122 Indian Journal of Otology | July 2013 | Vol 19 | Issue 3 |

ORIGINAL ARTICLE
INTRODUCTION
Te mobile phone is a ubiquitous piece in this modern world.
An estimated 85% of Americans, 60% of the British, and
perhaps 45% of Indians use it, as of today. Of particular concern
to the World Health Organization (WHO) is the fact that, if
any adverse health efect is established from mobile phone use,
it will be a global concern because developing countries are
establishing this technology in preference to more expensive
fxed line systems. Te concern relate to the emission of radio
frequency (RF) radiation from mobile phones and the base
stations that receive and transmit signals. Tis study was
planned to study the impact of mobile phone usage on hearing.
MATERIALS AND METHODS
Te study was conducted in department of otolaryngology,
head and neck surgery and department of audiology, speech
and language pathology, Kasturba Medical College Hospital
and government Wenlock Hospital, Mangalore over a period
of 3 years from 2009 to 2012. Te study included mobile phone
users and non-users between the age group of 18 and 30 years.
Mobile phone users for more than 1 year with minimum
usage of more than 1 hour per day were included in the study.
Tose using hearing aids, with history of chronic suppurative
otitis media, history of head trauma or head fracture, family
history of hearing defects, and people exposed to constant
noise pollution or working noisy environment were excluded
from the study.
All the candidates were subjected to a detailed history taking
with special emphasis on duration, pattern, usage, and type
of mobile and hearing loss. Detailed enquiry was made about
onset and progression of hearing loss if any. An enquiry
was made in to any associated illness like diabetes mellitus
and systemic hypertension. Any history of childhood ear
discharge was asked for. Te occupational exposure to loud
noise and personal habits like smoking and alcohol were
asked for and recorded. Detailed clinical examination was
performed including a general systemic examination and
thorough examination of the ear using otoscope. Te character
of the tympanic membrane was observed in detail. Te three
standard tuning fork tests (Webers, Rinnes, and absolute bone
conduction tests) were done. All the candidates underwent
a pure tone audiometry (PTA) and immitance studies and
graphs were plotted. Pure tone audiograms were assessed for
type and percentage of hearing loss.
ABSTRACT
Address for correspondence: Dr. Vijendra S Shenoy,
Department of Otolaryngology, Kasturba Medical College Hospital,
Attavar, Mangalore - 575 001, Manipal University, Karnataka, India.
E-mail: drvijendras@gmail.com
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DOI:
10.4103/0971-7749.117480
Mobile phones: Its effect on hearing
Mahesh Chandra Hegde, Vijendra S Shenoy, Panduranga M Kamath, Raghavendra A
Rao, Vishnu Prasad, Bindu Sara Varghese
Department of Ear, Nose and Throat and Head and Neck Surgery, Kasturba Medical College, Mangalore, Manipal
University, Manipal, Karnataka, India
Background: Widespread concerns have been raised about the possibility that exposure to the radio
frequency felds from mobile telephones or their base stations could affect peoples health. Materials and
Methods: Effect on hearing in 120 mobile phone users and nonusers between age group of 18-30 years
were studied over 3 years. Group 1 using mobile phone more than 1 hour per day for more than a year
and group 2 no usage or less than 1 hour per day for less than a year. Results: Those using phones for
2-3 hours daily, loss of 5 dB in 10%, 10 dB in 3.3%, and 15 dB in 1.6% were noted. Also loss of 5 dB in
6.6% and 10 dB in 3.3% were noted in those using 3-4 hours daily. Sensorinueral hearing loss was seen in
26.6% of the subjects in study group and 3.3% in control group. Conclusion: Our study did not show any
signifcant hearing loss in mobile phone users.
KEYWORDS: Hours of exposure, Mobile phone, Sensorineural hearing loss, Years of exposure
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Hegde, et al.: Mobile phones and efect on hearing our experience
Indian Journal of Otology | July 2013 | Vol 19 | Issue 3 | 123
RESULTS
Te study was divided in to two groups: group 1, those using
mobile phones more than 1 hour per day for more than 1 year
and group 2, no usage or using for less than 1 hour for less
than a year. Statistical analysis was done using Chi-square
and Students t-tests and P-value of < 0.05 was considered
as signifcant. Te two groups were found to be comparable
with respect to sex and age distribution (P > 0.05, which was
statistically insignifcant).
Symptoms on presentation
Blocked sensation (15%) followed by tinnitus (10%) and
difculty in hearing (3.3%) were the main symptoms in the
study group at the time of presentation [Table 1]. None of the
subjects in control group had any symptoms at the time of
presentation. Statistically, blocked sensation and tinnitus were
signifcant with P value < 0.05, whereas difculty in hearing,
difculty in speech discrimination, and loudness intolerance
were statistically insignifcant (P value > 0.05) [Table 1].
Hours of exposure
In our study group 21 (35%) subjects had 1-2 hours of
exposure, 25 (41.7%) had 2-3 hours, and 14 (23.3%) had
3-4 hours exposure to mobile phones per day. Te Chi-square
value was found to be 120 and P value being 0.000, which was
statistically signifcant [Table 2].
Hours of exposure vs hearing loss (dB)
In our study group, those of the subjects using mobile phones
for 2-3 hours daily, 5 dB loss was noted in 10%, 10 dB loss
in 3.3%, and 15 dB loss in 1.6%. Also 5 dB loss in 6.6% and
10 dB in 3.3% was noted in those using mobile phones for
3-4 hours daily [Table 3].
Years of exposure
Mean years of exposure in group 1 was 2.47 years, while that
of group 2 was 0.12 years with a P value < 0.05, which was
statistically signifcant [Table 4].
In our study group, 32% of those who have been using mobile
phone since 2 years had sensorineural hearing loss and 22% of
those who have been using it since 3 years had sensorineural
hearing loss [Table 5].
Type of exposure
Types of exposure noted in the study group were either
intermittent or continuous, where continuous exposure
was seen to be associated more with minimal sensorineural
hearing loss noted in the study group, the association of
which was compounded by the increasing hours and years
of exposure. Exposure was of intermittent type in the control
group.
Type of deafness
Sensorineural hearing loss was seen in 26.6% of the
subjects in the study group and 3.3% in the control group
[Tables 6 and 7].
Table 1: Symptoms on presentation
Symptoms on
presentation
Group 1 Group 2 Chi-square
value
P value
Blocked sensation 15% 0% 9.730 0.002
Tinnitus 10% 0% 6.316 0.012
Decreased hearing 3.3% 0% 2.034 0.154
Table 7: Type of deafness (left ear)
Years of deafness Group 1 Group 2
Normal (n=110) 50 (83.3%) 60 (100%)
SNHL (n=10) 10 (16.6%) 0
(Chi-square value=10.909, P value=0.001)
Table 6: Type of deafness (right ear)
Years of deafness Group 1 Group 2
Normal (n=112) 54 (90%) 58 (96.6%)
SNHL (n=8) 6 (10%) 2 (3.3%)
(Chi-square value=2.143, P value=0.143)
Table 5: Years of exposure vs sensorineural hearing
loss incidence
Years of exposure Sensorineural hearing loss (5-15 dB)
2 years 32%
3 years 22%
Table 4: Years of exposure
Years of exposure Group n Mean
1 60 2.47
2 60 0.12
(t=29.845, P=0.000)
Table 3: Hours of exposure vs hearing loss (dB)
Hearing loss Hours of exposure per day
2-3 hours 3-4 hours
5 dB 10% 6.6%
10 dB 3.3% 3.3%
15 dB 1.6% 0%
Table 2: Number of hours of exposure in the study
group
Hours of exposure
(per day)
Number of
subjects
Percentage
(%)
1-2 hours 21 35
2-4 hours 25 41.7
3-4 hours 14 23.3
(Chi-square value=120.00, P value=0.000)
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Hegde, et al.: Mobile phones and efect on hearing our experience
124 Indian Journal of Otology | July 2013 | Vol 19 | Issue 3 |
In the group 1, 10% and 16.6% of cases had minimal
sensorineural hearing loss in the right and lef ear, respectively,
while in group 2, 3.3% had sensorineural loss in right ear only.
DISCUSSION
Te widespread use of mobile phones has been going sky-high
over the past decade and now its use is an essential part of
business, commerce, and society. Te fact that so many people
own mobile phones attests to their perceived importance to
the general public. Widespread concerns have been raised
about the possibility that exposure to the RF felds from mobile
phones or their base stations could afect peoples health. Such
has been the rapid growth of the mobile telecommunications.
Tere are two direct ways by which health could be afected
as result of exposure to RF radiation.
[1]
Tese are thermal
(heating) efects caused mainly by holding mobile phones
close to the body and also as a result of possible non-thermal
efects. Te well-liked belief is that adverse health efects can
be induced mostly by the heating efect of global system for
mobile communication (GSM) radiation. Te reported adverse
health efects and extensive portfolio of non-thermal efects
that have been published in the scientifc literature during
the past few years, which indicates that the kind of radiation
now used in GSM phone can and does afect living organisms
in various non-thermal ways. Phones emit a pulsed high
frequency electromagnetic feld,
[2]
which may penetrate the
scalp and the skull. Tese electromagnetic felds are known
to alter distinct aspects of the brains electrical response
to acoustic stimuli. Te extensive exposure to microwave
radiation has been found to afect a wide variety of brain
functions
[3]
such as electrical activity, electrochemistry,
[4,5]

permeability of the bloodbrain barrier,
[6]
and immune
systems.
[7]
Microwaves are known to non-thermally afect
the dopamine-opiate system
[8,9]
of the brain and to increase
the permeability of the bloodbrain barrier.
[10]
Exposure to
high density microwaves can cause detrimental efects on the
eyes, testis, and other tissues and induce signifcant biological
changes through thermal actions.
[11]
Te temporal region near
the phone antenna appeared to be under the most intensive
heating. Ultrahigh frequency radiation
[12]
induces signifcant
changes in local temperature and in physiologic parameters
of central nervous and cardiovascular systems. Besides a
hypotonic efect
[13]
with shortening of sleep onset latency, a
rapid eye movement (REM) suppressive efect with reduction
of duration and percentage of REM sleep was also found. Te
number of complaints was higher for people using the digital
(GSM) systems with pulse modulated felds, than for the using
the analogue nordisk mobile telecommunication
[14]
(NMT)
system. RF exposure from mobile phones is concentrated
to the tissue closest to the handset, which includes auditory
nerve.
[15]
Te efects on neuronal electrical activity, energy
metabolism, genomic responses, neurotransmitter balance,
bloodbrain barrier permeability, cognitive function, auditory
function, sleep, and various brain diseases including brain
tumors are of concern. Most of the reported efects are small
as long as the radiation intensity remains in the non-thermal
range, and none of the research reviewed gives an indication
of the mechanisms involved at this range.
Of particular concern to the WHO is the fact that, if any adverse
health efect is established from mobile phone use, it will be
global concern because developing countries are establishing
this technology in preference to the more expensive fxed line
systems. Keeping in view the hazards of the mobile phones,
the present study was designed to investigate the association
of use of mobile phones and hearing loss.
Age and sex
Te study and control groups were found to be comparable
with respect to the sex distribution.
Symptoms
In our study, blocked sensation (15%) followed by tinnitus
(10%) and difculty in hearing (3.3%) were the main symptoms
at the time of presentation. None of the subjects in the control
group had any symptoms at the time of presentation. In
contrast, in a study conducted by l-Khlaiwi et al.,
[1]
the overall
mean percentage for presenting complaints in all group were
headache (21.6%), sleep disturbance (4%), tension (3.9%),
fatigue (3%), and dizziness (2.4%). Meo and Drees
[16]
in a study
showed about 34.59% of problems were related with impaired
hearing, earache and/or warmth on the ear, and 5.04% of
complaints with decreased and/or blurred vision.
Years of exposure
In our study, 32% of those who have been using mobile
phone since 2 years had sensorineural hearing loss and 22%
those who have been using it since 3 years had sensorineural
hearing loss. Tis indicates that the minimal hearing loss
(5-15 dB) noted in the study group depended not only on years
of exposure, but also on hours of exposure per day and type
of exposure. Panda et al.,
[17]
in their study assessed the efects
of chronic exposure to electromagnetic waves emitted from
the GSM mobile phones on the auditory function in users. No
signifcant diferences were found for high frequency hearing
loss, distortion product oto-acoustic emissions (DPOAE),
auditory brain stem response (ABR), and middle-latency
responses (MLR) in the users. High frequency hearing loss
was seen in subjects using the phone for more than 4 years
(P = 0.04).
In our study, we also observed that none of the subjects in the
study group sufered from signifcant hearing loss (>25 dB).
Tis correlates with the fndings of Davidson and Lutman
[18]

in his survey of mobile phone use and their chronic efects
on the hearing of a student population. High or long-term
users reported no worse hearing, tinnitus, or loss of balance
than low or short-term users. However, there appear to be no
harmful efects of mobile phone usage on their audiovestibular
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Hegde, et al.: Mobile phones and efect on hearing our experience
Indian Journal of Otology | July 2013 | Vol 19 | Issue 3 | 125
systems within the range exposure of the study, in so far as can
be detected by the self-report method employed. Similarly, in
a study by Sievert et al.,
[19]
to investigate the biological efect
of the high frequency radiation produced by the GSM mobile
phone on the inner ear with its sensors of the vestibular and
auditory systems showed that the electromagnetic fields
generated in using the mobile phone do not have an efect on
the inner ear and auditory system to the colliculus inferior in
the brain stem and on the vestibular receptors in the inner ear
and vestibular system.
Hours of exposure
Although none in our study group had signifcant hearing loss,
we observed an increase in hearing threshold between 5 and
15 dB in the study group (26.6% of the subjects in the study
group and 3.3% in control group had hearing loss of 5 dB.
Nearly 10 dB hearing loss was noted in the study group in 6.6%
and 15 dB in 1.6%, especially in those exposed to mobile phone
usage for more than 2 hours per day, more so if the pattern of
usage is continuous. Tis relates to the study by Callejo and
Santamaria
[20]
in a group of 323 healthy and normoacoustic
volunteers who were usual customers of mobile phone for
whom an audiometric evaluation was made at the beginning
of its use and 3 years later, inquiring about the periods of time
per day and ear employed on direct contact contacts with the
phone. A healthy and normoacoustic control group of non-
users was studied too. Audiometric curve was similar in cases
and controls at beginning of the study. Afer this follow-up,
cases showed an increase in hearing threshold between 1 and
5 dB more than controls in speech tones (P < 0.001).
Our fndings were also in agreement with the study by Oktay
and Dasdag
[21]
of department of otolaryngology, medical
school of Diyarbakir, Turkey, who conducted a study to
investigate the efects of radiation emitted by mobile phones
on the hearing of users. Te study was carried out on three
groups: (1) 20 men who have used cellular phone frequently
and spoken approximately 2 hours per day for 4 years; (2) 20
men who have used a cellular phone for 10-20 minutes per
day for 4 years; and (3) 20 healthy men who have never used
a cellular phone (control group). Brainstem-evoked response
audiometric (BERA) and PTA methods were used to measure
the efects of exposure on hearing function of the subjects.
Te BERA results showed no diferences among the groups
(P > 0.05), in PTA measurements, no diferences were observed
between moderate mobile phone users (10-20 minutes per
day) and the control subjects. However, detection thresholds
in those who talked approximately 2 hours per day were found
to be higher than those in either moderate users or control
subjects. Diferences at 4000 Hz for both bone conduction and
air conduction for right ears, and 500 and 4000 Hz bone and
air conduction for lef ears were signifcant for mean hearing
threshold. Tis study shows that a higher degree of hearing
loss is associated with long-term exposure to electromagnetic
feld generated by cellular phones.
A case of sensorineural hearing loss due to GSM mobile
was reported in Saudi Medical journal in 2007.
[22]
While,
those in our study with mobile phone usage of less than
2 hours per day showed normal audiometric curves, which
can be related to study by Sievert et al.,
[23]
in 12 healthy test
persons, with normal hearing. Auditory brain stem refexes
recordings were performed before, during, and afer exposure
to electromagnetic emissions by standardized mobile phone
devices. Two modes of electromagnetic emissions felds
were administered: pulse and continuous. For acoustic
stimulation, simultaneous to feld exposure, special pug-
in earphones had to be used. Tere are no adverse efects
of mobile phone emissions on the ear function, at least on
a short-term range.
A WHO f ac t s he et updat i ng concl us i ons and
recommendations regarding health efects from mobile
phone use and exposure to base stations was published in
June 2000 (WHO 2000).
[24]
It states that none of the recent
reviews have concluded that exposure to the RF felds from
mobile phones or their base stations cause any adverse
health consequence. However, there are gaps in knowledge
that have been identifed for further research to better assess
health risks.
In the mean time, WHO recommend the following:
a) Strict adherence to health-based guidelines. International
guidelines have been developed to protect everyone in the
population: mobile phone users, those who work near or
live around base stations, as well as people who do not use
mobile phones.
b) Precautionary measures: Present scientifc information
does not indicate the need for any special precautions for
use of mobile phones. If individuals are concerned, they
might choose to limit their own or their childrens RF
exposure by limiting the length of calls, or using hands
free devices to keep mobile phone away from the head
and body.
It is advisable therefore that the use of mobile phones is a
risk factor for health hazards and suggest that excessive use
of mobile phones should be avoided by health promotion
activities, such as group discussions, public presentations,
and through electronic and print media sources. In addition,
we also suggest that more research is required to observe the
efects of mobile phones with diferent systems of the human
body along with clinical examination.
CONCLUSION
Our study did not show any significant hearing loss in
mobile phone users since 0-25 dB hearing loss is taken for
all practical purpose as normal. But still we observed a
minimal hearing loss of 5-15 dB in those exposed to mobile
phone usage of more than 2 hours per day, the pattern of use
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Hegde, et al.: Mobile phones and efect on hearing our experience
126 Indian Journal of Otology | July 2013 | Vol 19 | Issue 3 |
being continuous. Hence we recommend a long-term follow
up study in long-term mobile users before we can come to a
defnitive conclusion.
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How to cite this article: 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.
Source of Support: Nil. Confict of Interest: None declared.
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