Musicians and the Prevention of Hearing Loss Catherine V. Palmer, PhD Director of Audiology, UPMC Associate Professor, Communication Science and Disorders
By attending this presentation, you will have to think differently about the way you do things.
I would go as far as to say that it would be extremely uncomfortable to have this information and not take action…
Understanding the ear and hearing
3 Primary Divisions
With musicians, hearing loss is not the only problem …
Pitch perception problems
Two Critical Factors Affecting Hearing Loss
Who is in danger?
Remember, the danger of damage to the hair cells and subsequent hearing loss has to do with the individual’s total dose.
You have to think about all the loud sounds that the individual will be exposed to during the day.
Decreased sensitivity (you need sounds louder to hear them)
Diminished clarity (frequency resolution is poor). This impacts playing music, enjoying music, and hearing speech.
Tinnitus (ringing sounds, often high pitched)
After exposure there may be no symptoms, or the individual may experience ringing in the ears, a sensation of fullness, or sounds my seem “dull”
The damage and functional change is gradual. The individual may not notice a problem for a decade or more.
The damage continues
We know that hair cells continue to die well after the exposure.
Musical Levels 95-112 dB Piccolo (5 minutes to 1.25 hrs) 85-111 dB Flute (1.25 hours) 90-94 dB Oboe (2.5 to 5 hours) 82-92 dB Cello (5 hours) 84-102 dB Violin (1.25 hours) 92-95 dB Piano Fortissimo (2.5 to 5 hours) >90 dB Regular, Sustained Exposure May Cause Permanent Damage 75-85 dB Chamber Music in Small Auditorium 60-70 dB Normal Piano Practice
Musical Levels (cont) 100-120 dB 125 dB Band at a Sporting Event (2.5 min) Marching Band (4 seconds) 120-137 dB Orchestra Peaks (2.5 minutes) 106 dB Timpani and Bass Drum Rolls (5 min) 97 dB Ensemble (average) (1.25 to 2.5 hours) 85-114 dB Trombone (5 min to 1.25 hrs) 90-106 dB French Horn (5 min to 1.25 hrs) 92-103 Clarinet (1.25 hours) dB Music Levels
Take a look at the graph in your handout Major Sporting event Drumline rehearsal Marching Band Hours Minutes Seconds
Take home message
Once instrumentalists play in a group, they are in danger of permanent noise induced hearing loss within minutes
Drummers are always in danger of hearing loss (practicing alone or in a group)
You have to consider the total daily dose
The impact of hearing loss may not be noticed for years
These times are based on adult data and there are some animal studies that suggest that children are more susceptible
What can instrumental instructors (and parents) do?
Protect your students (children)
Educate your students (children)
Hearing health care should be part of every music program and part of health class
Let’s talk about hearing protection…
“ Who wants earplugs that won’t let you hear?”
Description of School Programs
A recent national study estimated that approximately 12% of all children ages 6 to 19 years have noise-induced hearing loss.
Children are the fastest growing population of individuals with noise-induced hearing loss.
Goals of the Program
Provide instrumental music instructors with education related to hearing loss and hearing protection and music
Provide instrumental music instructors with non-custom Musicians’ Earplugs or custom Musicians’ Earplugs at a reasonable cost
Provide non-custom Musicians’ Earplugs to instrumental music students through the instructors
Provide education to instrumental music students through the instrumental music teachers
Putting Hearing Protection in Context
We would not consider sending students to chemistry class or shop class without protective goggles.
We would not consider allowing students to play football without a helmet.
We may know that a football player rides his bike with no helmet, but that would not make us decide not to bother with a helmet during football just because he has increased his chance of having a head injury anyway.
Parents have the right to assume that schools make school activities as safe as possible using current information and technology.
It actually would be much simpler if noise induced hearing loss caused pain or bleeding – then you can be sure hearing protection would be required.
The damage is invisible…finally there is functional impact but it can be years after the damage
Are we saying that music is dangerous?
No, but we are saying like many things we engage in, you need to use the appropriate equipment to make it safe and to be able to enjoy it over a long period of time.
Successful Programs So Far
What message is the teacher sending if he/she wears hearing protection in front of students? Good health habits
Mandatory – when you come into the band room, the first thing you do is get your hearing protection.
No hearing protection – you don’t participate in class. (keep lots of extras)
Help the students adjust. It takes about 2 weeks to get used to using the hearing protection (horns are the toughest)
Easy to use
The plugs come with cords so the students can have them in and out if needed and drape them over their necks
The plugs come in a case that can be hooked to a back pack or instrument case
Students are welcome to use these earplugs throughout their days, weekends, etc. or the teacher may want to keep them in the band room
Who should absolutely be using hearing protection?
Steel Band students
All drumming groups
Most other group-type musical students
What about IPods?
They are not inherently dangerous.
It’s the level and amount of time.
Custom earplugs can reduce the volume used, but then you can’t hear the sounds around you.
I’m only talking about hearing safety, there are other concerns with being “plugged” in for hours and not interacting with your environment.
Remember, it’s all about total dose.
If you have to shout to be heard from 3 feet away, then the noise (music) is too loud.
Turn down the volume or wear hearing protection.
A Avoid loud sounds
R Reduce the volume
S Shorten the time in noise
Any type of music can cause permanent hearing loss and ringing in the ears.
It is intensity level and length of exposure that matters.
The type of hearing loss people get from sound exposure is permanent.
The loss starts in the high frequencies and progresses. It causes difficulty communicating in noisy situations and impacts how music is perceived.
Sound exposure also may cause ringing in the ears (tinnitus).
Some musicians need to wear hearing protection when they are practicing alone.
All musicians need to wear hearing protection when they are playing in a group (band, orchestra) if they want to avoid hearing loss.