Purpose
We aimed to develop and validate the Musicians' Hearing Handicap Index (MHHI), a new self-evaluation tool for quantifying occupation-related auditory difficulties in music professionals. Although pure-tone audiometry is often considered the “gold standard” and is usually employed as the main instrument for hearing assessment, it cannot fully describe the impact of hearing dysfunction. The MHHI is an attempt to complement the hearing impairment assessment toolbox and is based on a unique approach to quantify the effects of hearing-related symptoms or hearing loss on the performance of musicians and other music industry professionals.
Method
An initial set of 143 questionnaire items was successively refined through a series of critical appraisals, modifications, and suggestions. This yielded an intermediate questionnaire consisting of 43 items, which was administered to 204 musicians and sound engineers. After exploratory factor analysis, the final form of the MHHI questionnaire was obtained, consisting of 29 items. The questionnaire's test–retest reliability, internal consistency, discriminating power, content validity, criterion validity, and aspects of construct validity and inherent conceptual structure were assessed.
Results
Exploratory factor analysis revealed a combination of four common factors for the 29 validated questionnaire items. They were named “impact on social and working lives,” “difficulties in performance and sound perception,” “communication difficulties,” and “emotional distress.” The MHHI was shown to be a valid and reliable instrument to assess musicians' and sound engineers' occupational difficulties due to hearing impairment and related symptoms.
Conclusion
The ability of the MHHI to discriminate between groups of music professionals with different auditory symptoms or pure-tone audiometry thresholds suggests that auditory symptoms might influence a professional's performance to an extent that cannot be assessed by a pure-tone audiogram.
<p class="abstract"><strong>Background:</strong> Research on noise induced hearing loss pathophysiology has recently focused on synapses rather than outer hair cells, following relevant evidence from animal studies. Findings from human studies, mainly targeting on effect of chronic exposure are controversial. Aim of this study is to investigate the immediate effect of noise exposure to synaptic function with use of ABR and DPOAEs.</p><p class="abstract"><strong>Methods:</strong> Ten participants with normal hearing levels underwent DP-gram between 1 and 6 KHz and ABR at 90dB and click rates 33/sec and 44/sec before and after exposure to standardized music. Four of them were professional musicians and six were controls. Material for reliable and constant exposure to music was created, consisting of 56 wav files with music with a total duration of 2.5 hours. Files were presented in stable dB SPL levels and absolute control of dB SPL levels to ear phones was ensured. Subjects were asked to listen to music of their preference in maximum for 30 minutes. Patients exceeding 83 dB SPL maximum comfortable levels were eligible for the study. </p><p class="abstract"><strong>Results:</strong> Statistically significant differences were observed before and after exposure to music for all SNRs from 1.5 to 6 KHz. Changes were similar between musicians and non-musicians. No differences were observed in ABR latencies and amplitudes in any of the waveforms before and after noise exposure.</p><p class="abstract"><strong>Conclusions:</strong> A reliable technique has been developed for standardized exposure to loud sounds in humans, which can be used in future studies. Exposure to music induced decrease in DPOAE SNRs.</p><p class="abstract"> </p>
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