|Year : 2020 | Volume
| Issue : 15 | Page : 31-35
Self-reported ear symptoms among mobile phone users at a tertiary institution
Auwal Adamu1, Abdulazeez Ahmed2, Abdulakeem Aluko2, Yasir Jibril Nuhu1, Emmanuel Sara Kolo2
1 Department of Otorhinolaryngology, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Otorhinolaryngology, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria
|Date of Submission||29-Jan-2019|
|Date of Acceptance||07-Jan-2020|
|Date of Web Publication||11-May-2020|
Dr. Auwal Adamu
Department of Otorhinolaryngology, Aminu Kano Teaching Hospital, Kano
Source of Support: None, Conflict of Interest: None
Background: Globally, the use of mobile phones has increased considerably and as such there have been increasing concern about its effects on the ear. It was observed that university students used mobile phones excessively not only for communication purpose but also for leisure (such as listening to music/radio), thus possibly predisposing their ears to untoward effects. Aims: The aim was to determine the prevalence of self-reported ear symptoms among mobile phone users. Materials and Methods: It was a cross-sectional descriptive study, conducted among university students aged 16–40 years. Participants were recruited using multistage random sampling technique. A self-administered, pretested, and validated questionnaire was used to collect the data, which were analyzed using Statistical Product and Service Solution version 20.0. Results: A total of 388 participants were recruited into the study. The duration of usage of mobile phone ranged between 1 and 17 years with a mean of 7 ± 3.5 years. The time spent on phone use per day ranged between 1 and 16 h with a mean of 2.6 ± 2.3 h. The overall prevalence of self-reported ear symptoms was 29.1%. Eighty-four (21.6%) of the respondents had ear pain, 68 (17.5%) had tinnitus, 44 (11.3%) had hearing impairment, 20 (5.2%) had vertigo, and 38 (9.8%) had other symptoms. The self-reported ear symptoms were found to have a statistically significant association with the time spent on the phone per day (P = 0.001) and the duration of use of the phone in years (P = 0.001). Conclusions: The prevalence of self-reported ear symptoms among mobile phone users was low. More detailed studies on the association between mobile phone use and ear symptoms, particularly tinnitus and hearing impairment would be worthwhile.
Keywords: Hearing impairment, mobile phone, self-reported ear symptoms
|How to cite this article:|
Adamu A, Ahmed A, Aluko A, Nuhu YJ, Kolo ES. Self-reported ear symptoms among mobile phone users at a tertiary institution. N Niger J Clin Res 2020;9:31-5
|How to cite this URL:|
Adamu A, Ahmed A, Aluko A, Nuhu YJ, Kolo ES. Self-reported ear symptoms among mobile phone users at a tertiary institution. N Niger J Clin Res [serial online] 2020 [cited 2020 Aug 9];9:31-5. Available from: http://www.mdcan-uath.org/text.asp?2020/9/15/31/284082
| Introduction|| |
The mobile phone has become an essential part of human life, and it is considered as an integral part of the society. Mobile phone is not only a communication device but also a necessary social accessory patronized by majority of people. Globally, the usage of mobile phones has increased considerably in all countries. In Nigeria, there are about 149 million active mobile phone users, of which about 7.8 million users are in Kano.
It has been reported that university students use mobile phones excessively not only for communication but also for other social activities such as listening to music, watching videos, and playing games, thereby predisposing their ears to noise-induced tinnitus, noise-induced hearing loss, and other harmful effects to the ear.,,
According to European commission directive on noise exposure limits, the maximum exposure level recommended is 80 dB (A) of sound for 8 h, and 113 dB (A) of sound for >1 min is considered unsafe for hearing., Mobile phone has proximity to the ear during usage, and it is capable of emitting sounds of 80–115 dB (A) directly into the ear canal might predispose to ear problems. In particular, several studies among students reported that the prolonged use of mobile phones resulted in the increased hearing thresholds, sensorineural hearing loss, tinnitus, and ear pain.
Mobile phone technology has progressively changed from analog to digital systems, which emit electromagnetic radiations (EMR). Exposure to such radiations could affect health and hearing specifically. The reported effects of EMR emitted from the mobile phone include memory problems, dizziness, warmth around the ear, headache, and sleep disturbance. The EMR was shown to be a potential risk for acoustic neuroma and other brain tumors.
Similar to other societies, students in Nigeria are recognized as one of the largest and most active users of mobile phones. However, the possible hazards of mobile phone usage on their ears have not been well documented in our environment. Therefore, the aim of this study was to determine the prevalence of self-reported ear symptoms among mobile phone users in our environment.
| Materials and Methods|| |
The cross-sectional descriptive study was conducted among university students and followed the protocol of the Helsinki Declaration of 1975. Ethical clearance was obtained from the institutional research and ethics committee, and consent was obtained from each participant. The sample size was calculated using the Fisher's formula for descriptive studies at standard normal deviate corresponding to 95% confidence interval and degree of precision of 5% (0.05) on the normal distribution curve. Participants included into the study were students who use mobile phones on a regular basis for at least 1 year and are between the ages of 16 and 40 years. Participants excluded were those with hearing loss, family history of hearing loss, exposure to loud sound from other sources, ototoxic drugs, and chronic medical condition, e.g., diabetes, hypertension, and migraine. Participants were recruited using a multistage random sampling technique: in the first stage, six faculties were selected at random by balloting from 12 faculties. In the second stage, a department was selected at random from each of the six selected faculty. In the third stage, the questionnaires were distributed proportionate to the level of study in each selected department. In the fourth stage, the participants were selected by simple random from each level of study until required sample size was reached.
The study instrument was a self-administered, semi-structured questionnaire that was pretested by doing a pilot study in different institutions from the study location. Subsequently, some modifications and corrections were made on the questionnaire. Data were obtained about the sociodemographic variables, the pattern of mobile phone use, and self-reported ear symptoms, among other health problems.
The data collected were entered into Microsoft Excel Spreadsheet for data cleaning. It was then imported to Statistical Product and Service Solution version 20.0 (IBM Inc., Chicago, Illinois, USA) for analyses. The data were summarized and presented as qualitative and quantitative variables. Quantitative variables were presented using mean and standard deviation, whereas qualitative data were presented using frequencies, percentages, and charts and compared using Chi-square. The level of statistical significance was set at P ≤ 0.05, at 95% confidence interval.
| Results|| |
The age of the respondents ranged between 16 and 40 years, with a mean of 23.6 ± 5.3 years; most (66%) were in the age group of 16–24 years. Majority (250, 64%) of the participants were male and about 316 (81.4%) were single [Table 1].
The overall prevalence of self-reported ear symptoms among mobile phone users was 113 (29.1%). Eighty-four (21.6%) of the respondents had ear pain/discomfort, and 68 (17.5%) reported both tinnitus and headache, respectively. The prevalence of hearing impairment among the mobile phone users was 11.3%, vertigo/dizziness was seen in 20 (5.2%) of the respondents, whereas 38 (9.8%) reported other symptoms such as lack of concentration, insomnia, anxiety, and body aches [Figure 1].
|Figure 1: Prevalence of self-reported ear symptoms among mobile phone users|
Click here to view
The number of phones used by these students ranged from one to three. Two hundred and eighteen (56.2%) respondents use one phone, 164 (42.3%) use two phones, whereas 6 (1.5%) use three phones.
The duration of usage of mobile phone among the respondents ranges between 1 and 17 years, with a mean of 7 ± 3.5 years. One hundred and sixty-seven (43%) respondents used mobile phone for ≤6 years, whereas 221 (57%) of them used it for >6 years.
The time spent on mobile phone-related activities per day (phone calls, listening to music, and watching videos) among the respondents was between 1 and 16 h with a mean of 2.6 ± 2.3 h. The respondents who used mobile phone for ≤3 h were 279 (71.9%), whereas those who used it more than 3 h were 109 (28.1%) [Figure 2].
[Table 2] showed that there was no statistically significant association between the self-reported ear symptoms, age, and gender, respectively. However, there was a statistically significant association between the self-reported ear symptoms and time spent on phone calls per day (P = 0.000) and the duration of use of the phone in years (P = 0.001), respectively.
|Table 2: Association between self-reported ear symptoms and other variables|
Click here to view
| Discussion|| |
From this survey, 29.1% of the mobile phone users reported symptoms such as ear pain/discomfort, tinnitus, hearing impairment, dizziness, and headache. In agreement with our findings, similar complaints were reported among mobile phone users in Saudi Arabia, even though the prevalence of the symptoms was higher (44.4%) than our study. This may be explained by the fact that the average duration of mobile phone usage in this study was less and long-term usage of the mobile phone has been documented to be significantly associated with a decrease in hearing threshold. It was also reported that 34.6% of problems of mobile usage were related to hearing impairment, ear pain, or warmth around the ear.
The finding of this study revealed that the manifestation of hearing impairment and other symptoms were strongly associated with time spent on mobile phone activities per day and the duration of use of mobile phone in years, respectively. This was corroborated by Manisha et al. who found strong positive correlation between hearing threshold and daily use of music players, although the correlation with the duration of usage of earphones and years of usage was poor. This is also supported by a study of adverse effects of excessive mobile phone use among medical students where 44.4% of the participants related their symptoms to mobile phone use.
Regarding time spent on phone calls and related activity per day, 28.1% of the participants of this study used mobile phone for more than 3 h/day and complaint of hearing impairment was found to be higher in them. This was corroborated by Jamal et al. who also considered spending more than 3 h on a mobile phone per day as heavy usage. A significant hearing loss was also reported in individuals who used a mobile phone for 2–3 h daily, as well as 3–4 h daily. Similarly, some studies reported hearing loss from the use of mobile phone for 2 h/day, and >30 min/day. Conversely, some workers reported normal hearing for users of mobile phone <2 h/day., Similarly, another study showed that the electromagnetic fields generated by mobile phone do not have an effect on the inner ear and auditory system.
The prevalence of self-reported hearing impairment among the participants of this study was 11.3%, contrary to a higher prevalence of hearing impairment (36.06%) reported among students who used personal music players and mobile phones. This might be due to the fact that participants in their study use both the personal music player and mobile phone which has additive effect, and exposure to both of them leads to contact with noise for the greater length of time, hence increasing the prevalence of hearing impairment. Furthermore, the higher prevalence reported in these studies may be due to the fact that the researchers used audiometer that can detect even mild and subclinical hearing loss, thus increasing the yield of respondents with hearing impairment.
Other self-reported symptoms found in this study included ear pain/discomfort, tinnitus, dizziness, headache, and sleep disturbance. Other studies have reported similar findings., Headache was reported by 17.5% of participants of this research, which agreed with a report by Khan. However, this was higher than the percentage of headache reported in Sweden (2.5%), Poland (4.9%), and Norway (11.0%), but lower than percentage of headache documented in Saudi Arabia (20.8%), Egypt (43.0%), and Iran (47.4%), and in an India survey, headache was found to be the most common symptom (51.47%). Furthermore, dizziness was seen in 5.2% of the respondents of this study; this was higher than the reports from Poland (0.5%), Sweden (1.1%), and Saudi Arabia (2.5%), but it is less than the findings from Norway (8.1%) and Iran (26.8%). These differences in the manifestation of symptoms might be attributed to the pattern of mobile phone usage and probably individual resilience.
The strength of this study was based on the utility of the questionnaire as a tool for the initial assessment of hearing loss. The use of questionnaire has been proven to have good predictive value and likelihood ratio, and there were strong associations between self-reported hearing impairment assessed through questionnaires and true hearing loss.,
The limitations of the study include inability to use audiometric evaluation tests to confirm and note the severity of self-reported hearing impairment. Therefore, more detailed studies, perhaps comparative cross-sectional, case–control or longitudinal designs, on hearing thresholds of mobile phone users with a focus on the association between hearing loss and mobile phone usage, (using otoacoustic emission device, pure tone audiometry, and high frequency audiometry) would be quite instructive.
| Conclusions|| |
The overall prevalence of self-reported ear symptoms among mobile phone users was 29.1%, and that of self-reported hearing impairment was 11.3%. Therefore, it is recommended that awareness campaign on the hazards of mobile phone and health education about hearing conservation measures should be improved.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Gupta N, Garg S, Arora K. Pattern of mobile phone usage and its effects on psychological health sleep and academic performance in students of a medical university. Natl J Physiol Pharm Pharmacol 2016;6:132-9.
Chung JH, Des Roches CM, Meunier J, Eavey RD. Evaluation of noise-induced hearing loss in young people using a web-based survey technique. Pediatrics 2005;115:861-7.
Sadhra S, Jackson CA, Ryder T, Brown MJ. Noise exposure and hearing loss among student employees working in university entertainment venues. Ann Occup Hyg 2002;46:455-63.
Fligor BJ, Cox LC. Output levels of commercially available portable compact disc players and the potential risk to hearing. Ear Hear 2004;25:513-27.
Scientific Committee on Emerging and Newly Identified Health Risk. Potential Health Risks from Exposure to Noise from Personal Music Players and Mobile Phones Including a Music Playing Function. Scientific Committee on Emerging and Newly Identified Health Risk; 2008. Available from: http://ec.europa.eu/ health/ph risk/risk en.htm
. [Last accessed on 2018 Nov 12].
Ramya CS, Karthiyanee K, Vinutha S. Effect of mobile phone usage on hearing threshold: A pilot study. Indian J Otol 2011;17:159-61. [Full text]
Manisha N, Mohammed NA, Somayaji G, Kallikkadan H. Effects of personal music players and mobiles with ear phones on hearing in students. J Dent Med Sci 2015;14:31-5.
Khayria AA. Effects of the mobile phones on the hearing function of the users. Bahrain Med Bull 2008;30:2.
Al-Khlaiwi T, Meo SA. Association of mobile phone radiation with fatigue, headache, dizziness, tension and sleep disturbance in Saudi population. Saudi Med J 2004;25:732-6.
Uloziene I, Uloza V, Gradauskiene E, Saferis V. Assessment of potential effects of the electromagnetic fields of mobile phones on hearing. BMC Public Health 2005;5:39.
Lönn S, Ahlbom A, Hall P, Feychting M. Mobile phone use and the risk of acoustic neuroma. Epidemiology 2004;15:653-9.
Hardell L, Carlberg M, Söderqvist F, Mild KH, Morgan LL. Long-term use of cellular phones and brain tumours: Increased risk associated with use for & amp;gt; or =10 years. Occup Environ Med 2007;64:626-32.
Kasiulevičius V, Šapoka V, Filipavičiūtė R. Sample size calculation in epidemiological studies. Gerontologija 2006;7:225-31.
Meo SA, Al-Drees AM. Mobile phone related-hazards and subjective hearing and vision symptoms in the Saudi population. Int J Occup Med Environ Health 2005;18:53-7.
Khan MM. Adverse effects of excessive mobile phone use. Int J Occup Med Environ Health 2008;21:289-93.
Jamal A, Sedie R, Haleem KA, Hafiz N. Patterns of use of ''smart phones'' among female medical students and self-reported effects. J Taibah Univ Med Sci 2012;7:45-9.
Hegde MC, Shenoy VS, Kamath PM, Rao RA, Prasad V, Varghese BS. Mobile phones: Its effect on hearing. Indian J Otol 2013;19:122-6. [Full text]
Oktay MF, Dasdag S. Effects of intensive and moderate cellular phone use on hearing function. Electromagn Biol Med 2006;25:13-21.
Sievert U, Eggert S, Pau HW. Can mobile phone emissions affect auditory functions of cochlea or brain stem? Otolaryngol Head Neck Surg 2005;132:451-5.
Sievert U, Eggert S, Goltz S, Pau HW. Effects of electromagnetic fields emitted by cellular phone on auditory and vestibular labyrinth. Laryngorhinootologie 2007;86:264-70.
Acharya JP, Acharya I, Waghrey D. A study on some of the common health effects of cell-phones amongst college students. J Community Med Health Educ 2013;3:1-4.
Al-Muhayawi S, Eldeek B, Abubakr H, Benkuddah R, Zahid A, Abukhashabah H. The impact of medical education on Saudi medical students' awareness of cell phone use and its health hazards. Life Sci J 2012;9:3-8. Available from: http://www.lifesciencesite.com
. [Last accessed on 2018 Nov 17].
Wilén J, Sandström M, Hansson Mild K. Subjective symptoms among mobile phone users-a consequence of absorption of radiofrequency fields? Bioelectromagnetics 2003;24:152-9.
Szyjkowska A, Gadzicka E, Szymczak W, Bortkiewicz A. The risk of subjective symptoms in mobile phone users in Poland-an epidemiological study. Int J Occup Med Environ Health 2014;27:293-303.
Salama OE, Abou El Naga RM. Cellular phones: Are they detrimental? J Egypt Public Health Assoc 2004;79:197-223.
Mortazavi SM, Ahmadi J, Shariati M. Prevalence of subjective poor health symptoms associated with exposure to electromagnetc fields among university students. Bioelecromagnetic 2007;28:326-30.
Chou R, Dana T, Bougatsos C, Fleming C, Beil T. Screening adults aged 50 years or older for hearing loss: A review of the evidence for the U.S. preventive services task force. Ann Intern Med 2011;154:347-55.
Nondahl DM, Cruickshanks KJ, Wiley TL, Tweed TS, Klein R, Klein BE. Accuracy of self-reported hearing loss. Audiology 1998;37:295-301.
[Figure 1], [Figure 2]
[Table 1], [Table 2]