Prevalence, Patterns, and Predictors of Hearing Handicap in Relation to Personal Listening Device Use: A Cross-Sectional Study in Saudi Arabia

Background/Objectives: Personal listening devices (PLDs) have become ubiquitous in modern daily life, raising growing concerns about their cumulative impact on auditory health. This study examined the prevalence and patterns of PLD use and the independent predictors of perceived hearing handicap among Saudi adults. Methods: A nationwide cross-sectional survey was conducted between November 2025 and January 2026 among 2018 adults (aged 18 years or older) residing in Saudi Arabia. Participants completed a self-administered online questionnaire assessing sociodemographic characteristics, PLD usage patterns, and hearing handicap measured by the Revised Hearing Handicap Inventory (RHHI-18). Results: Participants had a mean age of 29 ± 12 years, 54.0% were female, and 93.9% were Saudi nationals. Earphones and headphones were used by 51.1% and 47.7% of participants, respectively, and 68.1% reported current use of at least one personal listening device. The mean RHHI-18 total score was 10 ± 18, and 23.0% of participants scored within the hearing handicap range (mild-to-moderate: 16.2%; significant: 6.8%). All PLD use categories were independently associated with higher RHHI-18 scores relative to non-use: headphones only (beta = 4.58; p < 0.001), earphones only (beta = 3.29; p = 0.002), and combined use (beta = 2.87; p = 0.005). Further independent correlates of higher RHHI-18 scores were stroke (beta = 21.51; p < 0.001), diabetes mellitus (beta = 8.64; p < 0.001), hypertension (beta = 4.84; p = 0.006), non-Saudi nationality (beta = 3.92; p = 0.014), male sex (beta = 3.09; p < 0.001), and older age (beta = 0.16; p = 0.002). Conclusions: PLD use is highly prevalent among Saudi adults and is independently associated with greater perceived hearing handicap. These findings support public health efforts promoting safe listening practices at the population level.