Experts have warned that prolonged exposure to loud sounds through headphones for much of the day can damage hair cells in the inner ear, leading to acoustic trauma and permanent hearing loss. They particularly cautioned against increasing headphone volume to mask external noise.
Headphones used to listen to music, podcasts and various digital content throughout the day have become an integral part of daily life, particularly among young people, with the spread of digital technology.
Experts point out that the problem is not simply headphone use itself, but exceeding safe decibel levels, prolonged exposure and choosing the wrong type of headphones.
Excessive and uncontrolled exposure to high-intensity sound can cause cell death in the inner ear, paving the way for irreversible damage.
Professor Suat Turgut, head of the Ear, Nose and Throat (ENT) Department at the Health Sciences University’s (SBÜ) Şişli Hamidiye Etfal Training and Research Hospital, told Anadolu Agency (AA) that listening to music at very high volumes for prolonged periods can cause hearing loss at certain frequencies.
Turgut said sounds at 30-40 decibels, roughly the level of normal conversation, do not cause "acoustic trauma” to the ear, but warned against turning up the volume to drown out background noise.
"Young people increase the volume to eliminate the masking effect of outside noise. As the volume of the music increases, the risk of ‘acoustic trauma’ to the inner ear also increases. Do not listen to music at volumes far above the level at which you normally speak to other people,” he said.
Turgut also addressed the physical risks associated with in-ear headphones, noting that headphones inserted directly into the ear canal can damage the outer ear canal and cause infections.
Turgut said newer technologies could be used both to protect hearing health and maintain awareness of the surrounding environment, noting that open-ear, bone-conduction headphones designed to sit on the outer ear, similar to earrings, have recently been developed.
He said these headphones transmit sound through the bones while leaving the ear canal open.
"Unlike other devices, these headphones leave the ear canal open, preventing damage to the skin inside the canal and eliminating problems such as itching, infections and discomfort in the ear,” he said.
Volume matters more
Professor Zahide Mine Yazıcı, an ENT specialist at Bakırköy Dr. Sadi Konuk Training and Research Hospital, noted that headphone use is widespread among young people, saying the main concern is not headphone use itself but hearing loss caused by listening at high volumes.
"If we listen to sounds above a certain decibel level, there are specific limits. We should only listen to an 80-decibel sound for up to 40 hours a week. At 83 decibels, that drops to 20 hours and at 86 decibels, it falls to 10 hours. The volume of sound is a much more important factor for us than headphone use itself,” she said.
Yazıcı stressed that headphone volume should not be turned up beyond 60% of the device’s maximum level and recommended using headphones that block external noise in loud environments.
"When using headphones on public transportation or in very noisy environments, people inevitably increase the volume to hear clearly or to hear their music properly. This causes greater damage to our ears. Therefore, headphones with noise-canceling features can be beneficial because they suppress external noise and prevent people from increasing the volume,” she said.
Yazıcı said hearing loss is more likely to be reversible if exposure to loud sounds is detected early and stopped, but the risk of permanent damage increases the longer the exposure continues.
She noted that the safe exposure time decreases as sound intensity rises, saying exposure to sounds at 105 decibels should not exceed 10 minutes.
Audiometric assessments
Yazıcı said routine hearing tests may not always provide a complete picture of ear damage.
"We need to conduct audiometric assessments specifically checking high frequencies. The absence of hearing loss on a standard hearing test does not mean that the patient has no hearing loss. If we suspect such a problem, we need to examine the patient more thoroughly and also check their high-frequency hearing,” she said.
Yazıcı said World Health Organization (WHO) data demonstrate the seriousness of the situation.
"The World Health Organization says that, due to listening habits, particularly if we do not follow safe listening practices, around 1 billion young people could eventually suffer from noise-induced hearing loss. Therefore, as physicians and people responsible for informing the public, we must warn young people by providing recommendations on safe hearing practices,” she said.