CHICAGO – For high school sophomore Sophia Pellar, a pair of special earplugs has put an end to the pain she suffered when playing flute in the pep band.

Nonetheless, the Mozart-loving teen giggles nervously when she explains that the earplugs — tethered by a bright blue string and designed to protect musicians from noise-induced hearing loss — have yet to become part of her regular repertoire. "I wear earplugs during pep band season, because it can be crazy loud," said Sophia, 16. "But the thought of wearing them every day is a little embarrassing."

With research indicating that as many as 20 percent of teens suffer from hearing loss, much of it caused by noise damage, more doctors and school band directors are urging kids to take precautions such as wearing earplugs. Yet, the experts say, their messages are being undermined by an "uncool" stigma similar to that which once impeded the use of bike helmets and sunscreen.

Officials say even the most vigilant parents typically are unaware of the need for their children to take precautions.

Sophia's mother, Dr. Chimene Pellar, said that while she's thrilled that her three teens enjoy the band program, she became alarmed recently when she learned that Sophia is often in pain after playing her flute in close ranks with her fellow musicians.

"I had never thought of it at all … and she has been playing the flute since she was in fourth grade," said Pellar, a physician. "I also have concerns when I walk by my kids when they have their earbuds in and I can still hear their music. And the longer they listen, the louder it seems to get."

Audiologists who study teen hearing loss say high-decibel music from instruments, concerts and earbuds — as well as other loud noises — can harm the hair cells in the ear's cochlea, leading to cumulative hearing damage that is irreversible.

"We're seeing a rise in the number of adolescents with hearing loss, which is not a surprise when you look at our society, which has gotten busier, nosier and overstimulated," said Dr. Henry Ou, an associate professor of pediatric otolaryngology at Seattle Children's Hospital.

"Sound is just energy, and when it's delivered at a high amplitude, it can cause damage," Ou said.

The National Association for Music Education urges teachers and band directors to address the dangers of noise-induced hearing loss during classes and rehearsals by, for example, ensuring that students are not performing at high volume levels for an extended time.

"It's something music educators talk to their students about all the time, and one of those issues where the band directors are actually ahead of Mom and Dad in being concerned," said Michael Butera, the association's executive director and CEO.

Music teachers and band directors can encourage and model safe behavior, Butera said, but requiring student musicians to wear earplugs is another matter entirely.

Teachers "don't have the power of the school boards or the states, and the first time you talk about any regulations or mandates, everyone goes nuts," Butera said. "But it's important for teachers to be aware of the hearing-loss issue and for them to be able to discuss it with their students."

At Chicago's Barrington High School, band director Randy Karon said he often talks to his students about the need to be vigilant about protecting their hearing, during rehearsals and performances and outside of the band program, too.

"My general rule is, if your ear feels uncomfortable at any time, put a pair of earplugs in," said Karon, who keeps a jar in the band room stocked with foam earplugs for his students.

After decades of playing trumpet and directing student musicians, Karon said, he also is increasingly aware of the need to protect his own hearing. "Music is my livelihood, and if I can't hear, I'm in trouble," he said.

At Sophia Pellar's New Trier High School, band director Matt Temple' said only time will tell if his young musicians will wear their new earplugs beyond pep band season.

"A lot of our percussion members already have form-fitted earplugs, and they wear them a lot," Temple said, adding, "But we're dealing with the [perceived] invincibility of teenagers."