The unseen impact of earphone overuse on young adults: is it time for ENT specialists to intervene early?

doi:10.15406/joentr.2025.17.00565

Journal of

eISSN: 2379-6359

Otolaryngology-ENT Research

Opinion Volume 17 Issue 2

The unseen impact of earphone overuse on young adults: is it time for ENT specialists to intervene early?

Aditya Saran,¹ Aditi Saran²

¹Final Year MBBS Student, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R.N. Cooper Municipal General Hospital, India
²First Year MBBS Student, Government Medical College, GT and Cama Hospital, India

Correspondence: Aditya Saran, Final Year MBBS Student, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India

Received: April 28, 2025 | Published: May 16, 2025

Citation: Saran A, Saran A. The unseen impact of earphone overuse on young adults: is it time for ENT specialists to intervene early?J Otolaryngol ENT Res. 2025;17(2):49‒50. DOI: 10.15406/joentr.2025.17.00565

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Abstract

In the digital age, earphones have become a ubiquitous tool among young adults, especially medical students, for academic, entertainment, and communication purposes. While their convenience is undeniable, earphone overuse, particularly at high volumes, poses significant risks to both auditory and cognitive health. This opinion article explores the unseen consequences of prolonged earphone use, including auditory complaints such as tinnitus, ear pain, and hearing changes, as well as cognitive and systemic symptoms like headaches, mental fatigue, and reduced concentration. A cross-sectional study conducted among 747 MBBS (Bachelor of Medicine and Bachelor of Surgery) students in Mumbai revealed that nearly 90% reported auditory complaints, while approximately 47% exhibited cognitive symptoms. These findings underscore the urgent need for early intervention from ENT specialists.

ENT specialists can play a pivotal role in addressing this emerging health challenge by shifting from a reactive to a preventive approach. This includes routine screenings for hearing health, awareness campaigns promoting safe listening practices, and leveraging technology such as smartphone apps to monitor listening habits. Public health initiatives, including digital hygiene education and peer-led campaigns, are crucial in raising awareness and fostering behavior change among young adults. Given the growing prevalence of earphone-related health issues, it is imperative that ENT specialists adopt a more proactive stance to safeguard the hearing and cognitive well-being of this generation.

Keywords: smartphone, earphones, hearing, health

Introduction

In the current digital ecosystem, earphones are an indispensable accessory- especially among young adults like medical students—used extensively for academics, entertainment, communication, and multitasking. However, these seemingly harmless tools come with silent risks. Sound output from earphones can range between 75 dB SPL (Sound Pressure Level) to 136 dB SPL, which exceeds the recommended safe exposure limit of 85 dBA (A-weighted decibels) for up to 8 hours per day as per WHO and NIOSH guidelines.^1,2

In our cross-sectional study conducted among 747 MBBS (Bachelor of Medicine and Bachelor of Surgery) students in Mumbai, 89.3% reported auditory complaints such as ear pain, tinnitus, and hearing changes, while 68% reported headaches and nearly 50% experienced mental fatigue. These findings, mirrored globally, point to an emerging health challenge that ENT specialists must address through early interventions, screenings, and public education.

The health toll: what we observed among medical students

Our study revealed: Auditory complaints in 89.3%: including ear pain (48.3%), tinnitus (43.1%), hearing changes (43.2%), itching (47.6%), and increased wax (49.7%).

Systemic symptoms in 47.1%: headache (68%), increased blood pressure (25.3%).^3,4

Cognitive symptoms: mental fatigue (49.1%), decreased memory recall (30%), reduced concentration (28.5%), and sleep disturbance (29.6%).^3,5

Additional studies corroborate these effects: Ramya et al. and Hareedy et al. report tinnitus rates ranging from 29–43%, with vertigo, ear infections, and academic difficulties also noted.^6,7 Thomas et al.⁸ found 56–92% of chronic earphone users had positive cultures for otitis externa-causing bacteria. Fasanya et al.⁹ also linked headphone use with academic underperformance.

Risk factors identified include:

Wired earphones associated with higher risk vs Bluetooth.^3,6

Lack of earphone hygiene: Only 58.2% of students cleaned their devices; shared usage (45.9%) increased odds of infection.^3,8

Prolonged daily usage (>4 hours) correlated with adverse outcomes across all domains.³

Why ENT specialists can’t wait anymore?

Unlike occupational NIHL, which is monitored and regulated under frameworks like the Factory Act and WHO guidelines, recreational noise exposure lacks structure and surveillance, despite affecting nearly 1.1 billion people globally aged 12–35 years.^1-10

ENT consultations are often delayed or sought only after symptoms become severe. Students normalize signs such as tinnitus or concentration loss, failing to recognize them as red flags. Our data suggests even asymptomatic students may be at risk, especially those with poor hygiene practices or prolonged exposure.

This necessitates a paradigm shift in ENT care—from reactive to preventive.

Reimagining the ENT role: prevention, screening, and advocacy

We propose a proactive, three-pronged approach for ENT specialists:

Clinical screening: Integrate hearing health into routine OPD (Outpatient Department) evaluations for young adults. Include PTA (Pure Tone Audiometry), tympanometry, and tinnitus assessment for students reporting ear pain, dizziness, or cognitive symptoms.
Campus outreach: Organize awareness workshops in colleges on safe listening habits, ideal hygiene practices, and the 60/60 rule (60% volume for ≤60 minutes/day).¹¹
Counseling with technology: Recommend decibel-monitoring apps and educate patients on decibel thresholds, using smartphone-based hearing tests like WHO’s hear WHO tool.¹²

Tech as both the problem and the solution

While personal audio devices are central to the issue, they can also be leveraged for prevention. ENT societies should collaborate with developers to integrate:

Auto-volume capping.

Listening-time tracking dashboards.

Push alerts when sound exposure exceeds safe thresholds.

Additionally, colleges can enforce device-use codes for study areas, and ENTs can use infographics, QR-linked audio safety material, and voice-based awareness campaigns for early outreach.

Raising public health consciousness

Our study found 60.2% of students were already considering reducing usage after becoming aware of its harms.³However, behavior change remains limited unless reinforced by public health messaging. Recommended steps include:

IEC campaigns in clinics and libraries.

Integration of “digital hygiene” education in MBBS (Bachelor of Medicine and Bachelor of Surgery) curriculum.

Multilingual content to reach broader populations.

Advocacy through ENT forums and student-led initiatives.

Conclusion

Earphone overuse is no longer a niche or future problem—it’s a present and growing public health challenge. Our findings demonstrate substantial auditory, cognitive, and systemic consequences, especially among high-risk groups like medical students. It’s time ENT specialists shift from being passive observers to active educators, screeners, and advocates. With evidence mounting and preventive strategies available, early ENT intervention can protect this generation’s hearing—and mental well-being—for decades to come.

Acknowledgments

The author thanks the co-investigators and survey respondents from Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N. Cooper Municipal General Hospital for their participation and support.