Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras

Abstract

Objectives An investigation of the hearing status of musicians of professional symphony orchestras. Main questions are: (1) Should musicians be treated as a special group with regard to hearing, noise, and noise related hearing problems (2) Do patterns of hearing damage diVer for diVerent instrument types (3) Do OAE have an added value in the diagnosis of noise induced hearing loss (NIHL) in musicians. Methods 241 professional musicians, aged between 23-64 participated. A brief medical history and the subjective judgment of their hearing and hearing problems were assessed. Musicians were subjected to an extensive audiological test battery, which contained testing of audiometric thresholds, loudness perception, diplacusis, tinnitus, speech perception in noise, and otoacoustic emissions. Results Most musicians could be categorized as normal hearing, but their audiograms show notches at 6 kHz, a frequency that is associated with NIHL. Musicians often complained about tinnitus and hyperacusis, while diplacusis was generally not reported as a problem. Tinnitus was most often localized utmost left and this could not be related to the instrument. It was usually perceived in high frequency areas, associated with NIHL. In general, musicians scored very well on the speech-in-noise test. The results of the loudness perception test were within normal limits. Otoacoustic emissions were more intense with better pure-tone thresholds, but due to large individual diVerences it can still not be used as an objective test for early detection of NIHL.Conclusions Musicians show more noise induced hearing loss than could be expected on the basis of age and gender. Other indicators, such as complaints and prevalence of tinnitus, complaints about hyperacusis and prevalence of diplacusis suggest that musicians' ears are at risk. Continuing education about the risks of intensive sound exposure to musicians, with the emphasis on the possible development of tinnitus and hyperacusis and the need for good hearing protection is warranted.

Limiares auditivos em músicos militares: convencionais e altas frequências

“…In a study with 329 music students (aged between 18 and 25 years), there was no evidence of hearing loss, but of acoustic notch in 45% of the students (78% of them presented acoustic notch in 6,000 Hz and 22% in 4,000 Hz) (17) . Other studies also found hearing disorders among musicians, but not at high proportions; however, they observed acoustic notch in the frequencies of 4,000 or 6,000 Hz, more often than expected when compared to non-musicians, considering the same age and gender (1,3,8,9,(18)(19)(20) . It was observed that hearing thresholds of musicians got worse with time of exposure to music and, in this assessed group, the longer the time of exposure (in years), the worse the hearing thresholds found in high-frequency audiometry (Table 1).…”

“…Researchers throughout the world described hearing disorders caused by exposure to music, such as hearing impairment or differences in hearing thresholds, not necessarily as disorders related to hearing loss, especially in high frequencies (3)(4)(5)(6)(7)(8)(9)(10).…”

“…For the early diagnosis of hearing disorders among musicians, in order to show problems that are not yet visible in conventional audiometry, some studies have used the highfrequency audiometry (from 9,000 to 20,000 Hz) together with conventional audiometry (from 250 to 8,000 Hz) (3,8,9,(11)(12)(13) . This decision is made by the audiologist, since high-frequency audiometry is an important examination to detect hearing impairment located at the base of the cochlear duct, before its characteristic effects can be detected at the conventional frequency rate (14,15) .…”

Músicos de pop-rock: avaliação da satisfação com protetores auditivos

“…In these studies, the frequency of the complaint tinnitus ranged from 37.5% to 45%, and the complaint intolerance to loud sound ranged from 19% to 48%. 4,[6][7][8]14,16,[22][23][24][25] The same complaints were also reported after shows; tinnitus in this situation may be related to a temporary change in hearing thresholds as a result of exposure to highly amplified music, even for short time periods. It should be noted that the average daily exposure was three hours and the average weekly exposure was ten hours, which are lower than a regular workday (8h/day or 40h/ week).…”

“…Because hearing loss caused by high sound pressure levels starts with outer hair cell damage, [27][28][29][30][31] OAE may be more sensitive than pure tone audiometry to detect early changes due to exposure to amplified music. 4,7,16,25,26,31 Responses in the questionnaire on satisfaction with the HiFi ER 20 hearing protector were concentrated in the "agree" and "fully agree" groups, indicating a positive attitude towards using hearing protectors. Two questions were exceptions: clear perception of high frequency sounds, and full-time use of the ER 20 hearing protector during shows.…”