Awareness Among Parents About Cotton Earbud Use in Children in the Western Region, Saudi Arabia: A Cross-Sectional Study

Background and objectives The use of cotton swabs for ear cleaning is a widespread practice among parents, often perceived as a convenient and effective method to remove earwax. However, there is increasing concern regarding the health risks associated with cotton swab use, particularly in children. These risks include ear canal damage, infections, earwax blockage, and even eardrum perforation. This study aims to assess the prevalence of cotton swab use among parents in the Western Region of Saudi Arabia, evaluate their awareness of the potential health risks, and explore the factors influencing ear hygiene practices for children. Methods This cross-sectional study was conducted between July and August 2024, targeting 705 parents residing in the Western Region of Saudi Arabia. Participants were selected randomly, with exclusion criteria that included individuals under the age of 18 and more. A validated, reliability-tested online questionnaire in Arabic was used to collect data. The questionnaire consisted of 25 questions designed to gather demographic information and evaluate parents' knowledge, attitudes, and practices related to the use of cotton swabs for ear cleaning, as well as their awareness of the associated health risks. Statistical analysis was performed using SPSS version 23.0 (IBM Corp., Armonk, USA). Categorical data were analyzed using chi-square and Fisher's exact tests, with a significance level set at p < 0.05 for all statistical analyses. Results A total of 705 parents participated in the study, of whom 66.2% were female. The majority (29.3%) were aged between 36 and 45 years, and 82% were married. Most participants (72%) had university degrees, and 82.4% worked in non-medical professions. A significant majority (96.7%) were Saudi nationals. Regarding cotton swab use, 28.3% of parents reported using cotton swabs to clean the inside of their children's ears, with many also using them to clean both the inside and outside of the ear. The most common reason for using cotton swabs was earwax removal (30.2%). Most parents (37.9%) had used cotton swabs for over five years, and 60.4% reported using them less than once a day. Despite the widespread use of cotton swabs, 72% of participants acknowledged the associated risks, including earwax buildup, infections, and eardrum perforation. However, only 58.5% had received prior health education about these risks, with otolaryngologists being the primary source of information. Notably, 13% of parents reported complications related to cotton swab use, with ear pain being the most common (61%). Conclusion This study highlights that, despite moderate awareness of the risks, the use of cotton swabs remains prevalent among parents in the Western Region of Saudi Arabia. The findings underscore the need for targeted health education initiatives led by healthcare professionals to promote safer ear hygiene practices. Raising awareness of the risks associated with cotton swabs and advocating for safer alternatives could help reduce reliance on cotton swabs and minimize ear-related complications in children.