HMN 2025: How One in eight adolescents shows signs of hearing damage by age 18

A comprehensive new study published in Otolaryngology–Head and Neck Surgery reveals alarming rates of hearing loss among adolescents, with 6.2% experiencing sensorineural hearing loss and 12.9% showing signs of probable noise-induced hearing damage by age 18.

The research, part of the Generation R Study—one of the world’s largest birth cohorts—followed 3,347 Dutch adolescents through standardized hearing assessments at ages 13 and 18. While overall prevalence rates remained relatively stable during this five-year period, the study uncovered concerning trends: bilateral hearing notches became more common, and among those already showing high-frequency hearing loss at age 13, their hearing deteriorated significantly by age 18.

“Our longitudinal study shows that while the overall prevalence of hearing loss in adolescents remains relatively stable from ages 13 to 18, the severity of both sensorineural and noise-induced hearing loss increases over time,” said corresponding author Stefanie N. H. Reijers, MD, of the Department of Otorhinolaryngology and Head and Neck Surgery at Erasmus University Medical Center Rotterdam. “These findings highlight the importance of early monitoring and prevention, as even mild changes in hearing during adolescence may have long-term consequences.”

The study employed rigorous audiometric testing to identify hearing loss patterns characteristic of noise exposure, including distinctive “notches” in hearing thresholds—a hallmark sign of noise-induced damage. Recreational noise exposure from personal music players, gaming, and attending loud venues are known contributors to permanent hearing damage in young people.

Understanding the risk: What parents need to know

Noise-induced hearing loss (NIHL) occurs when loud noises damage the delicate hair cells of the cochlea in the inner ear. These sensitive structures convert sound energy into electrical signals that travel to the brain. Once damaged, these hair cells cannot regrow and lose the ability to transmit sound, resulting in permanent hearing loss.

According to the AAO-HNSF patient information website ENThealth.org, as many as 17% of teens (ages 12 to 19) already have features of their hearing that suggest NIHL in one or both ears. The damage can occur through a single exposure to an intense sound or by continuous exposure to loud sounds over time.

Long or repeated exposure to sounds at or above 85 decibels (dB) can cause both temporary and permanent hearing loss. Common sources of dangerous noise exposure include:

• Personal listening devices: The average portable music player is played at 100 dB, and cellphones or listening devices in the U.S. can produce a maximum of 115 dB
• Concerts and live music: Sound levels often exceed 85 dB, with some reports suggesting intensity may reach 90 to 122 dB
• Other: Fireworks, motorcycles, and sirens can range from 95 to 150 dB

Why this matters for public health

Hearing loss in adolescence can have far-reaching consequences beyond difficulty hearing. Research shows that even mild hearing loss can:

• Disrupt communication skills and social interactions
• Impair academic performance and cognitive development
• Lead to social isolation and reduced quality of life
• Accelerate age-related hearing loss later in life

The symptoms of NIHL can be hard to detect in early stages. Hearing loss tends to occur first for high-pitched sounds only, meaning the volume of sound heard may be unchanged but the quality lessens. Over time, speech may be heard but not completely understood, and background noise can make speech hard to understand. Ringing or buzzing (tinnitus) may also occur as a result of NIHL.

Call for prevention and education

The researchers emphasize several key implications for parents, educators, and policymakers:

1. Awareness is critical: Many adolescents may be unaware they’re damaging their hearing through everyday activities
2. Prevention is possible: Unlike genetic or age-related hearing loss, noise-induced hearing damage is largely preventable
3. Early intervention matters: Identifying at-risk youth early could prevent progression to more severe hearing loss
4. Systematic monitoring needed: Regular hearing screenings during adolescence could catch problems before they worsen

The study authors call for future research to examine specific sources of recreational noise exposure and their cumulative impact on hearing health, as well as exploration of why some adolescents appear more susceptible to hearing damage than others.

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