Prolonged exposure to loud music can induce hearing loss. Adolescents are increasingly exposed to loud music.
What This Study AddsWhen using MP3 players, adolescents are much more likely to engage in risky behaviors than protective behaviors. Frequent use of MP3 players indicates the prevalence of MP3 player-related risky behaviors and the absence of preventive behaviors.
ABSTRACTOBJECTIVE. The goal was to assess risky and protective listening behaviors of adolescent users of MP3 players and the association of these behaviors with demographic characteristics and frequency of use.METHODS. In 2007, 1687 adolescents (12-19 years of age) in 68 classes in 15 Dutch secondary schools were invited to complete questionnaires about their music-listening behaviors.RESULTS. Ninety percent of participants reported listening to music through earphones on MP3 players; 32.8% were frequent users, 48.0% used high volume settings, and only 6.8% always or nearly always used a noise-limiter. Frequent users were Ͼ4 times more likely to listen to high-volume music than were infrequent users, and adolescents in practical prevocational schools were more than twice as likely to listen to high-volume music as were those attending preuniversity education.CONCLUSIONS. When using MP3 players, adolescents are very likely to engage in risky listening behaviors and are unlikely to seek protection. Frequent MP3 player use is an indicator of other risky listening behaviors, such as listening at high volumes and failing to use noise-limiters. Pediatrics 2009;123:e953-e958 T HE HUGE INCREASE in the popularity of portable MP3 players has increased young people's exposure to high sound levels dramatically. [1][2][3] Various studies reported that increasing numbers of adolescents and young adults now experience symptoms indicative of poor hearing, such as distortion, tinnitus, hyperacusis, or threshold shifts. [4][5][6] The Hearing Alliance of America reported that levels of hearing loss in 15% of college graduates are now equal to or greater than those of their parents, largely because of listening to music at high volumes. 7 Currently, use of MP3 players may be the most important risk factor for music-induced hearing loss in young people.The rapid development of digital technology has led to the production of new kinds of portable music players whose sound quality at higher volumes is much better, because the sound is no longer distorted. 3 Because the music players are equipped with improved earphones, sound leakage is almost absent, which means that the music players can be played at hazardous high volumes in most environments without disturbing other people. 3,8 The use of earbud-style earphones increases the volume level by another ϳ5.5 dB, 3,9 because of the smaller ear canal volume. Also, the recordings are made with much stronger compression, which allows for an average sound level closer to the maximal output level.In noisy environments, listeners are especially likely to choose high volume settings, 10 which, over longer periods, are potent...