Risk factors for early hearing threshold shifts in regular earphone users: a cross-sectional study

Abstract Background Prolonged earphone use is routine among young adults and may contribute to early changes in auditory thresholds. However, the specific usage patterns that predict auditory threshold elevation remain unclear. Hence, the present study evaluated frequency-specific auditory thresholds in young earphone users and usage-related predictors influencing auditory thresholds. A cross-sectional study was conducted among 110 medical students. Data on daily duration of earphone use, weekly frequency, years of exposure, preferred output volume, and gender were collected using a structured questionnaire. Pure-tone audiometry was performed for both the ears at frequencies from 0.25 to 8 kHz. Multiple linear regression analyses were applied separately for each frequency and ear to identify significant predictors of auditory thresholds shifts. Results Daily hours of earphone use emerged as a significant predictor of increased thresholds at low and mid frequencies (0.25–1 kHz, p < 0.01) in the right ear. Output volume was the most consistent predictor for left ear thresholds across multiple frequencies (0.5–8 kHz; p < 0.05). Weekly use showed a limited association, reaching significance only at 8 kHz in the right ear. Overall model fit was modest, with adjusted R² values ranging from − 0.03 to 0.11. Gender differences in mean thresholds were not statistically significant across frequencies. Conclusion Higher daily earphone use and increased output volume are associated with subtle, frequency-specific elevations in hearing thresholds in medical students. Although thresholds remained within normal limits, findings suggest early auditory stress. Adoption of safe listening practices may help prevent future noise-induced hearing loss.