Binge Listening Is exposure to leisure noise causing hearing loss in young Australians? Harvey Dillon, Warwick Williams, Megan Gilliver, Elizabeth Beach

Noise-induced hearing loss Work-related hearing loss Leisure-related Work-related hearing loss Leisure-related Work-related hearing loss Leisure-related Work-related hearing loss Leisure-related

Overview Australian Hearing on-line survey of 1000 people aged 18 to 35 Dosimeter measurements at various leisure activities Measurements of actual noise exposure from MP3 players

Measuring noise levels in leisure activities 4

- Have to shout to be heard - Can cause permanent hearing loss NOISE A crash course in < 75 dB SAFE 75 – 85 dB LOUD > 85 dB VERY LOUD - Have to shout to be heard - Can cause permanent hearing loss 5

Workplace Noise Limits 85 dB for 8 hours = 1 ADE (acceptable daily exposure) 88 dB 4 hours 91 dB 2 hours 94 dB 1 hour 97 dB 30 min 100 dB 15 min 6

Noise levels in leisure activities Average noise level (dB) 7

Leisure noise exposure on a typical night out Noise level: 100 dB for 4 hours = 16 ADEs Enter Club A 89 dB Enter Club B 106 dB Enter Club C 104 dB 114 dB 64 dB 85 dB 9:34pm 1:42am 8

Binge Listening 9

Risky activities Risk Loudness Exposure time (how long, how often) How many people Mixing many high risk activities

Life-time noise exposure Activities change over life So noise/sound exposure changes Noise injury due to noise exposure is cumulative over the life-time Using a ‘noise exposure profile’ can highlight the most significant noise sources for typical individuals Prevention activities can be better targeted

Sound exposure profile over a life-time Sound exposures add up! 42-year old with accumulated noise-exposure of a 60 year-old Williams, 2008

Level x time x regularity = exposure

Annual noise dose

Attendance at night clubs / dance parties

Night-club / dance venue 97 dB Sporting event 93 dB Gym with music 92 dB Concert 84 dB Pub/club 83 dB

Club sound levels during the evening

MP3 player use

Personal stereo players (PSP) Long term study Average level (LAeq) 84 dB Average use per day ~2:20 h:m Average exposure (LAeq,8h) 78 dB Users potentially at risk 23% Users seriously at risk ~4%

MP3 exposure levels 2003 2006 2009

MP3 daily noise doses

Total annual leisure exposure (5 activities) 747 13% get more than one year’s max acceptable noise dose each year

Total annual leisure exposure (MP3 use) 24% get more than one year’s max acceptable noise dose each year

Total annual leisure exposure (MP3 use) + 43% get more than one year’s max acceptable noise dose each year

Does age and gender affect exposure?

Is exposure affecting self-rated hearing difficulty?

Is MP3 player use affecting hearing difficulty?

Do noise-exposed people perceive the risk to their hearing from leisure noise?

Do noise-exposed people perceive the risk to their hearing from MP3 exposure?

Do noise-exposed people perceive the risk to their hearing from leisure sound exposure?

Is it permanent?

There is reasonable awareness about noise and hearing loss Noise Causes Damage Awareness of Risk: You can damage your hearing when exposed to loud noise at events like concerts and nightclubs (85% agree) Being exposed to noise at sporting events and gym classes can damage people’s hearing (40% agree) Awareness of Hearing loss: Damage is permanent Once your hearing is damaged it cannot ever be restored to its original state (63% agree) These days, if you damage your hearing, the medical profession can’t bring it back to its original state (59% agree) 34

Stages of Change Reported Behaviour 14% 48% 39% 35 Going deaf is something old people to have to deal with. Loud noise doesn’t bother me. I like my music loud. I think loud noise/music can permanently damage hearing - but I don’t take any action to avoid it Sometimes after loud noise/music I get ringing in my ears. It worries me a bit, until it goes away I worry about short and long term effects of loud noise/music I try to avoid and/or limit my exposure. Stages of Change 14% 48% 39% 35

Exposure varies between behaviour groups 36

Conclusions - Exposure Most people enjoy leisure activities safely Clubbing and MP3 use both impart dangerous noise doses to a small proportion of young people Those with the greatest noise exposure report the greatest number of hearing loss symptoms Exposure diminishes with age over the range 18 to 35 years Life-time risk depends on years of exposure, and work-related exposure MP3 exposure (per person) may be dropping over time

Conclusions - Awareness There is widespread awareness that excessive sound causes hearing loss, but: Over 20% of those with high leisure noise exposure think they personally have little or no risk, even if they know there is a general link More than 1/3 of people don’t realise that sound-induced hearing loss is permanent.

Acknowledgments Hearing loss prevention program, Office of Hearing Services, Department of Health and Ageing Australian Hearing, Marketing and Communication team The Hearing CRC