The individual devices with earphone had revolutionized the form to hear music. For being practical and portable they had become almost indispensable accessories in the day the day. This modern habit has mobilized the researchers to study the negative impact of the inadequate use of this equipment on the hearing. A recent study it discloses that the portable players of music can cause auditory damages in the long run for who hear music in high volume for a drawn out time (1).
The hearing is the one of the main ways for which human being interacts with way, being one them more important directions, moreover, it has a sufficiently complex and primordial function in the communication human being and preservation of the species. It is by means of it that we hear and we identify to all the sounds of the environment. Injuries in the sensorial structures of the hearing provoke damages in the detention, localization and discrimination of the sounds.
The growth of the urbanization and the advance of the technology had favored the rise of the levels of noise in the streets, the work and the leisure, causing damage to the welfare mental physicist and, as well as the hearing of the individuals (2). Authors ratify this affirmation, and add that the noise does not affect only the hearing, but also can produce symptoms as gastrointestinal increase of the arterial pressure, riots, sleeplessness and irritability (3). Currently, the ambient noise has been considered a problem of public health for being part of the majority of the daily activities of the human being (4).
The young, in its majority, adolescents, habitually is displayed music amplified of high intensity, especially in its activities of leisure (5). Music, in general, is a pleasant sound that provides pleasant sensation, however, can become a source of sonorous pollution depending on the way and it sound level that is used (4).
It is observed that adolescent in the age group of 12 the 18 years, had increased the equipment use very personal stereos (EP), many times, used in inadequate way, for many hours and in intensities very raised. It has two preoccupying reasons that they make with that these modern equipment is harmful for user: the first one is the great capacity of memory and high durability of the battery, what it favors its use in extensive days. And the second is the design of the phones, whose current trend it is the use of the insertion phones that are capable to concentrate all the sonorous energy produced inside of the external conduit auditory, being considered, for this characteristic, the most harmful (6).
Another preoccupying aspect is the intensity level with that these equipment is used, allowing that people to a meter of distance listen to the music that this being heard for the user through the phones. Studies had demonstrated that the sound pressure levels of these 120 equipment can reach dB, intensity enough to provoke auditory injury (7, 8, 9).
The great number of studies concerning this subject evidences the concern of that the use of these equipment in abusive and incorrect way can cause irreversible damages to the hearing (2,6).
In this way, considering the relevance of the subject, the objective of this work was to verify the prevalence of symptoms related for users of players of digital music amplified and to know its habits in relation to the use of these equipments.METHOD
Drawing of the study and population
This is about an observational study like transversal cut, lead with primary data, carried through in the city of Salvador/BA in the period of September to November of 2010. It was developed in three institutions, one of average education and two of superior education, being two of public net and one of private net.
400 students had participated of the research, of both genders, with age group between 14 and 30 years that had related the habit to use personal stereos. The sample was composed for students of average education and superior in public and private colleges, independent of the course.
Data collection and Ethical Aspects
The data had been gotten through a questionnaire structuralized (Appendix A) on the daily habits of use of the personal stereos, auditory symptoms after use of these equipment and the degree of awareness concerning the possible risks that these equipment can cause the hearing. Also a visual analogical scale was used, in order esteem the band of volume habitually used by the users, the same one consists of a straight line of 10 cm destitute of numbers, in which it has only indications in the extremity to the left of minimum volume, that corresponds 0 cm and to the right maximum volume that corresponds 10 cm.
For posterior analysis of the scale, the following considerations had been made:
Previously to the application of the questionnaires the institutions that had participated of the research had signed an assent term authorizing the application of the questionnaires in its dependences, as well as, all the participants had also signed a term of free and clarified assent.
This study it was submitted to the Committee of Ethics in research of the College of Technology and Science (FTC), having been approved, without restrictions through seeming in the 2037 year.
Analysis of Data
The data had been typed in the program EpiData Entry 3,1 (CDC, Atlanta, GA) and analyzed, quantitatively, in the SSPS version 15. The data had been tabulated and presented in form of Table and Graphs.
For categorical variable had been esteem frequencies simple and compared with the qui test - squared of Pearson. While for continuous 0 variable they had been esteem average and medium. They had been considered as resulted statistical significant those that present p-VALUE < that 0,05.RESULTS
Table 1 shows the partner-demographic data of the population. 200 students of average education had participated of the research and 200 of the superior education of these 300 belonged to public institution and 100 of private. The age group varied between 14 and 30 years, however 91.6% had age up to 25 years, 64.8% were of the feminine sex.
Table 2 evidences the results how much to the daily habits of exposition to music electronically amplified in individual devices. How much to the use frequency 31.7% to the times are observed that 62.3% of the participants had related to use frequent, 6% rarely.
In what it says respect to the band of volume of habitual use, 57% of the individuals affirm to hear in high volume, 33% in moderate volume, and only 10% in low volume. Valley to stand out that 50.8% had told to have knowledge of the maximum volume of exit of its equipment.
It was still verified, that 34% of the young use to hear music for a period that varies of 2 hours until 6 hours per day. An inverse correlation was observed enters the time of exposition and the band of age (p=, 000). How much to the type of phone 75.5% they had affirmed to use insertion phone, 20.8% aural phone circum and 3.3% use both the phones.
The musical sorts more presented in the preference of the participants are the MPB with 63% followed of rock (48.3%) and pagode (41.5%).
The majority of interviewed (71.3%) use to use portable player in noisy environments how much quiet, however, 13.7% only use in noisy environment; 46.8% relate the habit to sleep hearing music in the personal stereos.
How much to the presence of symptoms exposition to music electronically amplified (Table 3), 67.2% of the interviewed ones already had after presented at least a symptom, being that 18.7% had related more than a symptom.
The symptoms most prevalent had been auricular fullness (30.5%) followed of humming (27.5%), otalgia (12.8%), hyperacusis (11.5%), giddiness (4.8%) and others (4.0%). 34% had not related to symptoms after the use. It was verified that how much bigger the lesser the presence of symptoms after use and how much lesser age the bigger age group is the prevalence of the humming in this population. Also a direct relation is observed enters the time of exposition and the increase of the prevalence of the humming. Valley to stand out, that the use in high intensities keeps a direct relation with the amount of cited symptoms.
As permanent complaint 43.5% of the participants the intense sounds had affirmed to present discomfort and difficulty in perceiving sounds and understanding speaks in noisy environments (36.5%). 15.8% related not to hear well.
It was evidenced that how much bigger the time of exposition that the prevalence of humming complaint.
In what it says respect to the degree of awareness in relation to the possible risks that the use of personal stereos can cause the hearing, 91.5% believe that these can cause auditory loss and 75.5% already had gotten some information on the harmful effect that the noise can bring for health. The ways of bigger access to these informations had been TV/radio (40.8%), Internet (29.8%), professionals of health (26%), written media (24.8%) and school (23.8%).DISCUSSION
For being practical, portable and to be in fashion the personal stereos equipments had become almost indispensable accessories in day-by-day, mainly between the young. This habit of modern consumption has generated great quarrels and research in the scientific way concerning the damages that can cause to the hearing of these individuals.
The fact calls the attention of that the use of these equipments, even so more common between adolescents, is present today in all the age bands. This habit is each incorporated time more to the routine of the people and the inadequate use becomes in a risk the auditory health.
Although the reduced dimension, these equipments are more powerful each time, with great capacity of memory and high durability of the battery favoring its use in extensive days (6). Moreover, studies show that the sound pressure levels of these equipments can reach 120 dB, intensity of potential risk to the human ear (7, 8, 9).
It was evidenced that 62.3% of the studied population have the habit to frequent use personal stereos for long periods of exposition and in raised intensities, these findings corroborate other studies with this population (2, 8, 9, 10, 11, 12).
The risks to the auditory health are evidences when we observe the habits of use and the correlation with the auditory symptoms. In this direction, it has a direct correlation enters the time of exposition and the presence of auditory symptoms (p= 0,004) being distinguished the humming as the symptom whose correction has greater tack statistics. Statistical significant relation also was found between the time of exposition and the age group (p=, 0000).
The use of these portable equipments occurs in diverse noisy environments as in the transit, school, college, street, academy of gymnastics etc. In general, in these places, the noise level is raised what it makes with that the users increase the volume to hide sounds external (11,12). It was observed in this study that 81.5% of the young use to use personal stereos in noisy environments.
Another aspect to be considered is design of the earphones whose model can potentiate the sonorous capacity of these equipments. The phones of insertion, for being discrete, are more aesthetic and for possessing superior practicality to the voluminous external phones that recover the ear (circum-aural), are currently most popular (6). In this population it was observed that 75.5% have preference for the insertion phones, agreeing to other authors (4, 6, 9). The position of this type of phone, inserted in the external auditory conduit, favors potentiate of the intensity since all the sonorous pressure is lead for average ear. For GARSTECKI (2006), professor of clutters and sciences of communication of the Northwestem University (U.S.A.), the problem aggravates when these small phones do not incase perfectly in the ears and allow the entrance of external sounds, what it makes with that the user increases more the volume of player to stifle the external racket (13).
A significant number of young 67.2%, had affirmed to have after presented at least one of the symptoms exposition to music electronically amplified. The auditory symptoms more related by the users of personal stereos had been auricular fullness, followed of humming; these findings had been similar to the found ones in other studies (2, 5, 8, 9, 14, 15). Some authors believe that the humming, the sensation of covered ear and reduction of the hearing after extreme exposition to amplified music, can be the first signals of induced auditory loss for music (9,14).
The presence of temporary changes of the threshold is consensus in literature (TTS) after exposition the noises of high intensity (4, 9, 14, 15, 16, 17). However, derive from temporary changes of overexpusure to the noise can result in permanent changes of the threshold (3,18). The main factors for the development of auditory loss are the time of exposition, sonorous intensity and the individual susceptibility (3, 15, 18).
On the other hand, auditory loss for some authors is not the only resultant injury of the exposition the doses of superimposed noises. These individuals can present complaints as buzzed chronic, conscription and hypersensitivity to the sound (hyperacusis) (19). This study evidenced that great part of the participants (43.5%) related to discomfort the intense sounds, agreeing to other studies (3). Hyperacusis or hypersensitivity to the sounds is the constant bothers the sounds of weak, moderate or strong, independent intensity of the situation or environment (3,19).
It is worth highlighting that injuries of the agency of corti, hyperacusis, humming, among others alterations can hinder or make it difficult the full use of the auditory abilities, harming the quality of life of the individuals (19). A significant number of respondents 36.5% related to present difficulty in perceiving sounds and to understand speaks in noisy environments, corroborating similar research (2, 4, 8,10).
The negative impact of the inadequate use of these equipments on the hearing, no doubt belongs to the field of the public health (1). The individual portable equipment is arriving each time earlier at the hands and ears of the young; the necessity of the precocious implantation of educative actions becomes evident since basic education. In this study an inverse correlation was observed enters the exposition time and the band of age, that is, youngest has a propensity to use portable player in bigger intensities (p=, 000).
The majority of the interviewed citizens (91.5%) believes that the use of personal stereos in maximum volume can cause auditory loss and 75.5% already had gotten some information on the harmful effect that the noise can bring for health, these findings are in accordance with other similar studies (5, 8). Contrarily, a study carried through in São Paulo 85% of the young they believe that the use of these equipment in high intensity not cause auditory loss (6).
Although the ample percentage of young that already had had access the information on the harmful effect of the noise on the health, the described findings demonstrates that a great contingent remains with inadequate habits of use of these equipment. Some authors specifically argue the lack of action of protection and prevention of the auditory alterations caused for exposition to amplified music (2,4).
The school is the way of information less cited by the participants (23.8%) and the most cited the TV/Radio (40.8%). Other cited ways had been the Internet (29.8%), professionals of health (26.0%) and the written media (23.8%). These numbers suggest an insignificant participation of the school front to the role that it plays in the formation of the young.CONCLUSION
The more prevalent auditory symptoms in the individual portable equipment users had been discomfort the intense sounds, difficulty in perceiving sounds and to understand speaks in noisy environments, auricular fullness, humming, otalgia and hyperacusis. How much bigger the lesser age the presence of symptoms after the use and how much lesser the bigger age group is the prevalence of the humming in this population.
The daily habits of exposition evidence the inadequate use of these equipment characterized for long periods of exposition, raised intensities, frequent use and preference for the insertion phones.
Although the totality (91.5%) of the young almost to believe that the use of personal stereos in maximum volume can cause auditory loss and relate previous information on the harmful effect of the noise on the health, a great contingent remains with inadequate habits of use of these equipments.
The school appears as the way of information that less contributed for the formation of the knowledge concerning the harmful effect of the noise. A more active participation of the school is suggested front to the role that it plays in the formation of the young, development of educational actions on the risks that the inadequate exposition to the noises can cause the health. BIBLIOGRAPHIC REFERENCES
1. Tarantino M. Cuidado: o som alto do seu tocador portátil pode provocar perda auditiva. Revista eletrônica Medicina e Bem Estar capturada, novembro 2006. Disponível em: http://www.terra.com.br/istoe/1932/medicina/1932_abaixe_o_volume.htm Acesso em 15.11.09
2. Bahia CS, Borja ALV. Sintomas auditivos referidos pelos usuários de player portátil. In: XVIII Congresso Brasileiro de Fonoaudiologia. Anais; 2009. Salvador (BA); 21 a 24 de outubro. p. 2141.
3. Morata TC, Santos UP. Efeitos do ruído na audição. In: Santos UP. Ruído: riscos e prevenção. 1ª Ed. São Paulo: Hucitec; 1999, pp. 43-53.
4. Ventura CT, Fiorini AC. Música amplificada: uma revisão sobre seus efeitos na saúde. In: XVIII Congresso Brasileiro de Fonoaudiologia. Anais; 2009. Salvador (BA); 21 a 24 de outubro. p. 2698.
5. Borja ALV, Souza BF, Ramos MM, Araújo RPC. O que os jovens adolescentes sabem sobre as perdas auditivas induzidas excesso de ruído? Rev Ciênc Méd e Biol. 2002, 1(1):86-98.
6. Russo ICP, First D, Abud NCD. El uso del estéreo personal: conocimiento y la concienciade los adolescentes. Asha. 2009, 1:22-37.
7. Momensonh-Santos TM, Freitas TVD, Molinaro MCG, Lamas C, Bueno C, Nogueira M. O uso dos equipamentos de som pessoais e a presença de zumbido. In: XVIII Congresso Brasileiro de Fonoaudiologia. Anais; 2009. Salvador (BA); 21 a 24 de outubro. p. 2201.
8. Nascimento DP, Santos APB, Yonezaki C. Efeitos do uso excessivo de equipamentos eletroportáteis em altos níveis sonoros na audição. In: XVII Congresso Brasileiro de Fonoaudiologia. Anais; 2008. Campos Jordão (SP); 24 a 27 de setembro. p. 1149.
9. Gonçalves VSb, Lacerda JMV, Brito LKB, Oliveira NCM. Estudo dos hábitos auditivos em estudantes de escola privadas na cidade de João Pessoa. In: XVIII Congresso Brasileiro de Fonoaudiologia. Anais; 2009. Salvador (BA); 21 a 24 de outubro. p. 2417.
10. Jorge Jr. JJ, ALegre ACM, Greco MC, Angelini MCA, Barros PM. Hábitos e limiares auditivos de jovens em relação à música eletronicamente amplificada através de equipamentos com fone de ouvido. Rev Bras de Otorrinolaringol. 1996, 62(6):424-34.
11. Momensonh-Santos TM, Lopes MKD. Uso de sistemas de som estéreos pessoais em um grupo de trabalhadores. In: XVII Congresso Brasileiro de Fonoaudiologia. Anais; 2008. Campos Jordão (SP); 24 a 27 de setembro. p. 173.
12. Garstecki D. Fones de ouvido IPods podem danificar audição. Plantão INFO, janeiro. 2006. Disponível em: http://info.abril.com.br/aberto/infonews/012006/02012006-6.shl. Acesso em 20 de out. 2010.
13. Andrade AIA, Russo ICP, Lima MLLT, Oliveira LCS. Avaliação auditiva em músicos de frevo e maracatu. Rev Bras de Otorrinolaringol, 2002, 68(5):714-720.
14. Jorge Jr JJ, Alegre ACM. A audição dos jovens e sua relação com hábitos de exposição à música eletronicamente amplificada. Introdução ao tema e uma revisão bibliográfica. Rev Bras de Otorrinolaringol. 1995, 61(1):7-13.
15. Russo ICP, Momensohn TM, Busgaib BB, Osterne FGJ. Um estudo comparativo sobre os efeitos da exposição à música em músicos de trio elétrico. Rev Bras de Otorrinolaringol. 1995, 61(6):477-484.
16. Silveira JAM, Brandão ALA, Rossi JD, Ferreira LLA, Name MAM, Estefan P, Gonçalez F. Avaliação da alteração auditiva provocada pelo uso de walkman, por meio da audiometria tonal e das emissões otoacústicas (produto de distorção): estudo da 40 orelhas. Rev Bras de Otorrinolaringol. 2001, 67(5):650-654.
17. Russo ICP. Ruído, seus efeitos e medidas preventivas. In: ______ (Org). Acústica e Psicoacústica aplicada à fonoaudiologia. 1ª Ed. São Paulo: Lovise;1999, pp. 157- 169.
18. Santos-Momensohn TM, Duran A. Risco de perda auditiva por uso de discman: estudo sobre os níveis de pressão sonora medidos em sistema de CD player. Rev Distúrbio da Comunicação. 1995, 61(3):7-13.
19. Tochetto TM, Gonçalves MS, Gambini C. Hiperacusia em músicos da banda militar. Rev Soc Bras Fonoaudiol. 2007, 12(4):298-303.
1) Graduation in Phonoaudiology. Phonoaudiologist.
2) Master in Medicine and Health Human being for the Bahiana Foundation for the Development of Sciences, FBDC, Brazil. Professor of the Federal University of the Bahia.
Institution: Federal University of the Bahia - Institute of the Science of the Health. Salvador / BA - Brazil. Mailing address: Tiara Santos da Luz - August Viana Street - Quarter: Vale do Canela - Salvador / BA - Brazil - Zip-code: 40110-060 - Telephone: (+55 71) 8628-7013 - E-mail: email@example.com
Article received in June 15, 2011. Article approved in November 14, 2011.