# Hearing Impairment Among Nursing Students: A hearWHO-Based Screening Study

## TL;DR

This study used the hearWHO app to screen nursing students for hearing impairment and found that headphone use behaviors were strongly linked to hearing issues.

## Contribution

The study demonstrates the effectiveness of the hearWHO app for hearing screening in a student population and identifies key behavioral risk factors.

## Key findings

- 14.6% of nursing students showed possible hearing impairment using the hearWHO app.
- Headphone type and ignoring volume alerts were significantly associated with poorer hearing scores.
- Daily headphone use duration did not correlate with hearing thresholds.

## Abstract

Background

Hearing loss among young adults is increasingly recognized as a public-health concern, often linked to harmful listening practices. While conventional audiometry is the diagnostic standard, smartphone-based screening tools such as the WHO’s hearWHO offer a low-cost, scalable option for early detection. This study estimated the prevalence of possible hearing impairment in a cohort of nursing students using the hearWHO app and examined related risk factors.

Methods

In this cross-sectional study, 592 nursing students (≥18 years) at Subbaiah Institute of Nursing, Shivamogga, underwent hearing screening with the hearWHO Digits-in-Noise test. Participants who recorded scores below 50 dB were retested after 15 minutes, and the mean of the two readings was used for final classification. A pretested questionnaire collected demographic data, headphone habits, and relevant medical history. Data were analyzed in IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States); significance was set at p < 0.05.

Results

The sample had a mean age of 20.5 ± 1.5 years and comprised 84.8% females. On initial testing, 475 participants (80.2%) scored 50-75 dB, 102 (17.2%) scored below 50 dB, and 15 (2.5%) scored above 75 dB. After reassessment, the prevalence of hearing impairment (mean score <50 dB) was 87 students (14.6%) (p = 0.000). Significant associations with poorer hearWHO scores were observed for age distribution (p = 0.018), type of headphones used (p = 0.045), and noncompliance with device volume alerts (p = 0.001). The average daily headphone use (2 ± 1.5 hours) showed no significant correlation with hearing thresholds (r = −0.009, p = 0.869).

Conclusions

The hearWHO application is a practical screening method for identifying potential hearing impairment in a student population. Behavioral factors related to listening practices, especially headphone type and disregard of volume alerts, were more closely linked to impaired screening results than either demographic variables or daily listening duration.