Noise exposure burden and hearing protection compliance among Saudi military personnel: A cross-sectional study

Background: Noise-induced hearing loss (NIHL) results from prolonged or intense exposure to loud sounds, causing permanent auditory damage often accompanied by tinnitus, reduced hearing sensitivity and difficulty understanding speech. Use of appropriate hearing protection is essential to minimizing exposure, preventing cochlear injury and reducing the long-term impact of NIHL. Objectives: This study aimed to assess noise exposure experiences, their effects on hearing sensitivity and the use of hearing protection among Saudi military personnel. Methods: This cross-sectional study used a self-administered Arabic questionnaire developed after a literature review and consultation with a focus group. Copies were distributed to military personnel visiting the audiology clinic at King Abdulaziz Medical City in Riyadh from 2024 to 2025 and shared via social media nationwide. The questionnaire included 14 items across three sections: demographics, experience with noise exposure and hearing protection and awareness of noise-related impacts. Results: A total of 256 participants completed the questionnaire; the majority were male (97.3%), lived in Riyadh (85.2%), and were aged 31 years–40 years with a high school education. Most reported no hearing loss across years of experience and exposure to loud sound sources. Notably, 130 participants (50.8%) did not use hearing protection despite being aware that loud noise can cause hearing loss and tinnitus (p = 0.01). Significant associations were found between reported hearing loss and involvement in shooting or use of weapons (p = 0.01) as well as noise source types (p = 0.02). Conclusion: Although most participants were aware of the harmful effects of loud noise and related symptoms, only one-third consistently used hearing protection. Training to enhance awareness of NIHL risks, along with periodic hearing assessments for early detection, is recommended. Contribution: This study highlights a gap between awareness of noise-induced hearing loss and the use of hearing protection among Saudi military personnel. It identifies weapon-related noise exposure as associated with reported hearing loss, emphasizing the need for targeted hearing conservation strategies.