The Effect of Education on the Decision to Wear Ear Plugs


As published in the Update (Volume 28, Issue 1), the official newsletter of the Council for Accreditation on Occupational Hearing Loss.

From a young age, children learn to brush their teeth every day and to sit through regular eye examinations. Unfortunately, the same kind of lifelong education is lacking for auditory health. We use q-tips regularly and attend concerts without protection — habits that unknowingly leave us susceptible to auditory damage. What if information about general ear health were provided? Would awareness catalyze action to prevent damage to hearing? How does access to resources change health behavior?

College students are a population at high risk for noise-induced hearing loss due to noise exposure at bars, concerts, workout classes, and sporting events. Beyond a general risk, over half of college students voluntarily expose themselves to harmful levels of music and noise.1 The reality of college students’ elevated risk to hearing damage raises the following important research questions: Are college students taking preventative action to protect their hearing? What would motivate them to do so? My three-part study evaluated the decisions of college students to wear or not wear hearing protective devices when attending on-campus music concerts.

The first part of the study took place at a concert at a private Midwestern university. An exit survey, completed by 149 students, gauged how much students knew about auditory health, the dangers of loud music, and their decisions to wear (or not) ear plugs. The students attending the concert were not given any information about the risk of entering without hearing protection nor were they provided with ear plugs. The results were unsurprising. Only around five percent of students reported wearing hearing protection during the concert.

Part two of the study was conducted at the following campus-wide concert. A group of 36 students attended a voluntary session before the concert on noise-induced hearing loss and the harmful effects of attending the concert without protection. The students were provided with ear plugs. After the concert, the students took a survey which asked whether they wore the ear plugs that were provided and if there were any noticeable changes in their hearing abilities as a result of the concert. The results from the second part of the study showed that, with face-to-face education and the provision of free ear plugs, overScreen Shot 2016-03-23 at 11.27.48 PM half (55.6%) of the students reported wearing hearing protection at the concert. Education and resources together catalyzed preventative action in a high-risk population.

However, would the strategy be as effective without a face-to-face presentation on noise-induced loss? The last part of the study, conducted at the succeeding concert, employed a different educational strategy. Signs and handbills displayed noise-induced hearing loss facts as well as risks of attending the concert without protection. Over 2,000 students walked by the signs and picked up the handbills, three-fourths of those picking up a pair of ear plugs on their way into the concert venue. Volunteers were available to demonstrate or assist on how to properly insert the ear plugs. As attendees exited the venue, a survey evaluated whether the attendee wore the ear plugs, why or why not, and if there were any noticeable changes in hearing abilities as a result of the concert. Of the 152 students surveyed, almost 50% reported to have worn ear plugs at the concert (see Figure 1).

Why did students choose to wear or not wear free ear plugs provided on-site? The majority of college students reported their motivation to wear ear plugs came from the availability Screen Shot 2016-03-23 at 11.27.36 PMof resources and the loud concert environment. A smaller percentage chose not to wear hearing pr
otection because ear plugs distorted the quality of the music and made it difficult to converse with friends. Overall, the top two concerns that students identified as reasons to not wear ear plugs (“Music sounds distorted…” and “Uncomfortable to wear”) could be addressed by the use of musicians’ ear plugs. Unlike the standard (and highly affordable) plugs used in the present study, musicians’ ear plugs, which fit comfortably in the canal, would allow for sound to be attenuated without a reduction in sound quality.

As audiologists attempt to broaden awareness of the field while encouraging preventative health behaviors, it is important to evaluate whether national educational campaigns could have a significant impact on changing attitudes and actions towards auditory health. The results of the study suggest that, at least in the setting of campus concerts, providing education and resources has an impact on an individual’s decision to take preventative action for their auditory health. Face-to-face education, such as an in-person presentation, showed to be more effective in motivating students to wear ear plugs than indirect educational strategies, such as pamphlets. The availability and allocation of resources is another important factor to consider for audiologists interested in promoting public health. Beyond education strategies, the present study suggests that, if resources to promote hearing health are made available, individuals are likely to take advantage of them. Evidence for the impact of education and resource allocation gives promise to audiologists’ efforts to promote positive health behavior. Perhaps it will be a hearing test that finally joins the ranks of other annual doctor’s appointments.



1 Rawool VW, Colligon-Wayne LA. Auditory lifestyles and beliefs related to hearing loss among college students in the USA. Noise Health 2008;10:1-10

Author Bio:

Elizabeth Marler is a first year graduate student in the AuD program at Purdue University in West Lafayette, IN. She is a graduate of Truman State University in Kirksville, Missouri, where she conducted her research. Elizabeth has presented this research at the 2015 Missouri Speech-Language-Hearing Association annual conference, the 2015 American Speech-Language-Hearing Association annual conference and will present at the American Academy of Audiology Conference in April.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

Create a free website or blog at

Up ↑

%d bloggers like this: