Youth Hearing Health: Device Use & Noise Impact Study

Over a 13-year period, the rate of tinnitus reported by adolescents after loud leisure activities tripled. This is a central finding from a longitudinal study that tracked the hearing health and listening habits of young Canadians from 2009/2010 to 2022/2023. Researchers Katya Feder, Leonora Marro, and E.P. Fitzpatrick re-examined 237 participants, now aged 10-17, to see how behaviors and hearing outcomes had changed.

How the Study Tracked Changes in Hearing Habits

The study employed a longitudinal design, meaning the same group of individuals was assessed at two points in time, 13 years apart. At both Time 1 and Time 2, participants completed a detailed questionnaire. This survey asked about their use of personal listening devices (PLDs like smartphones and MP3 players), volume levels, duration of use, earbud tightness, exposure to other sources of leisure noise (concerts, sports events), use of hearing protection, and any self-reported hearing symptoms like tinnitus or difficulty following conversations.

Audiometric testing was also conducted to measure hearing thresholds across different frequencies. The researchers then used statistical models to analyze the relationships between listening behaviors, noise exposure, and hearing outcomes over time.

Key Findings: More Hours, More Symptoms, Same High Volume

The data revealed significant shifts in behavior and symptom reporting. The most dramatic change was in self-reported tinnitus following loud leisure activities, which increased threefold. Weekly PLD listening time more than doubled, rising from an average of 7 hours to 18 hours per week. Male participants logged significantly longer listening durations than females.

Despite increased awareness—use of hearing protection in noisy situations doubled—one risky behavior remained stubbornly constant: approximately 20% of listeners reported using “high” volume settings on their devices at both Time 1 and Time 2. Furthermore, more participants at Time 2 reported creating a tight seal with their earbuds or headphones, a practice that can increase sound pressure levels at the eardrum.

Stable Audiograms Mask Potential Hidden Damage

A curious finding was that while behavioral changes and symptom reports increased, the standard measure of hearing loss prevalence and average hearing thresholds were actually slightly better at Time 2 compared to Time 1. The researchers propose this does not necessarily mean hearing health improved. Instead, it points to the possibility of “hidden hearing loss.”

Hidden hearing loss refers to damage to the neural connections between the inner ear and the brain (the synapses) or the auditory nerve fibers themselves, which is not detected by a standard pure-tone audiogram. This type of damage can manifest as difficulty understanding speech in noise or the perception of tinnitus, even when the audiogram looks normal. The tripling of tinnitus reports, coupled with more affirmative answers to questions about hearing difficulty, supports this concern. The rise in mobile phone use tied to hearing processing issues in other research adds context to these findings.

Changes in Self-Reported Symptoms and Behaviors

Beyond tinnitus, the study found that more participants at Time 2 responded “yes” to other hearing health symptom questions. Combined with the massive increase in weekly listening duration and the persistent subset of high-volume users, a picture of accumulated risk emerges. The extended use, even at moderate volumes, could contribute to noise exposure dose over time that standard tests miss.

Practical Implications for Hearing Health

This research has clear, practical implications for public health and education. First, it underscores that a “normal” audiogram does not guarantee a fully healthy auditory system, especially for a generation growing up with constant PLD access. The increased reporting of symptoms like tinnitus is a clear warning sign. For those experiencing such symptoms, understanding the shared pathways between auditory distress and other conditions can be validating.

Second, the findings highlight where education efforts should focus: volume level and duration. While the use of hearing protection at concerts doubled, the unchanged rate of high-volume PLD use indicates a critical gap. Educational outreach must emphasize the 60/60 rule (no more than 60% volume for 60 minutes) and the benefits of over-ear headphones versus tight-sealing earbuds. For adolescents struggling with sound sensitivity, which can co-occur with tinnitus, strategies for managing misophonia in teens and young adults may also be helpful.

Finally, the study authors call for more longitudinal research with larger follow-up samples to confirm these trends and better understand the long-term progression of hidden hearing loss.

Source: Feder, K., Marro, L., & Fitzpatrick, E. P. (2026). Longitudinal changes in personal listening device use, leisure noise exposure, and auditory symptoms in adolescents. International Journal of Audiology. https://doi.org/10.1080/14992027.2026.2678286