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Hey, Teens, Listen Up!

Coleman, Matthew

doi: 10.1097/01.HJ.0000411247.91778.f5
Figure. B

Figure. B

Take a leisurely stroll down the hallway of any high school between periods, and you will inevitably see wires trailing from students' ears to the MP3 players in their pockets. These devices, usually iPods, are ubiquitous, but they are putting teens at risk for hearing loss later in life.

A study from Tel Aviv University's Sackler Medical Faculty indicated that a quarter of 289 participants aged 13-17 are at severe risk for hearing loss because of their personal listening devices. (Int J Audiol 2011 Nov 28. [Epub].)

“The study group was asked to answer questions about their habits on [personal listening devices], specifically their listening levels and duration,” said Chava Muchnik, PhD, a professor in Tel Aviv University's Department of Communication Disorders. The researchers measured listening levels on 74 teens in quiet and noisy environments, and those were used to calculate the risk to hearing according to damage risk criteria laid out by industrial health and safety regulations, she said.

“The study findings are worrisome. Eighty percent of teens use their [personal listening devices] regularly, with 21 percent listening from one to four hours daily, and eight percent listening more than four hours consecutively,” she said.

These alarming data are just examples of a widespread problem, especially in the United States where the devices' maximum level can go up to 129 decibels; European standards limit the output to 100 decibels.

“We should establish a music damage risk criteria, and adopt the European standards that limit the output,” Dr. Muchnik said. “We must also implement educational programs in the elementary schools to increase awareness of hearing health before the loud music listening becomes a habit.”

One such attempt to increase the dialogue with teens about the potential for hearing loss is being made by the Baptist Memorial Health Care Foundation, the nonprofit arm of Baptist Memorial Health Care, which operates 14 hospitals in West Tennessee and northern Mississippi.

The foundation's national Play It Down campaign, launched to change listening habits and reduce hearing loss in American teens, created a free app where users can “Auto-Old My Music,” which was designed to scare teens into turning down the music. It allows them to hear popular music the way their hearing-impaired parents would. (

“The app is more meant to be a tool to reach teens and to get discussion going among teens about hearing loss,” said Ericca Hardee, AuD, of Baptist Memorial Health Care. “Teens are not screened as frequently in school for hearing loss as younger students are, and they may already have signs of high-frequency hearing loss and not even know it. Based on our research, we felt it was important to get information about hearing loss out there and in a fun way so it didn't feel like teaching.”

The app makes teens realize that personal listening devices can negatively affect their hearing, even if their hearing currently seems fine. “I don't think teens think about hearing loss one bit,” Dr. Hardee said. “The signs of hearing loss are so subtle that they can be doing damage over the course of years and not realizing it. Teens and young adults think they are invincible so that's why we wanted to reach them at a young age.”

Dr. Hardee said Facebook and other social media sites also can make teens more aware of hearing loss risk. “I think that this is a great way to reach teens,” she said. “In addition to the Play It Down app, we are developing a tool kit that can be given to teachers and schools to distribute information about hearing loss to teens.”

While listening to an iPod daily can put teens at greater risk for future hearing loss, many teens may be more willing to take the risk than give up their precious tunes. But there is a way for teens to experience the best of both worlds.

AfterShokz ( are not your typical headphones. Instead of going in the ears, they sit in front of the ear and utilize bone conduction technology to deliver sound through the listener's cheekbones to the inner ear. Because the headphones do not use the eardrums to transmit sound, they allow users to listen to music without risk of eardrum damage.

“If you are using these, you are not hurting your hearing,” said Dennis Taussig of AfterShokz. “Parents have little or no control over how loud their kids listen to music, but if young people can start listening to music with these headphones early, they may be able to prevent future issues.”

Because the headphones are not inserted into the ear, the listener is also able to experience the world around them. And as Dr. Muchnik made clear, listeners who use their devices in a noisy environment tend to increase the music levels to even higher levels to block out other sound. “Using the proposed bone conduction headphones when listening to [these devices] might bring about the need to use higher music levels, as the ear canals remain open to competing noise,” Dr. Muchnik said.

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