How noise impacts children and teenagers

What is it about?

Noise exposure is rising across modern childhood, yet its effects remain underestimated in paediatric practice. This article synthesizes evidence showing that noise pollution impairs development, learning, and hearing, contributing to lifelong inequality. Children, with developing auditory and cognitive networks, are uniquely vulnerable. By reframing noise as a modifiable determinant of health, we highlight opportunities for paediatricians to influence safer listening, improve classroom and clinical soundscapes, and champion policies that protect young ears and minds. Creating child-centred soundscapes is both urgently needed and entirely achievable.

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Photo by WrongTog on Unsplash

Photo by WrongTog on Unsplash

Why is it important?

Noise pollution is a modifiable public-health risk with consequences across the life course. Evidence links environmental and recreational noise to cardiovascular disease, sleep disturbance, cognitive impairment, mental health effects and reduced quality of life (1-3). Children are particularly vulnerable due to developing auditory neural networks and high exposure of noise in schools, on transport and when accessing digital content, music and games. Yet policies and design standards can lag behind the science, leaving children in particular, insufficiently protected. FOETUS AND NEWBORN PERIOD Experimental and modelling work indicates a wider range of frequencies reaches the foetus than previously thought, supporting the question of whether antenatal counselling about excessive noise could be valuable (4,5). In neonatal units, routine sound levels from alarms and equipment frequently exceed recommended limits (1-3), with implications for infant sleep, car-diorespiratory stability and staff stress. Ward redesign and alarm management are valued by staff and have shown promise in pilot studies (6-8). EARLY AND MIDDLE CHILDHOOD Classroom acoustics strongly influence listening, attention, reading and memory, particularly for children who are learning the skills of extracting speech from background noise (9-11). Otitis media with effusion (OME, or "glue ear") affects up to 80% of children at least once before age eight (frequently arising after the common cold or following an acute ear infection where residual fluid builds up behind the ear drum affecting the transfer of sound) and causes temporary, fluctuating conductive loss that makes listening in noise especially difficult (12-14). Listening in noise matures slowly, approaching adult levels only in mid-adolescence (9,15). ADOLESCENCE TO ADULTHOOD Recreational exposure (personal audio devices, venues) is an additional risk. The WHO (World Health Organisation) estimates over one billion young people are at risk of noise-induced hearing loss from unsafe listening (16,17). Research suggests that lifelong exposure contributes to cardio-metabolic disease and cumulative hearing decline. HEARING DIVERSITY BEYOND THE "AVERAGE LISTENER" Hearing is not homogeneous. Sex, age and individual auditory processing profiles influence sensitivity across frequencies and in noise (19,20,27,28). Standard audiograms measure detection in quiet and can miss real-world difficulties (e.g., listening ability in background noise; spatial listen-ing; listening fatigue). School and clinic pathways could potentially incorporate speech-in-noise (assessing the understanding of speech, in the presence of specifically selected background noise, for example, word identification with background speech shaped babble noise that simulates background chatter at a specified decibel level) and functional listening measures alongside pure-tone audiometry. This may be particularly relevant in populations with OME-related hearing fluctuations.