Association between Prolonged Earphone Exposure and Hearing-Related Communication Difficulties among Medical Students

Personal listening via earphones is ubiquitous in medical education, yet the relative roles of listening time versus self-reported volume level in auditory symptoms remain unclear.

To estimate the prevalence and patterns of earphone use among clinical-year MBBS students at a Malaysian medical university, and to examine associations between listening behaviours and (i) any hearing symptom and (ii) communication strain.

A descriptive cross-sectional study was conducted among Year 3–5 students (N = 207). Data were collected via a validated, structured questionnaire covering sociodemographic, device use (type, daily duration, typical volume, purpose), symptoms, and perceived impact. Descriptives were reported as n (%). Bivariate testing used chi-square and Spearman rank tests. Multivariable modified Poisson regression (robust SEs) estimated adjusted prevalence ratios (PRs) for binary outcomes; ordinal logistic regression estimated common odds ratios (ORs) for conversation strain. Significance was set at p < 0.05.

Overall, 65.2% (135/207) reported at least one hearing symptom (95% CI: 58.5–71.4). Each step up in daily use time (<30 → 30–60 → 60–120 → >120 minutes) was associated with higher prevalence of any symptom (adjusted PR 1.20, 95% CI 1.10–1.32, p<0.001) and more frequent conversation strain (common OR 1.72, 95% CI 1.31– 2.26, p<0.001). Volume level (20%→100%) showed no independent association with symptoms (p=0.96). Compared with Year 3, Year-4 students had lower symptom prevalence (PR 0.78, 95% CI 0.63–0.98, p=0.031). High impact was uncommon (5.3%); Year-5 vs Year-3 showed a higher adjusted prevalence (PR 6.46, 95% CI 1.01–41.22, p=0.049; wide CI due to few events).

In this cohort, time of use—not volume level— was the consistent driver of increased symptoms and communication strain. Health messaging should prioritize managing total listening time (with breaks and limits), alongside general safe-listening practices. Further longitudinal work with objective exposure logging is warranted.