Effectiveness of Earplugs in Preventing Recreational Noise–Induced Hearing Loss

Prerana Patel, Mercer University College of Pharmacy

The National Institute of Health (NIH) states that exposure to high decibels (dB) for more than 15 minutes per day may cause long-term hearing damage. [1]

The Hearing Loss Association of America introduced the 60/60 rule, which advised that the volume should not be turned up to more than 60% of the maximum volume of the device and do not listen for longer than 60 minutes at that volume. Second, it was suggested to use ear plugs or noise-blocking earmuffs and avoid loud noises in certain environments.  Lastly, the association states to look for noise ratings when making purchases on appliances, small electronic devices, and power tools. [2]

Title: Effectiveness of Earplugs in Preventing Recreational Noise–Induced Hearing Loss [3]
Design Randomized, single-blind clinical trial, N = 51
Objective To assess the effectiveness of earplugs in preventing temporary hearing loss immediately following music exposure
Study Groups Earplugs (n = 25); unprotected (n = 26)
Methods Participants were randomly assigned to a group using earplugs or an unprotected group during a 4½-hour festival visit.
Duration September 5, 2015 during a four and a half hour long music festival
Primary Outcome Measure The change in the ability to hear three and four kilohertz before and after attending a music festival
Baseline Characteristics   Unprotected group Earplug group
Age, mean (SD), y 27.0 (6.2) 27.3 (5.6)
Male sex, No. (%) 9 (35) 9 (36)
Visits music club or festival ≥ 2 times/ mo, No. (%) 17 (65) 17 (68)
Duration of festival visit, mean (SD), min 277 (27) 270 (29)
Alcohol use, mean (SD), units 4.0 (2.2) 4.2 (2.3)
Drug use, No. (%) 6 (23) 5 (20)
Results   Unprotected group Earplug group  
Frequency, kHz Before After Change Before After Change p-value
Pure tone average 3 and 4 kHz, mean (SD), decibel
Right ear 4.1 (7.0) 12.4 (7.9) 8.3 (5.4) 6.1 (9.7) 8.4 (11.4) 2.4 (4.2) <0.001
Left ear 7.0 (7.9) 13.8 (9.6) 6.8 (5.8) 9.2 (8.2) 10.3 (10.2) 1.1 (4.9) <0.001
Adverse Events Common Adverse Events: N/A
Serious Adverse Events: N/A
Percentage that Discontinued due to Adverse Events: N/A
Study Author Conclusions Earplug use is effective in preventing temporary hearing loss after loud music exposure.

With the attendance of concerts and outdoor music festivals increasing, healthcare providers must educate patients on the potential risk of hearing loss and help them find ways to keep their ears safe from noise.  This article not only looks at sound decibels, but also takes into account drug and alcohol use, which could both be contributing factors to hearing loss at music festivals.  Overall, the study could be used to better serve the public by recommending that patients use earplugs or earmuffs when attending such events.




[1] Hearing loss and music: MedlinePlus Medical Encyclopedia. (2014, May 18). Retrieved April 15, 2016, from https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000495.htm


[2] The Hearing Loss Association of America. Noise Pollution. Available at: http://www.hearingloss.org/sites/default/files/docs/NoisePollution_Infographic_h.pdf. Accessed April 15, 2016.


[3] Ramakers GG, Kraaijenga VJ, Cattani G, Van zanten GA, Grolman W. Effectiveness of Earplugs in Preventing Recreational Noise-Induced Hearing Loss: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2016.


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