Microenvironment Matters: Venue Setting, Listener Position, and Hearing Symptoms at Live Music Events

Sunday, October 18, 2026

8:30 AM - 8:36 AM PT

Location: 501AC

Presenting Author(s)

Suhyoung Ahn, BS

Medical Student
College of Medicine, California Northstate University, Elk Grove, CA.
Torrance, CA, United States

Co-Author(s)

OA

Oluwatobiloba O. Ayo-Ajibola, BS

Medical Student
Keck School of Medicine of University of Southern California, Los Angeles, California, USA
Los Angeles, CA, United States

Co-Author(s)

Matthew E. Lin, MD

Resident Physician
UCLA Department of Head and Neck Surgery
Los Angeles, CA, United States
SH

Song Hon Hwang, MD

PGY-5
UCLA Department of Head & Neck Surgery
Los Angeles, CA, United States
LE

Lauren K. Evans, MD

Resident Physician
UCLA, United States

Senior Author(s)

Janet S. Choi, MD MPH

Assistant Professor
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA
Los Angeles, CA, United States
JD

Joni Doherty, MD PhD

Associate Professor
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States

Disclosure(s):

Matthew E. Lin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Exposure to loud music events increases risk of noise-induced hearing loss and tinnitus, but hearing protection (HP) use is low and influenced by individual risk perception and subculture. This study examined how micro-environmental factors, setting and crowd position, relate to HP use, symptoms, and perceived efficacy.

Methods: Cross-sectional survey of online music community participants’ demographics and attendance characteristics (n=2352). Group differences were assessed using descriptive statistics, t-tests, and Pearson’s chi-square. Multivariable linear regression was used to assess factors associated with post-event hearing symptoms.

Results: Respondents reported attending indoor music venues more frequently than outdoor (52.8% vs 47.2%); tinnitus was more common after indoor events (51.4% vs 37.2%, p< 0.001). Difficulty hearing others was more frequent after outdoor events (32.3% vs 24.3%, p=0.011). Compared to the back, the front position increased ear pain (15.0% vs 10.2%, p=0.050) and required others to repeat themselves (37.0% vs 30.4%, p=0.047). Front-standing attendees reported lower concern about hearing effects (5-point Likert mean=2.51 vs 2.68; p< 0.001) and lower perceived HP effectiveness (2.84vs 3.00; p=0.001). Music enjoyment without HP was higher at the front (7.17 vs 6.53; p< 0.001), whereas enjoyment with HP was lower (5.87 vs 6.30; p< 0.001). Beliefs and music enjoyment did not differ by venue type. Outdoor venues (OR 0.66, 95% CI 0.46–0.94,) and HP use (0.66, 0.44–0.98) were associated with lower odds of tinnitus. Attending events for ≥3 hours was associated with higher odds of difficulty hearing others (4.06, 1.62–10.22), and attending >20 events annually was associated with increased odds of ear pain (8.42, 2.11–33.57). Standing position was not independently associated with symptoms.

Conclusions: Music venue type and listener position are important determinants of post-event hearing symptoms, suggesting targeted, environment-specific hearing conservation counseling and preventive strategies for patients reporting attendance at social music events.