Teens and Noise Exposure Carol Rousseau, Au.D., CCC-A Rochester Hearing and Speech Center 21 May 2010

Purpose of Presentation  Rationale: the beginnings of Noise Induced Hearing loss often start when teenagers become exposed to more adult activities or enter the work force.  Discuss typical venues and activities where teenagers are exposed to potentially damaging noise and how audiologists can address this issue.

Topics to be Discussed  Is there a concern?  Age/Population  Prevalence of NIHL  Effects of NIHL  Common noise sources  Prevention of hearing loss

Is Noise Exposure in Teens a Concern?  Parents are concerned about the damage that noise is causing to their kids’ ears More than ear infections, sleep & Asthma  Risk of NIHL greater for youth engaged in farming, utilizing firearms, playing with hazardous toys or fireworks, listening to amplified music, or involved in school woodwork or band

Is Noise Exposure in Teens a Concern?  Adolescence is the time when occupational noise exposure potentially begins  More than half of high school students surveyed report at least one symptom of hearing loss (ASHA & Zogby, 2010)  Thanks to technological advances, teens becoming more involved in noisier activities for longer periods

Population: what age group are we discussing?  Cited research includes ages 6-25  Studies conducted in US and Western Europe

Prevalence  Relatively large numbers of school boys failed their hearing screenings at 4000 Hz (Weber et al, 1967; Cozadetal et al, 1974; & Hull et al,1975)  1% of school age population has some degree of NIHL (Blair et al, 1996).  Prevalence of a high frequency hearing loss in school age children was 12.7% (Niskar et al,1998)  12.5% of 6-19 year olds had a prevalence of Noise Induced threshold shifts (Niskar et al 2001)

The Effects of Hearing Loss  Language/Speech  Stress  Academic Achievement  Social Effects Isolation Depression

Effects of NIHL  Tinnitus Correlation with excessive noise exposure 61% of concert attendees and 46% of club goers experienced tinnitus after attending event (Chung, 2005) 86% of musicians and concert goers suffered tinnitus after attending loud music venues (H.E.A.R.) Questionnaire by Mercier & Hohman (2002), 71% reported experiencing post- exposure tinnitus for at least one day

Effects of NIHL  Temporary threshold shift (TTS) Can lead to cumulative cellular damage Early indicator of hearing loss TTS of > 10 dB was seen after listening to music through headphones for 3 hours at normal used input levels (Lee et al, 1985) A 9 dB TTS was observed at 6000 Hz when teens listened to music at their habitual listening level after one hour (Hellstrom & Axelsson, 1998)

Effects of NIHL  Temporary threshold shift (TTS) Babisch et al (1985) found TTS values of 8 dB after two hours of music exposure at 85 dB

Effects of NIHL  Permanent threshold shift (PTS) Occurs at 3000 to 6000 Hz, with largest effect at 4000 Hz Over time, can effect as low as 2000 Hz Meyer & Bisch (1996) found PTS between 3000 and 6000 Hz in young adults Significant increase between 1976 and 1991 in the number of adolescents with >20 dB losses between 3000 and 6000 Hz (Kiderport, 1992)

Effects of NIHL  Permanent threshold shift (PTS) 30% of young military recruits had unilateral or bilateral hearing loss of > 20 dB in frequencies between 3000 and 8000 Hz (Borchgrevink, 1988 & 1993).

Effects of NIHL  Negative consequences for future employment Some jobs require minimum hearing levels  Police, Pilots, Trucking, Bus Diver Some jobs it will limit effectiveness  Musicians, Sound Engineers, Phone Work  Damage from chronic exposure to high sound levels is cumulative so the slight loss in childhood can lead to a substantial loss in adulthood

Sources of Excessive Noise  Environmental Traffic  Recreational Toys November 2003: declared acoustic standards of 90 dB measured at 25 cm Video games, firearms, paint ball, vehicles (ATV, Jet skis, etc)

Sources of Excessive Noise  Amplified music MP3  Output up to 120 dB  Listening for long periods Concerts  Can be 120 to 130 dB Garage Bands

Sources of Excessive Noise  School Band  82 to 114 dB Gym  Loud sports  Hockey play-off games measured between 104 and 120 dB (Hodgetts et al, 2006)  Coaches whistle up to 115 dB Woodshop  Up to 115 dB

Sources of Excessive Noise  Work Force 12.4% of students confirmed work-place noise exposure (Lankford et al, 1991) Mowing lawns  Up to 105 dB Farming  Up to 100 dB Construction

Prevention  Education Explain the auditory mechanism Those who received instruction were more likely to use hearing protection Musicians who are role models Teachers/school administrators need to implement hearing conservation programs

Prevention  Screenings Frequencies 3000 Hz and higher Currently implemented school-based screening guidelines are non-standardized and inadequate for early identification of NIHL (Meinke & Dice, 2007)

Prevention  Protection HPDs Parental controls on MP3 players Increase distance from sound source Regulations  Noise ordinances  Require HPDs for noisy classroom activities  Limit construction during school hours