Do negative attitudes towards loud music prevent music-induced hearing loss?

1. Do negative attitudestowardsloudmusicpreventmusic-induced hearing loss? Stephen Widén University West, Sweden Soly Erlandsson University West, Sweden Margareta Bohlin University West, Sweden Alice Holmes Gainsville, University of Florida Ted Johnson Elmira, College, Elmira, New York

2. Someempirical work… Widén, Holmes, A.E., Johnson, T., Bohlin, M., & Erlandsson, S.I. (2009). Hearing, use of hearing protection, and attitudestowardsnoiseamongyoung American adults. International Journal of Audiology; 48: 537-545 Erlandsson, S.I., Holmes, A.E., Widén, S.E., Bohlin, M. (2008). Cultural and social perspectives on attitudes, noise and risk behaviour in children and young adults. Seminars in Hearing, 29: 29-41. Holmes A.E., Widén, S.E., Erlandsson, S.E., Carver, C.L.,White, L.L. (2007). Perceived hearing status and attitudes towards noise in young adults. American Journal of Audiology, 16: 182-189. Widén, S.E., & Erlandsson, S.I. (2007). Risk perception in musical settings –a qualitative study. International Journal of Qualitative Studies on Health and Well-being 2:1, 33-44. Widén, S.E., Holmes, A.E., Erlandsson, S.I. (2006). Reported Hearing Protection Use in Young Adults from Sweden and the USA: Effects of Attitude and Gender. International Journal of Audiology 45: 273-280. Olsen Widén, S.E., & Erlandsson, S.I. (2004). The Influence of Socio-Economic Status on Adolescent Attitude to Social Noise and Hearing Protection. Noise & Health 7: 25, 59-70.

3. Noise or music? ”It´s a matter of perception and attitudes” What is music for the adolescent is mostlikelynoise to the parent… Loud decibels may be harmful to the hearing independently of it´sorigin.

4. General purposes with the research To get an understanding for adolescents’ healthrisktakingbehaviourregardingnoise exposure e.g. whydosomeuse hearing protection and other’s not? To provide a theoreticalframework to be able to describe and understandadolescents’ risk takingbehaviourregardingmusic exposure.

5. Definitions of Risk and Risk Perception Risk can be defined as an objectivereality, whichmeans that risks existsindependently of individuals’ awareness of them. Risk perception can be defined as a social construction, the risk will be created as an construction in our mind, whenwenoticesomethingbeingdangerous. Discourse in society makes usbecomeaware of the risks. Experiences (own as well as other’s) makes becomeaware of risks.

6. Possible risks associated with loudmusic • Stronger and better digital technique, improves the quality of the sound, makes it morecomfortable to listen to. • Frequence and duration of exposure are important for the development of a hearing impairement. • Hearing impairements are also a social handicap that affectsourability to communicate, (secondaryeffect). • Adolescence is a relativelyshort period of life, butestablished habits during this time mayhaveconsequences to the health later in life, and the consequencesmay be difficult to perceive.

7. Theoreticalperspectives on whyadolescentsexposethemselves to loud decibels in musical settings Music is an importantingredient in manyadolescents’ creation of an identity. Self image Judgement of risks Norms and ideals

8. Social Norm Norm. Ideals Perceivedsusceptib-ility Experience Attitudes Risk consideration Behaviour

9. Study: Hearing, use of hearing protection, and attitudestowardnoiseamongyoung American Adults Participants: Sample 258 undergraduate students (age 17-21) Gender distribution was 28% male, and 72% female. Socio-economicbackgroundwashomogenious (high or medium high educationlevel of the parents).

10. Audiologicalmeasurements Otoscopy, individuals with impactedcerumenwereexcluded Tympanometry, excludingpeople with middleear problems Hearing screening (pure-tone audiometry) in a sound-attenuatedaudiologybooth, 20 dB was the screening criterion. Screening 500, 1000, 2000, 4000 and 6000Hz.

11. Questionnaires Hearing symptom descriptionscale (Erlandsson & Olsen 2004). Adolescents Habits and Use of Hearing Protection (Erlandsson & Olsen, 2004). YouthAttitudeTowardsNoisescale (Widén & Erlandsson 2006).

12. Results Out of 258, 67 (26%) failed the pure tone audiometry 26% of those who reportedtheyhad normal (n=247) hearing actuallyfailed the screening test. 11 persons reported in the questionnaire that theyhad a hearing loss, butonly 3 of thesefailed the screening test. Noisesensitivitywasreported by 81 persons (31%). Out of them 25% failed the screening test.

13. Results Temporaryself-reported hearing symptoms werereportedmostly in musicrelatedactivities (discos, concerts, clubs). Temporary tinnitus (lasting 24h or more after noise exposure) werereported by 15%. Nearly 50% reported that they on occationhadexperienced pain in relation to loudvolumes (discos 10%, concerts 38%).

14. Results symptoms and attitudes In general, thoseexperiencingtemporary symptoms (ear pain, temporary tinnitus) heldsignificantlymoreanti-noseattitudes. Anti-noiseattitudes in turn are significantlyrelated to morefrequentuse of hearing protection.

15. 4 ”symptom groups” No hearing problem at all (n = 127) Failed hearing screening (n = 47) Noisesensitivity (n = 57) Failed hearing screening + noisesensitivity (n = 20)

16. 4 symptom groups and attitudes Significantdifferencesbetween the 4 groups Those with no selfexperienced symptoms or those who failed the hearing screening held the mostpro-noiseattitudes, whereasthosereportingnoisesensitivity (or a combination of noisesensitivity and failing hearing screening) held the mostanti-noiseattitudes.

17. Conclusion Self experienced symptoms are morepositivelyrelated to stronger anti noiseattitudesthan hearing loss on itsown. Self experienced symptoms may serve as a ”feed back” that noisemay be a problem, whereasthresholdshifts pass unnoticed to the individual. Therefore, it is not possible to take action regarding the behaviour, when you are not aware of that you have a problem.

18. Previous studies confirms that: Self experienced symptoms such as noisesensitivity, temporary or permanent tinnitus, and ear pain are associated with moreanti-noiseattitudes and a higherdegree of hearing protectionuse, whereas no experience of hearing ”problems” are associated with morepro-noiseattitudes and less hearing protectionuse at concerts and discos.

19. Reflections It’sourawareness of a health problem (from feed back) and the interpretation we make of this, that may serve as a trigger for changingourattitudes and behaviour. Discourse are important for howwe interpret the feed back, that is, the perception of noise/music as a risk.

20. Preventive work Attitude and behaviouralchange are importantaspects in preventive work. By providing ”good” knowledgeaboutnoise and hearing, it mayaffectadolescentsattitudes and behaviour in a health preventive way.

21. Hearing screening versusself reports… In total 67 persons failed the hearing screening test, only 3 of them (4%) hadreported in the questionnaire that theyhad a hearing loss. 8 out of 11 (73%) selfreported hearing loss couldnot be verified in the hearing screening test.

22. Wehave a measurement problem! The reliability of self reports (questionnaires) withinhealth research should be called in question. Whatreliability problems are there with screening tests? Does thesetwomeasurementsmeasure the same thing?

23. Contacts stephen.widen@hv.se