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

Binge ListeningIs 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 hearing loss

Noise

Work-related hearing loss

Leisure-related hearing loss

Work-related

hearing loss

Leisure-related

hearing loss

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 dBVERY LOUD

- Have to shout to be heard- Can cause permanent hearing loss

Workplace Noise Limits

85 dB for 8 hours

= 1 ADE

(acceptable daily exposure)

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

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

Enter Club A89 dB

Enter Club B106 dB

EnterClub C104 dB

114 dB

64 dB

85 dB

9:34pm 1:42am

Binge Listening

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-timeSound exposures add up!

0

10

20

30

40

50

60

70

15 25 35 45 55 65

Age (years)

Exp

osu

re (

aye)

Work

Music

Concerts

Work+Music+Concerts

42-year old with accumulated noise-exposure of a 60 year-old

Williams, 2008

Level x time x regularity = exposure

Annual noise doseC urrent e f f ec t : F (4, 3996)=200.14, p=0.0000

Vert ic a l bars denote 0.95 c onf idenc e interv als

Sp o rtPu b

GymC o n ce rt

N ig h tclu b / d a n ceMP3 p la ye r

AC TIVITY

0 .0

0 .1

0 .2

0 .3

0 .4

0 .5

An

nu

al n

oise

do

se (A

YE

un

its)

Attendance at night clubs / dance parties

>1

pe

r we

ek

1 p

er w

eek

eve

ry 2 to

3 w

ee

ks

1 p

er m

on

th

eve

ry 2 to

3 m

onth

s

eve

ry 4 to

6 m

onth

s

1 o

r 2 p

er ye

ar

<1

pe

r year

ne

ver

Q 2_5 G o to a n ight c lub or dance-music venue

0

20

40

60

80

100

120

140

160

180

200

No o

f pe

op

le

Night-club / dance venue 97 dB

>1

per w

eek

1 p

er w

eek

eve

ry 2

to 3

wee

ks

1 p

er m

onth

eve

ry 2

to 3

mo

nth

s

eve

ry 4

to 6

mo

nth

s

1 o

r 2 p

er y

ear

<1

per y

ear

ne

ver

Q 2_5 G o to a night c lub or dance-music venue

0

20

40

60

80

100

120

140

160

180

200

No o

f pe

ople

Sporting event 93 dB

>1

pe

r we

ek

1 p

er w

ee

k

eve

ry 2

to 3

we

eks

1 p

er m

on

th

eve

ry 2

to 3

mo

nth

s

eve

ry 4

to 6

mo

nth

s

1 o

r 2 p

er y

ea

r

<1

pe

r ye

ar

ne

ve

r

Q 2_1 Attend a live sporting event

0

20

40

60

80

100

120

140

160

180

200

220

240

260

No

of o

bs

Gym with music 92 dB

>1

per w

eek

1 p

er w

eek

eve

ry 2

to 3

wee

ks

1 p

er m

onth

eve

ry 2

to 3

mo

nth

s

eve

ry 4

to 6

mo

nth

s

1 o

r 2 p

er y

ear

<1

per y

ear

ne

ver

Q 2_3 Attend a fitness class set to music

0

100

200

300

400

500

No o

f ob

s

Concert 84 dB

>1

per w

eek

1 p

er w

eek

eve

ry 2

to 3

wee

ks

1 p

er m

onth

eve

ry 2

to 3

mo

nth

s

eve

ry 4

to 6

mo

nth

s

1 o

r 2 p

er ye

ar

<1

per ye

ar

ne

ver

Q 2_4 G o to a concert or live music venue

0

20

40

60

80

100

120

140

160

180

200

220

240

260

280

No o

f ob

s

Pub/club 83 dB

>1

pe

r we

ek

1 p

er w

ee

k

eve

ry 2

to 3

we

eks

1 p

er m

on

th

eve

ry 2

to 3

mo

nth

s

eve

ry 4

to 6

mo

nth

s

1 o

r 2 p

er y

ea

r

<1

pe

r ye

ar

ne

ve

r

Q 2_2 Vis it a pub or reg istered c lub

0

20

40

60

80

100

120

140

160

No

of o

bs

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)

0

43

704

121

52

25

1523

83 1

0

3 1 100.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0

Total yearly dose (AYE units)

20

40

60

80

100

120

140

160

180

200

Num

ber of people

747

13% get more than one year’s max acceptable noise dose each year

0

10

20

30

40

50

60

70

0 1 2 3 4 5 6 7 8 9>=

10

Total yearly dose (aye units)

Per

cen

t o

f p

eop

leTotal annual leisure exposure (MP3 use)

24% get more than one year’s max acceptable noise dose each year

0

2

4

6

8

10

12

14

16

0 1 2 3 4 5 6 7 8 9 >=10

Total yearly dose (aye units)

Per

cen

t o

f p

eop

leTotal annual leisure exposure (MP3 use)

43% get more than one year’s max acceptable noise dose each year

+

Vertica l bars denote 0 .95 con fidence in te rva ls

18-24 25-29 30-35

Age G roup

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

Exp

osu

re to

tal (A

YE

)

M ale Female

Does age and gender affect exposure?

Curren t e ffect: F (2 , 917)=3 .7525, p=.02382

Vertica l bars denote 0 .95 con fidence in te rva ls

Low (< 0.1 aye) M edium (0.1 - 1 aye) High (>1 aye)

Exposure group

-0.2

-0.1

0.0

0.1

0.2

0.3

0.4

Co

mp

osite

he

arin

g d

ifficulty

(po

pu

latio

n sta

nd

ard

de

viatio

ns)

Is exposure affecting self-rated hearing difficulty?

Is MP3 player use affecting hearing difficulty?Curren t e ffect: F (2 , 917)=3.4196, p=.03314

Vertica l bars denote 0 .95 con fidence in te rva ls

None / no t loud Loud Very loud

M P 3 p layer use

-0 .2

-0 .1

0 .0

0 .1

0 .2

0 .3

0 .4

0 .5

Co

mp

osite

he

aring

difficu

lty(p

opu

latio

n sta

nd

ard

de

viation

s)

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

0%

5%

10%

15%

20%

25%

30%

35%

40%

Per

cen

tag

e o

f p

eop

le

No risk Verysmall

Small Medium Large Verylarge

Self-perceived risk to hearing

Low activity exposure

Mid activity exposure

High activity exposure

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

0%5%

10%15%20%25%30%35%40%45%50%

Per

cen

tag

e o

f p

eop

le

No risk Verysmall

Small Medium Large Verylarge

Self-perceived risk to hearing

Low MP3 exposure

Mid MP3 exposure

High MP3 exposure

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

0%

5%

10%

15%

20%

25%

30%

35%

40%

Per

cen

tag

e o

f p

eop

le

No risk Verysmall

Small Medium Large Verylarge

Self-perceived risk to hearing

Low exposure

Mid exposure

High exposure

Is it permanent?

Once your hea ring is damaged it canno t ever be res to red to its o rigina l s ta te (Q7b)

3%

9%

26%

42%

21%

Strongly disagreeD isagree

Don't knowAgree

S trongly agree0

50

100

150

200

250

300

350

400

450

No

of p

eo

ple

T hese days, if you damage your hearing, the medical pro fession can bring it back to its orig inal state (Q 7i)

17%

41%

33%

8%

1%

Strongly disagreeD isagree

Don't knowAgree

S trongly agree0

50

100

150

200

250

300

350

400

450

No

of p

eo

ple

There is reasonable awareness about noise and hearing loss

14% 48% 39%

Stages of Change

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