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Noise & Health • Volume 16 • Issue 72 • September-October 2014 • Pages 197-250
A Bi-monthly Inter-disciplinary International Journal
www.noiseandhealth.org
July-August 2014 | Volume 16 | Issue 72
A little bit less would be great: Adolescents’ opinion
towards music levels
Annick Gilles1,2, Inge Thuy1, Els De Rycke3, Paul Van de Heyning1,2
Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, 2Department Translational
Neuroscience, Faculty of Medicine, Campus Drie Eiken, Antwerp University, Wilrijk, 3Department of Human and Social Welfare, University
College Ghent, Ghent, Belgium
1
Abstract
Many music organizations are opposed to restrictive noise regulations, because of anxiety related to the possibility
of a decrease in the number of adolescents attending music events. The present study consists of two research parts
evaluating on one hand the youth’s attitudes toward the sound levels at indoor as well as outdoor musical activities
and on the other hand the effect of more strict noise regulations on the party behavior of adolescents and young adults.
In the first research part, an interview was conducted during a music event at a youth club. A total of 41 young adults
were questioned concerning their opinion toward the intensity levels of the music twice: Once when the sound level was
98 dB(A), LAeq, 60min and once when the sound level was increased up to 103 dB(A), LAeq, 60min. Some additional questions
concerning hearing protection (HP) use and attitudes toward more strict noise regulations were asked. In the second
research part, an extended version of the questionnaire, with addition of some questions concerning the reasons for
using/not using HP at music events, was published online and completed by 749 young adults. During the interview, 51%
considered a level of 103 dB(A), LAeq, 60min too loud compared with 12% during a level of 98 dB(A), LAeq, 60min. For the other
questions, the answers were similar for both research parts. Current sound levels at music venues were often considered
as too loud. More than 80% held a positive attitude toward more strict noise regulations and reported that they would
not alter their party behavior when the sound levels would decrease. The main reasons given for the low use of HP were
that adolescents forget to use them, consider them as uncomfortable and that they never even thought about using them.
These results suggest that adolescents do not demand excessive noise levels and that more strict noise regulation would
not influence party behavior of youngsters.
Keywords: Adolescents, attitude, hearing protection, noise legalization, questionnaire, recreational noise levels
Introduction
In modern society, adolescents and young adults are often
exposed to loud music at social activities. Adolescents
often attend indoor as well as outdoor music venues where
sound levels easily reach 104-112 dB(A).[1] In addition,
the use of personal listening devices of which maximum
output levels often exceed safety barriers,[2-4] has become
an established act in the daily lives of this group. As a
consequence of increased recreational noise exposure,
noise-induced hearing symptoms such as hearing loss,
tinnitus, and hyperacusis have become more prevalent in
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285
the younger population.[5] One quarter of young people are
weekly exposed to more than 85 dB(A) and the incidence
of hearing symptoms seems to correlate with increased
noise dose.[6] Tinnitus with a temporary character is
experienced by 75% of adolescents and young adults after
loud music exposure, usually disappearing within 2 h after
noise exposure. Moreover, already 18% reports to perceive
permanent tinnitus. Despite the high incidence of noiseinduced tinnitus, which is a clear sign of overexposure,
this does not seem to be a motivator for the use of hearing
protection (HP) as less than 5% of adolescents uses HP in
noisy situations.[7,8] Despite the high prevalence of noiseinduced symptoms after recreational noise exposure,
adolescents and young adults seem to have low awareness of
the possible risks[8,9] and preventive campaigns have yielded
only limited effects on the behavior of youngsters.[10] As a
result, other preventive measures are required and there is
clearly a growing need for sound level limitations during
music venues, in order to protect people from suffering
from hearing damage. In Flanders (the Dutch-speaking part
of Belgium), such legislation is already well established
Noise & Health, September-October 2014, Volume 16:72, 285-291
Gilles, et al.: Adolescents’ opinion towards loud music levels
in an industrial environment and compulsory protective
actions are required whenever workers are exposed to
noise over 85 dB(A) for 8 h a day. For recreational noise
environments, such legislation has been subject of debate
for several years but since January 2013, the government
also put forward new noise legislation for music venues,
indoor as well as outdoor. A music organization can apply
for an environmental license in three different categories. In
category 1 a maximal intensity level of 85 dB(A) LAeq, 15min
is permitted and sound measurements are not required in
this category. In category 2 sound levels are greater than
85 dB(A) LAeq, 15min but may not exceed 95 dB(A) LAeq, 15min
during the entire musical activity. Sound levels should be
measured at a representative location and a clear visual
indication of the sound levels to the person responsible for
playing the music should be provided. Finally, in category
3 sound levels are higher than 95 dB(A) LAeq, 15min but may
not exceed 100 dB(A) LAeq, 60min. This is the highest possible
category where intensity levels may reach up to 100 dB(A)
averaged over a period of 60 min. Output levels should be
constantly measured and monitored during the entire music
activity. Again a clear visual indication of the sound levels
to the person responsible is required and withal, the free
distribution of HP to the public is obliged. This legislation
was not warmly received by many organizations of music
venues, mainly because they feared a decrease of attendees
due to lower sound levels. The current study contained two
research parts. In the first part, which was conducted prior
to the new noise regulations, a practical pilot study was
performed exposing young people to sound levels below and
above 100 dB(A) LAeq, 60min while asking for their opinions
concerning the noise levels in both situations in order to
reveal their opinions toward lower and higher sound levels
at music venues. Previous research revealed that attitudes
toward noise and the use of HP play a role in the actual
behavior of using HP in noise situations.[8,11] However, the
use of HP is very low considering the high prevalence of
noise-induced symptoms. Therefore, the second research
part, conducted in February 2013, consisted of an online
questionnaire assessing noise-induced symptoms, the
attitudes toward more strict noise regulations, frequency of
attendance at open air and indoor musical events, and the
reasons why adolescents and young adults do (not) use HP
in noisy situations.
Methods
Research part 1
The study was conducted in a youth club in November 2012,
thus prior to the noise legislation. The owner of the youth
club was well informed as well as the regular in-house DJ
who cooperated in the study. Forty-one young adults of
which 26 were females and 15 were males, voluntarily
participated in the study (mean age = 19.2 years, standard
deviation [SD] = 2.1 years). The DJ was asked to keep the
Noise & Health, September-October 2014, Volume 16
volume below 100 dB(A) LAeq, 60min for 2 consecutive hours.
Output levels were measured at a referential place (middle
of the room) by use of a portable dosimeter (Casella USA,
dBadge Micro Noise Dosimeter Kit) and a level of 98 dB(A)
LAeq, 60min was registered. After that the DJ was told to play
music at the level he usually does at this particular youth
club. Sound levels were again measured and a noise level
of 103 dB(A) LAeq, 60min was registered. At the beginning of
the evening, all participants underwent a short interview
performed by the same interviewer. First, it was assessed
whether they had knowledge of the new noise legislation
(yes-no) and whether they were positive, negative or neutral
toward such a measure. In accordance with Weichbold
and Zorowka (2005) it was asked what the opinion of
the adolescents was concerning the intensity levels at
discotheques.[12] The answer possibilities were (a) noise
levels should be raised, (b) noise levels should be lowered
and (c) noise levels should stay the same. In addition, it was
assessed whether, in case of a slight decrease of intensity
levels at music events, adolescents would go out (a) more
often, (b) as often as now and (c) somewhere else where
the noise levels are higher. Furthermore, when assessing
HP use, one had to confirm one of following sentences: ‘I
usually wear HP’, or ‘I usually do not wear HP’. In case
when adolescents used HP they had to report whether it
was universal HP or custom made HP. After approximately
30 min, the participants were asked whether they considered
the current noise levels (98 dB(A) LAeq, 60min) (a) too loud,
(b) too quiet or (c) perfect. After the volume was raised to
103 dB(A) LAeq, 60min the adolescents were asked the same
question a second time.
Research part 2
During the month of February 2013, an online questionnaire
was filled out by 749 adolescents and young adults (age
range = 13-25 years old; mean age = 19 years old, SD = 3 years)
of which 198 male and 551 female participants. In order to
reach as much as young people as possible, the link to the
questionnaire was published online and promoted on social
media such as Facebook. In addition, 10 high schools and
five colleges cooperated in the study and published the link
to the questionnaire on their official websites. A first section
concerned the frequency of attendance at musical events.
For all questions a distinction between indoor (e.g., youth
club, night club) and outdoor (e.g., festival) activities was
made. The frequency of attendance for both categories was
questioned as well as the opinion toward the current intensity
levels at such events. In addition, it was questioned how often
they experienced following symptoms after recreational
noise exposure: Hearing loss, “stuffy ears”, tinnitus, balance
problems, ear pain, and hyperacusis. Answer possibilities
were always (100%), often (75%), sometimes (50%), seldom
(25%) and never (0%). In accordance with the previous
research part, it was assessed whether one was aware that
new noise legislation came into force. Irrespective of the
286
Gilles, et al.: Adolescents’ opinion towards loud music levels
answer to the latter question, it was asked whether one was
positive or negative toward this new regulation. In addition,
one had to indicate a top three (1 = main reason) of reasons
why one held a positive or a negative attitude toward the
noise legislation. The next question was also similar to one in
the previous research part: “Now we have more strict noise
regulations, how often would you go to a youth club or night
club?” The same question was asked for outdoor musical
activities. Answer possibilities were:
a. I would go out less,
b. I would go out as often as before,
c. I would go out more often.
The second section of the questionnaire concerned the use
of HP in adolescents and young adults. First was evaluated
how often (always [100%], often [75%], sometimes [50%],
seldom [25%] and never [0%]) one used HP in noisy
environments where again a distinction was made for
indoor and outdoor activities and whether one used HP of
the universal type or custom made. When one indicated not
to use HP, a list of possible reasons was given and one had
to select a top three of reasons why one does not use HP.
In the opposite case, one had to select a top three why one
does use HP. The given reasons for using/not using HP are
depicted in Figures 1 and 2.
Results
Research part 1
The answers of all participants during the interview are listed
in Table 1. Almost half of the students were informed that
new noise legislation would be in force in the future. Most
students reported to be satisfied with the current noise levels in
discotheques (in November 2012). However, more than 70%
held a positive attitude toward a more restrictive measure.
Eight out of the 41 students usually uses HP. Nevertheless,
at the time of the interview, only four students actually wore
HP. Figure 1 illustrates the opinion towards the noise levels
at the music venue. During the first 2 h a noise level of 98
dB(A) LAeq, 60min was measured. At that time, 85.4% of the
students considered the noise levels as “perfect”, 12.2%
thought the music was “too loud” and 2.4% thought it was
“too quiet”. When the noise level was raised to 103 dB(A)
LAeq, 60min and students were asked for their opinion again, only
48% still thought the noise level was “perfect” and 51% now
considered the music as “too loud”.
Research part 2
Table 2 provides all answers of the respondents. The
visiting rate of discotheques was quite high as 42%
regularly (every 2 weeks or more) attend in night clubs.
More than half of the students (55.3%) rated the noise
levels at these occasions as too loud and the other half
(43.4%) thought that the levels should remain the same.
Slightly other results were seen for festivals and open
air activities. First, the attendance of festivals is much
Table 1: Answers of the 41 participants during the interview
Questionnaire item
Informed about new noise regulation
Yes
No
Opinion toward new noise regulation
Negative
Positive
No opinion
Opinion discotheque levels
Should be raised
Should be lowered
Should stay the same
Party behavior after more strict regulation
Would go out more often
Would go out as often as now
Would go somewhere else where the noise
levels are higher
Use of HP
I usually wear HP
I usually do not wear HP
% (n = total of participants)
43.9 (18)
56.1 (23)
19.5 (8)
70.7 (29)
9.8 (4)
4.9 (2)
24.4 (10)
70.7 (29)
4.9 (2)
90.2 (37)
4.9 (2)
19.5 (8)
80.5 (33)
HP = Hearing protection
Figure 1: Opinion toward the noise levels of 41 young adults
during a music event at a youth club
287
Figure 2: Frequency of reasons given for using hearing protection
among 749 adolescents and young adults
Noise & Health, September-October 2014, Volume 16
Gilles, et al.: Adolescents’ opinion towards loud music levels
Table 2: Reponses of 749 adolescents and young adults on the
online questionnaire
Questionnaire items
% (n = total of
participants)
Frequency youth club, party hall or discotheque
attendance
1× a week
>1× a week
Every 2 weeks
Monthly
Less than monthly
Frequency festival/open air activity
<1× during season
1× during season
2× during season
3× during season
4× during season
5× during season
>5× during season
Opinion youth club, party hall and discotheque noise
levels
Should be raised
Should be lowered
Should stay the same
Opinion festival/open air activity noise levels
Should be raised
Should be lowered
Should stay the same
Informed about new noise legislation
Yes
No
Opinion towards new noise legislation
Negative
Positive
Party behavior after more strict regulation
(discotheque)
Would go out more often
Would go out as often as now
Would go out somewhere else where the noise
levels are higher
Party behavior after more strict regulation (festival)
Would go out more often
Would go out as often as now
Would go out somewhere else where the noise levels
are higher
Frequency of hearing protection use (disco) (%)
Always (100)
Often (75)
Sometimes (50)
Seldom (25)
Never (0)
Frequency of hearing protection use (festival) (%)
Always (100)
Often (75)
Sometimes (50)
Seldom (25)
Never (0)
Type hearing protection
Universal
Custom made
Noise & Health, September-October 2014, Volume 16
21.2 (159)
8.8 (66)
12.1 (91)
20.7 (155)
37.1 (278)
34.3 (257)
24.4 (183)
20.2 (151)
12.3 (92)
3.5 (26)
1.5 (11)
3.9 (29)
1.3 (10)
55.3 (414)
43.4 (325)
3.3 (25)
35.4 (265)
61.3 (459)
45.9 (344)
54.1 (405)
18 (134)
82 (612)
8.8 (66)
85.7 (642)
5.5 (41)
8.5 (64)
83.6 (626)
7.9 (59)
lower as most students only visit one festival during the
summer period. In addition, the noise levels are rated more
comfortable as 61% says that the noise levels should remain
the same. As shown in Table 3, the prevalence of noiseinduced symptoms at indoor as well as outdoor musical
events is quite high, especially when looking at tinnitus,
hearing loss and “stuffy ears”. In addition, approximately
half of the respondents had knowledge concerning the
new noise legislation and 82% held a positive attitude
toward a more strict noise regulation. Furthermore, the
lowering of noise levels at musical venues, indoor as well
as outdoor activities would not change the party behavior
of adolescents and 85.7% would go out as much as now.
Interestingly, a high rate of HP use was found as 11.9%
always uses HP at night clubs and even 20% uses HP
at festivals. Figure 2 illustrates adolescents’ reasons for
using HP. Looking at the most chosen primary reasons the
main three reasons were:
1. To prevent noise-induced hearing symptoms;
2. I think it is important to protect my hearing;
3. The music is often too loud.
The most chosen primary reasons for not using HP, as
illustrated in Figure 3, were:
1. I never thought about using it;
2. I am seldom in noisy situations;
3. I forget to use it. In addition, a fourth important reason
is that HP is considered as uncomfortable by many
adolescents.
Discussion and Conclusions
The question whether sound levels at music venues should
be lowered has been under debate for quite a time. The
present study, assessing adolescents’ opinion towards
music noise levels at social activities, showed that
adolescents and young adults do not necessarily require
such excessive noise levels as Mercier and Hohmann
(2002) also previously stated.[13] The present study also
11.9 (89)
13.2 (99)
10.1 (76)
7.5 (56)
57.3 (429)
20.3 (152)
15.6 (117)
6.4 (48)
3.3 (25)
54.3 (407)
82 (287)
18 (63)
Figure 3: Frequency of reasons given for not using hearing
protection among 749 adolescents and young adults
288
Gilles, et al.: Adolescents’ opinion towards loud music levels
Table 3: frequency of noise-induced hearing symptoms after
recreational noise exposure in 749 adolescents and young adults
Experience of noiseinduced symptoms
Youth club/party
hall/discotheque
Hearing loss
“Stuffy ears”
Tinnitus
Imbalance
Ear pain
Hyperacusis
Festival/open air
activity
Hearing loss
“Stuffy ears”
Tinnitus
Imbalance
Ear pain
Hyperacusis
Always
(100%)
Often Sometimes Seldom Never
(75%)
(50%)
(25%) (0%)
3.5
6.8
14.8
0.8
1.3
3.9
11.1
21.0
21.4
0.9
4.1
7.9
19.6
24.0
25.8
6.7
14.4
14.3
31.4
24.8
24.3
11.1
23.2
21.6
34.4
23.4
13.8
80.5
56.9
52.3
3.2
3.2
9.1
0.9
1.2
3.1
6.5
10.1
13.0
0.9
3.2
4.8
14.6
19.9
21.0
5.1
10.9
11.2
27.5
28.7
26.3
10.4
20.0
20.2
48.2
38.1
30.7
82.6
64.6
60.7
found that most young people show a positive attitude
toward a more strict noise regulation and that their party
behavior would not be altered by such measure. Moreover,
it appears that many young people often consider the sound
levels as too loud, while going out. In the first research
part, approximately 86% of the participants considered 98
dB(A) LAeq, 60min as a perfect intensity level during a party.
When the noise level was raised up to 103 dB(A) LAeq, 60min,
half of the students considered this level as too loud.
Nevertheless, 49% still rated such a loud level, which may
cause serious hearing damage after prolonged exposition,
as “perfect”. Adolescents’ attitudes toward noise may
account for this perception. Most adolescents and young
adults have positive or neutral attitudes toward loud noise
exposure, which means they do not see loud music as
something dangerous, but rather as something “normal” in
today’s society.[8,14-16] Many adolescents and young adults
often perceive noise-induced symptoms such as tinnitus
after loud music exposure, but most do not consider this
as “alarming” and think they would not develop hearing
loss until at a later age.[17] One possible way to alter such
perceptions toward loud music is preventive campaigns
focusing on the risks of highly amplified music.[18]
Previous research has revealed that the model of the
theory of planned behavior might provide a theoretical
framework to predict and alter human health behavior.[11]
According to this model, by use of preventive campaigns,
attitudes toward noise and HP can be altered resulting into
an increase of HP use.[19]
The authors would like to remark that the order of the
intensity of music presentation in the present study might
influence the opinion towards the sound levels. As such,
also the opposite presentation- first 103 dB(A) LAeq, 60min
and afterwards 98 dB(A) LAeq, 60min- should have been
performed, but this idea was not supported by the DJ. In
289
addition, this part of the study comprised the participation
of only 41 subjects. As a result, interpretations should be
made with caution. However, in the second research part,
a survey was posted online reaching 749 young people
showing that also in this group half of the respondents
were familiar with the new noise legislation and 82% had a
positive attitude toward such a measure. In this population
almost 55% reported the sound levels at discotheques as
too loud whereas only 35% thought the same of festivals.
In accordance to the first research part, 85% reported that
their party behavior would not be altered as a result of
more strict noise regulations. The fact that adolescents
support more strict noise regulations, which intend to
protect their hearing, evokes some confusion. Despite of
previous studies finding that the majority of adolescents
are well aware of the possibly damaging risks of loud
music exposure[7,17] the use of HP has been proven to be
very low nonetheless.[7,8,16,20] Such findings are surprising
considering the high prevalence of noise-induced symptoms
such as tinnitus, hearing loss and hyperacusis after leisure
noise exposure.[8,21-23] In the present study, the use of HP
was almost double as high at outdoor activities such as
festivals (20.3% always uses HP) compared with indoor
activities such as discotheques (11.9% always uses HP).
Such a distinction between indoor and outdoor activities
was also made by Widén et al. (2009), but the use of HP
was much lower compared with the present study as there
was 3% of the participants using HP at open air festivals/
concerts and 0% used HP at youth clubs/discotheques.
There are probably multiple reasons for these differing
findings. First, it is possible that attitudes toward noise and
HP differ between countries because of cultural and social
factors. For example, Widén et al. (2006) compared the use
of HP in Swedish and US young adults aged 17-21 years
old. Swedish students were almost 13 times more likely
to use HP at concerts compared to US students (61.2% of
the Swedish students used HP compared with 9.5% of the
US students).[24] However, this difference was more due
to the difference in attitudes towards noise and especially
toward elements concerning youth culture (such as sound
levels at discotheques) and not to the variable “country”.
[24]
Second, the timing of interrogating adolescents may
be a very crucial factor as the attitudes toward noise and
HP are probably subject to temporary factors such as
preventive campaigns. In the case of Widén et al. (2006),
preventive campaigns focusing on the risks of hearing
damage caused by loud music exposure preceded the
study where in the US such campaigns have been mainly
targeting industrial environments. Recently in Belgium,
similar results were found as the use of HP increased
fourfold after an informational campaign.[19] However, the
long-term effects of such behavioral changes are unknown
and it is well possible that the use of HP returns to baseline
in the absence of preventive campaigns presented on a
regular basis. Nevertheless, the present study also focused
on the reasons why or why not young people use HP in
Noise & Health, September-October 2014, Volume 16
Gilles, et al.: Adolescents’ opinion towards loud music levels
noisy situations. The reasons for not using HP are quite
similar to those found by Crandell et al. (2004) who also
found that HP is mainly seen as inconvenient, one forgets
to use it and many never even thought about it.[20] The fact
that HP is often considered as uncomfortable probably has
multiple reasons. Most often universal HP is used, which
is assumed to fit for everyone. However, in smaller ear
canals the HP does not fit which might cause discomfort
as a result of pressure and occlusion of the ear canal. On
the contrary, in larger ear canals the HP will not stay in
place and the ear plugs tend to fall out, which also causes
discomfort and the need for frequent reinsertion may lead
to the cessation of HP use. Properly made custom HPs
can reduce discomfort in many cases. In addition, some
individuals may benefit from special musician’s earplugs
that include special filters, which can maintain the music
quality as opposed to universal HPs, which might distort
sounds.[25]
Address for correspondence:
Dr. Annick Gilles,
Department of Otorhinolaryngology and Head and Neck
Surgery, Antwerp University Hospital, Wilrijkstraat 10,
Edegem 2650, Belgium.
E-mail: annick.gilles@uza.be
References
1.
2.
3.
4.
5.
Some extra information was found by also asking why one
does use HP. Although the main reason was to prevent
noise-induced hearing damage, it was also clear that many
students used HP because they already experienced noise
damage in the form of hearing loss, tinnitus or hyperacusis
and they want to prevent further damage. As shown in
Table 3, temporary noise-induced hearing symptoms are
quite prevalent after recreational noise exposure. These
findings hold useful information for future preventive
campaigns, which should not only focus on the long-term
effects of recreational noise but should more carefully
consider the short term symptoms such as hearing loss,
tinnitus and hyperacusis in order to make young people
more aware of the risks. As temporary symptoms are
often seen as a “normal” condition after noise exposition
by adolescents,[8] future campaigns should underline the
importance of temporary symptoms as a warning signal
for possible permanent damage. Demonstration of a
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which may not recover some day. To date, it is unclear,
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HP, which is obliged for venues originating in category
3 and the display of sound levels visible to the public
with information on the risks of amplified music might
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noise-induced damage in adolescents but further research
is required.
Noise & Health, September-October 2014, Volume 16
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How to cite this article: Gilles A, Thuy I, De Rycke E, de Heyning PV. A
little bit less would be great: Adolescents’ opinion towards music levels.
Noise Health 2014;16:285-91.
Source of Support: Nil, Conflict of Interest: None declared.
Noise & Health, September-October 2014, Volume 16