do negative attitudes towards loud music prevent music- induced hearing loss? stephen widén...

Do negative attitudes towards Do negative attitudes towards loud music prevent music-loud music prevent music-

induced hearing loss?induced hearing loss?

Stephen WidénStephen Widén University West, SwedenUniversity West, SwedenSoly ErlandssonSoly Erlandsson University West, SwedenUniversity West, SwedenMargareta BohlinMargareta Bohlin University West, SwedenUniversity West, SwedenAlice HolmesAlice Holmes Gainsville, University of FloridaGainsville, University of FloridaTed JohnsonTed Johnson Elmira, College, Elmira, New YorkElmira, College, Elmira, New York

Some empirical work…Some empirical work…

Widén, Holmes, A.E., Johnson, T., Bohlin, M., & Erlandsson, S.I. (2009). Hearing, use of Widén, Holmes, A.E., Johnson, T., Bohlin, M., & Erlandsson, S.I. (2009). Hearing, use of hearing protection, and attitudes towards noise among young American adults. hearing protection, and attitudes towards noise among young American adults. International Journal of Audiology; 48International Journal of Audiology; 48: 537-545: 537-545

Erlandsson, S.I., Holmes, A.E., Widén, S.E., Bohlin, M. (2008). Erlandsson, S.I., Holmes, A.E., Widén, S.E., Bohlin, M. (2008). Cultural and social Cultural and social perspperspectives on attitudes, ectives on attitudes, noise and risk behaviour in children and young adults. noise and risk behaviour in children and young adults. Seminars in Hearing, 29:Seminars in Hearing, 29: 29-41. 29-41.

Holmes A.E., Widén, S.E., Erlandsson, S.E., Carver, C.L.,White, L.L. (2007). Perceived Holmes A.E., Widén, S.E., Erlandsson, S.E., Carver, C.L.,White, L.L. (2007). Perceived hearing status and attitudes towards noise in young adults. hearing status and attitudes towards noise in young adults. American Journal of American Journal of Audiology, 16: Audiology, 16: 182-189.182-189.

Widén, S.E., & Erlandsson, S.I. (2007). Widén, S.E., & Erlandsson, S.I. (2007). Risk perception in musical settings –a Risk perception in musical settings –a qualitative study. qualitative study. International Journal of Qualitative Studies on Health and Well-International Journal of Qualitative Studies on Health and Well-being 2:1,being 2:1, 33-44. 33-44.

Widén, S.E., Holmes, A.E., Erlandsson, S.I. (2006). Reported Hearing Protection Use in Widén, S.E., Holmes, A.E., Erlandsson, S.I. (2006). Reported Hearing Protection Use in Young Adults from Sweden and the USA: Effects of Attitude and Gender. Young Adults from Sweden and the USA: Effects of Attitude and Gender. International International Journal of Audiology 45: Journal of Audiology 45: 273-280.273-280.

Olsen Widén, S.E., & Erlandsson, S.I. (2004). The Influence of Socio-Economic Status Olsen Widén, S.E., & Erlandsson, S.I. (2004). The Influence of Socio-Economic Status on Adolescent Attitude to Social Noise and Hearing Protection. on Adolescent Attitude to Social Noise and Hearing Protection. Noise & Health 7: 25, Noise & Health 7: 25, 59-70.59-70.

Noise or music?Noise or music?

””It´s a matter of perception and It´s a matter of perception and attitudes”attitudes”

What is music for the adolescent is What is music for the adolescent is most likely noise to the parent… most likely noise to the parent…

Loud decibels may be harmful to the Loud decibels may be harmful to the hearing independently of it´s origin.hearing independently of it´s origin.

General purposes with the researchGeneral purposes with the research

To get an understanding for adolescents’ To get an understanding for adolescents’ health risktaking behaviour regarding health risktaking behaviour regarding noise exposure e.g. why do some use noise exposure e.g. why do some use hearing protection and other’s not?hearing protection and other’s not?

To provide a theoretical framework to be To provide a theoretical framework to be able to describe and understand able to describe and understand adolescents’ risk taking behaviour adolescents’ risk taking behaviour regarding music exposureregarding music exposure..

Definitions of Risk and Risk PerceptionDefinitions of Risk and Risk Perception

Risk can be defined as an objective reality, Risk can be defined as an objective reality, which means that risks exists independently of which means that risks exists independently of individuals’ awareness of them.individuals’ awareness of them.

Risk perception can be defined as a social Risk perception can be defined as a social construction, the risk will be created as an construction, the risk will be created as an construction in our mind, when we notice construction in our mind, when we notice something being dangerous. something being dangerous.

Discourse in society makes us become aware of Discourse in society makes us become aware of the risks.the risks.

Experiences (own as well as other’s) makes Experiences (own as well as other’s) makes become aware of risks.become aware of risks.

Possible risks associated with loud musicPossible risks associated with loud music

Stronger and better digital technique, improves the quality Stronger and better digital technique, improves the quality of the sound, makes it more comfortable to listen to.of the sound, makes it more comfortable to listen to.

Frequence and duration of exposure are important for the Frequence and duration of exposure are important for the development of a hearing impairement.development of a hearing impairement.

Hearing impairements are also a social handicap that Hearing impairements are also a social handicap that affects our ability to communicate, (secondary effect).affects our ability to communicate, (secondary effect).

Adolescence is a relatively short period of life, but Adolescence is a relatively short period of life, but established habits during this time may have consequences established habits during this time may have consequences to the health later in life, and the consequences may be to the health later in life, and the consequences may be difficult to perceive.difficult to perceive.

Theoretical perspectives on why Theoretical perspectives on why adolescents expose themselves to loud adolescents expose themselves to loud

decibels in musical settingsdecibels in musical settings

Music is an important ingredient in many

adolescents’ creation of an identity.

Self imageJudgement of

risksNorms and

ideals

SocialNorm

Perceivedsusceptib-

ility

Norm.Ideals

Risk considera

tion

Attitudes

Behaviour

Experience

Study: Hearing, use of hearing protection, and Study: Hearing, use of hearing protection, and attitudes toward noise among young American attitudes toward noise among young American

AdultsAdults

Participants:Participants:

Sample 258 undergraduate students (age 17-21)Sample 258 undergraduate students (age 17-21)

Gender distribution was 28% male, and 72% Gender distribution was 28% male, and 72% female.female.

Socio-economic background was homogenious Socio-economic background was homogenious (high or medium high education level of the (high or medium high education level of the parents).parents).

Audiological measurementsAudiological measurements

Otoscopy, individuals with impacted cerumen Otoscopy, individuals with impacted cerumen were excludedwere excluded

Tympanometry, excluding people with middle ear Tympanometry, excluding people with middle ear problemsproblems

Hearing screening (pure-tone audiometry) in a Hearing screening (pure-tone audiometry) in a sound-attenuated audiology booth, 20 dB was the sound-attenuated audiology booth, 20 dB was the screening criterion. screening criterion.

Screening 500, 1000, 2000, 4000 and 6000Hz.Screening 500, 1000, 2000, 4000 and 6000Hz.

QuestionnairesQuestionnaires

Hearing symptom description scale (Erlandsson & Hearing symptom description scale (Erlandsson & Olsen 2004).Olsen 2004).

Adolescents Habits and Use of Hearing Protection Adolescents Habits and Use of Hearing Protection (Erlandsson & Olsen, 2004).(Erlandsson & Olsen, 2004).

Youth Attitude Towards Noise scale (Widén & Youth Attitude Towards Noise scale (Widén & Erlandsson 2006). Erlandsson 2006).

ResultsResults

Out of 258, 67 (26%) failed the pure tone audiometryOut of 258, 67 (26%) failed the pure tone audiometry

26% of those who reported they had normal (n=247) 26% of those who reported they had normal (n=247) hearing actually failed the screening test.hearing actually failed the screening test.

11 persons reported in the questionnaire that they had a 11 persons reported in the questionnaire that they had a hearing loss, but only 3 of these failed the screening test. hearing loss, but only 3 of these failed the screening test.

Noise sensitivity was reported by 81 persons (31%). Out of Noise sensitivity was reported by 81 persons (31%). Out of them 25% failed the screening test.them 25% failed the screening test.

ResultsResults

Temporary self-reported hearing symptoms were Temporary self-reported hearing symptoms were reported mostly in music related activities reported mostly in music related activities (discos, concerts, clubs).(discos, concerts, clubs).

Temporary tinnitus (lasting 24h or more after Temporary tinnitus (lasting 24h or more after noise exposure) were reported by 15%.noise exposure) were reported by 15%.

Nearly 50% reported that they on occation had Nearly 50% reported that they on occation had

experienced pain in relation to loud volumes experienced pain in relation to loud volumes (discos 10%, concerts 38%).(discos 10%, concerts 38%).

Results symptoms and attitudesResults symptoms and attitudes

In general, those experiencing temporary In general, those experiencing temporary symptoms (ear pain, temporary tinnitus) symptoms (ear pain, temporary tinnitus) held significantly more anti-nose attitudes.held significantly more anti-nose attitudes.

Anti-noise attitudes in turn are Anti-noise attitudes in turn are significantly related to more frequent use significantly related to more frequent use of hearing protection.of hearing protection.

4 ”symptom groups”4 ”symptom groups”

No hearing problem at all (n = 127)No hearing problem at all (n = 127)

Failed hearing screening (n = 47)Failed hearing screening (n = 47)

Noise sensitivity (n = 57)Noise sensitivity (n = 57)

Failed hearing screening + noise Failed hearing screening + noise sensitivity (n = 20)sensitivity (n = 20)

4 symptom groups and attitudes4 symptom groups and attitudes

Significant differences between the 4 Significant differences between the 4 groupsgroups

Those with no self experienced symptoms Those with no self experienced symptoms or those who failed the hearing screening or those who failed the hearing screening held the most pro-noise attitudes, whereas held the most pro-noise attitudes, whereas those reporting noise sensitivity (or a those reporting noise sensitivity (or a combination of noise sensitivity and failing combination of noise sensitivity and failing hearing screening) held the most anti-hearing screening) held the most anti-noise attitudes.noise attitudes.

ConclusionConclusion

Self experienced symptoms are more positively Self experienced symptoms are more positively related to stronger anti noise attitudes than related to stronger anti noise attitudes than hearing loss on its own. hearing loss on its own.

Self experienced symptoms may serve as a ”feed Self experienced symptoms may serve as a ”feed back” that noise may be a problem, whereas back” that noise may be a problem, whereas threshold shifts pass unnoticed to the individual. threshold shifts pass unnoticed to the individual. Therefore, it is not possible to take action Therefore, it is not possible to take action regarding the behaviour, when you are not aware regarding the behaviour, when you are not aware of that you have a problem. of that you have a problem.

Previous studies confirms that:Previous studies confirms that:

Self experienced symptoms such as noise Self experienced symptoms such as noise sensitivity, temporary or permanent sensitivity, temporary or permanent tinnitus, and ear pain are associated with tinnitus, and ear pain are associated with more anti-noise attitudes and a higher more anti-noise attitudes and a higher degree of hearing protection use, whereas degree of hearing protection use, whereas no experience of hearing ”problems” are no experience of hearing ”problems” are associated with more pro-noise attitudes associated with more pro-noise attitudes and less hearing protection use at and less hearing protection use at concerts and discos. concerts and discos.

ReflectionsReflections

It’s our awareness of a health problem It’s our awareness of a health problem (from feed back) and the interpretation we (from feed back) and the interpretation we make of this, that may serve as a trigger make of this, that may serve as a trigger for changing our attitudes and behaviour.for changing our attitudes and behaviour.

Discourse are important for how we Discourse are important for how we interpret the feed back, that is, the interpret the feed back, that is, the perception of noise/music as a risk. perception of noise/music as a risk.

Preventive workPreventive work

Attitude and behavioural change are Attitude and behavioural change are important aspects in preventive important aspects in preventive work.work.

By providing ”good” knowledge By providing ”good” knowledge about noise and hearing, it may about noise and hearing, it may affect adolescents attitudes and affect adolescents attitudes and behaviour in a health preventive behaviour in a health preventive way.way.

Hearing screening versus self reports…Hearing screening versus self reports…

In total 67 persons failed the hearing In total 67 persons failed the hearing screening test, only 3 of them (4%) screening test, only 3 of them (4%) had reported in the questionnaire had reported in the questionnaire that they had a hearing loss.that they had a hearing loss.

8 out of 11 (73%) self reported 8 out of 11 (73%) self reported hearing loss could hearing loss could notnot be verified in be verified in the hearing screening test.the hearing screening test.

We have a measurement problem!We have a measurement problem!

The reliability of self reports The reliability of self reports (questionnaires) within health research (questionnaires) within health research should be called in question. should be called in question.

What reliability problems are there with What reliability problems are there with screening tests?screening tests?

Does these two measurements measure Does these two measurements measure the same thing? the same thing?

ContactsContacts

stephen.widen@hv.se