Personal Listening Device Use and Hearing Threshold Alterations in University Students: A Cross-Sectional Audiometric Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: University students are at increased risk of noise-induced auditory damage because of prolonged use of personal listening devices (PLDs), including earphones, headphones, and wireless earbuds. Continuous exposure to high-volume sound may lead to subclinical cochlear damage or “hidden hearing loss,” which can occur before abnormalities appear on conventional audiograms. Objective: To evaluate the audiometric impact of PLD use on hearing thresholds among university students and to examine associations between device type, noise exposure, tinnitus, and subclinical auditory changes. Methodology: A cross-sectional study was conducted among 323 university students aged 18–25 years at Shifa Tameer-e-Millat University after Institutional Review Board approval (IRB #472-25). Participants were recruited using convenience sampling. Exclusion criteria encompassed pre-existing hearing loss, any documented audiological disorder or chronic medical conditions known to affect auditory function (e.g., otosclerosis, Meniere's disease, ototoxic medication use), and a history of significant head trauma or ear surgery. Data were collected using a validated, structured questionnaire assessing listening habits, device type, PLD duration and frequency, loud-noise exposure, and tinnitus symptoms. Air conduction pure tone audiometry was performed bilaterally at 500 Hz, 1 kHz, 2 kHz, and 4 kHz using a calibrated audiometer. Hearing thresholds greater than 25 dB HL in the absence of overt hearing complaints were considered indicative of hidden hearing loss. Continuous variables were tested for distributional normality using the Shapiro-Wilk and Kolmogorov-Smirnov tests. Chi-square tests of independence were applied to assess associations between categorical variables. Results: The mean participant age was 22.32±1.83 years; 172 (53.3%) were males, and 151 (46.7%) were females. Hidden hearing loss was identified in 12.7% of left ears and 22.3% of right ears. Loud noise exposure showed a significant association with hidden hearing loss in the right ear (p<0.001). Tinnitus was reported by 51 participants (15.8%) and was significantly associated with left-ear hidden hearing loss (p<0.001). Conclusion: Subclinical auditory changes were detected in a considerable proportion of PLD using university students, suggesting early noise-induced cochlear damage before conventional audiometric impairment becomes evident. These findings highlight the importance of hearing conservation programmes, safe listening education, and routine audiological screening in university settings.
DOI: 10.55735/pkp8bn19
Institution: Shifa Tameer-e-Millat University
Language: English
Subfield: Sensory Systems
Field: Neuroscience
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7162009331