Auditory Risk in Shooting Sports and Motorsport: Noise Exposure, Hearing Outcomes, Protective Practices and Evidence Gaps - A Narrative Review

Background. Competitive shooting and motorsport expose athletes to impulse noise and prolonged high-level sound. Aim. To review noise exposure, auditory outcomes, audiological assessment and hearing protection in these sports. Material and Methods. PubMed, Google Scholar and Web of Science were searched for studies published mainly in 2015-2026; relevant older studies and reference lists were also examined. Full texts were reviewed and findings synthesised narratively. Sport-specific evidence was prioritised. Results. Noise exposure was substantial, but athlete-specific audiological evidence was limited and often cross-sectional. Findings included interaural threshold differences in shooters and hearing deficits in motorcycle racers; exposure was rarely linked to longitudinal outcomes. Conventional audiometry assesses hearing sensitivity, while the value of supplementary tests for routine athlete surveillance remains uncertain. Protectors and source controls reduced measured exposure under tested conditions. Practical challenges included consistent use, fit and communication. Laboratory studies found impaired localisation with protectors and partial improvement after training. Conclusions. Prevention should reflect sport-specific exposure, protector fit and functional needs. Prospective studies combining exposure monitoring, repeated hearing tests and evaluation of protective practices are needed to inform surveillance and prevention.