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The COVID-19 pandemic has created substantial and dynamic disruptions in society, personal behavior, and potentially chronic sound exposures, which are associated with hearing loss, cardiovascular disease, and other health impacts. Leveraging preliminary data from our unique nationwide Apple Hearing Study, we explored changes in personal sound exposures resulting from COVID-19-related social distancing. Volunteer participants opted to share environmental sound data from their Apple Watch and headphone sound data from their iPhone. Participants for this analysis were chosen from four states which exhibited diverse responses to COVID-19. Equivalent continuous average sound exposures (in A-weighted decibels, dBA) were computed per person-day and normalized to 8 hour L EX8h  exposures. Daily mean L EX8h  exposures across two time periods, a baseline period (before the first known US COVID-19 death at the time of analysis) and an intervention period (starting with each state’s first COVID-related public health social distancing announcement and ending on April 22, 2020) were defined to assess changes in sound exposure. We modeled sound levels across 5,894 participants and 516,729 monitored days using a linear mixed-effects model with random effects for participant. The overall reduction in LEX8h between baseline and intervention was 2.6 ± 0.05 dBA (mean ± SE). There was a significant day-of-week effect during the baseline period, with the lowest exposures on Monday and the highest on Saturday. This effect was not noted during the intervention period. COVID-19 social distancing measures were associated with an approximately 3 dBA reduction in personal environmental sound exposures; this represents a substantial and meaningful reduction in this harmful exposure. Our analysis demonstrates the utility of everyday use devices in detecting behavior and exposure changes associated with the COVID-19 pandemic, and the usefulness of longitudinal, large-scale characterization of personal exposures and health impacts using wearable technology.

Impacts of COVID-19-related social distancing measures on personal environmental sound exposures