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Original Investigation
August 2018

Association Between Portable Music Player Use and Hearing Loss Among Children of School Age in the Netherlands

Author Affiliations
  • 1Department of Otolaryngology and Head–Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
  • 2The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
  • 3Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
  • 4Department of Paediatrics, Erasmus University Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands
  • 5Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
JAMA Otolaryngol Head Neck Surg. 2018;144(8):668-675. doi:10.1001/jamaoto.2018.0646
Key Points

Question  What is the prevalence of noise-induced hearing loss among children aged 9 to 11 years in the Netherlands?

Findings  In this cross-sectional, population-based study among 3316 children with normal middle-ear function, audiometry data showed the prevalence of audiometric notches and high-frequency hearing loss was 14.2%. Portable music players, used by 40.0% of the cohort, were associated with high-frequency hearing loss.

Meaning  Signs of noise-induced hearing loss may already be present in children aged 9 to 11 years old and may be associated with portable music player use prior to exposure to known noise hazards, such as club and concert attendance.

Abstract

Importance  Portable music player use may have harmful effects on hearing. The magnitude and effect of frequent music exposure, especially at younger ages, on hearing are unclear.

Objectives  To examine the prevalence of noise-induced hearing loss in a 9- to 11-year-old population and associations with portable music player use and sociodemographic factors.

Design, Setting, and Participants  A cross-sectional study within an ongoing, prospective, birth cohort study within Rotterdam, the Netherlands was conducted. Between ages 9 and 11 years, 5355 children underwent their first audiometric evaluation. Children were excluded if they had missing or failed tympanometry results. The study was conducted from April 16, 2012, to October 25, 2015.

Exposures  Portable music player (PMP) use and sociodemographic factors assessed via parental questionnaires.

Main Outcomes and Measures  Hearing acuity measured by pure-tone audiometry at 0.5 to 8 kHz. Possible noise-induced hearing loss was contingent on a high-frequency notch and/or high-frequency hearing loss in the audiogram, or reported hearing-related symptoms.

Results  The final sample included 3116 participants who were a mean (interquartile range) age of 9.7 (9.6-9.9) years and equally distributed between boys (1550 [49.7%]) and girls (1566 [50.3%]). Of these, 1244 (39.9%) reported no PMP use, 577 (18.5%) reported use 1 or 2 days per week, 254 (8.2%) reported use 3 or more days per week, and for 1041 (33.4%), PMP use was not reported. Audiometric notches and high-frequency hearing loss were present in 443 (14.2%) of all children; 140 (4.5%) fulfilled the criteria of a notch, 238 (7.6%) of high-frequency hearing loss, and 65 (2.1%) of both. Of the cohort, 52 (1.7%) showed bilateral impairment. Hearing-related symptoms were reported for 232 (11.3%) of the respondents, and 831 (40.0%) of the respondents used portable music players. Portable music player use was associated with high-frequency hearing loss (odds ratio [OR], 2.88; 95% CI, 1.36-6.980 for 1 or 2 days per week and OR, 2.74; 95% CI, 1.22-6.96 for ≥3 days per week), but listening time and duration were not. There was no association of music exposure with high-frequency notches.

Conclusions and Relevance  In this study, 14.2% of school-aged children showed audiometric notches or high-frequency hearing loss. This hearing impairment is already present prior to exposure to known noise hazards, such as club and concert attendance, and may have lifelong consequences. Repeated measurements are needed to confirm the association of portable music player use with hearing impairment in children.

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