Facing the Music: Pre- and Postconcert Assessment of Hearing in Teenagers

Objective: Determine the effect of exposure to a single rock/pop concert on pure-tone hearing thresholds and outer hair cell function in teenagers. Study Design: Repeated measures pre- and postconcert assessment of hearing. Setting: Mobile hearing conservation test vehicle and large indoor concert venue. Subjects: Twenty-nine normal-hearing teenagers and young adults ages 13 to 20 years. Intervention: Attendance at a public rock/pop concert. Main Outcome Measures: Pre- and postconcert pure-tone thresholds in both ears from 500 Hz to 8 kHz, pure-tone average (PTA) for 2, 3, and 4 kHz, distortion product otoacoustic emissions (DPOAEs), proportion of subjects experiencing a PTA change of 10 dB or greater. Results: Concert sound levels at the subjects' position averaged 98.5 dBA. Only 3 subjects used the hearing protection provided. Thresholds for 2 to 6 kHz increased significantly from pre- to postconcert (p <= 0.001). The increase in PTA (2, 3, and 4 kHz) between test intervals averaged 6.3 and 6.5 dB for the right and left ears, respectively, and 33.3% of subjects had a threshold shift of 10 dB or greater in the PTA in at least 1 ear (p <= 0.001). The number of subjects experiencing a reduction in DPOAE amplitude (17/25) and the change in mean amplitude were statistically significant (p <= 0.001 and p <= 0.004, respectively). Conclusion: Exposure to a single live-music rock/pop concert can produce a threshold shift and decrease in otoacoustic emissions amplitude indicating impact on outer hair cell function. Results clearly indicate a need for research on this public health issue regarding "safe" listening levels, especially in younger people with more years for accrual of damage.