Prevention of noise-induced hearing loss in children – recommendations for safe listening at events

Abstract Purpose Events for children are often perceived to be too loud. Our study investigates the loudness of children’s events and its potential risk for noise-induced hearing loss. There are no specific regulations for recreational settings in many countries, including Hungary, therefore this research aims to provide a scientific basis for developing safety categories and noise level limits to protect children's hearing. Methods Thirteen events, including twelve specifically organized for children and one large festival with the participation of many children, were randomly selected for this study. Noise levels were measured at 25 points within the auditorium by acoustic engineers. The study involved children aged 3–12 years without any known hearing complaints or symptoms of disease. Otoacoustic emission measurements were performed on 38 children before and after the events to assess the impact on auditory function. Additionally, the subjective perception of loudness was surveyed through questionnaires completed by 51 children and their parents. Results Only seven out of 25 measurement points fell within the "safe" category. Ten places (40%) were categorized as "risky," and eight places (32%) as "dangerous." At risky conditions in some children a decrease in the inner ear function was detected after the event, which was significant at 4 and 5 kHz. High noise intensities were reported as uncomfortable or too loud by 80% of the children. Furthermore, the answers to the questionnaire highlighted that children were more sensitive to loudness than their parents. Age-related recommendations were made based on the analysis of results and the present knowledge of noise-induced adverse effects. Conclusions High noise intensity at children's events poses a significant risk for noise-induced hearing loss. Our findings highlight the need for monitoring and controlling sound levels at such events. We recommend implementing professional guidelines, public information, education, and warnings to prevent hearing loss in children. Based on the safety limit values ​​of 75dB and 85dB and event duration, we developed a detailed proposal for regulation and information. Our study emphasizes that event organization and listening habits must be adjusted to protect children's hearing effectively.