As a physician, I see many patients who suffer from noise-induced hearing loss. In the past, I would commonly see this in older patients who have experienced hearing loss from an exposure at work. According to The National Institute for Occupational Safety and Health, occupational hearing loss is one of the most common work-related illnesses in the U.S., with approximately 22 million workers exposed to hazardous noise levels at their jobs.

What few people realize, however, is that the simple activities we perform every day can also damage our hearing. Increasingly, I see younger patients with noise-induced hearing loss from exposures at home rather than the workplace. Estimates vary, but approximately 5 million children and adolescents, aged 6-19 years, currently suffer from permanent damage to their hearing from excessive exposure to noise. Some estimates cite that it could be as many as 1 in 5 adolescents. This is a 30 percent increase over the previous decade, and the main reason is believed to be the use of headphones. IPhones manufactured in the U.S. can reach levels of 115 decibels (dB), while phones manufactured in Europe are regulated to no more than 100 dB. An important fact to know is that at 110 dB, permanent damage can occur with regular exposure of more than 1 minute.

Many patients ask me why “earbud” headphones are so damaging. There are several reasons. One is the proximity of the earbud to the ear drum. It effectively raises the volume by approximately 10 dB louder than the same noise would be if it was heard outside the ear canal. Another is that the human ear engages an “acoustic reflex,” using small muscles in the ear to help dampen sound when it is too loud. Over time, children listening to earbuds tend to turn the music up to overcome this, which can cause additional damage. An additional reason is the overall time that people listen to music with earbuds is also damaging. Even moderately loud noise does damage over longer periods of time.

There is also a mistaken impression that earbuds can be used to “protect” your hearing from outside noise. I often have patients tell me that they are using the earbuds as a type of earplug when they mow the lawn. Unfortunately, most standard earbuds are not capable of blocking out all outside noise, and the user just ends up turning the music even louder. I always recommend the use of “over-the-ear” earmuffs to protect hearing when using power tools and machines.

So, what can be done to use earbuds safely and help prevent this damage? Generally speaking, most experts recommend a 60/60 rule of thumb. This involves not using earbuds at levels over 60 percent and for no longer than 60 minutes per day. While MP3-style players vary, by staying at less than 60 percent of the volume, the risk is lower that you are exceeding the 90-dB threshold. And listening for less than 60 minutes at a time allows the ears to “rest” and lowers the risk of damage from longer exposures. You can also consider buying better, noise-cancelling earbuds. These help reduce the effect of background noise, and allow users to listen to lower volumes. Using over-the-ear headphones instead of earbuds has also been shown to lower the volume that people feel comfortable listening to by reducing the effect of outside noise. For younger children, I tell them that they should be able to hear people around them talking, otherwise their earbuds are too loud. Parents should closely monitor their children’s use of earbuds, especially the length of time they are used. I also recommend that they consider using a volume control application available for some MP3 players and smartphones. These can be very helpful to prevent the listener from slowly increasing the volume as they become accustomed to it.

Noise-induced hearing loss is an irreversible and lifelong problem. Since there is no way to reverse nerve damage once it has occurred, prevention is the only way to preserve your hearing.


Common noise exposures