Mother is a central figure in the household. Mother habits significantly influence all aspects of a child's life, whether it is about education or health. A mother is responsible for maintaining the cleanliness and health of her child, including ear hygiene, so that every mother has the habit of cleaning her child's ears at least once a week. This habit is driven by the desire of the mother and hope that her ears of children are being cleaned and have a healthy hearing. According to Health Sciences, cerumen is not something that must be cleaned, but a sebasea gland produced by the ear to protect the ear from the entry of small animals such as ants, cockroaches etc., into the ear canal because of its sour smell and prevents bacteria and fungi from being infected by cerumen which functions as a bactericide.1 Thus, the habit of cleaning earwax (cerumen) actually removes ear protection and risks increasing the incidence of cerumen obturans (wax due to its position which is moved to the bone area so that it is buried in the ear and the risk of trauma/tearing of the eardrum by ear cleaning devices such as cotton buds, cerumen hooks or tools used such as hairpins or safety pins.2 Cerumen obturans is hardened ear wax, with a large size, and covers the eardrum's surface so that hearing becomes disturbed because the incoming sound imparts the movement of the eardrum.3 Cerumen obturans is one of the five main causes of hearing loss, especially in Elementary students in Indonesia, apart from middle ear infections, congenital abnormalities, aging, and noise trauma.4 Cerumen obturans causes a child's hearing to decrease so that social communicating will be disrupted and this will interfere the ability to absorb lessons, especially for children who are studying. The dangers and side effects of the habit of cleaning the ears were not realized by their mothers, so that the cerumen obturans incident was not even realized by the mother and would become a habit that was carried out routinely. Based on the above thoughts, this study aims to describe the mother habit's role in cleaning the ears against the incidence of cerumen obturans in children by taking samples of elementary school students.

This study is an observational analytic study with a cross-sectional approach to the incidence of cerumen obturans of students at Kera-Kera Elementary School in Makasssar, Indonesia, on ear cleaning habits. The samples consisted of 119 students divided into ≤10 years and >10 years age groups, who were subjected to otoscope examinations to determine the incidence of cerumen obturans and data on mother habits and ear cleaning habits were obtained through direct interviews and filling out questionnaires concerning people who performed ear cleaning, the tools used, reasons, knowledge, frequency of cleaning, level of education and the main activities of their mothers.5

From research conducted in August 2019 on 119 students of Kera-Kera Elementary School in Makassar, Indonesia, the characteristics of the following sample were obtained (Table 1).

The results of the analysis using chi-square on various variables on the incidence of cerumen obturans can be seen in Table 2.

From the results of this study, it can be seen that gender, the habit of cleaning the ears by the mother, the tools used, the knowledge, frequency, education, and main activities of the mother does not have a statistical significance on the incidence of cerumen obturans in children, and only the age factor is statistically significant to the occurrence of cerumen obturans. However, if analyzed further, the incidence of cerumen obturans at the age ≤10 years showed a high role in the mother's habit of cleaning the child's ears which reached 98 (82.4%). However, this does not mean statistically meaningless the role of the mother is not important in the increase of cerumen obturans incidence, but it does mean that both the cleaning of the ears by the mother and not the mother (other adults or themselves) together increase the incidence of cerumen obturans in children. Cerumen obturans in the child was caused by the habit of cleaning cerumen obturans in which the mother took a role of 82.4%. Likewise, that the habit of cleaning the ears is not influenced by knowledge, education level, or a mother busyness of work or non-work but is more driven by health goals, maintaining hearing without thinking is dangerous or not but more been motivated to the responsibility and protecting their children from something which is considered dirty and should be cleaned. This can be seen from the answer of respondents about the reasons for cleaning the ears 48.7% because of the unpleasant taste of the ears and 36.1% due to hearing loss, 6% because of itching, and even 9.2% did not have any complaints. Likewise, with the frequency of ear cleaning, we find that 79.8% do ear cleaning once per day/per week/per month, and there are 20.2% who do it with an unclear frequency. This study shows that whatever the reason and frequency, the habit of cleaning the ears has a role in the high incidence of cerumen obturans in children, especially in elementary school students.6 From this study, it was also known that knowledge about the dangers and side effects of cleaning mothers’ ears was still lacking. 94.1% of the responses stated that they did not know that cleaning the ears had dangerous side effects and was an action that was not recommended in health science. Therefore, it needs continuous efforts by the community health center team, academic community, and other community organizations to provide counseling so that prevention and management of cerumen obturans can be carried out and can participate in maintaining the health and hearing of our current and future young generations.7 Furthermore, it is from the hands of a smart and responsible mother, and we can realize the hope of creating healthy ears, good hearing for everyone in 2030.

In this study, it can be concluded that only the age factor has a significant effect on the incidence of cerumen obturans. However, the mother habit of cleaning the ears has an important role increased the incidence of cerumen obturans in children, especially the aged children ≤10 years, regardless of education level, main activities, and lack of mother's knowledge of the dangers and side effects of ear cleaning.