Apple’s Hearing Study

Hearing health is something many of us tend to ignore; in fact, we may not recognize the symptoms of hearing loss until communication becomes a significant challenge. Consider the fact that, according to Johns Hopkins Medicine, nearly 27 million Americans aged 50 and older have hearing loss, with only one in seven using a hearing aid.

Untreated hearing loss poses a serious threat to one’s overall quality of life, inhibiting learning and creating barriers that can lead to relationship challenges and isolation. Other effects include depression, poor balance, difficulty concentrating, and a greater risk of developing dementia.

Understanding the impact of noise exposure

Noise exposure is a constant threat to the hearing health of America. According to the Centers for Disease Control, 26 million Americans (aged 20-69) have “suffered permanent damage to their hearing from excessive exposure to noise.”

Recently, Apple set out to gain a better understanding of noise exposure and its overall impact on hearing loss and hearing health. In September 2019, the company launched its public hearing study, a collaboration with the University of Michigan School of Public Health, with the goal of guiding “public health policy and prevention programs designed to protect and promote hearing health in the U.S. and globally.”

Using the Apple Research app, study participants are asked to track their noise exposure and perform a variety of listening exercises using their Apple Watch or iPhone. Participants are also asked about tinnitus, hearing aid use, and their working environment.

With thousands of participants, the Apple Hearing Study appears to be an effective and less intrusive way to gather research data from a larger population. Another benefit: Participants can better understand and take control of their hearing health.

Researchers are able to collect individual user data to determine how headphone use and environmental sound exposure (including workplace noise) can affect hearing, stress levels, and cardiovascular health. Data from from the study is being shared with the World Health Organization’s Make Listening Safe initiative.

“Hearing loss can impact a person in many ways, and our goal is to drive increased focus on the importance of hearing health across decision-makers and the general population,” Ren Minghui, assistant director-general of the World Health Organization (WHO), has commented. “We encourage people to take the appropriate steps to protect their hearing and to seek care when needed.”

How noise levels are tracked by headphones

When you set the volume on your iPhone, Apple knows exactly how much sound is produced by your AirPods, EarPods, or Beats headphones. This is possible because Apple knows their own products intimately and has documented the relationship between volume settings and sound output levels for its own products in the lab.

For third-party headphones, Apple admits that noise level measurements are less accurate. To improve the accuracy of sound level estimations for third-party Bluetooth headphones, Apple recommends classifying them as “headphones” inside of the Bluetooth settings.

One thing to keep in mind—the sound intensity that reaches your eardrum will vary slightly from Apple’s estimates, regardless of whether you’re wearing Apple / Beats headphones or a third-party product. This is because no two ears are the same, and the resonant properties of your own ear will not be the same as the artificial ear Apple used in the lab when doing their measurements. Moisture and earwax can also impact earbud performance.

Apple uses the Noise app on the Apple Watch (SE and Series 4) to measure noise exposure for everyday sounds. The Apple Watch is known to be very accurate when it comes to measuring sound levels, and this data can be fed into the Apple Health app. Participants in the Apple Hearing Study were able to share Apple Watch noise level data in addition to noise levels produced by earbuds and headphones.

Insights from the Apple Hearing Study

Apple collected information from the research app and, a year into the study, released a report on March 2, 2021, publishing key findings.

“Even during this pandemic, when many people are staying home, we’re still seeing 25 percent of our participants experiencing high environmental sound exposures,” said Rick Neitzel, associate professor of environmental health sciences at the University of Michigan School of Public Health. “The results of this study can improve our understanding of potentially harmful exposures and help identify ways that people can proactively protect their hearing.”

Further insights realized from the Apple Hearing Study included:

• Approximately 10 percent of participants have been professionally diagnosed with hearing loss. Of these, 75 percent do not use a hearing aid or cochlear implant.
• 20 percent of participants experience hearing loss as determined by WHO standards; 10 percent have hearing loss that is consistent with noise exposure.
• Nearly 50 percent of participants haven’t had their hearing tested by a professional in at least 10 years.
• Almost 50 percent of participants work or have worked in loud environments.
• 10 percent of participants are exposed to higher than recommended headphone volume levels.
• For 10 percent of participants, the average weekly headphone exposure is higher than the WHO recommended limit, which is judged on the basis of intensity, duration and frequency.
• 25 percent of participants experience ringing in their ears (tinnitus) a few times a week or more, which is a possible sign of hearing damage.

The future of hearing healthcare and research

The application of technology like this has the potential to change both the research landscape and how we manage our hearing health. Indeed, through this study, Apple customers are already participating in innovative research using technology that’s part of their everyday lives. Hopefully, the learning will be used to raise awareness, better connect us with healthcare providers, and enhance our wellness.

There’s also a tremendous potential for this process to expand. As Apple put it, our “data and participation in similar studies could help advance researchers' understanding of areas in health that have not been well understood until now and could lead to the development of new products that will help millions lead longer and healthier lives… The future of health research is you!”

How you can use Apple products today to improve your hearing

If you are suffering from mild hearing loss, or just have difficulty hearing in loud background noise, you might be able to benefit from some of Apple’s recent hearing health innovations. As of iOS 14, AirPods Pro are capable of providing personalized amplification—similarly to hearing aids. And, Apple just announced that AirPods Pro owners will get access to beamforming directional microphones later this year with the launch of iOS 15.

For more information on personalized amplification with AirPods Pro, check out our guide to setting up your AirPods Pro as “hearing aids” (quotes because technically they are not FDA approved to function as hearing aids). For those with worse-than-mild hearing loss, be sure to check out our introductory guide to medical-grade hearing aids.