One of the study's authors, audiologist Sandra Vill, noted that the link between excessive headphone use and hearing loss has long been recognized. However, it had not previously been examined in the Estonian context — especially among young people, she said on the radio show "Vikerhommik."

"Our initial idea was to assess the hearing thresholds of ninth-grade students. We also had them fill out questionnaires to learn more about their listening habits — such as which sounds might bother them and how often they use headphones," Vill said.

Together with Avo-Rein Tereping, she also looked into the types of transportation students use to get to school and whether general urban noise has any impact on their hearing. "The world has become louder overall," Vill acknowledged. "Still, compared to smaller areas, we didn't observe a significant difference. It doesn't seem to be a major factor," she noted.

However, the researchers did identify a clear connection: frequent headphone use combined with loud music increases the likelihood of elevated hearing thresholds. "We tested nearly one thousand ninth-grade students. More than 20 percent of them use headphones for over three hours a day to listen to music. That's a very, very long time," the audiologist pointed out.

Sandra Vill emphasized that listening to music with headphones is perfectly fine — in fact, she does it herself — but what matters is the duration and the volume. That's why she recommends the so-called 60-60 rule. "Sixty minutes at 60 percent volume — no more. Then take a break. If it's quieter, you can listen longer. The 60-60 rule is a good one; it helps ensure that 20 or 30 years from now, you'll still be able to hear music clearly," she said.

The study also found that most of the children whose hearing thresholds had risen above 20 decibels were unaware of it before being tested. This suggests that young people may not recognize the symptoms of hearing loss or know when to seek help.

Unilateral hearing threshold elevation at frequencies of 6,000 Hz and 8,000 Hz was observed in just over 4 percent of students. In some cases, levels at those frequencies reached as high as 90 dB. Mild hearing loss was detected in two participants — representing 0.2 percent of the sample.

No way to reverse noise-induced hearing loss

According to Sandra Vill, one of the first signs of hearing loss is tinnitus — a ringing or buzzing sound in the ears that occurs even in the absence of an external noise source. "It's a major warning sign that some kind of damage may have occurred. Tinnitus is very commonly associated with hearing loss or changes in hearing," the audiologist said.

In the study, tinnitus was reported by 347 respondents — more than a third of participants. That's a higher prevalence than typically seen for tinnitus. However, Vill noted the elevated percentage might be due to how the question was phrased, as it didn't specify whether it referred to constant or long-term tinnitus.

"When a patient comes to me and says they have tinnitus, the first thing we do is a hearing test. Another red flag is frequent requests for repetition. If someone often doesn't understand what's being said to them and keeps asking for clarification, it could be related to hearing issues. Turning up the volume on the TV or radio more and more or favoring one ear due to hearing loss in the other — these are all typical signs," Vill explained.

Noise-induced hearing loss usually cannot be reversed, she noted. Vill also warned against excessively loud concerts: "A couple of years ago, there was a news story about a Rammstein concert where many people went home with ringing or buzzing in their ears. That already indicates some level of hearing damage."

While such ringing is usually temporary, some degree of damage remains, Vill stressed. That's why it's important to be especially cautious at concerts. The study also found that nearly 70 percent of students felt concerts were too loud. "If young people already find it too loud, then it's likely even more overwhelming for older audiences," she remarked.

"I ended up at an event over the weekend where the music was louder than usual, and there was also a bar. I didn't check whether the bartenders were wearing earplugs, but if you have to work in a noisy environment, earplugs can be incredibly helpful. The same goes for nightclub staff, DJs, sound technicians and group fitness instructors. Construction workers are also at very high risk. In my view, awareness of this issue is still far too low," Sandra Vill concluded.

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