs, pediatricians, and public health officials is necessary to properly address this problem

Noise-Induced Hearing Loss as a Growing Threat to Society

The purpose of this paper is to determine the exact dangers of leisure music to society, as peoples’ hearing can be negatively impacted by excessive exposure to music, in terms of both duration and sound (dB) level. Two types of studies are analyzed. One study analyzes the effects of concert and disco style music on musicians and party guests, primarily through experiments which test pure-tone audiometry, distortion product otoacoustic emissions (DPOAE), and general sound levels of people and places before, during, and after exposure. Another study analyzes the effects of personal listening devices (PLDs) on the population, mainly through studies, questionnaires, hearing tests, and experiments. The results of many studies show that, due to the popularity of personal listening devices, people are listening to more music, more often, in more places, and at higher dB levels than ever before. The results determine that whereas both PLDs and concerts are harmful to society, PLDs pose a greater threat to users’ auditory functions