Overexposure to loud music, including on personal listening devices (PLDs), and unsafe listening practices are on the rise. According to the World Health Organization (WHO), over 1 billion people aged 12 to 35 years risk losing their hearing due to prolonged and excessive exposure to loud music and other recreational sounds. Last year, on World Hearing Day observed on March 3, the WHO chose the theme: ‘Changing mindsets: Empower yourself to make ear and hearing care a reality for all!’ This theme was aimed at encouraging individuals of all ages to recognise the importance of ear and hearing health; for behavioural changes such as protecting one’s hearing from loud sounds, regular hearing checks, practicing safe listening, and supporting those living with hearing loss.
Who is at risk?
Research shows that those with pre-existing hearing loss have a higher chance of worsening hearing loss, even more so when their device’s volume alert is not complied with. Other studies have shown that among users of PLD of more than four years, two-thirds who experienced ear ringing or buzzing sensations, or fullness, had hearing loss, and young adult PLD users with daily listening times of over 30 minutes and total listening times of 7 hours or more per week had significant differences in hearing thresholds of up to 8000 Hz frequencies. Higher frequencies were affected with prolonged listening periods at 70% or more of the device volume.
Loud sounds, however, do not necessarily have to be on personal listening devices. They can be at the workplace (occupational/industrial), environmental (vehicles), gardening equipment, music concerts and celebratory gatherings that use extra speakers.
How does hearing loss occur?
Loud noises can cause injuries to the delicate cells present in the inner ear, which are connected to the hearing nerve. The level of intensity of sound is measured in decibels (dB). Sounds when speaking during a normal conversation are around 50-60 dB. The safe upper sound level that does not cause injury to the inner ear cells is 75 dB. This listening level is safe for eight hours. If the sound level is increased, the safe exposure time is markedly reduced. When the sound goes above 85 dB, the safe listening time is halved with every increased 3 dB.
When loud is too loud
When the sound can be heard by someone standing very near the device-user, one can be sure that the sound is too loud for the user. Youngsters listen to sounds as high as 90-110 dB while listening to music. A person’s hearing can be damaged over time by any sound over 85 dB, a sound intensity level which is that of a food blender.
The volume setting is mentioned in percentages (60/%-100%), by default, on most devices. This output setting, as per WHO recommendations, is between 75-80 dB. This is considered to be equivalent to 60% on the volume setting. In devices bought in the United States, this default setting may not be activated.
Bluetooth devices
While no short-term harmful effects of bluetooth electromagnetic field exposure have been reported, caution while using bluetooth devices among children has been suggested. Similarly, those devices with a special feature filtering background noise (called ‘Active Noise Cancellation’ or ANC), have also been discouraged for use among children as in the long run, the use of such devices may cause children difficulties with understanding speech in noisy surroundings.
Recognising hearing loss
There may be no symptoms in the early stages of hearing loss. Sometimes, a ringing sound or roaring/buzzing sound may be heard by those affected. Affected persons may ask others to speak loudly or even take to staying away from social gatherings.
Noise-induced hearing loss is an added risk to an already damaged ear. Ageing, increased blood pressure and cholesterol levels, as well as diabetes can reduce blood flow to the inner ear, causing damage and hearing difficulties. Ear infections, measles and mumps as well as medicines such as gentamicin, streptomycin, certain cancers and malaria medicines can also cause hearing loss.
Safe listening practices
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Set the device volume and the duration of listening time correctly.
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Activate the control limits of the device’s volume.
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Follow the 60/60 listening rule: 60% device volume with 60 minutes per session.
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Take listening breaks
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Limit the use of devices with ‘Active Noise Cancellation’
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Avoid using devices for the entire day.
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Rotate device usage: alternate headphone and earbud devices
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Be aware of hearing issues such as tinnitus/difficulty in hearing conversations at noisy places or ear discomfort
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Clean earbud devices regularly
A hearing screener called ‘HearWHO’, which is a smart phone-based app has also been validated for use by the general public, by the WHO. This enables easy and regular hearing checking to maintain a ‘hearing diary’. Its scores range from 0 to 100, grouped as more than 75, 50-75 and less than 50, the third one indicating hearing loss.
studies have shown that among users of PLD of more than four years, two-thirds who experienced ear ringing or buzzing sensations, or fullness, had hearing loss, . Educating them to change mindsets towards safe and healthy listening habits for themselves, and for other young yet vulnerable populations, should become a national and global priority.
(Dr. Mary Kurien is professor and head, department of ENT, Naruvi Hospitals, Vellore. mary.k@naruvihospitals.com; Dr. Vikram M. is consultant, department of ENT, Naruvi Hospitals, Vellore. vikram.m@naruvihospitals.com; Sadhana Chandrababu is an advanced audiology practitioner, and Dr. Yogeshwari Hiremath is a specialist, department of ENT, Naruvi Hospitals, Vellore. yogeshwarihiremath.h@naruvihospitals.com)
Published – January 13, 2026 12:53 pm IST