Introduction

Noise-Induced Hearing Loss (NIHL) is a widespread occupational health problem affecting people in various industries, including healthcare [1, 2]. Medical professionals in healthcare are particularly vulnerable to noise exposure because they are frequently exposed to high-intensity noise sources, such as medical equipment, alarms, and patient care activities [2-4]. Medical students play a critical role in this population because they are the future healthcare providers [5, 6]. However, their awareness and use of hearing protection remain a concern [7]; therefore, there is an urgent need to investigate awareness and practices related to NIHL among medical students in Saudi Arabia.

Noise-induced hearing loss occurs when the delicate structures of the inner ear are damaged by prolonged or excessive exposure to noise. It is an insidious, irreversible condition that can significantly impact a person’s quality of life, communication ability, and overall well-being [8]. In healthcare settings, medical students are exposed to noise levels above recommended safe limits, putting them at risk of developing NIHL if appropriate preventive measures are not taken [9].

Studies conducted in various occupational settings have shown that lack of awareness and inadequate use of hearing protectors contribute to the prevalence of NIHL [10, 11]. However, few studies specifically address medical students who represent a particular population with unique challenges and potential knowledge gaps related to hearing health.

Saudi Arabia, with its rapidly growing health sector and numerous medical institutions [12], provides an ideal setting to study awareness and use of hearing protection among medical students.

The implications for healthcare providers, educational programs, and policymakers. Understanding the level of awareness and utilization of hearing protection among medical students will help tailor educational interventions to meet the specific needs of students. By identifying factors that influence awareness and behavior, we can gain insight into current practices and knowledge gaps in this population, leading to the development of targeted interventions to promote hearing health.

Using mixed methods, this study aims to provide a comprehensive understanding of NIHL awareness and hearing conservation use among medical students in Saudi Arabia. Integrating qualitative and quantitative data will increase the validity and depth of the findings and provide valuable insights for improving hearing health promotion and prevention efforts in this special population.

This study aims to investigate the level of awareness of NIHL and hearing conservation use among medical students in Saudi Arabia.

Methodology

Study design: This study used a mixed methods approach combining qualitative and quantitative methods to comprehensively investigate Noise-Induced Hearing Loss (NIHL) awareness and hearing protection use among medical students in Saudi Arabia. Integrating qualitative and quantitative data provides a more comprehensive understanding of the topic and offers triangulation of findings.

Sampling: Quantitative sampling: purposive sampling technique was used to recruit a representative sample of medical students from different universities and colleges in Saudi Arabia. The sample size was determined using appropriate statistical considerations to ensure sufficient power and generalizability of the results.

Qualitative Sample: within the quantitative sample, a subset of participants was selected for qualitative interviews. The selection was based on various characteristics such as gender, year of study, and previous noise exposure.

Data Collection: Quantitative data: A structured questionnaire was developed based on a literature review and previous studies. The questionnaire included demographic information, questions about awareness of NIHL, use of hearing protection, access to information, personal experiences, and other relevant factors. The survey was administered electronically or in person, whichever was most convenient for the participants.

Qualitative Data: Semi-structured interviews were conducted with a subset of participants to explore their experiences, perceptions, and attitudes about NIHL and hearing protection. Interviews were recorded with participant consent and transcribed verbatim for subsequent analysis.

Data Analysis: Descriptive statistics, such as frequencies and percentages, were used to summarize demographic characteristics and questionnaire responses. Inferential statistical tests (chi-square tests or logistic regression) were performed to assess the associations between variables and to determine the factors that influence awareness and use of hearing protection. Interview transcripts were subjected to thematic analysis to identify recurring themes and patterns related to awareness, experiences, and factors influencing hearing protection use. Data analysis included coding, categorizing, and developing themes to capture rich qualitative data.

Logistic regression analysis and its coefficient, odds ratio, and p-value are listed. The coefficient represents the change in log odds of awareness for a one-unit change in the corresponding factor. The odds ratio indicates the multiplicative change in the odds of awareness for a one-unit change in the factor. The p-value assesses the statistical significance of the association between the factor and awareness.

Integration of Data: The quantitative and qualitative data were integrated into the interpretation phase to understand the phenomenon comprehensively. The results were triangulated by comparing and contrasting the quantitative results with the qualitative themes to understand the subject better.

Ethical Considerations: The study adhered to ethical guidelines and was approved by the institutional review board of Bisha University. Informed consent was obtained from all participants, ensuring their anonymity, confidentiality, and right to withdraw from the study at any point.

Results

The Table 1 presents demographic data and general characteristics of the participants in a study. The sample comprises 262 male respondents (63%) and 150 female respondents (37%).

Table 1: Participants’ demographic data and general characteristics) n=416).

In terms of age distribution, the respondents are as follows: 75 individuals (36.4%) are between 19 and 20 years old, 70 individuals (34.0%) are between 21 and 22 years old, 42 individuals (20.4%) are between 23 and 24 years old, and 19 individuals (9.2%) are between 24 and 25 years old. Most respondents, 90.8%, are medical students, while 9.2% are student nurses. Regarding the academic level, 52.9% of the respondents are in the preclinical stage of their education, while 47.1% are in the clinical phase. Regarding family income levels, 69.7% of the respondents reported an above-average family income, 24.3% reported an average income, 3.1% reported a below-average income, and 2.2% preferred not to answer.

Regarding personal experiences, 16.0% of the respondents reported experiencing temporary hearing loss after exposure to loud sounds or ear infections. Additionally, 29.6% reported having a relative or friend with hearing loss, and 5.8% reported having hearing loss or impairment. Ear pain due to noise exposure was reported by 33.5% of the respondents, while 11.7% reported experiencing temporary hearing loss after noise exposure. Furthermore, 3.4% of the respondents reported already using a hearing aid, and 19.9% reported experiencing tinnitus or ear ringing. Regarding the use of earplugs, 20.4% of the respondents reported using them, while 23.8% reported planning to use them in the future.

With an awareness rate of 59.32%, it suggests that a significant proportion of medical students in Saudi Arabia have knowledge and understanding of noise-induced hearing loss. Table 2 lists each factor included in the logistic regression analysis along with its coefficient, odds ratio, and p-value. The coefficient represents the change in the log odds of awareness for a one-unit change in the corresponding factor. The odds ratio indicates the multiplicative change in the odds of awareness for a oneunit change in the factor. For every one-unit increase in education level, the odds of being aware of noise-induced hearing loss increase by 2.59 (p=0.021), holding other factors constant. Age is not significantly associated with awareness of noise-induced hearing loss (p=0.305). Better access to information is associated with increased odds of awareness (odds ratio = 3.07, p=0.012). No statistically significant association exists between cultural and social factors and awareness of noise-induced hearing loss (p=0.184). A trend towards significance indicates that higher income is associated with increased odds of awareness (odds ratio =2.03, p=0.057). Personal experience is moderately associated with awareness (odds ratio =1.75, p=0.092). Having relatives with hearing loss increases the odds of awareness (odds ratio =2.49, p=0.034). Individuals with hearing loss or impairment have higher odds of awareness (odds ratio =2.27, p=0.046). Ear Pain, temporary hearing loss, tinnitus, or ringing in the ear: These factors are not significantly associated with awareness of noise-induced hearing loss (p>0.05). Using hearing aids is strongly associated with increased odds of awareness (odds ratio = 3.94, p=0.006).

Table 2: Logistic regression analysis of factors influencing awareness of noise-induced hearing loss.

Table 3 summarizes the qualitative data analysis conducted on noise-induced hearing loss and the use of hearing protection. It presents various themes from the analysis and briefly describes each theme’s results. The qualitative data analysis revealed several factors influencing the awareness of noise-induced hearing loss and the use of hearing protection. These findings provide insights into the barriers, attitudes, and contextual factors that impact individuals’ decisions and behaviors regarding hearing protection.

Table 3: Qualitative Data Analysis of Noise-Induced Hearing Loss and Use of Hearing Protection.

Discussion

This study focuses on exploring the awareness and use of hearing protection among medical students in Saudi Arabia. The outcomes of this research will provide valuable insights into the current practices and knowledge gaps related to NIHL within this population. The study sheds light on the current awareness and use of hearing protection among medical students in Saudi Arabia. This population is often exposed to high occupational noise levels in healthcare settings. The findings highlight the need for targeted interventions and education programs to improve awareness and promote the use of hearing protection among this specific group.

This study result indicating an awareness rate of 49.32% among medical students in Saudi Arabia suggests that a significant proportion of these students possess knowledge and understanding of noise-induced hearing loss. This finding highlights the importance of raising awareness about hearing health among medical professionals, as they play a vital role in promoting preventive measures and educating others about the risks associated with noise exposure. This finding indicates that almost half of the medical students in Saudi Arabia have knowledge and understanding of noiseinduced hearing loss. Several studies have investigated the awareness of noise-induced hearing loss among healthcare professionals in Saudi Arabia [13], which the findings consisted with our study results. Another study, examined the knowledge and attitudes of physicians, including medical professionals, toward occupational noise-induced hearing loss in Saudi Arabia. Although not limited to medical students, the findings revealed that healthcare professionals, including physicians, had a moderate level of knowledge about noise-induced hearing loss [14]. Healthcare professionals, including medical students, play a crucial role in disseminating accurate information about hearing health and promoting the use of hearing protection in various settings. The lack of awareness may be attributed to a variety of factors, including inadequate education on hearing health and prevention, limited access to information, and social norms that do not prioritize hearing protection.

The logistic regression analysis examined various factors and their associations with awareness of noise-induced hearing loss. The coefficients, odds ratios, and p-values were calculated to determine the significance of these factors. Education level demonstrated a significant positive association with awareness. This implies that higher education levels are linked to a greater likelihood of being aware of noise-induced hearing loss [15].

Age, however, did not exhibit a significant association with awareness (p=0.305). This suggests that age alone does not strongly influence the awareness of noise-induced hearing loss among the participants [16].

Better access to information was found to be significantly associated with increased odds of awareness. Participants with improved access to information had an odds ratio of 3.07 (p=0.012), indicating that having better access to information is associated with higher awareness of noiseinduced hearing loss [17].

Cultural and social factors did not demonstrate a statistically significant association with awareness (p = 0.184). This suggests that these factors may not play a significant role in determining awareness of noiseinduced hearing loss among the participants [18].

Income level showed a trend towards significance, suggesting that higher income is associated with increased odds of awareness (odds ratio =2.03, p=0.057). Although not statistically significant, this trend implies that individuals with higher income may have a slightly higher likelihood of being aware of noise-induced hearing loss [19].

Personal experience, such as having relatives with hearing loss, showed a moderate association with awareness (odds ratio = 1.75, p=0.092). This suggests that personal experiences, particularly witnessing the impact of hearing loss on close family members, may contribute to a higher awareness of noise-induced hearing loss [20].

Having hearing loss or impairment was found to increase the odds of awareness (odds ratio =2.27, p=0.046). This indicates that individuals with hearing loss or impairment have a higher likelihood of being aware of noise-induced hearing loss [21].

Factors such as ear pain, temporary hearing loss, tinnitus, or ringing in the ear did not show a significant association with awareness (p>0.05). This suggests that these specific symptoms alone may not strongly influence awareness of noise-induced hearing loss among the participants [22].

Using hearing aids was strongly associated with increased odds of awareness (odds ratio =3.94, p=0.006). This finding highlights the importance of hearing aid use in promoting awareness of noise-induced hearing loss [23].

Personal experience and the influence of relatives with hearing loss were identified as factors that can positively impact awareness and behavior. Medical students who have either experienced hearing loss themselves or witnessed its impact on others may be more motivated to take preventive measures and use hearing protection [24]. Therefore, sharing personal stories and experiences of individuals with hearing loss can be an effective educational strategy to raise awareness and promote behavioral change.

The findings of this study have important implications for healthcare institutions, educational programs, and policymakers. It is essential to implement targeted educational interventions that address the specific needs of medical students and provide them with the necessary knowledge and skills to protect their hearing. Such interventions should emphasize the importance of hearing protection, provide information on the available options, and address misconceptions and barriers associated with its use.

Conclusion

In conclusion, the study highlights the need for increased awareness and utilization of hearing protection among medical students in Saudi Arabia. By addressing the factors influencing awareness and behavior, including education, access to information, cultural and social factors, personal experience, and the influence of relatives, interventions can be tailored to effectively promote hearing protection and prevent noise-induced hearing loss. Future research should focus on evaluating the effectiveness of educational interventions and exploring innovative strategies to enhance awareness and behavior change in this population.

Limitations

Potential limitations of this study include the reliance on self-reported data, which may be subject to recall bias, and the generalizability of the findings to other populations beyond medical students in Saudi Arabia.

Acknowledgement

I thank my colleagues at the University of Medicine, Bisha University, for their valuable contributions to this study. Their expertise, dedication, and hard work contributed to the success of this study. I want to sincerely thank all medical students in Saudi Arabia who participated in this study. Their willingness to share their experiences and insights greatly enriched the results and contributed to the overall quality of the study.