MP3 Generation: Noise-induced hearing loss rising among children and adolescents

With the increasing use of iPods and other MP3 players, more and more children and adolescents are putting their hearing at risk. Prior to the introduction of MP3 players, hearing loss among children was estimated at around 12.5 percent. More recent studies, however, estimate that 16 percent of teenagers, or approximately 6 million children, suffer from permanent noise-induced hearing loss (NIHL).

And the problem may only get worse. “We are still in the infantile stages of NIHL,” said Roland D. Eavey, MD, director of the Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences at the Vanderbilt University School of Medicine in Nashville, Tenn. “It is a little like where we were with smoking in the early 1940s. Everyone thought it was glamorous, and soldiers were given cigarettes in their K-rations.” As with cigarette smoking, “after a while it is going to become painfully obvious that use of MP3 players is damaging, and it will be too late to reverse the hearing loss,” he said.

NIHL is already a problem for many baby boomers weaned on rock concerts. “The baby boomer generation has 26 percent more hearing loss than that of the senior population,” noted Marcella Bothwell, MD, chair of the Pediatric Airway and Aerodigestive Team at Rady Children’s Hospital of San Diego.

So where do otolaryngologists fit into this issue? Experts interviewed by ENT Today agreed that otolaryngologists need to not only screen children and adolescents for hearing loss but also educate them about causes of NIHL.

Lack of Awareness

At the heart of the problem is a lack of awareness among adolescents that their music listening behavior may have dire long-term consequences. To measure the pulse of American adolescents, Dr. Eavey and colleagues conducted a Web-based survey in 2002 and then repeated the survey five years later to see if attitudes about loud music had changed. The two surveys wereconducted through Music Television’s Web site (

The first survey, which included analysis of 9,693 Web surveys, found that only 8 percent of respondents felt that hearing loss related to listening to loud music was “a very big problem.” Adolescents consistently rated other health issues as bigger problems than hearing loss: sexually transmitted disease, 50 percent; drug/alcohol use, 47 percent; depression, 44 percent; nutrition and weight loss, 31 percent; and even acne, 18 percent (Pediatrics. 2005;115(4):861-867).

The first survey was notable, Dr. Eavey told ENT Today, because most of the respondents said they had experienced tinnitus or hearing impairment after attending a concert (61 percent) or going clubbing (43 percent). At the time of the survey, only 14 percent of respondents had used earplugs. When asked if they would consider wearing ear protection if they were aware of the potential for permanent hearing loss, 66 percent of the respondents said yes, while 59 percent said they would do so if advised by a medical professional.

We should be asking all our patients about their listening habits: Do you listen to an iPod? Are you aware that listening to your iPod at high volumes can cause permanent hearing loss? We have that responsibility.
—Marcella Bothwell, MD

Enter the MP3 Player

At the time of the first MTV survey, “MP3 players were not even on the radar screen,” noted Dr. Eavey. Apple first introduced the iPod in October 2001. As of September 2009, Apple reported that close to 225 million iPods had been sold and that they controlled 74 percent of the market share in personal music players. Introduced with the iPod were “ear buds,” earphones that direct music straight into the ear canal.