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Music Induced Hearing Loss

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MUSIC INDUCED HEARING LOSS: IMPROVING LISTENING HABITS

INTRODUCTION It is now a norm in Singapore to see young individuals listen to music through their earphones or headphones in many of their typical day to day activities. Technological advances in audio devices have improved its sound quality and battery life thereby influencing more people to purchase such devices. Though it is generally regarded as a socially acceptable behaviour, detrimental effects will arise to the individual once there is abuse of audio volume in these devices. Unbeknownst to these teenagers, their exposure to music is condemning their ears to harmful levels of sound which will result in irreversible music induced hearing loss.
Music induced hearing loss by definition is the disorder in which a person has been exposed to high levels of music over a prolonged period of time (HealthBridges info, 2011). Data from Changi General Hospital states that in recent years, hearing loss cases amongst younger generations in Singapore have doubled (Ng, 2010). The higher incidence of hearing loss in the population stems from a combination of prolonged usage of audio devices at high levels which will deteriorate hearing ability over time (Faloon, 2010). Hence it is imperative that public ignorance be rectified as the problem will exacerbate if it remains unaddressed. Given the effectiveness of social media in Singapore and the relative ease of highlighting Singapore’s health issues to the level of public debate, it is critical that increasing public focus play a fundamental role in mitigating noise induced hearing loss.

Public Misconceptions of Hearing Loss

Ignorance about proper listening habits

There are many intricacies pertaining to proper music listening habits which the public might be unaware of. Almost half the number of youths nowadays are listening to music at near-maximum volume without prior knowledge of what volume levels their hearing can safely endure (Vogel, 2009). Music players currently give a maximum output level of over 100 dB (Figure 1) which is in fact, comparable to being in 1m proximity with a chainsaw (Table 4, see Appendix) In addition, there is a significant number of youths who listen to their audio devices at high volumes for approximately two to three hours per day (Faloon, 2010). However, they might be unaware that recommended listening periods for certain types of earphones at high volume ranges from approximately an hour to mere minutes per day, as shown by the statistics in Table 2.

Figure 1: Output levels of music for different music players
Source: National Hearing Conservation Association (2006) Table 2 Recommended listening periods at different volume levels

Source: National Hearing Conservation Association (2006)

Misconception on the onset of hearing loss

Many are unaware that hearing loss afflicts not just senior Singaporeans but also a significant number of the younger generation as well. A majority of youths are under the misimpression that music induced hearing loss only becomes a pertinent issue when they reach middle to senior age (Vogel, 2009). However they do not realise that currently, 40 per cent of hearing loss cases are suffered by individuals forty years and younger (Ng, 2010). It is this misconception which then breeds a sense of nonchalance in Singaporean youths about their listening habits.

Lack of detecting measures of hearing loss
There is a lack of measures detecting the onset of music induced hearing loss amongst young Singaporeans. The detrimental effects of hearing loss can actually occur without the knowledge of the individual due to its subtle nature. A study conducted by associate professor Lynne Lim director of the Centre for Hearing Intervention and Language Development at the National University Hospital showed that a fifth of the participants involved had no knowledge that they suffered from hearing loss (Quek, 2010). The ignorance concerning this issue arises from the fact that the onset of hearing loss can only be detected through a proper hearing test, which the Singaporean youths of today are hardly exposed to. Even through government health legislation, only students in primary one are exposed to such tests to check their hearing ability, whereas eyesight tests are conducted more frequently (Table 5, see Appendix). Due to this lack of exposure, the detection of hearing loss among the masses is minimal, thus resulting in the general sense of nonchalance concerning the overall issue.

Irreversibility of hearing loss
Once inflicted, music induced hearing loss is irreversible. Dr Yuen Hang Wai, an otolaryngologist from Changi General Hospital explains that listening to loud music for extended periods will cause permanent damage to the ear. Thus any degree of hearing loss is considered to be irreparable regardless of severity (Poon, 2010). This has serious implications for the individual as those who are already suffering from mild hearing loss are already accustomed to loud audio volumes and would have no qualms with increasing the volume even further to compensate for their decrease in hearing ability.

Consequences of hearing loss
Even for mild cases of hearing loss, treatment cost is expensive. Purchase of hearing aids can cost up to thousands of dollars (SingHealth, 2003). This is a pertinent problem for lower income families or individuals if they were forced to bear such costs financially. There is also the possibility that those who are hearing impaired will choose to overlook seeking treatment due to its high cost. Furthermore with the perceptive unpopularity of hearing aid devices amongst adolescents and teenagers, those affected by hearing loss will be unwilling to seek consultation on measures to artificially restore their hearing abilities (Vogel, 2009). The knowledge that they have hearing impairment coupled with their unwillingness to seek treatment can result in psychological detriments such as embarrassment, depression and low self-esteem (Low, 2005).

Current responses and limitations
There have been efforts to enhance the awareness of the public to hearing health. In 2010, Siemens Singapore launched an application on iPhone to conveniently test your hearing. However, public education on the benefits of early diagnosis of hearing loss through hearing test should be done in conjunction with such applications. Once the public is made aware of the dangers of hearing loss, they would have incentive to go for regular hearing check-ups. The hearing test by Siemens is also not a viable replacement for the actual test conducted by a certified professional.
In Singapore, there is greater emphasis to prevent noise induced hearing loss at the workplace. For example, there have been many pamphlets and brochures including those by Workplace Safety and Health Council to educate workers regarding hearing safety regulations implemented here (Tan, Leong, and Ng, 2012). Unfortunately, there are not many responses to music induced hearing loss at this instance.

RECOMMENDATIONS
Media advertising
Media advertising can help increase public awareness of music induced hearing loss. Research on media advertising effectiveness conducted by the National Health Service in the United Kingdom has shown that advertisements are capable of educating the public and thus provide the motive for public debate (NHS, 2004). Media advertisements should display public misconceptions previously stated earlier, followed by the facts and statistics refuting them. Warning labels and graphic images on earphones packaging regarding music induced hearing loss would make the public more aware of its potential threat. This has been proven effective in anti-smoking labels on cigarette packs where large pictures depict detrimental messages about potential smoking hazards (Riordan, 2012). Figure 3 is an example of a warning label that could be placed on such packaging. The information displayed on these labels are able to quell public misconceptions and create awareness about music induced hearing loss amongst the masses. A multi-pronged approach in media advertising and labelled product packaging will be helpful in increasing public awareness about the issue.

Figure 3: Example of a warning label on earphones packaging

Inculcation into schools
Awareness about hearing loss should be implemented through talks and exhibitions in Singapore’s schools. Research from the National Health Service in the United Kingdom has shown that talks providing accurate information through specific messages are capable of effectively bringing about changes in social behaviour (NHS, 2004). The overall theme of each talk and exhibition would be to address the current underestimations which young students might have about music induced hearing loss. This can also be accompanied by information on healthy music listening habits and on the recommended listening periods for different types of earphones, as shown previously in figure 1. Exhibitions can also be organised containing interactive pedagogies and games. This will gain more appeal with adolescents who are generally more receptive to information and communication technologies (Miller, 2008; Squire, 2002).
Furthermore, free hearing trials can be conducted during the exhibitions themselves so that attendees can immediately identify themselves as those experiencing mild cases of hearing loss. Hence, it is viable for these campaigns to be conducted by schools in conjunction with local hearing aid companies such as BayAudio and Beltone Singapore as these companies would benefit due to the potential influx of consumers. This will potentially improve the reputations of their hearing aid shops and also aid in their aim to reach out to the younger generations about the pertinence of music induced hearing loss (Quek, 2010).

Implementation of compulsory of hearing test
Hearing tests are the best way to determine the existence and severity of hearing loss in an individual. As stated previously, only students in primary one are subjected to such tests to check their hearing ability. However, due to the rising trend of young people diagnosed with hearing defects at such a young age, the Ministry of Health should make regular hearing tests mandatory for students from primary two to secondary four. The hearing tests are effective in detecting any hearing defects. For those with some form of hearing loss, the doctors can better inform them and the parents or guardians involved about the causes of hearing disability and the forms of treatment available. Such an implementation can hopefully raise awareness for hearing loss and prevent students from further harming their hearing. The parents will then be able to monitor the listening habits of their children and advise them appropriately.
The overall intent of all these measures will then raise this issue to the level of public debate. With enough public attention, this will spur the involvement of government health bodies and other autonomous health organisations such as the Health Promotion Board and the Singapore Association for the Deaf. Their resources and wider outreach will enable a formal campaign to be established with more media exposure and interaction for a larger public audience.

Conclusion
There is no doubt that music induced hearing loss continues to impede Singaporean society by afflicting those of the younger generation. With the advancement of communication technology and the receptivity of public health campaigns in Singapore, increased awareness on the risks of listening to loud music can be communicated more effectively through means of mass media and through reaching out to student bodies across the country. Although we suggested solutions to raise awareness on music induced hearing loss, the onus is upon the individual on whether the measures are indeed effective. The society can only do so much and it is up to every individual to practice safe and healthy listening habits.

Reference
Falloon, K (2010, June). Noise-induced hearing loss is completely preventable. Retrieved from http://search.proquest.com.libproxy1.nus.edu.sg/docview/507587300
Health Development Agency (2004). The effectiveness of public health campaigns. Retrieved from http://www.nice.org.uk/niceMedia/documents/CHB7-campaigns-14-7.pdf
Health Promotion Board (2012, October). Singapore comes together to celebrate 20 years of healthy lifestyle. Retrived from http://www.news.gov.sg/public/sgpc/en/media_releases/agencies/hpb/press_release/P-201210261/AttachmentPar/0/file/Media%20Release%20National%20Healthy%20Lifestyle%20Campaign%202012%20%20%28FINAL%29.pdf
Low, W.K (2005). Managing hearing loss in Children and Adults: Singapore Context. Retrieved from http://www.annals.edu.sg/cpdMay05.html
Miller, L. C., Christensen, J. L., Godoy, C. G., Appleby, P. R., Corsbie-Massay, C., & Read, S. J. (2008). Reducing risky sexual decision-making in the virtual and in the real world: Serious games, intelligent agents, and a solve approach. In M. Cody, U. Ritterfeld, P. Vorderer (Eds.), Serious games: Mechanisms and effects (pp. 34-37). London: Routledge.
Ng J.Y. (2010, November). More younger people suffer hearing loss. Retrieved from http://news.xin.msn.com/en/singapore/article.aspx?cp-documentid=4455177
Poon, C.H. (September, 2010). Hearing Loss – Irreversible Damage. Retrieved http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Hearing-Loss-Irreversible-Damage.aspx
Quek, E (May, 2010). Turn down Hearing Loss. Retrieved from http://www.healthxchange.com.sg/News/Pages/Turn-down-hearing-loss.aspx
Riordan, M (2012, August). Tobacco warning labels: evidence of effectiveness. Retrieved from http://www.tobaccofreekids.org/research/factsheets/pdf/0325.pdf
SingHealth (2003, July). Hearing Aids for Adults. Retrieved from http://www.sgh.com.sg/Clinical-Departments-Centers/Otolaryngology/Documents/PDF/Hearingaids.pdf
Tan K.T., Leong L, & Ng Z (2012) Workplace Safety and Health Guidelines - Hearing Conservation Programme Retrieved from http://www.mom.gov.sg/Documents/safety-health/Guidelines%20on%20Hearing%20Conservation%20Programme.pdf
Vogel, I, Brug, J, Hosli, E.J., van der Ploeg, C.P.B, Raat, H (2009) MP3 Players and Hearing Loss: Adolescents’ Perceptions of Loud Music and Hearing Conservation. Retrieved from http://www.sciencedirect.com.libproxy1.nus.edu.sg/science/article/pii/S0022347607006610
Western Pennsylvania Health Information (2011, October). Music Induced Hearing Loss Is Becoming A Big Problem. Retrieved from http://www.healthbridges.info/?p=1081

Appendix
Table 4
Table of sound levels

Source: Sengpielaudio (n.d.)

Table 5
Health screening in schools from primary 1 to secondary 4

Source: Health Promotion Board (n.d.)

Evaluation of Sources

Group no: 12 E36
Names of Students:
Muhammad Farhan Bin Abdul Rahman
Muhammad Soffian Bin Yusoff

No. | Relevant Databases | Reason(s) for selection | 1 | PubMed | 1. There are many medical journals and studies conducted on the causes and effects of hearing loss with very specific results and sample size group. 2. The statistics provided by the journals are recent and very relevant. For example, studies were conducted on the usage of earphones. | 2 | ProQuest | 1. Contains comprehensive medical journals and articles complete with recommendations on how to tackle the issues involved. 2. Gives a global perspective on the prevalence of the issue involved. |

No. | Irrelevant Database | Reason(s) for selection | 1 | Factiva | 1. Although it contains articles pertaining to medical issues, there are none which are specific to music induced hearing loss. | 2 | Academic OneFile | 1. Even though there were many articles and reports, many of the reports were not available in full-text. |

No. | Relevant Database | The most relevant reference | Reason(s) for selection | 1 | PubMed | Vogel,Verschuure, van der Ploeg, Brug & Raat (2009, June 6). Adolescents and MP3 Players: Too Many Risks, Too Few Precautions. Pediatrics Vol.12 Retrieved from http://pediatrics.aappublications.org.libproxy1.nus.edu.sg/content/123/6/e953.long | 1. The articles displays deeply relevant and specific information about the relationship between music induced hearing loss in youths and the usage of audio devices. 2. It encompasses many aspects such as the average music volumes which youths listen to, and the duration in which they listen to music. | 2 | ProQuest | Faloon, K (2010, June 23) Noise-induced hearing loss is completely preventable. McClatchy - Tribune Business News [Washington] Retrieved from http://search.proquest.com.libproxy1.nus.edu.sg/docview/507587300/13D444D7CB91C6DB7D0/1?accountid=13876 | 1. Gives insights and opinions of professional medical experts about the issue of noise induced hearing loss. 2. Provides suitable elaboration on recommendations and solutions pertaining to the issue which are carried out in other countries. |…...

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...The purpose of this paper is to discuss how to live with hearing loss and methods to cope with the emotional, psychological, and social effects of a hearing loss. The physical aspects of hearing impairment, including hearing mechanisms and how the ear functions are also discussed. The topic is important because understanding the various causes of hearing loss in addition to methods and resources to help with coping with a hearing loss will assist in improving communication with family members, friends, co-workers and complete strangers resulting in a better quality of life. This paper is organized into seven sections. Section one will discuss how hearing loss affect people in the U.S.; the physical parts of the human ear; how the ear functions, and different types of hearing loss. Section two will discuss the psychological, (i.e., social and emotional) effects of hearing loss. Section three will discuss how hearing loss can effect relationships. Section four will discuss where to seek medical help. Section five will discuss the pros and cons of hearing aids and associated cost. Section six will discuss tinnitus (ringing or roaring in the ear), and my personal experience coping with tinnitus and hearing loss. Section seven will present the conclusion. People of all ages suffer from hearing loss and in particular as a result of noise damage, whereby “many cases of hearing loss – at least 10 million of the 28 million total cases in the U.S. – are a......

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Hearing Loss and Perceptual Development

...Hearing Loss and Perceptual Development By Audrey Davies due by April, 6 2012 Psych 310 1 Intro Perceptual development is the way in which we use our senses to gather and organize information in order to understand and interpret the world around us. We gather information through sensory stimuli by hearing, seeing, touching, smelling, and tasting. Starting from infancy, perceptual development begins when babies begin to take the world in through these senses. They begin by giving meaning to the objects that they see and hear. According to Mark K. Fagan and David B. Pisoni, “infants learn about their environment through sensory exploration, acquiring knowledge that is important for cognitive development...the fundamental information that infants obtain through sensory perception and exploration of their environment contributes to the learning and development of important cognitive concepts” (Fagan & Pisoni, 2009). Hearing is especially important and key to their brain development, and any deficiency can possibly lead to delays in speech, and language. Hearing loss is a result of several reasons such as trauma, severe ear infections, in utero infections and a vast number of other diseases and disorders. In all actuality we hear with our brains and not our ears. However the ears play an important function which allows us to transmit sound. Before going into further details here is some basics of the auditory system. The Cochlea is the is the......

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