Output sound pressure levels of personal music systems

and their effect on hearing

Ajith Kumar, Kuruvilla Mathew, Swathy Ann Alexander, Chitra Kiran

Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

Dr. MV Shetty College of Speech and Hearing, Vidyanagar, Mangalore - 575 013, India
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024

Abstract
This study looked at output levels produced by new generation personal music systems (PMS), at the level of eardrum
by placing the probe microphone in the ear canal. Further, the effect of these PMS on hearing was evaluated by
comparing the distortion product otoacoustic emissions and high frequency pure tone thresholds (from 3 kHz to
12 kHz) of individuals who use PMS to that of age matched controls who did not use PMS. The relationship between
output sound pressure levels and hearing measures was also evaluated. In Phase I output SPLs produced by the PMS
were measured in three different conditions - a) at volume control setting that was preferred by the subjects in quiet
b) at volume control setting that was preferred by the subject in presence of 65 dB SPL bus noise c) at maximum volume
control settings of the instrument. In Phase II pure tone hearing thresholds and DPOAEs were measured. About 30%
of individuals in a group of 70 young adults listened to music above the safety limits (80 dBA for 8 hours) prescribed
by Ministry of Environment and Forests, India. Addition of bus noise did not increase the preferred volume control
settings of the subjects significantly. There were no significant differences between the experimental and control groups
for mean pure tone threshold and for mean DPOAE amplitude comparisons. However, a positive correlation between
hearing thresholds and music levels and a negative correlation between DPOAE measures and music levels were found.

Keywords: Personal music system, hearing loss, noise, distortion product otoacoustic emission system, output SPL
DOI: 10.4103/1463-1741.53357

Introduction Early studies by Wood and Lipscomb[4] and Katz et al.,[5]

There are growing concerns over noise exposure via personal
music systems (PMS) use by young adults. It is said that with the
massive growth in popularity of portable MP3 players, exposure
to high noise levels has increased, and millions of young
people are potentially putting themselves at risk for permanent
hearing loss every time they listen to their favorite music. As no
evidence-based definition exists for hazardous sound levels of
music, as a substitute, standards for exposure to occupational
noise have been proposed for use.[1] The ISO 1999 standard for
occupational noise[2] defines a time-weighted average (TWA)
level of 85 dBA for an 8 hour period per day as the maximum
permissible dose of sound energy. The limit 85 dBA is not fully
harmless, as a few percent of people may still incur a permanent
hearing loss if exposed to it. The ISO standard recognizes that
there is a tradeoff between the exposure time and the sound
level, which is quantified by a ‘3 dB exchange rule’: Every 3 dB
increase in the exposure level must be compensated by halving
the exposure time to keep the risk constant. This means that
an 8 hour exposure to 85 dBA bears the same risk for hearing
loss as 4 hours of exposure to 88 dBA, or a 2 hour exposure to
91 dBA, and so on. In India, the Ministry of Environment and
Forests[3] has proposed a TWA level of 80 dBA for an 8 hour
period per day as the maximum permissible exposure.
looked at the maximum output levels produced by the personal
cassette players through headphones. These investigators
reported levels as high as 124 dBA and 110-128 dBA
respectively for compact disc (CD) and cassette players.
Based on these reports both the papers concluded that CD and
cassette players produce sound levels that are hazardous to
hearing. However, these reported output levels were measured
at maximum volume control settings which do not represent
the everyday use settings. Moreover these measurements
were made on a 9BS 9A coupler. Other researchers[6,7] asked
users to set the volume control level to their preferred setting
and measured the output levels. Results showed that output
levels were substantially less than what is reported by Wood
and Lipscomb[4] and Katz et al.,[5] but even so a significant
percentage of people set the listening levels higher than the
permissible level of 80 dBA. Fligor and Cox[6] recorded
the output levels of the different commercially available
CD players in combination with a variety of earphone styles
on a KEMAR. They concluded that output levels varied
across different manufacturers of CD players and style of the
earphone. But generally smaller insert earphones produced
sound pressure levels higher than the permissible limits
compared to bigger headphones. Output levels from PMS
have been reported to be as low as approximately 80 dBA[9]

Noise & Health, July-September 2009, 11:44,132-40

Volume 11 132
 Kumar, et al.: Personal music system and hearing
to as high as 121 dBA.[8] Airo et al.,[10] measured the output
levels of personal cassette players in an acoustic coupler at
maximum volume control settings, comfortable volume
control settings in quiet and in the presence of background
noise. They reported that personal cassette players were able
to produce high sound levels but the typical listening levels
chosen by the users were not alarming. The output levels on
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
average exceeded 85 dBA when the background noise level
was 72 dBA, potentially creating some hearing loss risk when
cassette players are used in noisy conditions at work or among
traffic. Hodgetts et al.,[11] measured the preferred listening
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024
levels for a MP3 player in normal hearing adults. Using probe
microphone measures, Hodgetts et al.,[11] measured the dBA
weighted sound pressure levels produced by a commercially
available MP3 player for different types of earphones (ear bud,
over-the-ear, and over-the-ear with noise reduction circuitry).
Preferred listening levels ranged from 75-78 dBA for different
types of earphones. Preferred listening levels were higher for
the ear bud style of earphones compared to the over-the-ear
style. Furthermore, preferred listening levels were increased
by 6-10 dB when background noise was introduced to the
listening environment to simulate the ‘real world’ situation.
Torre[12] measured the output SPL of PMS in the ear canal
of 32 participants at four loudness categories: Low, medium,
loud and very loud. Their results showed that mean output
SPLs values were 62, 72, 88 and 98 dB SPL for low, medium,
loud and very loud categories respectively. Based on these
measurements they concluded that output SPLs produced by
PMS at medium or loud volume control settings may not be
hazardous as most of the subjects reported they listen to music
at these volume control settings for about 1 to 3 hours a day.
Meyer-Bisch [13]
found significantly poorer pure tone
thresholds in people using PMS longer than 7 hr/week than
in the matched control subjects. Lepage and Murray[14]
measured the transient evoked otoacoustic emission in
700 individuals and found reduced amplitudes of these in
individuals with a positive history of noise exposure or PMS
use. Recently, Montoya et al.,[15] compared the amplitude,
incidence and spectral content of transient and distortion
product otoacoustic emissions in normal hearing MP3 player
users to those of control group who were non-users of MP3
players. Results showed that subjects who had used MP3
players for greatest number of years and for more hours
each week exhibited a reduction in incidence and amplitudes
of both types of otoacoustic emissions and an increase in
distortion product otoacoustic emission thresholds.
Previous research has shown that maximum output levels
produced by cassettes and CD players are above the
permissible limits. However, more recent research has shown
that output SPLs of newer generation PMS like iPods, MP3
players at medium or loud volume control settings are within
the permissible limits and may not be hazardous. However,
there is a paucity of data regarding the output levels and their
effect on auditory system of new generation MP3 players and
133
mobile phones MP3 systems. In developing countries like
India, mobile phone ownership is growing rapidly. About
six million new mobile subscriptions are added every month
and three quarters of India’s population will be covered by
a mobile network by the end of 2008. Moreover, the studies
mentioned above have been carried out in Western population
and it is known that output SPL values as well as susceptibility
to noise-induced hearing loss depends on the race and
ethnicity.[12,16,17] Hence, it is important to measure and document
the output sound pressure levels and their effect on hearing
of these new generation PMS including mobile phones in
different racial/ethnic groups. This study specifically looked at
output levels produced by newer generation PMS in an Asian-
Indian population, when measured at the level of the eardrum
by placing the probe microphone in the ear canal. Output
levels were measured in three conditions – a) at the volume
control setting that was preferred by the subject in quiet b) at
the volume control setting that was preferred by the subject in
presence of bus noise and c) at the maximum volume control
settings of the instrument. The effect of this new generation
PMS on hearing was evaluated by comparing the distortion
product otoacoustic emissions and high frequency pure tone
thresholds (from 3 kHz to 12 kHz) of individuals who use
PMS to that of age matched controls who did not use PMS.
Furthermore, the relationship between output sound pressure
levels and hearing measures was also evaluated.
Materials and Methods
Participants
Participants comprised two groups. The experimental
group had 70 adults (35 males and 35 females; age range of
17-24 years; mean age 20.5 years) who reported listening to
music regularly through their PMS. A detailed history regarding
the PMS and its usage was collected from each participant using
a questionnaire [Appendix I] All the subjects in the experimental
group had been using PMS for a period of over two years. The
control group had 30 adults who never/very rarely listened to
music through PMS. Participants in the control group had their
hearing thresholds less than 15 dB HL at octave frequencies
from 250 Hz to 8000 Hz. Subjects in both the groups showed
no evidence of occluding cerumen or middle ear pathology on
otoscopy and tympanometry. Furthermore, subjects in both
groups did not report of any history of occupational noise
exposure or ototoxic drug usage. Subjects were recruited from
different graduate schools in and around Mangalore, a city in
south India. Written consent was obtained from all the subjects.
The study was approved by the research review board of the Dr.
MV Shetty College of Speech and Hearing.
Procedure
The study was conducted in two phases. In Phase I output
sound pressure levels (SPLs) produced by the PMS were
measured in three different listening conditions - at volume
control settings preferred by the subjects in quiet, volume
Noise & Health, July-September 2009, Volume 11
 Kumar, et al.: Personal music system and hearing
control settings preferred by the subjects in the presence of
background of 65 dB SPL bus noise and at the maximum
volume control setting of the PMS - using a probe microphone.
Output SPLs in the presence of background bus noise was
measured to simulate a real life listening situation. Bus noise
was chosen as the background noise source as our preliminary
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
survey showed that more than 90% of the participants listen
to music while commuting to the college by bus. To simulate
this “real world” listening condition we measured the SPL
at a distance of 2 m from the bus engine (to represent the
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024
maximum noise that the commuter may be exposed), inside
the bus, using a sound level meter (Quest 1800) and a
microphone (Quest 4180). The noise was measured while
the bus was running in fourth gear (approximately 1600
RPM) and travelling approximately at 40 kilometers/hour.
These conditions represent the city ride to which listeners are
generally exposed. Four sound level measurements were done
under these conditions and the average noise level produced
by the bus engine was 65 dB SPL. This sound source was then
digitally recorded and used as the background noise source in
the experiment. Noise was played back through sound field
speakers connected to a personal computer. The volume of
the speakers was adjusted to produce a SPL of 65 dB at the
position of the subject’s head. The amplitude of the noise at
the position of the subject’s head was measured using sound
level meter (Quest 1800) and a microphone (Quest 4180).
In Phase II pure tone hearing thresholds and DPOAEs were
measured on these same subjects and were compared with
age matched normal subjects who did not use a PMS.
Phase I: measurement of output SPL of PMS
Only the experimental group participated in this phase of the
study. Output SPLs produced by the PMS were measured in the
subject’s ear canal using a probe microphone. A commercially
available real ear probe microphone measurement system
(Siemens Unity Ver 2.7) was used for this purpose. Insertion
depth of the probe was 28 mm from the tip of the tube to tragal
notch. This insertion depth is the standard insertion depth
used while doing real ear probe microphone measurements in
adults.[18] All the measurements were made with the subject’s
own PMS and earphones. After placing the probe tube in the
ear canal, the earphone was placed. Subjects were asked to
play one of their frequently played songs. Output SPLs were
measured in three different conditions
(i) by asking the subjects to adjust the volume control to
their preferred listening setting in quiet
(ii) by asking the subjects to adjust the volume control to
their preferred listening setting in the presence of 65 dB
SPL bus noise
(iii) by setting the volume control to maximum level.
Position of the probe microphone was not changed between any
of the measurements. All the measurements were done in a semi-
acoustically treated room. Ambient noise in the test environment
ranged between 40-45 dB SPL during the measurements.
Noise & Health, July-September 2009, Volume 11
Output SPLs were measured at individual frequencies from 125
Hz to 8000 Hz in octave and mid octave intervals. These ear canal
SPLs were converted to equivalent diffuse field SPLs to which
an ear was exposed, by subtracting the transfer function of the
open ear.[19] The transfer function of the open ear was obtained
by calculating the difference between the reference location at
the opening of the ear canal and the probe microphone SPL near
the eardrum for a sweep frequency tone presented at 60 dB SPL.
The output SPLs at individual frequencies were converted to
dBA values by adding the A-weighting adjustment values. The
overall SPL in dBA was then determined by logarithmically
adding dBA values at each frequency. From this data 8 hour
equivalent continuous A-weighted noise exposure (Leq8h) was
calculated following the same procedures as Williams.[9] This
was mathematically calculated from the equation
Leq8h = LT + 10 log10 [T/8]
where Leq8h is the 8 hour equivalent continuous noise
exposure, T = exposure time in hours, LT = Level of noise
exposure over the time period T.
Phase II: Pure tone audiometry and DPOAE
Pure tone audiometry
Pure tone audiometry was done using a calibrated audiometer
(GSI 61 with TDH 50 head phones fitted with supra aural ear
cushions). All the subjects were screened at 15 dB HL in octave
frequencies between 250 Hz to 1 kHz. Pure tone thresholds
were measured at octave and mid-octave frequencies from
2000 Hz to 12000 Hz using the modified version of Hughson
and Westlake procedure. This approach was utilized since
previous research has shown that frequencies above 2 kHz
are more sensitive to noise exposure and will get affected
first.[20,21] Both experimental and control groups participated
in this experiment.
Distortion product otoacoustic emission
Both the experimental and control group participated in
this experiment. A computer based DPOAE analyzer (GSI
AUDERA) was used to record DPOAEs. DPOAEs were
recorded for seven pairs of frequencies in which f2 was at
1031, 1594, 2098, 3152, 4184, 4816, 6340 and 7277 Hz. The
f2:f1 ratio was 1.20.[22,23] In this article, the DPOAE data is
represented with reference to f2. The L1/L2 was 65/55 dB SPL.
Data acquisition lasted for 30 s for every frequency irrespective
of signal to noise ratio. A frame was rejected if it exceeded
the 30dB SPL rejection criterion or if L1 and L2 differed by
more than 2 dB from the target values. These test acceptance
criteria and test rejection criteria were selected because they are
consistent with the values that are employed in clinical settings
with this instrumentation.[24-26] Subjects sat in a comfortable chair
and the OAE probe was adequately sealed in the external ear
canal and otoacoustic emissions were recorded with the above
mentioned parameters. An intrinsic real ear intensity calibration
was used to determine the quality of the DPOAE probe seal
134
 Kumar, et al.: Personal music system and hearing

before starting the DPOAE measurement. DPOAE amplitude

and SNRs at each frequency were measured.

Both pure tone audiometry and the DPOAE testing were

carried out in an audiometric testing room where the ambient
noise was within the permissible levels and the testing was
done by a qualified audiologist with a bachelor’s degree in
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

audiology and speech language pathology. The order of Phase

I and Phase II was counterbalanced among subjects to avoid
any order effect and there was a gap of about 15 minutes
between the two phases during which subjects completed
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024

the questionnaire. All the statistical analysis was performed Figure 1: Mean Leq8h at preferred volume control settings for males
and females for mobile phone users
using SPSS (version 13) software.

Results

On average, young adult subjects listened through PMS for

a period of 1.5 hours a day (range: 10 min-4 hours). Most of
them reported that they listened to music while commuting to
college/hometown. Of the 70 subjects, 62 subjects used mobile
phones to listen to music, 4 used iPods to listen to music and 4
used locally made MP3 players to listen to music. As the iPod
or MP3 players were fewer, these subjects were not included
in further statistical analysis. Therefore, the results pertain to
mobile phone PMS only. None of the subjects used cassette
players or CD players to listen to music. All the subjects used
insert kind of headphones to listen to music. None of them Figure 2: Mean output levels at preferred listening settings in
quiet, in the presence of 65 dB SPL bus noise and at maximum
reported any symptoms of temporary threshold shifts like
volume control settings for mobile phones. Mean output in dB SPL
blocking sensation, tinnitus after listening to music. Though is depicted at octave frequencies along with overall dBA and Leq8h
the information regarding the different manufacturers and
models was obtained, it was not used in data analysis as the
main aim of the study was to see if young adults listen to
music at potentially hazardous levels and not to compare the
output produced by PMS of different manufacturers.

Phase I: Measurement of output spl of pms

PMS used by young adults mainly consisted of mobile phones,
and very few used iPods and locally made MP3 players.
Figure 1 shows the mean Leq8h at preferred volume control
settings for males and females for mobile phone users. An
independent samples ‘t-test’ revealed no significance difference
in mean Leq8h between males and females in all three listening
conditions tested (t = 1.43, 0.89 and 0.65 respectively for quiet,
in presence of bus noise and at maximum volume, p > 0.05).
Since there were no statistically significant differences between Figure 3: Mean output levels used by the subjects at preferred
mean output SPLs preferred by males and females data from listening settings in quiet, in the presence of 65 dB SPL bus noise and
both the genders were combined for all further analysis. at maximum volume control settings for iPods. Mean output in dB
SPL is depicted at octave frequencies along with overall dBA and Leq8h
Figures 2-4 illustrate the mean output SPLs at preferred
listening settings in quiet, in the presence of 65 dB SPL bus quiet. Listening in the presence of bus noise did not increase
noise and at maximum volume control settings for mobile the output SPLs significantly. A paired ‘t-test’ did not show a
phones, iPods and locally made MP3 players respectively. The significant difference between means Leq8h produced by mobile
mean Leq8h were 73 dBA for mobile phones (range: 40 dBA phones in quiet and in the presence of bus noise (t = 1.71,
to 93 dBA), 76 dB for iPods (range: 56 dBA to 86 dBA), p > 0.05). Statistical analysis was not carried out for the
and 79 dBA for locally made MP3 players (range: 70 dBA other types of PMS as the number of instrument users was
to 84 dBA), at subject preferred volume control settings in limited. At maximum volume control settings the output levels

135 Noise & Health, July-September 2009, Volume 11

 Kumar, et al.: Personal music system and hearing
increased compared to the subject preferred volume control
setting. Paired ‘t-test’ revealed that Leq8h produced at maximum
volume control settings were significantly more compared to
other two listening conditions (t = 12.8, 13.2, P < 0.01).
Figure 5 shows the Leq8h at the preferred volume control settings
obtained in the presence of 65 dB SPL bus noise for individual
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
subjects. As can be seen from the Figure 5, a majority of the
subjects (70%) listened to music at less than Leq8h of 80 dBA.
Nineteen mobile phone users, 1 MP3 player listener and 1 iPod
listener listened to music at higher than Leq8h of 80dBA.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024
Phase II: Pure tone audiometry and dpoae
Pure tone audiometry
Based on the results of Phase I, subjects in the experimental
group were divided into two groups: Individuals who used
PMS at Leq8h of less than 80 dBA and individuals who
used PMS at Leq8h of more than 80 dBA. Data from all three
types of PMS users are pooled as the main purpose was to
see if listening to music through PMS causes damage to
auditory system or not. ANOVA was done to find out the
significance of difference between mean pure tone thresholds
of individuals who used PMS at Leq8h of less than 80 dBA,
individuals who used PMS at Leq8h of more than 80 dBA, and
individuals who did not use PMS. ANOVA failed to show
any significant main effect of subject groups on pure tone
hearing thresholds in both right [F = 2.7 (2,98) p >.05] and
left ear [F = 1.8 (2,98) p >.05]. Descriptive analysis showed
that none of the subjects who used PMS had pure tone
thresholds more than 25 dB HL in 3 kHz to 8 kHz region in
both ears. Figure 6 shows the average pure tone thresholds
of individuals who used PMS at Leq8h of less than 80 dBA,
individuals who used PMS at Leq8h of more than 80 dBA, and
individuals who did not use PMS.
Figure 4: Mean output levels used by the subjects at preferred
listening settings in quiet, in the presence of 65 dB SPL bus noise
and at maximum volume control settings for locally made MP3
players. Mean output in dB SPL is depicted at octave frequencies
along with overall dBA and Leq8h
Noise & Health, July-September 2009, Volume 11
Distortion product otoacoustic emission
All the subjects in the experimental group showed normal
DPOAEs amplitudes and signal to noise ratios (re: Clinic
normative values). ANOVA was done to find out the
significance of difference between mean DPOAE amplitudes
and SNR values between individuals who used PMS at Leq8h of
less than 80 dBA, individuals who used PMS at Leq8h of more
than 80 dBA, and individuals who did not use PMS. ANOVA did
not show a main effect of subject groups on means of DPOAE
amplitudes and SNR values at all the tested frequencies in both
ears. Figures 7 and 8 show DPOAE amplitudes and SNRs
in different subject groups across different frequencies. Data
is represented with reference to f2. Error bars show 1 SD
variation.
Relationship between Leq8h and hearing measures
To evaluate the relationship between output SPLs and
hearing thresholds Pearson’s product moment correlation
was carried out between subjects’ pure tone thresholds as
dependent variable and Leq8h measured in presence of bus
noise as the independent variable. Data from all the PMS
users were pooled for this analysis. The results are shown
in Table 1. There was a significant positive correlation
between hearing thresholds at 6000 Hz and exposed music
levels, in both ears. Results of correlation analysis between
exposure levels and DPOAE measures are shown in
Tables 2 and 3. There was a significant negative correlation
between DPOAE amplitudes and dBA Leq8h at 6340 Hz in
both ears and at 2098 Hz in right ear. It can be inferred from
Table 3 that there was a significant negative correlation
between DPOAE SNR and dBA Leq8h at 4816 Hz, 6340 Hz
and 7277 Hz in right ear and at 4816 Hz in left ear. These
negative correlations indicate that DPOAE amplitudes and
SNRs were lesser in individuals who tend to listen to music
at higher output levels.
Figure 5: Mean output Leq8h values at subjects’ preferred volume
control settings in the presence of 65 dB SPL bus noise for
individual subjects
136
 Kumar, et al.: Personal music system and hearing
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024

Figure 6: The mean pure tone hearing thresholds for different subject groups across different frequencies

Figure 7: DPOAE amplitudes in different subject groups across different frequencies. Data is represented with reference to f2. Error
bars show 1 SD variation

Figure 8: DPOSE SNRs in different subject groups across different frequencies. Data is represented with reference to f2. Error bars
show 1 SD variation

Discussion college/hometown. The mean dBA Leq8h at preferred volume

The majority of the young adults studied here used their
mobile phones to listen to music. Of 70 subjects 62 subjects
used mobile phones to listen to music (88.6%), 4 used iPods
to listen to music (5.7%) and 4 used local made MP3 players
to listen to music (5.7%). On average, young adults listened to
music through PMS for a period of 1.5 hours a day. Most of
them reported that they listened to music when commuting to
control settings was 73 dBA for mobile phones, 76 dBA
for iPods, and 79 dBA for local made MP3 players. These
preferred listening levels are similar to what participants
selected as “sounds best to you” in the Hodgetts et al.,[11] study
or “medium/comfortable” in the Torre[12] study. Hodgetts
et al.,[11] reported that participants increased the level of the
music approximately 6 to 10 dB when either street noise or
multitalker babble was added to the listening environment. But

137 Noise & Health, July-September 2009, Volume 11

 Kumar, et al.: Personal music system and hearing

Table 1: r and P values of Pearson’s product moment correlation between hearing thresholds and music exposure levels
Right ear Left ear
3000 Hz 4000 Hz 6000 Hz 8000 Hz 12000 Hz 3000 Hz 4000 Hz 6000 Hz 8000 Hz 12000 Hz
r .023 −.066 .325 .239 .238 −0.58 −.029 .276 .190 .213
P .8 .6 .01** .06 .06 .6 .8 .03* .13 .06
**Correlation is significant at the 0.01 level (2-tailed); *Correlation is significant at the 0.05 level (2-tailed)
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

Table 2: r and P values of Pearson’s product moment correlation between DPOAE amplitudes and music exposure levels
Right ear Left ear
1031 Hz 1594 Hz 2098 Hz 3152 Hz 4184 Hz 4816 Hz 6340 Hz 7277 Hz 1031 Hz 1594 Hz 2098 Hz 3152 Hz 4184 Hz 4816 Hz 6340 Hz 7277 Hz
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024

r −.07 −.19 −.27* .02 .04 .03 −.25* −.15 −.18 −.18 −.13 .05 .07 .12 −.27* −.14
P .5 .13 .03 .8 .9 .7 .04 .25 .14 .28 .14 .6 .5 .3 .03 .26
*Correlation is significant at the 0.05 level (2-tailed)

Table 3: r and P values of Pearson’s product moment correlation between DPOAE SNRs and music exposure levels
Right ear Left ear
1031 Hz 1594 Hz 2098 Hz 3152 Hz 4184 Hz 4816 Hz 6340 Hz 7277 Hz 1031 Hz 1594 Hz 2098 Hz 3152 Hz 4184 Hz 4816 Hz 6340 Hz 7277 Hz
r .04 −.16 −.19 .02 −.23 −.24* −.3* −.26* −.089 .07 −.11 −.06 .026 −.2* −.05 −.14
P .73 .24 .13 .8 .07 .05 .02 .04 .4 .5 .3 .6 .8 .05 .6 .2
*Correlation is significant at the 0.05 level (2-tailed)

in the present experiments, with the addition of 65 dB SPL bus

noise, participants did not increase the preferred output levels.
This discrepancy between the results of the two studies may
be due to intrinsic differences in the background noise source
used in each study. Bus noise was utilized as a background
noise as this simulates the most realistic condition replicating
the environment where the majority of our participants used
their PMS in daily life. However, it is surprising that when
65 dB SPL bus noise was added, subjects did not significantly
raise the output levels of the PMS. Most likely, this is due to
the fact that all the subjects used insert earphones and these
Figure 9: The mean attenuation provided by the earphones
earphones may have attenuated the bus noise reaching the ear.
As a retrospective experiment we measured the attenuation
who listen to music through PMS may be putting themselves
created by the earphones on ten subjects who had participated
at risk for permanent noise induced hearing loss if exposed
in the original experiment. Figure 9 shows the mean
for extended periods of time (years).
attenuation provided by the earphones. As can be seen from
the figure, insert ear phones provided maximum attenuation
of about 23 dB around 3 kHz. Due to the attenuation of mid- However, the results of pure tone audiometry and otoacoustic
frequency bus noise, young adults may not have increased the emissions showed that there are no statistically significant
preferred volume control settings in the presence of bus noise. differences between pure tone hearing thresholds and
amplitudes of DPOAEs of individuals who use PMSs at Leq8h
The majority of the individuals listened to music at an over of less than 80 dBA,, individuals who used PMS at Leq8h of
SPLs less than 80 dBA even in the presence of 65 dB SPL more than 80 dBA and those who don’t. Readers should be
bus noise. No evidence based definition exists for hazardous cautious about interpreting these results of the present study as
sound levels of music. As a substitute, standards for exposure i) the measurement was done when subjects were listening
to occupational noise have been proposed for use.[11] In India, to one of their favorite songs and the listening level cannot
the Ministry of Environment and Forests[3] has proposed a be generalized to different kinds of music that individuals
time weighted average level of 80 dBA for an 8 hour period may be listening to during any particular day.
per day as the maximum permissible limit. ‘5 dB exchange ii) all participants in the present study were young adults
rule’ has been proposed by the Ministry of Environment and and were using PMS for a period of two years or more.
Forests as a tradeoff between exposure time and sound level. These young adults are less likely to show the signs of
Referencing this criterion about 30% individuals in a group noise induced hearing loss due to their limited length of
of 70 young adults listened to music above the safety limits listening time and because of their age.
prescribed by Ministry of Environment and Forests. This is iii) we measured the output levels in the ear canals of young
an alarmingly large proportion as one in three individuals adults. These results cannot be generalized to children as

Noise & Health, July-September 2009, Volume 11 138

 Kumar, et al.: Personal music system and hearing
output levels produced in their smaller ear canals may be
significantly more than what is reported in this study.
However, the results of correlation analysis between
exposure levels and audiological measures are interesting.
A significant positive correlation between hearing thresholds
and exposed music levels at 6000 Hz in both the ears suggests
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
that individuals who listened to music at high levels tend
to have higher pure tone hearing thresholds at 6000 Hz. A
negative correlation between DPOAE measures at high
frequencies and exposure levels suggest that individuals
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024
who listened to music at higher levels had reduced DPOAE
amplitudes and SNRs. It should be noted that all individuals
who used PMS had “clinically normal” hearing thresholds,
DPOAE amplitudes and SNRs and there was no group
difference between these measures among individuals who
uses PMSs at Leq8h of less than 80 dBA, individuals who used
PMS at Leq8h of more than 80 dBA and those who don’t.
Miller et al.,[27] reported that amplitudes of DPOAEs are more
sensitive to noise induced hearing loss than pure tone hearing
thresholds. Our results show that listening to music through
PMS at preferred volume control settings for a period of two
years may not result in “clinically significant” elevation of
hearing thresholds or reduction of DPOAE amplitudes and
SNRs. The correlations between output levels and auditory
measures suggest that listening to music through PMS at
higher intensities may cause subtle pre-clinical damage to
the auditory system and over the years such behavior may be
hazardous to hearing. However, these long-term effects need
to be studied through long-term controlled experiments.
Acknowledgement
Authors would like to thank Dr. T.A. Subba Rao, Principal, Dr. M.V
Shetty college of speech and hearing and management for all the
support.
Address for correspondence:
Dr. Ajith Kumar,
Dr. MV Shetty College of Speech and Hearing, Vidyanagar,
Mangalore – 575 013, India.
E-mail: ajithkumar18@gmail.com
References
1. World Health Organisation (WHO). 1999. Guidelines for community
Noise (edited by Berglundb., Lindvall T. and Schwela D.H.). Available
from: http://www.who.int/docstore/peh/noise/guidelines2.html
2. International Organization for Standardization, ISO 1999. Acoustics:
Determination occupational noise exposure and estimation of noise –
induced hearing impairement.Geneva: International Organization for
Standardization.
3. Ministry of Environment and Forest. (2000) S. O. 123 (E), [14/2/2000]
Noise pollution (Regulation control) Rules, 2000. Available from www.
envfor.nic.in/legis/legis.htm/#k (last accessed on 26 Sep 2008)
139
4. Wood WS, Lipscomb DM. Maximum available sound pressure levels
from stereo components. J Acoust Soc Am 1972;52:484-7.
5. Katz AE, Gertsman HL, Sanderson RG, Buchanan. Stereo ear phones
and hearing loss. N Engl J Med 1982;307:1460-1.
6. Catalano PJ, Levin SM. Noise Induced Hearing Loss and Portable
radios with headphones. Int J Pediatr Otorhinolaryngol 1985;9:59-67.
7. Lee PC, Senders CW, Gantz BJ, Otto SR. Transient sensory neural
hearing loss after over use of portable headphone cassette radios.
Otolaryngol Head Neck Surg 1985;93:633-25.
8. Fligor BJ Cox LC. Output levels of commercially available portable compact
disc players and the potential risk to hearing. Ear Hear 2004;24:513-27.
9. Williams W. Noise exposure levels from personal stereo use. Int J
Audiol 2005;44:231-6.
10. Airo E, Pekkarinen J, Olkinuora PL. Listening to Music with Earphones:
An assessment of Noise exposure. ACUSTICA, acta acustica
2001;82:885-94.
11. Hodgetts WE, Rieger JM, Szarko RA. The effects of listening
environment and earphone style on preferred listening levels of normal
hearing adults using an MP3 player. Ear Hear 2007;28:290-7.
12. Torre P. Young adults use and output level settings of personal music
systems. Ear Hear 2008;29:791-9.
13. Meyer-Bisch, C. Epidemiological evaluation of hearing damage related
to strongly amplified music (personal cassette players, Discotheques,
Rock concert)-high-definition and metric survey on 1364 subjects.
Audiol 1996;35:121-42.
14. Le page EL, Murray NM. Latent cochlear damage personal stereo users:
A study based on click – evoked otoacoustic emissions. Med J Aust
1998;169:588-92.
15. Montoya FS, Ibarquen AM, Vences AR, del Rey AS, Fernandez JM.
Evaluation of cochlear function in normal-hearing young adults exposed
to MP3player noise by analyzing transient evoked otoacoustic emissions
and distortion products. J Otolaryngol Head Neck Surg 2008;37:718-24.
16. Jerger J, Jerger S, Pepe P, Miller R. Race difference in susceptibility to
noise-induced hearing loss. Am J Otol 1986;7:425-9.
17. Ishii EK, Talbott EO. Race/ethnicity differences in the prevalence of
noise-induced hearing loss in a group of metal fabricating workers.
J Occup Environ Med 1998;40:661-6.
18. Hawkins D, Alvarez E, Houlihan J. Reliability of three types of probe
tube microphone measurements. Hear Instrum 1991;42:14-6.
19. Berger EH. Available from http://www.e-a-r.com/pdf/hearingcons/
FAQTFOE.pdf (last accessed on 03 Mar 2008).
20. Axelsson A, Lindgren F. Pop music and hearing. Ear Hear 1981;2:64-9.
21. Attias J, Horovitz G, El-Hatib N, Nageris, B. Detection and clinical
diagnosis of noise induced hearing loss by otoacoustic emissions. Noise
Health 2001;3:19-31.
22. Harris FP, Lonsbury - Martin BL, Stagner BB, Coats AC, Martin GK.
Acoustic distortion products in humans: Systematic changes in
amplitude as a function of f2/f1 ratio. J Acoust Soc Am 1989;85:220-9.
23. Gaskill, SA, Brown, AM. The behavior of the acoustic distortion
product,2f1-f2, from the human ear and its relation to auditory
sensitivity. J Acoust Soc Am 1990;88:821-39.
24. Grason-Stadler. Grason-Stadler GSI 60 DPOAE: Distortion product
otoacoustic emission system user manual. Milford, NH:GSI 1996;
Grason –Stadler.
25. Kim DO, Sun SM, Jung MD, Leonard G. A new method of measuring
distortion product otoacoustic emissions using multiple tone pairs:
Study of human adults. Ear Hearing 1997;18:277-85.
26. Painter J. Grason Stadler Incorprated (GSI) In: J. W. Hall editors. Handbook
of otoacousstic emissions. San Digo, CA: Singular; 2000. p. 291-303.
27. Lapsley Miller JA, Marshall L, Heller LM, Hughes LM. Low-level
otoacoustic emissions may predict susceptibility to noise-induced
hearing loss. J Acoust Soc Am 2006;120:280-96.
Source of Support: Nil, Conflict of Interest: None declared.
Noise & Health, July-September 2009, Volume 11
 Kumar, et al.: Personal music system and hearing

Appendix 1
Subject name: Ref no:
Age/sex
Note: please tick in the box
Do you listen to music? yes/no, if yes,which type of music:
 Pop
 Rock
Downloaded from http://journals.lww.com/nohe by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

 Hard metal
 Classic
 Reggae
 Others – specify:
Please specify the duration of listening to music on a daily basis ….Hr…min.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2024

What kind of device you used to listen music?

 Mobile
 Mp3 player
 i-pod
 Walkman
 Others – specify:
Please note: Manufacturer:
Model no:
At what loudness do you generally prefer to listen music?
 Low
 Medium
 High
Specify the situation when you listen to music?
 Travelling
 Reading
 Leisure time
 Others – specify:
Do you feel any problem in hearing for a short period of time after listening to music?
Do you feel any of the below mentioned sensation in the ear, when you stop listening to music after a long period:
 Blockage
 Ringing
 Heaviness
 Irritation
 Headache
While listening to music are you aware of the external or surrounding noises?
Do you feel?
 Happy
 Relaxed
 Active
After listening to music

Noise & Health, July-September 2009, Volume 11 140