Noise-induced hearing loss occurs when loud sounds damage the delicate structures of the inner ear. Most people associate noise trauma with explosive sounds. However, in our daily lives we are also exposed to noise trauma risk when we use earphones and headphones , for example to listen to music, audiobooks or podcasts. Avoiding noise trauma is one of the most effective ways to reduce the risk of deafness. Therefore, to use these devices safely, it is also necessary to know how to make good choices and follow some precautions. How does noise-induced hearing loss occurs? Neither earphones nor headphones are completely harmless. What most influences the risk of noise trauma is the combination of sound intensity (measured in decibels) and duration of exposure to noise. Choosing a safe sound level Listening to music above 85 decibels (dB) for long periods can cause irreversible hearing damage . According to the National Institute for Occupational Safety and Health (NIOSH) and the Centers for Disease Control and Prevention (CDC), a sound level of 85 dB is considered safe for up to 8 hours. For every 3 dB increase, the safe listening time is halved, for example: 88 dB: 4 hours; 91 dB: 2 hours; 94 dB: 1 hour; 97 dB: 30 minutes; 100 dB: 15 minutes. Many music players easily reach 100 dB, which drastically reduces safe listening time. However, most modern devices alert users when the volume reaches potentially harmful levels. The problem is that these warnings are often ignored. Therefore, a prudent recommendation is to always keep the volume below 70% of the device total capacity . Do not exceed exposure time Since exposure time is also very important, the 60/60 rule is recommended for safety , that is: Listen at 60% of the maximum volume for a maximum of 60 minutes. Then, take a break of at least 30 minutes. Headphones or earphones: which is the best option? Risk of noise trauma Although volume and exposure time are the main factors, the type of device also influences the risk of noise trauma . Headphones cover the ear (over-ear) and therefore are outside the external auditory canal, meaning the sound source is not as close to the eardrum as in-earphones. In addition to allowing listening at lower intensities, headphones also often have active noise cancellation, which avoids having to increase the volume in noisier environments, such as on airplanes. However, headphones are not harmless and, if used at high volume for too long, can also cause noise trauma. Headphones are generally more comfortable during prolonged use, but can cause discomfort if they are too tight. Pressing on the earlobe can cause pain, skin irritation, and chondritis (cartilage infection), which is more difficult to treat and can lead to irreversible ear deformation. Therefore, pain is always a warning sign, and if it happens, the headphones should be adjusted or replaced. Earphones end up being the most used because they are compact and easy to carry. However, the sound is emitted closer to the eardrum and can be up to 9 dB louder than that emitted by headphones at the same volume level. Therefore, the safe listening time decreases from two hours to 15 minutes, even when listening at 91 dB. Since earphones are not as associated with active noise cancellation, they end up encouraging increased volume in noisy environments. Other aspects to consider Besides the risk of noise trauma, there are other relevant factors to consider when deciding which device to purchase. The external auditory canal naturally contains earwax and bacteria. Earphones, being inserted into this canal, end up pushing the earwax deeper , increasing the risk of its accumulation. Additionally, the user ends up feeling the need to increase the volume. Earphones are also associated with a higher risk of irritation and consequent external otitis, due to friction, especially if they are not properly cleaned. By occluding the external auditory canal, earphones promote the moisture retention , especially after exercising, which creates a suitable environment for the proliferation of microorganisms, such as bacteria and fungi. It is known that they can lead to an increase of up to 11 times more bacteria in the external auditory canal. The use of any of these devices – headphones and earphones – while walking, cycling or driving, can reduce the perception of sound . Environmental noises, such as horns or sirens, can seriously compromise safety, especially in urban areas. If you still want to listen to music, use only one earphone or opt for bone conduction headphones, which allow you to simultaneously hear what happens in the surrounding environment. Essential care to protect hearing Hearing loss is often a gradual and irreversible process. The good news is that, in most cases, it is preventable. When it comes to using headphones and earphones, there are a number of precautions to take to use them correctly and prevent hearing loss: 1. Lower the volume Set a maximum limit on your device, ideally below 70%. 2. Take regular breaks to limit exposure time Follow the 60/60 rule to allow your ears to recover: up to 60% of the maximum volume for a maximum of 60 minutes at a time. 3. Prefer over-ear headphones They reduce the intensity of direct sound in the external auditory canal. 4. Choose models with noise cancellation Especially important in noisy environments, such as airplanes. 5. Adjust the bass on the equalizer If you appreciate the vibration (bass effect), you can slightly increase the bass in the settings instead of increasing the volume. 6. Do not sleep listening to music with headphones or earphones 7. If you suffer from tinnitus (ringing in the ears) or a feeling of fullness in the ear (a "blocked" ear), you should reduce the use of hearing aids . 8. Do not share headphones or earphones with other people , clean them weekly (and whenever they are visibly dirty) with cotton lightly moistened with alcohol (especially if used during physical exercise), store them in a clean, dry case, and avoid using them if you have any wounds in your ear, due to the risk of infection. In short… Although no device is harmless, headphones end up being the ones with the least risk of infection, earwax buildup, and noise trauma. Whatever the device, it is always important to follow the necessary precautions to protect your hearing. Listening to music should enrich your life and not compromise one of your most valuable senses. Sources American Academy of Otolaryngology-Head and Neck Surgery. Your ear gear and hearing health . Dinnauer P. Earbuds vs. over-the-ear headphones: which should you Use? Hearing Health Foundation . de Waard D, Edlinger K, Brookhuis K. Effects of listening to music, and of using a handheld and handsfree telephone on cycling behavior. Transportation Research Part F: Traffic Psychology and Behaviour 2011;14:626-37. Mukhopadhyay C, Basak S, Gupta S, Chawla K, Bairy I. A comparative analysis of bacterial growth with earphone use. Online J Health Allied Scs 2008;7(2):4. Author : Patrícia Fernandes Lopes (otorhinolaryngology) Meet the otorhinolaryngology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
