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by Ellie Apuzzo

Noise induced hearing loss can happen to anyone in contact with loud music. Learn the hazards and how to protect yourself!

Quality Protection

The last thing, a travel weary, instrument lugging, rehearsal haggard, make-ends-meet musicians want is another thing to worry about and invest in. But there is one. Perhaps the most important one.
Risk to hearing may
actually be greater for
orchestral musicians. . .
Their hearing. Years of loud music takes its toll and every musician's hearing is at risk. The fact that excessive exposure to high levels of music can cause hearing loss is supported by dozens of studies dating back more than 30 years. And this may come as a surprise: the music genre is irrelevant. Risk to hearing may actually be greater for orchestral musicians than it is for the rock and roller. (One study suggests that up to 52% of classical musicians suffer job related hearing loss.)

Here are some statistics. Musicians routinely face sound pressure levels in potentially hazardous ranges. They extend up to 120-130 decibels while 3 feet from the speaker in amplified rock/pop bands, 83-112 decibels on stage in various orchestras and 80-101 decibels on stage in jazz, blues, and country and western bands. That reality, plus the fact that many musicians practice and/or perform 4 to 8 hours a day, suggests a strong causal relationship between their chronic loud music exposure and their "noise-induced hearing loss (NIHL)."

How do these numbers effect a musician's life and profession? Let's take a look. It is widely known that difficulty in speech comprehension seen in NIHL is secondary to hearing loss in the high frequencies.
High-frequency hearing loss
is particularly detrimental
for musicians and singers
because . . .
At first, the high-frequency loss may be mild enough not to cause any problems but as exposure continues and loss progresses, understanding certain words, especially in the presence of background noise, may become increasingly difficult. Distinguishing certain consonant sounds (i.e., "s" and "f") of higher frequencies and the higher pitched women and children's voices may become more difficult too. The performing artist is not immune to these frustrating consequences . . . in social context or at work. High-frequency hearing loss is particularly detrimental for musicians and singers because they not only need to understand conversational speech but they must match frequencies over a broad range, including frequencies above those required for understanding speech. High-frequency hearing loss may lead to:

  1. excessively loud playing at higher pitches,
  2. arm and wrist strain (i.e. a violinist) in order to compensate, may "overbow", and lastly,
  3. music takes on a distorted sound losing it's color and clarity due to the high-frequency loss.
For the singer, monitoring of one's voice is essential during singing in allowing for vocal adjustments. Impaired self-monitoring caused by hearing loss or trying to sing over background music that is too loud can lead to vocal abuse. This in turn can lead to the development of dysphonia from associated vocal cord inflammatory pathology (i.e., nodules, polyps etc.).

A musician's hearing loss
is often asymmetric
A musician's hearing loss is often asymmetric, probably relating to the position of the instruments and/or amplifiers on the stage. The rock drummer, tends to be worse in the left ear owing to its closer proximity to the high-hat cymbals. In the violinist also, it is more often the left ear that will be effected, but the flute and piccolo players experience greater loss in the right ear. This imbalance often cause the musician to complain of distortion, even in their better ear.

What can be done? I'm glad to be able to offer some possible solutions. There are plugs that musicians' can wear that will help to protect their hearing while allowing the music to come through. The plugs are custom made and are far from the perceived "stuff-it-in-your-ear" complete muffling type of ear protection. One company which offers this product is Etymotic Research. They developed and patented the attenuator used in Musicians Earplugs. The attenuator serves to filter incoming sounds and gently reduces the intensity. The ER-15 attenuates oncoming sound by 15 decibels, the ER-25 by 25 decibels, and the newest addition is the ER-9 which will reduce the incoming signal by, you guessed it, 9 decibels. All of these attenuator "buttons" can be used, interchangeably, in the same custom made earmolds. The molds are made of one of two materials, vinyl or silicone. The silicone is softer and usually more comfortable to wear. The plugs are designed to maintain high fidelity reproduction of music without compromising the musician's ability to listen. Music and speech can still be heard clearly, but will not be as loud. A lower cost alternative is the ER-20 HI-FIT, a non-custom plug.

Production Quality

Ear Monitors are fast becoming popular as an on-stage aid to performing artists. These in-the-ear monitors benefit the performer in sound quality, clarity, and performance. In other words, they hear themselves more clearly.
. . . the use of ear monitors
also raises a serious question
about benefit versus risk
However, the use of ear monitors also raises a serious question about benefit versus risk. A custom-fit monitor has the capability of significantly reducing the amount of ambient stage noise that the performer hears, and thus extends safe exposure time to harmful loudness. The down side is that most monitors currently available on the market have the ability to cause hearing damage if the volume levels or "mix" is not carefully controlled.

There are three general types of personal ear monitors to choose from: completely custom earpieces, occluding modular designs, and non-occluding modular designs. One popular custom monitor currently seen in the professional touring category, the Ultimate Ears UE5 Pro, is manufactured at Westone Laboratories. That design places two drivers with a passive crossover in the earpiece for exceptional sound quality and clarity. A special acoustic seal allows the artist to have a lower "at ear" volume, even on high-volume stages.

Modular occluding (sealed ear) designs are based on earpieces that can be used either with generic foam tips or with an earmold. Examples include the Shure Bros. models E1/E5 and the Sensaphonics Pro-Phonic 4.

Modular non-occluding (partially open ear) designs are usually used with commercially designed earbuds. The earpieces can be custom molded or generic fit. These products should be limited to the quietest of performance venues as there is little ambientnoise reduction. When used in louder venues, there may be a tendency to operate the monitors at an extreme level in an attempt to mask the ambient noise.

Every study confirms that excessive loudness, over time, results in hearing loss. And hearing loss effects every aspect of a musician's career. But noise-induced hearing loss can be prevented, and proper prevention should begin with the school band member and carry through to the touring professional. For more information, call the Hearing Aid Center of Orange County at 845-564-1593, or visit the Westone website.


Ellie Apuzzo owns and operates Ellie's Consider It Done. She provides "on-site oversight for absentee owners" here in the Florida Keys; and so far, this lifelong New Yorker just can't seem to get into "Keys time!" Ellie can be reached at

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