Output capabilities of personal music players and assessment of preferred listening levels of test subjects: Outlining recommendations for preventing music-induced hearing loss

Objectives/Hypothesis: Our goal was to assess the impact of personal music players, earphones, and music styles on output, the subject's preferred listening levels, and outline recommendations for the prevention of music-induced hearing loss. Study Design: Experimental study. Personal music players' output capabilities and volunteers' preferred output levels were assessed in different settings. Based on current noise-induced hearing loss exposure limits, recommendations were outlined. Methods: On three different devices and earphone types and 10 music styles, free field equivalent sound pressure output levels were assessed by applying a microphone probe inside the auditory canal. Forty-five hearing-healthy volunteers were asked to select preferred listening levels in different background noise scenarios. Results: Sound pressure output reached 126 dB. No difference was found between device types, whereas earbud and supra-aural earphones showed significantly lower outputs than in-ear earphones (P < .001). Three distinct music style groups were identified with as much as 14.4 dB difference between them. In silence, 17.8% of volunteers spontaneously selected a listening level above 85 dB. With 90 dB background noise, 40% selected a level above 94 dB. Earphone attenuation capability was found to correlate significantly with preferred level reductions (r = 0.585, P < .001). In-ear and especially supra-aural earphones reduced preferred listening levels the most. Conclusions: Safe-use recommendations were outlined, whereas selecting the lowest volume setting comfortable remained the main suggestion. High background noise attenuating earphones may help in reducing comfortable listening levels and should be preferred. A risk table was elaborated, presenting time limits before reaching a risky exposure. Laryngoscope, 2012