Understanding Hearing Loss from Loud Music: Why Musicians Need Earplugs
Many musicians struggle with hearing loss as they age and it is easily preventable by using special musicians’ earplugs. This article describes how to get your hearing tested by an Audiologist, and has recommendations about the best earplugs for musicians. Tinnitus and other hearing problems will be explained, along with types of hearing issues musicians experience, and what to do if you experience a sudden catastrophic event with your hearing.
As we learn why musicians should wear earplugs, we will explore:
- What hearing loss is and what causes it
- How you can protect your hearing
- Testing by an Audiologist
- Types of hearing protection
- Dangerous conditions to watch out for
- What to do if you have sudden hearing loss
- Use of in-ear monitors and headphones
- Playing it safe
It is common for musicians to suffer from hearing loss, experiencing a decrease over time in their ability to hear. Most older musicians report some level of decline, and there are plenty of truly accomplished musicians who have gone completely deaf by the time they reached middle age. Beethoven is but one famous example, and though he continued to compose music, he suffered from depression in his later years at least partly due to having lost the ability to hear his own compositions. Many older rock musicians have also lost most or all of their hearing (yours truly included). Some have been forced to give up performing live. The really sad thing about this is that it can be so easily prevented.
During a recent ensemble performance class I teach at Berklee College of Music, students were playing arrangements of current and older pop, funk, rock, and jazz popular hits. After the 2-hour rehearsal, I asked them how many were wearing hearing protection. Not one student raised their hand. I wasn’t shocked because when I was a student I never wore earplugs either. Now I regret it and wish I could go back and do this period of my life over. I have lost 80% of my hearing in my left ear, and 30% in my right ear. While I can hear very little with my left ear, my right ear is pretty functional still, so it’s not all gloom and doom. The Doctor told me I need to take measures if I want to preserve the hearing I have left. I now religiously wear specially fitted musicians’ earplugs. I showed them to my students. I’ll tell you more about these earplugs below, but I told my class that any student that would get their hearing tested and get a pair of those special earplugs would get an automatic A grade for the semester.
If you are a musician, what could be more important than your hearing? Don’t be foolish, protect your hearing so you will still have it in your later years. It’s possible to lose your hearing completely, whether it happens in one moment or over a long period of time. There are steps you should take now to raise the likelihood you will keep your hearing. Besides testing and getting the right kind of protection, you should also know what to do in the case of a catastrophic event with your hearing. This last item I wish I had known earlier because that is how I lost the hearing in my left ear. As you learn about how to protect your hearing, you should also learn about how the ear functions, and what situations pose the most danger to your hearing.
What Is Hearing Loss and What Causes It?
The ear is a very delicate piece of machinery. While this is not meant to be a medical synopsis, for our purposes we should know that there are three areas of the ear: the outer ear, middle ear, and the inner ear. The outer ear is the part we can see. The middle ear starts with the eardrum, also called the tympanic membrane, and includes three tiny bones linked together called the ossicular chain that transmit the sound from the eardrum to the oval window of the inner ear. The bones in the ossicular chain, called ossicles, are among the smallest in the human body. The inner ear includes the cochlea which is a fluid-filled spiral tube with tiny hair cells known as cilia that connect to the auditory nerve which transmits impulses to the centers of the brain responsible for hearing. The inner ear also contains the vestibular system which is responsible for sensing motion and balance.
If there is damage to any of these components, hearing loss will result. If the ossicles are damaged there would be a lack of transmission of sound to the inner ear from the eardrum. If the eardrum is punctured or torn it will not function properly in sensing sound vibrations from the air. If the hair cells are damaged, the sound will not be transmitted to the auditory nerve. There can even be damage to the nerve itself, or a tumor in the brain causing hearing loss.
As humans, our hearing apparatus is incredibly sensitive and complicated and there are even some mysteries we don’t have explanations for. For example, little is known about what happens in the brain and how we identify the various frequencies of sound waves after they’ve been processed by the ear and the auditory nerve. Healthy hearing can be disrupted in many ways, from physical damage to disease. If you are serious about your music, you should be serious about protecting your hearing. It’s wise to learn all you can about how to do so, which of course is why you are reading this article.
If you are a musician, what could be more important than your hearing? Don’t be foolish, protect your hearing so you will still have it in your later years. It’s possible to lose your hearing completely, whether it happens in one moment or over a long period of time. There are steps you should take now to raise the likelihood you will keep your hearing.
How You Can Protect Your Hearing
One of the most common causes of hearing loss is loud sounds. The louder the sound, the more damage it can cause to your hearing. We measure both sound intensity and the perceived loudness of sounds using the decibel scale. A doubling of perceived loudness is represented by an increase of 10 decibels, although the actual sound energy increase represented is much greater than that. It’s important to understand that the decibel scale is a logarithmic scale, not a linear scale. According to Acousticians and Doctors, any sound above 85 decibels can damage your hearing. Musical instruments and especially amplified music can easily reach levels much higher than this.
When considering the danger caused by sound, other factors also come into play. Your distance from the sound source matters, as does the duration of the sound. A very loud sound of short duration, such as a single gunshot, may not pose as much of a hazard as exposure to prolonged sound pressure, such as at a rock concert. Therefore, musicians (and everyone, actually) should always wear some kind of ear protection when around loud sounds, whether performing, rehearsing, at a concert or club, or in any environment where there could be danger (such as a workplace), whether intermittent or prolonged in duration.
It’s easy to say “use hearing protection” but in reality, there are many kinds of earplugs or hearing protection devices, and not all are created equal. I’ll give you a rundown on what is available and what you should use, but first let’s talk about where to go to get your hearing tested.
Testing by an Audiologist
I strongly recommend visiting an audiology laboratory to get your hearing tested. You can find an Audiologist to test you at any major hospital center or large university. I’ve been going to the Audiology Laboratory at Northeastern University in Boston for many years, and the testing is free. It usually takes about an hour. They put you in this little room that is super-insulated for sound, and the Technician sits on the other side of a window. You put on a pair of comfy audiophile headphones and they play you little beeps and tones in a variety of frequency ranges, slowly decreasing the volume. Every time you hear a tone, you signal to them with your hand. Then they start mixing in some background noise while they play other sounds or words and ask you to signal them when you hear something. At the end, they have a printout for you that shows your hearing response in all audible frequency ranges.
It’s very interesting to see where you might hear one frequency better than others, and you will learn the highest and lowest frequencies you can hear. More importantly, if you do this regularly, you can keep an eye on your hearing and find out over time if there is any degradation in your ability to hear. I recommend getting tested every 2-3 years.
You only get one set of ears, so you’d better take good care of them, especially if you are a musician. You depend on them for your profession and your pleasure so you want them to last a lifetime. As the old expression goes: Better safe than sorry. Get tested, get earplugs, carry them with you, and use them whenever there is any chance of danger from loud sounds or loud music.
Types of Hearing Protection
After your test, the Audiologist can order you a pair of specially made musicians’ earplugs. This is the best part. They inject foam into your ears which hardens after just a few minutes. Then they send the mold of your ear out to a special lab that makes silicone earplugs that fit exactly to the shape of your ears. They are labeled so you know one is for the left and one is for the right. Inside the silicone ear-mold is a tiny attenuator which can be removed. (Note: an attenuator is a small filter which lowers the decibel level with flat response across all frequencies.) The attenuator is usually minus 15 or 20 decibels, which means the sound pressure will be reduced evenly so you can hear everything exactly the same, but at a lower, safer volume. What I like about the musicians’ earplugs system is that you can increase the attenuation by changing out the little filters. So for softer music where I still want protection, I use the minus 15 decibels attenuator, and I use the 20 or 25-decibel filter for louder music.
These are the best earplugs available and they are also super comfortable, unlike the store-bought ones that are one-size-fits-all. The foam or soft silicone putty earplugs they sell at the pharmacy work well, are inexpensive, and certainly better than nothing, but they always become uncomfortable if you leave them in for very long. With the musicians’ earplugs (that’s what they’re called) you can leave them in for extended periods of time, and you will forget you are wearing them because they fit so perfectly in your ear canal.
Dangerous Conditions to Watch Out For
Have you ever been out at a concert or a loud dance club for an evening, and noticed a ringing or high pitched tone in your ears afterward? You may have sustained hearing damage. While the ear will often recover from this in a day or so, if you repeat the experience too often you may end up with a condition called tinnitus (pronounced: “TIN-ni-tus”). This annoying condition can be best described as a constant ringing or high pitched tone that never goes away. People who suffer from tinnitus typically experience variation in the intensity and loudness of the tone; it can be maddeningly loud at times and then barely noticeable, but it’s always present.
Tinnitus can interfere with proper hearing and also diminish the overall quality of life of the sufferer. Many musicians suffer from the condition as a result of years of unprotected exposure to loud sounds, and it is one of the most common forms of hearing degradation. While many people hear ringing in their ears from time to time, tinnitus is a serious condition and there is no treatment for it as of yet. The rule of thumb should be that whenever you know you might be exposed to loud sounds, you should carry your earplugs with you and put them in at the first sign of danger. I try to keep a pair on me at all times, literally. It’s better to have them and not need them, than to need them and not have them!
Besides concerts and clubs, the cinema, sporting events, or political rallies, anywhere sound reinforcement (public address systems) or music gear is in use may pose a danger. Even noisy street traffic can be dangerous if you are exposed to it for long periods. I wear them in the subway, where besides the screeching of wheels, public announcements can be excruciatingly loud. Acoustic musical instruments are generally less hazardous, but if you were in an enclosed rehearsal space with a symphony orchestra, that would undoubtedly call for hearing protection.
Headphone use can be dangerous, too. Never turn up music loud when wearing headphones, and if you are listening for long periods using headphones it is crucial to take regular breaks to let your ears rest. Remember that it is not only sound pressure but duration of the sound that adds to the danger. Factory workers and machine operators are usually required to wear hearing protection, and there are high and low-frequency sounds outside of our audible range that can cause damage when at high amplitude. This means your hearing could be damaged by sounds you can’t even hear. The Occupational Safety and Health Administration (known as OSHA) is a federal agency that tests for these kinds of frequencies when monitoring workplace safety conditions.
What to Do if You Have Sudden Hearing Loss
If you experience an event which you feel has caused trauma to your ears, whether from loud sounds or a foreign item in your ear, the first thing to do is visit an emergency room immediately. If your city has a specialty hospital or clinic for ear health (in Boston we have Mass Eye and Ear Hospital), go there as quickly as possible and tell the Doctor what happened. If you have sustained damage to your ears there are measures which could be crucial to saving your future hearing, but they must be undertaken quickly. For example, steroids can be used to reduce swelling, which might limit damage to the sensitive parts of your ears. Always refer to a Doctor about your situation, and do it quickly.
Use of In-Ear Monitors and Headphones
In-ear monitors can be used to limit sound pressure in a noisy stage environment, but I’m not certain they provide the same level of protection as the musicians’ earplugs do. If you can control the volume, and they seal off your ear canal tightly, they should provide some protection. The point is not to turn them up too loud or keep them in for extended periods.
The same applies to headphone use. Be very careful to read the manufacturer’s instructions as they will often contain information about the dangers of hearing loss while using the headphones. It’s been documented that using headphones turned up loud or for long periods can cause hearing damage and hearing loss. This also applies to the earbuds people use with their smartphones.
Playing It Safe
You only get one set of ears, so you’d better take good care of them, especially if you are a musician. You depend on them for your profession and your pleasure so you want them to last a lifetime. As the old expression goes: Better safe than sorry. Get tested, get earplugs, carry them with you, and use them whenever there is any chance of danger from loud sounds or loud music. It can take a little getting used to, but once you acclimate to them you won’t even know you are wearing them. It’s definitely possible to have effective hearing protection that is comfortable and natural sounding. In my experience, the most difficult thing is to remember to carry them with me. I had to make an effort to make it a habit. Even though I’ve lost a portion of my valuable hearing ability, which is frustrating, I am determined to protect what I have left. I’m going to need it.
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