Music professionals rely on good hearing to monitor properly while performing. When hearing loss occurs, critical listening skills may suffer as a result of diminished pitch, loudness and temporal perception. Regardless of this, many musicians accept potential hearing loss as a part of their job, essentially sacrificing their hearing in order to perform in the music arts profession. Part of the reason for this acceptance is the lack of information about the causes and consequences of “music-induced hearing loss,” concerns about job security, and fears that hearing protection will hinder their capacity to work or perform.

In recent years a growing number of music professionals have taken initiatives to find out more about music-induced hearing loss and to protect their hearing. Research in this specialized area has led to some interesting and surprising findings – such as the fact that classical musicians are more likely to develop a hearing loss from their work than are rock musicians. This has been attributed to more rigorous practice and work schedules, the higher spectral energy in classical music, and repetitive work and practice sessions. There also seems to be a relationship between the level of stress or annoyance associated with sound in the work environment and changes in hearing associated with it.

In most industries where noise levels are high, standards such as those established by the Occupational Safety and Health Administration (OSHA) are applied in order to protect workers’ hearing. These regulations are based on years of research and debate on how sound affects hearing over time. One question scientists have tried to answer is “how much is too much?” There is no simple answer, due to differences in the many noise sources, the complexities of experimental design in studying noise effects, and individual and cultural differences. As a result, no universal formula exists to define what constitutes risk to everyone.

Identifying those at risk in the music community is even more difficult, due to the different forms of music, ever-changing exposures associated with work schedules, locations, performance and rehearsal schedules, etc. Between all of these factors, the best one could predict for musicians would be to say, “If you are exposed to an average workday of 90 dB or more of music, some of you may develop changes in hearing from your work; at 85dB all day long, less of you likely will; and at 80 dB, almost none of you will.” Considering the necessity of good hearing for your careers, music professionals must decide whether this is what you want for your future. If the answer is no, then what can be done?

The first step is to look beyond regulations developed with the manufacturing industry in mind and consider the unique characteristics and needs of the music worker:

• For example, OSHA’s regulations were developed to protect workers from “material hearing loss.” Changes of up to 25 dB in hearing are acceptable to OSHA – but would this be acceptable to music workers?
• Unlike factory workers, music workers are exposed to varying and often unpredictable levels of sound. How can we identify individuals at risk?
• In addition, musicians by nature are often very tuned in to perceptual issues and may experience greater stress than non-musicians would from conditions such as tinnitus (ringing) and hyperacusis (sensitivity to sound). Although existing regulations do not consider these issues, should musicians address them?

The answer to all of these questions is that the music community must identify its unique and specific needs and then develop a mechanism to address them.

One important component of this process is to monitor for changes in hearing. Every musician should have a hearing test once a year. You should recognize that your hearing will decrease naturally as you grow older. However, if your hearing test indicates the possibility of noise-induced hearing loss, strategies to limit the damage can be implemented. The testing session also provides an opportunity to discuss your concerns about hearing issues, both on and off the job, and any secondary problems that may be bothersome, such as tinnitus. It is important that you keep copies of hearing tests for comparison each year, so that subtle changes can be detected. It is not adequate to walk away from the examination with general impressions.

When concerns of excessive sound levels are identified, exposures can be reduced through sound engineering (the way the sound is mixed and delivered to monitors and the PA), environmental modifications, personal hearing protection or in-ear monitors. The key is to use the most appropriate application correctly for your work.

Earplugs and the various commercially available in-ear monitors each have unique response characteristics. This can be discussed with the hearing specialist. Even the acoustic characteristics of Musicians Earplugsä , the well known flat response earplugs developed by Etymotic Research, can be affected by the ear canal size, the depth of the impression taken of the ear, and the fit of the plug. The successful selection and fitting of hearing protection devices requires more than a generic approach.

Remember also that more is not always better, in terms of hearing protection. It is more important to use something consistently and lower your exposures realistically than to try to achieve maximum protection with something you can barely tolerate.

Unlike most other workers in high levels of sound, the music worker of today must assume responsibility for his or her own hearing health. Musicians must accept that they need to protect themselves now in order to enjoy their hearing in the future. If this is difficult, remind yourself that your livelihood depends on your hearing. Treat your ears as you would your most treasured musical instrument.

More information on hearing loss prevention is available at www.neatnoise.com, a web site for musicians. You may also reach Ellen Kelly, M.S. CCC-A in New Jersey at (732) 238-1664 or in New York through the Musicians’ Injury Prevention Program at Mount Sinai/Irving J Selikoff Center for Occupational Medicine at (212) 241-4833. A tutorial on Hearing Loss and Hearing Protection will appear in next month’s Allegro.