Kraaijenga VJC, et al. - Authors evaluated which factors were related to the occurrence of a temporary threshold shift (TTS) after music exposure and probed the behaviour of music festival attendees. Nonuse of earplugs, use of alcohol and drugs, and male sex as associated with a TTS at an outdoor music festival were identified in this study. These factors ought to be considered to raise awareness about the combined risk of attending music festivals without using earplugs while consuming alcohol and/or drugs. Experts correlated the intention to use earplugs with the loudness and appreciation of music with earplugs, which could advocate for the use of personalized earplugs.

Methods

• Experts conducted this prospective post hoc analysis on September 5, 2015, at an outdoor music festival in Amsterdam, the Netherlands and gathered data from a randomized, single-blind clinical trial.
• They recruited adult volunteers with normal hearing via social media from August 26 through September 3, 2015.
• Exclusion criterion was intention to use earplugs.
• Fifty one volunteers were included out of 86 assessed.
• From October 3, 2016, through February 27, 2017, this post hoc analysis was performed.
• The interventions were music festival visit for 4.5 hours.
• A TTS on a standard audiogram for the frequencies 3.0- and 4.0-kHz was the primary outcome.
• To determine which factors are associated with a TTS, multivariable linear regression was performed.
• Authors distributed a questionnaire on behavior, hearing, and tinnitus to the participants before and after the festival visit.

Results

• Findings suggested that a total of 51 participants were included (18 men [35%] and 33 women [65%]) with a mean (SD) age of 27 (6) years.
• As per results, mean (SD) threshold change across 3.0 and 4.0 kHz was 5.4 (5.7) dB for the right ear and 4.0 (6.1) dB for the left ear.
• An independent association of earplug use (absolute difference in the left ear, -6.0 dB [95% CI, -8.7 to -3.2 dB]; in the right ear, -6.4 dB [95% CI, -8.8 to -4.1 dB]), quantity of alcohol use (absolute difference per unit in the left ear, 1.1 dB [95% CI, 0.5 to 1.7 dB]; in the right ear, 0.7 dB [95% CI, 0.1 to 1.4 dB]), drug use (absolute difference in the right ear, 6.0 dB [95% CI, 0.9 to 11.1 dB]), and male sex (absolute difference in the right ear, 4.1 dB [95% CI, 0.3 to 5.9 dB]) with hearing loss was noted, with earplug use being the most important factor.
• Data demonstrated that significantly worse subjective hearing performance and tinnitus after the festival visit was reported by unprotected participants than did participants using earplugs (Cramer V, 0.62 [95% CI, 0.47-0.79] and 0.39 [95% CI, 0.16-0.62], respectively).
• Authors found that in the earplug group, the perceived loudness (r = -0.72; 95% CI, -1.00 to -0.43) and appreciation (r = 0.53; 95% CI, 0.29 to 0.78) of music and speech perception (r = 0.21; 95% CI, 0.09 to 0.35) were correlated with the duration of earplug use.