Ear buds. Earphones. Naked ears.
How one listens to music does not matter in terms of potential hearing damage as much as the combination of volume, proximity to the noise source and length of exposure.
This is common sense, yes. But when studies emerge like a recent one in the Journal of the American Medical Association that estimated one in five teenagers has hearing loss, the message of auditory moderation seems to bear repeating.
Or perhaps it should be shouted at 79 decibels.
That's about the highest level of noise intensity a person should be exposed to for an extended time, according to Susan Kaplan, an audiologist with the University of California-Davis health system.
"The louder you like to listen to music, the shorter amount of time" you should listen to it, Kaplan said. "It doesn't matter if you are 15 or 60."
Hearing loss occurs more often with sound above 80 decibels, or about the noise level of a ringing telephone, Kaplan said. At 100 decibels (lawn mower, chain saw, approximate maximum volume on an iPod), things get truly dicey.
Music fans who insist on listening to iPods at 100 percent volume through ear buds — those in-ear speakers that seem permanently attached to today's teens — should do it for only five minutes at a time, Kaplan said. At 80 percent volume, they can go an hour, Kaplan recommends. At 70 percent to 79 percent, a few hours, and 69 percent and below, four to five hours.
Ear buds are slightly more dangerous than over-the-ear earphones, Kaplan said, due to the buds' closer proximity to the cochlea, or auditory portion of the inner ear.
"The farther away you are from the source of the sound, the less impact it will have, even if it has the same intensity," Kaplan said.
By that token, music lovers who want to hear their favorite bands live as well as recorded should beware the giant speaker.
"If your body is vibrating, then so is your ear," Kaplan said.
She urged fans of live music always to consider ear plugs.
"It sounds dorky, but I do advise it, especially if (people) know they are going to a concert where the band plays really loud music," Kaplan said. "If you are listening to James Taylor play acoustic guitar, it is going to be different than listening to KISS."
Kaplan said the soft, foamy earplugs available at most drugstores will do the trick.
But for a Deftones show last month, Carol Gale of Sacramento, Calif., went industrial.
"I got mine from the hardware store," Gale said of the rubber earplugs she bought for the hard-rock show. "I knew (the Deftones) were going to be loud. It was the first time I ever wore earplugs, and I was so glad I did."
Gale has become more careful recently about protecting her hearing. She notices when veteran musicians she knows cock their heads and favor one ear. She now embraces the idea of earplugs.
Kaplan said she has seen musicians with noise-induced hearing loss at the University of California-Davis audiology clinic. But she has not encountered many teens affected by high volumes on personal listening devices.
That's because their hearing loss might still be slight enough that they have not noticed it, Kaplan said.
"I imagine that when these teens are middle-aged, we definitely will see a lot more of them needing hearing aids," Kaplan said.