Use of digital audio players by high school students: measurement of use intensity and usage habits. / Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso.

PURPOSE: The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. METHODS: This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. RESULTS: The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. CONCLUSION: The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

OBJETIVO: Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. MÉTODO: Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. RESULTADOS: A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. CONCLUSÃO: O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso / Use of digital audio players by high school students: measurement of use intensity and usage habits

RESUMO Objetivo Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. Método Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. Resultados A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. Conclusão O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

ABSTRACT Purpose The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. Methods This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. Results The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. Conclusion The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

[Frequencies of injuries and causes of accidents during ski touring on ski slopes - a pilot study]. / Verletzungshäufigkeit und Unfallursachen beim Pistentourengehen - eine Pilotstudie.

INTRODUCTION: Ski touring along ski slopes (slope touring) increased in recent years on Austrian ski slopes. However, ascending on the border of the slope and skiing downhill on the slope might be associated with a certain injury risk. Thus, the aim of this pilot study was to evaluate frequencies of injuries, causes of accidents and potential risk factors during slope touring. METHODS: Slope-tourers were interviewed from March to April 2014 at the bottom of 4 Austrian ski areas. Interviews were conducted during the week and at the weekend from 7.30 a. m. to 8.45 p. m. RESULTS: A total of 451 slope-tourers (60.1 % males) with a mean age of 39.3 ±â€Š14.4 years were interviewed. Interviewed persons reported that they perform about 20.6 ±â€Š16.0 slope tours per season mainly with a partner (48 %) and during the day (51 %). Ski helmet use was 60 %. A total of 57 persons (12.6 %) reported that they suffered at least once from an injury during slope touring needing medical care. This corresponds to a rate of 6 injuries per 1000 slope tours. Main injury causes were a fall (78 %) and a collision with another person (15 %) and the main injured body part was the knee (36 %). Slope-tourers with an injury were wearing more often back protectors, and were falling more often during downhill skiing, and were abstaining less often from alcohol and were listening more often to music during downhill skiing compared to slope-tourers without an injury. CONCLUSION: Based on the findings of this pilot study we recommend abstaining from alcohol and not listening to music during downhill skiing to reduce the injury risk during slope touring.

A study of the effectiveness of MP3 players to support family carers of people living with dementia at home.

BACKGROUND: Music can be therapeutic to people with dementia; however, little is known about its effect on the family carers. This project aimed to (1) assess the effects of MP3 player use by a person with dementia on caregivers' mental health and wellbeing, including their self-care and health-promoting behavior and (2) determine whether MP3 player use increases caregivers' self-reported capacity to cope with their role. METHODS: A pre-post quantitative and qualitative design was used. Carers completed a survey prior to commencing and four weeks after using the player. The survey included validated measures to assess the level of stress and coping among carers. Carers also kept a diary of the way they used the MP3 player. Half of the carers were interviewed about their experiences at the end of the study. RESULTS: Of 59 people who started using the MP3 player, 51 carers completed the four-week study period and surveys. Use of the MP3 player significantly decreased psychological distress, significantly improved the mental health and wellbeing of carers, significantly increased caregiver self-efficacy to manage symptoms of dementia, and was reported to provide valued respite from the high level of vigilance required for caring for a person with dementia. CONCLUSION: An MP3 player loaded with music can be a low cost and relatively simple and effective additional strategy to support families caring for people with dementia in the community.

College students' personal listening device usage and knowledge.

OBJECTIVE: To determine the usage and knowledge of safe limits on personal listening devices (PLD) among college students. DESIGN: First, information on health history was collected. Second, microphone in real ear techniques determined eardrum to free-field correction factors. Third, hearing levels were evaluated and information gathered about knowledge of safe listening behaviors. STUDY SAMPLE: 180 college students participated in a one-hour session using their PLDs and earphones set to their personal preference. RESULTS: Virtually all participants reported knowledge of hearing loss risk due to PLD use and accurately recognized their own PLD listening levels (p = .01) as either within or exceeding safe sound limits. Forty-four subjects listened at greater than 80-dBA free-field equivalent levels. Only 7% of these participants were aware of these hazardous levels and 15% of participants' exposure surpassed free-field equivalent levels normalized to eight hours. CONCLUSIONS: Despite reported knowledge of hearing loss risk due to PLD use in virtually all college students, 1 in 4 were found to listen to their PLDs at free-field equivalent levels greater than 80-dBA, with 94% unaware of their potential risk. Further research is needed to provide accurate PLD listening information and evaluate the possibility of long term PLD intensities that surpass recommended safety levels on hearing loss in adults over time.

Music-listening habits with MP3 player in a group of adolescents: a descriptive survey.

BACKGROUND: Listening to music through portable MP3 players has become a very popular mode among young people and adolescents. The aim of this study is to investigate the behaviors of adolescents engaged in listening to music with MP3 player and the attendance at clubs (pubs, discotheques) where music is played at high volume. METHODS: Among the 1470 students attending a secondary school in Scandicci (FI) during the school year 2009/2010, 1278 (86.9%) were at school the day of the examination and 1276 completely filled in the questionnaire. Descriptive analysis and univariate and multivariate logistic regression were performed to calculate the degree of association (OR) among the sociodemographic characteristics, listening habits and some factors identified as risky or protective as regards the possibility of developing health disorders. RESULTS: MP3 player users are 88.2% of the sample. Among these, a high proportion engaged behaviours that increase the risk of presenting disorders, including the exposure to high-volume (27.4%). Furthermore, 44.6% use the MP3 while driving. From the regression analysis it emerges that MP3 users showed a sort of addiction: by increasing the time and the occasions of exposure to music, they increased the volume, used maximum or medium-high volume, did not take breaks and did not decrease the volume. CONCLUSIONS: The study points out the spread of risky behavior in music listening, so it is necessary to better inform especially the youngsters and achieve specific preventive interventions.

Everyday music listening and affect regulation: the role of MP3 players.

The use of digital portable music devices such as MP3 players has rapidly increased during the last decade, and the sheer availability of music offered by such players raises questions about their impact on listeners' mental and physical health and well-being. This article explores MP3 player use as an everyday tactic for affect regulation, here understood as an individual's efforts to maintain or change the intensity or duration of a given affect. The ability to understand and regulate affects has significant health implications, and among the tactics relevant to such regulation, engagement with music has proven to be particularly successful. The material presented in this article is based on a qualitative interview study focused on MP3 player use as a medium for musical self-care. Because MP3 users can listen to whatever they want, whenever they want, and target their music in the interests of managing and regulating moods and emotions, the MP3 player represents a valuable and convenient technology of affect regulation.

Portable music player users: cultural differences and potential dangers.

Many studies have examined the use of portable music players portable listening devices (PLDs) from various ethnic groups. Some findings suggest that there may be differences among ethnic groups that lead to louder or longer listening when using PLD devices. For example, some studies found that Hispanic PLD users listen at higher volume levels while other studies found that African American PLD users listen at higher volume levels. No investigator has explained the reasons for differences among ethnic groups in listening intensity. This paper will address the possible reasons for these differences and offer guidelines for the prevention of noise-induced hearing loss.

Personal listening devices and the prevention of noise induced hearing loss in children: the Cheers for Ears Pilot Program.

To determine whether the Cheers for Ears Program on noise induced hearing loss prevention was effective in improving current knowledge of noise impact of personal listening devices on hearing, and in changing self-reported listening behavior of primary school students aged between 9 years and 13 years. A survey study was implemented at participating primary schools. Schools represented various levels of socio-economic status. Informed consent (parents and teachers) and informed assent (pupils) were obtained. All pupils participated in two interactive sessions (the second 6 weeks after first) and only those who provided assent and consent were surveyed at three points during the study: Prior to the first session (baseline), directly post-session and at 3 months post-session. A total of 318 pupils were surveyed. The median age of the participants was 11 years (nearly 50% of the total cohort). Significant changes are reported in their knowledge about hearing and in listening behavior of the participants as measured by pre- and post-measurement. The changes in behaviors were stable and sustained at 3 months post-intervention survey point and the success of the program can be attributed to the multimodal interactive nature of the sessions, the spacing of the sessions and the survey points. Wide-ranging support from schools and departments also played a role. The pilot Cheers for Ears Program is effective in increasing knowledge on the harmful effects of noise and therefore, it may prevent future noise-induced hearing loss.

Hearing risk associated with the usage of personal listening devices among urban high school students in Malaysia.

OBJECTIVES: To investigate listening habits and hearing risks associated with the use of personal listening devices among urban high school students in Malaysia. STUDY DESIGN: Cross-sectional, descriptive study. METHODS: In total, 177 personal listening device users (13-16 years old) were interviewed to elicit their listening habits (e.g. listening duration, volume setting) and symptoms of hearing loss. Their listening levels were also determined by asking them to set their usual listening volume on an Apple iPod TM playing a pre-selected song. The iPod's sound output was measured with an artificial ear connected to a sound level meter. Subjects also underwent pure tone audiometry to ascertain their hearing thresholds at standard frequencies (0.5-8 kHz) and extended high frequencies (9-16 kHz). RESULTS: The mean measured listening level and listening duration for all subjects were 72.2 dBA and 1.2 h/day, respectively. Their self-reported listening levels were highly correlated with the measured levels (P < 0.001). Subjects who listened at higher volumes also tend to listen for longer durations (P = 0.012). Male subjects listened at a significantly higher volume than female subjects (P = 0.008). When sound exposure levels were compared with the recommended occupational noise exposure limit, 4.5% of subjects were found to be listening at levels which require mandatory hearing protection in the occupational setting. Hearing loss (≥25 dB hearing level at one or more standard test frequencies) was detected in 7.3% of subjects. Subjects' sound exposure levels from the devices were positively correlated with their hearing thresholds at two of the extended high frequencies (11.2 and 14 kHz), which could indicate an early stage of noise-induced hearing loss. CONCLUSIONS: Although the average high school student listened at safe levels, a small percentage of listeners were exposed to harmful sound levels. Preventive measures are needed to avoid permanent hearing damage in high-risk listeners.

Music to whose ears? The effect of social norms on young people's risk perceptions of hearing damage resulting from their music listening behavior.

Professional and community concerns about the potentially dangerous noise levels for common leisure activities has led to increased interest on providing hearing health information to participants. However, noise reduction programmes aimed at leisure activities (such as music listening) face a unique difficulty. The noise source that is earmarked for reduction by hearing health professionals is often the same one that is viewed as pleasurable by participants. Furthermore, these activities often exist within a social setting, with additional peer influences that may influence behavior. The current study aimed to gain a better understanding of social-based factors that may influence an individual's motivation to engage in positive hearing health behaviors. Four hundred and eighty-four participants completed questionnaires examining their perceptions of the hearing risk associated with listening to music listening and asking for estimates of their own and their peer's music listening behaviors. Participants were generally aware of the potential risk posed by listening to personal stereo players (PSPs) and the volumes likely to be most dangerous. Approximately one in five participants reported using listening volumes at levels perceived to be dangerous, an incidence rate in keeping with other studies measuring actual PSP use. However, participants showed less awareness of peers' behavior, consistently overestimating the volumes at which they believed their friends listened. Misperceptions of social norms relating to listening behavior may decrease individuals' perceptions of susceptibility to hearing damage. The consequences of hearing health promotion are discussed, along with suggestions relating to the development of new programs.

The effects of iPod and text-messaging use on driver distraction: a bio-behavioral analysis.

This study was designed to empirically examine the effects of iPod device and text-messaging activities on driver distraction. Sixty participants were asked to perform a driving simulation task while searching for songs using an iPod device or text messaging. Driving errors as measured by lane deviations were recorded and analyzed as a function of the distracters. Physiological measures (EEG) were also recorded during the driving phases in order to measure participant levels of cortical arousal. It was hypothesized that iPod use and text messaging would result in a profound effect on driving ability. The results showed a significant effect of iPod use and text-messaging on driving performance. Increased numbers of driving errors were recorded during the iPod and text-messaging phases than the pre- and post-allocation phases. Higher levels of Theta activity were also observed during the iPod and Text-messaging phase than the pre- and post-allocation phases. Implications for in-vehicle systems design, training, and safety are also discussed.

Survey of high school students' perceptions about their iPod use, knowledge of hearing health, and need for education.

PURPOSE: High school students' knowledge about hearing health and their perceptions of how they use personal listening devices (PLDs) including iPods were surveyed to determine the need, content, and preferred format for educational outreach to them. METHOD: This study was a descriptive convenience survey of students at a California high school. An 83-item questionnaire was administered in December 2009 to assess students' demographics, knowledge of hearing health, perceived iPod use, and risk activities. RESULTS: The response rate was 56%. Most of the students perceived that they used iPods safely. However, responses indicated that many of the respondents could be at risk of injury to themselves or others if they became unaware of their surroundings while listening to iPods. Some students were knowledgeable about hearing health and safe iPod use, but most needed information about hearing loss and hearing conservation. CONCLUSION: Most of the students needed education (e.g., via health classes or the Internet) about hearing health, the warning signs of hearing loss, and how to prevent hearing loss. Resources for educational audiologists are provided.

Adolescents risky MP3-player listening and its psychosocial correlates.

Analogue to occupational noise-induced hearing loss, MP3-induced hearing loss may be evolving into a significant social and public health problem. To inform prevention strategies and interventions, this study investigated correlates of adolescents' risky MP3-player listening behavior primarily informed by protection motivation theory. We invited 1687 adolescents (12- to 19-year old) of Dutch secondary schools to complete questionnaires about their MP3-player listening, sociodemographic characteristics and presumed psychosocial determinants of MP3-player listening. Of all participants, 90% reported listening to music through earphones on MP3 players; 28.6% were categorized as listeners at risk for hearing loss due to estimated exposure of 89 dBA for ≥1 hour per day. Compared with listeners not at risk for hearing loss, listeners at risk were more likely not to live with both parents, to experience rewards of listening to high-volume levels, to report a high habit strength related to risky MP3 listening, and were less likely to be motivated to protect their hearing. Habit strength was the strongest correlate of risky listening behavior, suggesting that voluntary behavior change among adolescents might be difficult to achieve and that a multiple strategy approach may be needed to prevent MP3-induced hearing loss.

Noise exposure estimates of urban MP3 player users.

PURPOSE: To examine the sound level and duration of use of personal listening devices (PLDs) by 189 college students, ages 18-53 years, as they entered a New York City college campus, to determine whether noise exposure from PLDs was in excess of recommended exposure limits and what factors might influence exposure. METHOD: Free-field equivalent sound levels from PLD headphones were measured on a mannequin with a calibrated sound level meter. Participants reported demographic information, whether they had just come off the subway, the type of PLD and earphones used, and duration per day and days per week they used their PLDs. RESULTS: Based on measured free-field equivalent sound levels from PLD headphones and the reported PLD use, per day 58.2% of participants exceeded 85 dB A-weighted 8-hr equivalent sound levels (L(Aeq)), and per week 51.9% exceeded 85 dB A-weighted 40-hr equivalent continuous sound levels (L(Awkn)). CONCLUSIONS: The majority of PLD users exceeded recommended sound exposure limits, suggesting that they were at increased risk for noise-induced hearing loss. Analyses of the demographics of these participants and mode of transportation to campus failed to indicate any particular gender differences in PLD use or in mode of transportation influencing sound exposure.

Teenage use of portable listening devices: a hazard to hearing?

BACKGROUND: Recently, a number of popular media articles have raised some concern that portable listening devices (PLDs) may be increasing the risk for music-induced hearing loss (MIHL). However, literature regarding adolescents' listening behavior and how their attitudes and beliefs relate to behavior is currently limited. PURPOSE: The purposes of this study were (1) to investigate the relationship between volume control settings and output levels of PLDs, (2) to examine how adolescents' listening behavior changes as a function of background noise and noise isolation, (3) to investigate the relationship between self-reported listening levels and laboratory-measured listening levels, and (4) to evaluate the validity of the Listening Habits Questionnaire as a research tool for evaluating how attitudes and beliefs relate to PLD use behavior. RESEARCH DESIGN: A descriptive study. Experiment 1 evaluated the output levels of a set of PLDs, and Experiment 2 characterized the listening behavior and attitudes toward PLD use of a group of adolescents. STUDY SAMPLE: Twenty-nine adolescents aged 13-17 yr, with normal hearing, participated in Experiment 2. DATA COLLECTION AND ANALYSIS: Experiment 1 evaluated the output levels of a set of PLDs with stock and accessory earphones using an acoustic manikin. Experiment 2 included survey measures of listening behavior and attitudes as well as output levels measured using a probe microphone. CONCLUSIONS: The output levels of PLDs are capable of reaching levels that could increase the risk for MIHL, and 14% of teenagers in this study reported behavior that puts them at increased risk for hearing loss. However, measured listening levels in the laboratory settings did not correlate well with self-reported typical listening levels. Further, the Listening Habits Questionnaire described in this study may provide a useful research tool for examining the relationship between attitudes and beliefs and listening behavior.

Use of iPod™ technology in medical-surgical nursing courses: effect on grades.

Advances in computer technology, such as the portable and affordable iPod™, allow students to view lectures anywhere at any time. iPods™ are of special interest for nurse educators who strive to meet demands posed by a critical nursing shortage. A mixed-methods pilot study was conducted to assess whether iPod™ could be an effective teaching tool for medical-surgical nursing lectures. In a randomized study with 35 participants, together with eight students having their own iPods™, grades of students given pre-recorded class lectures on iPods™ were compared with grades of those who attended lectures without iPods™. Learning styles, amount and use of students devoted to iPod™ lectures were considered as well as grades. Most results were not significant, but there was some evidence that the control groups who attended classroom lectures received better grades than iPod™ users, and individuals who used iPod™ more frequently before the final exam received lower grades. These somewhat surprising results suggest the need for further research in the use of this technology as a resource for nursing education delivery.

Driving error and anxiety related to iPod mp3 player use in a simulated driving experience.

Driver distraction due to cellular phone usage has repeatedly been shown to increase the risk of vehicular accidents; however, the literature regarding the use of other personal electronic devices while driving is relatively sparse. It was hypothesized that the usage of an mp3 player would result in an increase in not only driving error while operating a driving simulator, but driver anxiety scores as well. It was also hypothesized that anxiety scores would be positively related to driving errors when using an mp3 player. 32 participants drove through a set course in a driving simulator twice, once with and once without an iPod mp3 player, with the order counterbalanced. Number of driving errors per course, such as leaving the road, impacts with stationary objects, loss of vehicular control, etc., and anxiety were significantly higher when an iPod was in use. Anxiety scores were unrelated to number of driving errors.

Adolescents and MP3 players: too many risks, too few precautions.

OBJECTIVE: The goal was to assess risky and protective listening behaviors of adolescent users of MP3 players and the association of these behaviors with demographic characteristics and frequency of use. METHODS: In 2007, 1687 adolescents (12-19 years of age) in 68 classes in 15 Dutch secondary schools were invited to complete questionnaires about their music-listening behaviors. RESULTS: . Ninety percent of participants reported listening to music through earphones on MP3 players; 32.8% were frequent users, 48.0% used high volume settings, and only 6.8% always or nearly always used a noise-limiter. Frequent users were >4 times more likely to listen to high-volume music than were infrequent users, and adolescents in practical prevocational schools were more than twice as likely to listen to high-volume music as were those attending preuniversity education. CONCLUSIONS: When using MP3 players, adolescents are very likely to engage in risky listening behaviors and are unlikely to seek protection. Frequent MP3 player use is an indicator of other risky listening behaviors, such as listening at high volumes and failing to use noise-limiters.

Medical student access to multimedia devices: most have it, some don't and what's next?

In recent years, the rise in total student intake of medical schools across England has not been met by an increase in medical teachers. Computer aided learning (CAL) has the potential to address this disequilibrium. We conducted a survey of clinical medical students at our institution to ascertain the level of access to media devices capable of delivering vision and/or audio. The aim was to establish a baseline to assist CAL providers plan for appropriate modes of content delivery. A questionnaire was emailed to all clinical medical students at UCL. To validate the email survey, an identical paper questionnaire was distributed to a compulsory class for third year clinical medical students. The e-questionnaire and validation questionnaire response rate was 46 and 100% respectively. Eighty-six percent of students had home access to broadband Internet, and 85% of home computers were suitable for a full multimedia experience. Seventy-four percent of students indicated that their primary place of access was at home. Sixty-three percent of students had portable MP3 devices and over 50% owned an iPod. The hardware environment appears favourable for the introduction of complex multimedia teaching programs to medical students, but access is not universal. In addition to personal computers, inexpensive portable multimedia players might offer the opportunity to deliver 'on demand' learning. Medical schools planning for delivery of CAL should consider student access to desktop and portable media devices when designing an e-learning curriculum.