That hearing can be damaged as a result of excessive levels of noise is not a recent phenomenon. Noise induced hearing loss has long been associated with traditional industries such as shipbuilding and coal-mining, amongst many others.

However, there is a new, even more widespread, cause of noise induced hearing loss which is affecting, and will affect, the present generation – that of ‘unsafe listening practices from personal listening devices (PLDs) and loud entertainment venues’.

This Study

Hearing loss is a growing global health concern, affecting over 430 million people worldwide. Without effective prevention, it is thought that this number could double in the coming decades.  Among the major causes of preventable hearing loss is exposure to loud noise, particularly from PLDs (like phones and headphones) and entertainment venues (such as clubs, concerts, and bars).  This recent study published in BMJ Global Health[1] has revealed alarming statistics about how common these unsafe listening habits are, particularly among adolescents and young adults.

The study, which analysed data from 33 research papers involving over 19,000 participants across 20 countries, found that nearly one in four young people (23.81%) listen to personal devices at volumes that could harm their hearing.  Further, almost half (48.20%) of those who attend loud entertainment venues are exposed to unsafe noise levels.

It is these habits which put an estimated 0.67 to 1.35 billion people aged 12 - 34 at risk of hearing loss worldwide.

The Problem

Exposure to excessive noise has long been known to have the potential to harm the delicate structures in the ear, such as the hair cells and nerve connections in the cochlea, which are essential for hearing. Whilst initial effects may be temporary, repeated or prolonged exposure often leads to permanent hearing loss.  It follows that young people who frequently expose themselves to loud sounds may accelerate hearing problems as they age, leading to difficulties much earlier in life than otherwise.  This pattern of damage mirrors occupational NIHL, although the source of the noise differs.

Beyond the more obvious health implications, the study also notes that hearing loss can have significant social and economic effects. For young people, it can negatively affect academic performance, reduce concentration, and limit future job opportunities. For adults, it is linked to poorer mental well-being, reduced income, and even cognitive decline. The financial costs are vast, with untreated hearing loss estimated to cost nearly $1 trillion annually.

Where Do These Risks Come From?

PLDs are a significant source of the problem. Many people unknowingly set their devices to unsafe volumes - sometimes as loud as 105 decibels, which exceeds safe limits even for short periods. Similarly, loud entertainment venues often expose attendees to noise levels between 104 - 112 dB, far exceeding what is considered safe. 

Over the years, I have dealt with a number of NIHL cases involving bar staff and the like – some entertainment venues are well-known to have noise levels comparable to, or even in excess of, the local factory.

The World Health Organization (WHO) considers that listening to 80 dB is considered safe for up to 40 hours a week, but exposure to 92 dB is only safe for about 2.5 hours a week. Many young people far exceed these thresholds, often without realizing the risks.

How Can This Be Prevented?

Clearly, hearing loss from noise exposure is preventable. The WHO has launched initiatives like "Make Listening Safe" to help reduce unsafe listening habits. These efforts focus on educating the public about safe listening practices, such as:

Keeping the volume of personal devices below 60% of maximum levels.

Using noise-cancelling headphones to avoid the need for high volumes in noisy environments.

Limiting time spent in loud environments like concerts or clubs.

Wearing ear protection, such as earplugs, at noisy events.

The WHO has also developed global standards for safe listening devices and venues. For example, they recommend that manufacturers include features like volume-limiting options and warnings for excessive exposure. Similarly, entertainment venues are encouraged to monitor and limit noise levels to protect those attending.

What Should Happen Next?

While the study provides valuable insight, it also highlights gaps in the understanding. Most of the research included in the analysis came from high and middle-income countries, leaving low-income regions underrepresented. This means the actual global impact of unsafe listening could be even greater than the current estimates suggest.

There is also a lack of standardized methods to measure and define unsafe listening.  Many studies use different criteria, making it harder to compare results or draw consistent conclusions.  I note this problem is similar to research in industrial disease fields such as vibration exposure.  Ideally, any future research should adopt global standards to provide more reliable data.

The Need for Action

Hearing loss is often gradual and invisible, making it easy to ignore until it is too late. This study chimes with my own experience – that people may have something of a relaxed attitude to noise exposure in their younger years, but later regret it.

This study serves as something of a wake-up call, with potentially over a billion young people at risk. Small changes - like turning down the volume or wearing earplugs at a concert - can make a big difference in preventing this preventable form of hearing loss.

Conclusion

The conclusion from the report speaks for itself:

“Unsafe listening practices are highly prevalent worldwide and may place over 1 billion young people at risk of hearing loss. There is an urgent need to prioritise policy focused on safe listening. The World Health Organization provides comprehensive materials to aid in policy development and implementation.”

[1] Dillard, L. K., Arunda, M. O., Lopez-Perez, L., Martinez, R. X., Jiménez, L., & Chadha, S. (2022). Prevalence and global estimates of unsafe listening practices in adolescents and young adults: a systematic review and meta-analysis. BMJ Global Health, 7(11), e010501.  https://doi.org/10.1136/bmjgh-2022-010501