Adolescent exposure to loud music has become a social and health problem whose study demands a holistic approach. The aims of the current study are:(1) To detect early noise-induced hearing loss among adolescents and establish its relationship with their participation in musical recreational activities and (2) to determine sound immission levels in nightclubs and personal music players (PMPs). The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs) were classifi ed as: normal (Group 1), slightly shifted (Group 2), and signifi cantly shifted (Group 3). The musical general exposure (MGE), from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01), in Group 3 compared with Group 2 (P < 0.05) only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01). Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05) and in Group 3 compared with Group 1 (P < 0.05). A signifi cant difference (P < 0.05) was found in Group 1's HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2) dBA and PMPs (82.9-104.6) dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

This interdisciplinary long-term study examined the effects of recreational noise exposure on the hearing of adolescents. Boys and girls (aged 14-17 years) were examined during a four-year period. Audiological, psychosocial, and sound measurements were performed yearly to determine the hearing threshold level (HTL) of participants in the 250-16000 Hz range, their participation in recreational activities, and the sound levels at discos and through personal music player use. A tendency of the mean HTL to increase in both genders during the study was observed, especially at 14000 Hz and 16000 Hz. Boys had a higher mean HTL than girls. The participation in musical activities increased yearly, 'attendance at discos' being the favourite musical activity for both groups. In general, boys were more exposed to high sound levels than girls. The equivalent sound levels in discos ranged between 104.3 and 112.4 dBA, and between 75 and 105 dBA from personal music players.

Part II, continuation of a previous paper, describes the significant hearing threshold shift found during the third year of the long-term study, which continued to be present in the fourth year, in a number of adolescents classified as Subgroup 2, who showed a higher mean HTL in the middle and especially in the high frequency ranges than the rest of the studied adolescents, classified as Subgroup 1. In both subgroups, the subjects showed high participation in recreational activities; nevertheless, the adolescents in Subgroup 2 showed higher participation in some of them in the last year of the study. From the beginning of the study, the mean HTL of the adolescents in Subgroup 2 was higher than the mean HTL of the adolescents in Subgroup 1. The exposure to high sound levels during leisure activities can be a cause of permanent hearing damage among young people with 'tender ears'.

Young people expose themselves to potentially damaging loud sounds while leisure activities and noise induced hearing loss is diagnosed in increasing number of adolescents. Hearing and music exposure in a group of adolescents of a technical high school was assessed at the ages of: 14-15 (test) and 17-18 (retest). The aims of the current study were: (1) To compare the auditory function between test and retest; (2) to compare the musical exposure levels during recreational activities in test and retest; (3) to compare the auditory function with the musical exposure along time in a subgroup of adolescents. The participants in the test were 172 male; in the retest, this number was reduced to 59. At the test and retest the conventional and extended high frequency audiometry, transient evoked otoacoustic emissions (TEOAEs) and recreational habits questionnaire were performed. In the test, hearing threshold levels (HTLs) were classified as: Normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3); the Musical General Exposure (MGE), categorized in: Low, moderate, high, and very high exposure. The results revealed a significant difference (P < 0.0001) between test and retest in the HTL and global amplitude of TEOAEs in Group 1, showing an increase of the HTL and a decrease TEOAEs amplitude. A subgroup of adolescents, with normal hearing and low exposure to music in the test, showed an increase of the HTL according with the categories of MGE in the retest. To implement educational programs for assessing hearing function, ear vulnerability and to promote hearing health, would be advisable.