Epidemiology and gender differences in pediatric recreational and firearms noise exposure in the USA

Laryngoscope. 2020 Feb;130(2):541-545. doi: 10.1002/lary.27958. Epub 2019 May 9.


Objective: We aim to identify contemporary noise exposures and hearing protection use among U.S. children in a large, population-based study.

Methods: Cross-sectional analysis of the 2014 National Health Interview Series was performed. Results from in-person interviews of families with children under 18 years of age in all 50 states were queried. Potentially harmful exposures to loud sounds and patterns of hearing protection use in the last 12 months were analyzed after representative sample weights were applied.

Results: Among 73.4 million children, 18.4% (9.1 ± 0.4 million) (boys: 23.2%, girls: 13.5%; P < 0.001) were exposed to firearms noise, and 28.2% (20.7 ± 0.6 million) (boys: 30.5%, girls: 25.8%; P < 0.001) to firecrackers and other explosive sounds. Exposure to recreational "very-loud" noise exposure was more common (7.9%; 5.8 ± 0.3 million), consisting of music players (46.5%), fireworks (44.8%), lawnmowers (42.6%), and firearms (32.5%). However, only 17.1% of boys and 15.6% of girls, totaling 16.4% of all children, always used hearing protection during noise exposures.

Conclusion: Children in the United States are commonly exposed to firearms and recreational loud noises. Hearing protection is infrequently used, and gender disparities in patterns of exposure and use of hearing protection are prevalent. Those children and families at risk should be identified via public health initiatives and appropriately counseled by healthcare providers.

Level of evidence: NA Laryngoscope, 130:541-545, 2020.

Keywords: contemporary noise exposures; explosive sounds; firearms; hearing protection.

MeSH terms

  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Ear Protective Devices / statistics & numerical data*
  • Explosions
  • Female
  • Firearms
  • Hearing Loss, Noise-Induced / epidemiology*
  • Hearing Loss, Noise-Induced / prevention & control*
  • Humans
  • Male
  • Music
  • Prevalence
  • Sex Factors
  • United States