Musical Instrument-Associated Health Issues and Their Management

Abstract

Playing musical instruments can bring joy to people, but can also cause a wide variety of health issues that range from mild disorders to potentially fatal conditions. Although sports medicine is an established medical subspecialty, relatively few studies have investigated the health issues associated with musical instruments. Here we present an overview of these health issues. These include infections due to microorganisms, allergic reactions, as well as mechanical injuries from sustained high pressures within the oral, mediastinal, thoracic, and abdominal cavities. For example, wind instruments can potentially harbor thousands of pathogenic organisms. If several players share the same instrument, these instruments present potential hazards in the spread of infections. A fatal case of hypersensitivity pneumonitis in a bagpiper is particularly noteworthy. Similarly, a case of gastrointestinal anthrax in an animal-hide drummer is a reminder of this rare but highly fatal disease. Although not fatal, hearing-related disorders, neuromuscular issues, musculoskeletal problems, and contact dermatitis are also very common among instrumentalists. This review aims to illuminate these under-recognized health issues by highlighting both the common conditions and the rare but fatal cases.

Contact dermatitis and sensitization in professional musicians

“…Musicians are at risk of developing eczema because of intense contact with sensitizing and/or irritating substances in their instruments. Besides musculoskeletal diseases such as tenosynovitis, carpal tunnel syndrome, acute injuries, and neurological diseases (focal dystonia), skin diseases are also common among professional musicians . In particular, irritant contact dermatitis, allergic contact dermatitis and callosities have frequently been reported in this group …”

Facial Muscle Activity Patterns in Clarinet Players: A Key to Understanding Facial Muscle Physiology and Dysfunction in Musicians

“…Associations between certain anatomical structures (the stomatognathic system or facial muscles) and disorders related to musical practice have been described in the literature. 2,3 From an anatomical viewpoint, mouthpiece stabilization can be achieved either by vertical forces exerted on the mandible by the masseter, temporal and pterygoid muscles, or by soft tissue pressure in the labial and sub-labial area. Such pressure is produced by the action of mimic muscles such as the mentalis, depressor oris and orbicularis oris.…”

Successful disinfection of trumpet mouthpieces using domestic steam disinfection

“…Given that woodwind and brass instruments involve the player physically blowing air into their instrument to create the sound through the mouthpiece of these instruments, these instruments may become contaminated with fluids from the player, including those originating from the gastrointestional tract, the respiratory tract and the mouth itself, as well as the skin/lips of the player as part of their embouchure. As a result, there have been numerous reports in the literature describing the diversity of microbial flora isolated from woodwind and brass instruments (Moore 2004;Marshall and Levy 2011;Okoshi et al 2017).…”