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
Noise
Work-related
hearing loss
Leisure-related
hearing loss
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
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
Workplace Noise Limits
85 dB
for
8 hours
88 dB
for
4 hours
91 dB
for
2 hours
94 dB
for
1 hour
97 dB
for
30 min
100 dB for
15 min
= 1 ADE
(acceptable daily
exposure)
Noise levels in leisure
activities
Average noise level (dB)
Leisure noise exposure
on a typical night out
Noise level: 100 dB for 4 hours = 16 ADEs
114 dB
Enter
Club A
89 dB
Enter
Club B
106 dB
85 dB
Enter
Club C
104 dB
64 dB
9:34pm
1:42am
Binge Listening
14
12
Lucas
Luca
ADEs
8
Workplace
Limit
6
6
4
2
2
0
0
Tue Wed Thu Fri
Tue Wed Thu
Sat Sun Mon
14
Fri
Sat Sun Mon
14
12
Brad
Tina
10
ADEs
10
ADEs
8
4
12
Rebecca
10
10
ADEs
12
14
8
8
6
6
4
4
2
2
0
0
Tue Wed Thu Fri
Sat Sun Mon
Tue Wed Thu Fri
Sat Sun Mon
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!
70
42-year old with accumulated
noise-exposure of a 60 year-old
Work
60
Music
Concerts
Exposure (aye)
50
Work+Music+Concerts
40
30
20
10
0
15
25
35
45
55
65
Age (years)
Williams, 2008
Level x time x regularity = exposure
Annual noise dose
Current ef f ect: F(4, 3996)=200.14, p=0.0000
Vertical bars denote 0.95 conf idence interv als
0.5
0.4
0.3
0.2
Annual noise dose (AYE
0.1
0.0
Sport
Gym
Pub
Nightclub / dance
Concert
ACTIVITY
MP3 player
Attendance at night clubs / dance parties
200
180
160
140
120
100
80
No of people
60
40
20
0
>1 per week
every 2
1 per month
every
every
1 or 2 per y
<1 per year
1 per week
never
Q2_5 Go to a night club or dance-music venue
200
180
160
60
40
20
No of people
120
>1 per week
>1 per week
>1 per week
1 per week
>1 per week
1 per week
every 2 to 3 weeks
1 per month
>1 per week
1 per week
never
1 per month
every
Q2_2 Visit a pub or registered club
1 per week
every 2 to 3 weeks
1 per month
never
20
0
83 dB
Pub/club
Q2_4 Go to a concert or live music venue
1 per week
every 2 to 3 weeks
1 per month
Q2_3 Attend a fitness class set to music
260
60
<1 per year
No of obs
140
<1 per year
No of obs
280
180
160
140
120
40
160
20
0
180
160
400
300
240
220
200
80
1 or 2 per year
<1 per year
60
No of obs
40
120
100
<1 per year
1 or 2 per
every
1 per month
never
1 or 2 per year
0
1 or 2 per year
100
every 2 to 3 months
never
80
84 dB
Concert
100
92 dB
Gym with music
200
every 2 to 3 months
0
every 2 to 3 months
500
every 2 to 3 months
20
every
40
every 4 to 6 months
60
every 4 to 6 months
80
No of obs
100
every 4 to 6 months
120
every 4 to 6 months
140
1 or 2 per year
200
Q2_1 Attend a live sporting event
93 dB
Sporting event
every 2 to 3 weeks
Q2_5 Go to a night club or dance-music venue
<1 per year
220
never
240
97 dB
Night-club / dance venue
140
100
80
260
0
Club sound levels during the evening
MP3 player use
Personal stereo players (PSP)
• Long term study
– Average level (LAeq)
– Average use per day
– Average exposure (LAeq,8h)
– Users potentially at risk
– Users seriously at risk
84 dB
~2:20 h:m
78 dB
23%
~4%
MP3 exposure levels
2003
2006
2009
MP3 daily noise doses
Total annual leisure exposure (5 activities)
200
747
180
160
140
120
121
100
13% get more than one year’s max
acceptable noise dose each year
80
Number of people
60
52
43
40
25
23
20
15
8
0
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3
3.5
3
1
4.0
4.5 0 5.0
Total yearly dose (AYE units)
1
5.5
1
6.0
6.5 0 7.0
Total annual leisure exposure (MP3 use)
60
50
40
30
24% get more than one year’s max
acceptable noise dose each year
20
10
Total yearly dose (aye units)
>=
10
9
8
7
6
5
4
3
2
1
0
0
Percent of people
70
Total annual leisure exposure (MP3 use)
Percent of people
16
+
14
12
10
43% get more than one year’s max
acceptable noise dose each year
8
6
4
2
0
0
1
2
3
4
5
6
7
8
Total yearly dose (aye units)
9
>=10
Does age and gender affect exposure?
Vertical bars denote 0.95 confidence intervals
0.9
Male
Female
0.8
0.7
0.6
0.5
0.4
0.3
Exposure total (AYE)
0.2
0.1
0.0
18-24
25-29
Age Group
30-35
Is exposure affecting self-rated hearing difficulty?
Current effect: F(2, 917)=3.7525, p=.02382
Vertical bars denote 0.95 confidence intervals
0.4
0.3
0.2
0.1
0.0
(population stand
Composite hearing
-0.1
-0.2
Low (<0.1 aye)
Medium (0.1 - 1 aye)
Exposure group
High (>1 aye)
Is MP3 player use affecting hearing difficulty?
Current effect: F(2, 917)=3.4196, p=.03314
Vertical bars denote 0.95 confidence intervals
0.5
0.4
0.3
0.2
0.1
0.0
(population s
Composite hea
-0.1
-0.2
None / not loud
Loud
MP3 player use
Very loud
Percentage of people
Do noise-exposed people perceive the risk to
their hearing from leisure noise?
40%
35%
Low activity exposure
Mid activity exposure
High activity exposure
30%
25%
20%
15%
10%
5%
0%
No risk
Very
small
Small
Medium
Large
Self-perceived risk to hearing
Very
large
Percentage of people
Do noise-exposed people perceive the risk to
their hearing from MP3 exposure?
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
Low MP3 exposure
Mid MP3 exposure
High MP3 exposure
No risk
Very
small
Small
Medium
Large
Self-perceived risk to hearing
Very
large
Percentage of people
Do noise-exposed people perceive the risk to
their hearing from leisure sound exposure?
40%
35%
Low exposure
Mid exposure
High exposure
30%
25%
20%
15%
10%
5%
0%
No risk
Very
small
Small
Medium
Large
Self-perceived risk to hearing
Very
large
Is it permanent?
Once your hearing is damaged it cannot ever be restored to its original state (Q7b)
450
42%
400
350
300
26%
250
21%
200
No of people
150
100
50
9%
3%
0
Strongly disagree
Disagree
Don't know
Strongly agree
Agree
These days, if you damage your hearing, the medical profession can bring it back to its original state
(Q7i)
450
41%
400
350
33%
300
250
200
17%
No of people
150
100
8%
50
1%
0
Strongly disagree
Disagree
Don't know
Strongly agree
Agree
There is reasonable awareness about noise
and hearing loss
Awareness of
Risk:
Noise Causes
Damage
Awareness of
Hearing loss:
Damage is
permanent
• 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)
• 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)
Reported Behaviour
Stages of Change
Loud noise
doesn’t bother
me. I like my
music loud.
I think loud
noise/music can
permanently
damage hearing
Going deaf is
something old
people to have to
deal with.
- but I don’t take
any action to
avoid it
14%
Sometimes after
I worry about
loud noise/music
short and long
I get ringing in
term effects of
my ears.
loud noise/music
It worries me a
bit, until it goes
away
48%
I try to avoid
and/or limit my
exposure.
39%
Exposure varies between behaviour
groups
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