Effect of recreational noise exposure on hearing impairment among teenage students

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Abstract

Several studies have focused on the potential impact of children's hearing loss on learning and development. Recently, numerous teenage students have been found to be fond of listening to music on personal devices and participating in recreational music activities. The objective of this study was to investigate teenage students’ hearing impairment, their experience with recreational noise exposure, and their self-reported hearing. The participants were 1878 first-year students at a university in Taiwan. The result of the pure tone audiometry test showed that 11.9% of the participants had one or two ears with a hearing threshold over 25 dB. Over the past year, approximately 80.9% of the participants had taken part in at least one loud-noise recreational activity, and 90.9% of the participants were in the habit of using earphones. Among the participants, 190 students with a high level of recreational noise exposure were assigned to the exposure group, and 191 students with a low level of recreational noise exposure constituted the control group. The exposure group had more hearing problems than the control group, but no significant difference existed between the two groups in the pure tone audiometry test (p = 0.857). It is suggested that the schools should reinforce hearing health education and proactively provide intervention measures, such as hearing tests, evaluation of noise exposure, and hearing protection.

Highlights

► Approximately 90.9% of the participants had the habit of using earphones during the past year. ► Pure tone audiometry showed 11.9% of subjects had one or both ears with hearing threshold over 25 dB. ► It was found that 13.5% of the subjects reported that they suffered from tinnitus. ► The noise exposure group had more self-reported hearing problems than the control group (p < 0.001).

Introduction

In the modern living environment, noise pollution has become one of the serious public nuisances. Studies of noise-induced hearing loss (NIHL) have focused mainly on adults’ occupational noise exposure. In the United States, as many as 738,000 individuals have severe to profound hearing loss. Of these, almost 8% are under the age of 18 (Blanchfield, Feldman, Dunbar, & Gardner, 2001). In addition, approximately 70,000 children, ages 6–21, received services for hearing under the Individuals with Disabilities Education Act (IDEA) Part B in the 2001 school year (U.S. Department of Education, 2002).

In recent years, the prevalence of using personal listening devices (such as MP3 players and portable stereos), attending music concerts, singing at Karaoke Television (KTV), or going to video game parlors has been on the rise among teenage students. Several studies have indicated that people using personal listening devices or attending rock concerts can be exposed to sound levels above 100 dB (Katz et al., 1982, Serra et al., 2007). In addition, many teenagers have the habit of using a personal listening device while reading, taking public transportation, or sleeping.

Long-term exposure to noise can lead to hearing impairment that these teenagers may not even become aware of (Vogel, Brug, van der Ploeg, & Raat, 2007). This is mainly because noise that can potentially impair one's hearing is more evident at frequencies higher than 4 kHz (Muhr et al., 2007, Niskar et al., 1998). Hearing loss of frequencies below 3 kHz will gradually affect speech frequency (0.5–2 kHz) after a longer period of exposure. Those who have lost their high-frequency hearing may not experience any obvious signs of this loss in everyday life and therefore may not discover their hearing impairment. In a study of 18-year-old Swedish men (N = 301,873), Muhr et al. (2007) found that the prevalence of hearing loss (≧25 dB) at frequencies of 0.5–6 kHz and 3–6 kHz was 13.1% and 11.9%, respectively.

Several researchers have indicated that the higher exposure to recreational noise would increase the risk of hearing impairment (Clark, 1991, Dalton et al., 2001, Jokitulppo et al., 1997, Meyer-Bisch, 1996, Tin and Lim, 2000). Dalton et al. (2001) studied the correlation between noisy leisure activities and hearing impairment. They concluded that among participants suffering hearing loss, participants in activities with noise over 90 dB significantly outnumbered those in activities without noise. Moreover, the risk of hearing loss would increase 6% after 5 years of exposure.

Clark (1991) conducted a review of studies on recreational noise exposure and indicated that the recreational noise, including rock concerts, symphony performances, and music heard over headphones, can cause hearing impairment. Meyer-Bisch (1996) investigated the effects of recreational noise on hearing and found that, among sufferers of hearing problems, those exposed to at least 7 h of music from a Walkman or those who attended at least 2 rock concerts each month outnumbered the control group by 12%.

Jokitulppo et al. (1997) found that 51% of Finnish teenagers may be easily exposed to sharp and harmful noise due to participation in recreational activities. They also indicated that symptoms associated with hearing correlated with the increase of the dose of noise exposure. Therefore, teenagers’ long-term use of personal stereo systems and participation in various loud-noise music activities definitely expose them to an environment with potential harm that can cause hearing impairment.

The participants in this study were first-year students at National Taiwan Normal University. A questionnaire was designed to survey their experience with recreational noise exposure and self-reported hearing. In addition, the pure tone audiometry test was performed on all the participants. The principal objective of this study was to investigate the effects of recreational noise on their hearing.

Section snippets

Research participants

This study was approved by the Ethics Committee of National Taiwan Normal University. On the day of the physical examination, the participants were asked to fill out the questionnaire and take the hearing test. The total times of using earphones (Near) and attending recreational activities (Nre) in a year were calculated according to the students’ frequencies of using earphones and attending recreational activities. The questionnaire was also designed to determine the average duration (Fear)

Background data

A total of 1787 valid responses were obtained; the male students represented 41% (733) of these responses, and the female students represented 59% (1054), respectively. The average age of the participants was 18.9 years old. Table 1 indicates that 138 students (7.7%) reported having suffered from ear injuries or diseases. Tympanitis was the major disease most of them suffered (85 persons). Other ear injuries included otitis, ruptured eardrum, various kinds of ear traumas (cut, penetration,

Discussion

In this study, the result of the hearing test showed 11.9% of the participants had at least one ear with a hearing threshold over 25 dB at any frequency. The third National Health and Nutrition Examination Survey (NHANES III) conducted in the United States during 1988–1994 found that of students between 6 and 19 years of age, approximately 12.5% (5.20 million persons) had the problem of noise-induced threshold shift (NITS), and most of them had hearing impairment (Niskar, Kieszak, Holmes,

Conclusions

Compared with people in other age groups, teenage students generally like to participate in all kinds of recreational activities and have rich experience in noise exposure. However, long-term and chronic hearing injury may result in NIHL. For teenage students, hearing is critical to communication and learning; therefore, hearing impairment may lead to social isolation and poor self-concept. Because most teenage students may have insufficient knowledge about threats to their hearing and how to

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