Noise-Induced Hearing Loss in Professional Orchestral Musicians

Abstract

The overall purpose of this study was to assess hearing status in professional orchestral musicians. Standard pure-tone audiometry (PTA) and transient-evoked otoacoustic emissions (TEOAEs) were performed in 126 orchestral musicians. Occupational and non-occupational risk factors for noise-induced hearing loss (NIHL) were identified in questionnaire inquiry. Data on sound pressure levels produced by various groups of instruments were also collected and analyzed. Measured hearing threshold levels (HTLs) were compared with the theoretical predictions calculated according to ISO (1990.Musicians were exposed to excessive sound at weekly noise exposure levels of for 81-100 dB (mean: 86.6±4.0 dB) for 5-48 years (mean: 24.0±10.7 years). Most of them (95%) had hearing corresponds to grade 0 of hearing impairment (mean hearing threshold level at 500, 1000, 2000 and 4000 Hz lower than 25 dB). However, high frequency notched audiograms typical for noise-induced hearing loss were found in 35% of cases. Simultaneously, about 35% of audiograms showed typical for NIHL high frequency notches (mainly occurring at 6000 Hz). When analyzing the impact of age, gender and noise exposure on hearing test results both PTA and TEOAE consistently showed better hearing in females vs. males, younger vs. older musicians. But higher exposure to orchestral noise was not associated with poorer hearing tests results.The musician's audiometric hearing threshold levels were poorer than equivalent non-noise-exposed population and better (at 3000 and 4000 Hz) than expected for noise-exposed population according to ISO (1990. Thus, music impairs hearing of orchestral musicians, but less than expected from noise exposure.

Exposure to excessive sounds and hearing status in academic classical music students

“…The prevalence of notches at 6000 Hz in the control group is not surprising since according to the Nord-Trøndelag Hearing Loss Study [31] such notches were observed both in unscreened and screened for a history of noise exposure and ear-related disorders and diseases populations of men and women up to 40 years old. Moreover, some earlier studies in musicians, including professional orchestral musician, have also shown high frequency notches (mainly at 6000 Hz) in audiograms [7,9,10]. Similar outcomes have been also obtained for younger (student) musicians [18,19].…”

“…Furthermore, Fearn [18] has estimated that students spent on average 10-35 h/week on playing musical instruments and additionally performed in orchestras for 2−3 h 56 times/year. For comparison, Pawlaczyk-Łuszczyńska et al [10] have found that professional orchestral musicians were usually exposed to music for 7-70 h/week (average 30 h/week) due to both on-the-job and off-the-job playing. Therefore, it is not surprising that Phillips et al [19], when analyzing the prevalence of hearing impairment in student musicians (aged 18−25 years), have found typical NIHL notches (occurring mainly at 6000 Hz) in 45% of 329 students.…”

“…Data on the students' musical experience, hearing symptoms such as tinnitus or hyperacusis, which can influence their work abilities more severely than the hearing loss itself. However, because of insufficient audiometric evidence of hearing loss caused purely by music exposure, there is still disagreement and speculation concerning the risk of hearing loss from music exposure alone [1][2][3][4][5][6][7][8][9][10]. According to the literature data, musicians, in particular classical orchestral musicians, are often exposed to sounds at levels exceeding the upper exposure action values from the Noise Directive 2003/10/EC [11] as well as the Polish maximum admissible intensity (MAI) values [12].…”

Exposure to excessive sounds during orchestra rehearsals and temporary hearing changes in hearing among musicians

“…These exposures vary considerably over time, and strongly depend on the repertoire. In order to illustrate the levels of noise, to which the musicians are exposed while playing instruments, the Table 1 presents aggregate results of measurements of sound pressure levels at positions of musicians playing various instruments [9][10][11].…”

“…The L EX,w values were estimated based on the results of our previous studies [9][10][11] and on a weekly time of playing an instrument declared by musicians. This table also presents data on the A-weighted noise exposure level during analyzed rehearsals (between TEOAE tests) normalized to a nominal 8-h working day (L EX,8h ).…”