1. Musicians and the PreventionMusicians and the Prevention
of Hearing Lossof Hearing Loss
Catherine V. Palmer, PhD
Director of Audiology, UPMC
Associate Professor, Communication Science and
Disorders

2. WarningWarning
By attending this presentation, you will
have to think differently about the way you
do things.
I would go as far as to say that it would be
extremely uncomfortable to have this
information and not take action…

3. Understanding the ear andUnderstanding the ear and
hearinghearing

4. 3 Primary Divisions3 Primary Divisions

5. Tour through the Ear.wmv

6. Auditory SystemAuditory System

9. With musicians, hearing lossWith musicians, hearing loss
is not the only problem …is not the only problem …
Tinnitus
Pitch perception problems

10. Two Critical Factors AffectingTwo Critical Factors Affecting
Hearing LossHearing Loss
 Intensity
 Duration

11. Who is in danger?Who is in danger?
Remember, the danger of damage to the
hair cells and subsequent hearing loss has to
do with the individual’s total dose.
You have to think about all the loud sounds
that the individual will be exposed to during
the day.

12. Functional ImpactFunctional Impact
Decreased sensitivity (you need sounds
louder to hear them)
Diminished clarity (frequency resolution is
poor). This impacts playing music,
enjoying music, and hearing speech.
Tinnitus (ringing sounds, often high
pitched)

13. After exposure there may be no symptoms,
or the individual may experience ringing in
the ears, a sensation of fullness, or sounds
my seem “dull”
The damage and functional change is
gradual. The individual may not notice a
problem for a decade or more.

14. The damage continuesThe damage continues
We know that hair cells continue to die well
after the exposure.

15. Musical LevelsMusical Levels
Normal Piano Practice 60-70 dB
Chamber Music in Small Auditorium 75-85 dB
Regular, Sustained Exposure May
Cause Permanent Damage
>90 dB
Piano Fortissimo (2.5 to 5 hours) 92-95 dB
Violin (1.25 hours) 84-102 dB
Cello (5 hours) 82-92 dB
Oboe (2.5 to 5 hours) 90-94 dB
Flute (1.25 hours) 85-111 dB
Piccolo (5 minutes to 1.25 hrs) 95-112 dB

16. Musical Levels (cont)Musical Levels (cont)
Music Levels dB
Clarinet (1.25 hours) 92-103
French Horn (5 min to 1.25 hrs) 90-106 dB
Trombone (5 min to 1.25 hrs) 85-114 dB
Ensemble (average) (1.25 to 2.5
hours)
97 dB
Timpani and Bass Drum Rolls (5
min)
106 dB
Orchestra Peaks (2.5 minutes) 120-137 dB
Band at a Sporting Event (2.5 min)
Marching Band (4 seconds)
100-120 dB
125 dB

17. Take a look at the graph in yourTake a look at the graph in your
handouthandout
Maximum Weekly Noise Exposure (NIOSH,
1998)
80
85
90
95
100
105
110
115
120
125
130
135
40 20 10 5 3 1 38 19 9 5 2 1 35 18 9 4 2 1
Hours Minutes Seconds
dB(A)
MajorMajor
SportingSporting
eventevent
DrumlineDrumline
rehearsalrehearsal
Marching BandMarching Band
HoursHours MinutesMinutes SecondsSeconds

18. Take home messageTake home message
 Once instrumentalists play in a group, they are in
danger of permanent noise induced hearing loss
within minutes
 Drummers are always in danger of hearing loss
(practicing alone or in a group)
 You have to consider the total daily dose
 The impact of hearing loss may not be noticed for
years
 These times are based on adult data and there are
some animal studies that suggest that children are
more susceptible

19. What can instrumental instructorsWhat can instrumental instructors
(and parents) do?(and parents) do?
Protect yourself
Protect your students (children)
Educate your students (children)
– Hearing health care should be part of every
music program and part of health class
– Let’s talk about hearing protection…

20. Hearing ProtectionHearing Protection
“Who wants earplugs that won’t let you
hear?”
Mead Killion

25. Description of School ProgramsDescription of School Programs
A recent national study estimated that
approximately 12% of all children ages 6 to
19 years have noise-induced hearing loss.
Children are the fastest growing population
of individuals with noise-induced hearing
loss.

26. Goals of the ProgramGoals of the Program
 Provide instrumental music instructors with
education related to hearing loss and hearing
protection and music
 Provide instrumental music instructors with non-
custom Musicians’ Earplugs or custom Musicians’
Earplugs at a reasonable cost
 Provide non-custom Musicians’ Earplugs to
instrumental music students through the
instructors
 Provide education to instrumental music students
through the instrumental music teachers

27. Putting Hearing Protection inPutting Hearing Protection in
ContextContext
 We would not consider sending students to chemistry
class or shop class without protective goggles.
 We would not consider allowing students to play
football without a helmet.
 We may know that a football player rides his bike
with no helmet, but that would not make us decide
not to bother with a helmet during football just
because he has increased his chance of having a head
injury anyway.
 Parents have the right to assume that schools make
school activities as safe as possible using current
information and technology.

28. It actually would be much simpler if noise
induced hearing loss caused pain or
bleeding – then you can be sure hearing
protection would be required.
The damage is invisible…finally there is
functional impact but it can be years after
the damage

29. Are we saying that music isAre we saying that music is
dangerous?dangerous?
No, but we are saying like many things we
engage in, you need to use the appropriate
equipment to make it safe and to be able to
enjoy it over a long period of time.

30. Successful Programs So FarSuccessful Programs So Far
 What message is the teacher sending if he/she wears
hearing protection in front of students? Good health
habits
 Mandatory – when you come into the band room, the first
thing you do is get your hearing protection.
 No hearing protection – you don’t participate in class.
(keep lots of extras)
 Help the students adjust. It takes about 2 weeks to get
used to using the hearing protection (horns are the
toughest)

31. Easy to useEasy to use
 The plugs come with cords so the students can
have them in and out if needed and drape them
over their necks
 The plugs come in a case that can be hooked to a
back pack or instrument case
 Students are welcome to use these earplugs
throughout their days, weekends, etc. or the
teacher may want to keep them in the band room

32. Who should absolutely be usingWho should absolutely be using
hearing protection?hearing protection?
Instructors
Band students
Orchestra students
Steel Band students
All drumming groups
Most other group-type musical students
Professional Musicians
All ages

33. What about IPods?What about IPods?
 They are not inherently dangerous.
 It’s the level and amount of time.
 Custom earplugs can reduce the volume used, but
then you can’t hear the sounds around you.
 I’m only talking about hearing safety, there are
other concerns with being “plugged” in for hours
and not interacting with your environment.
 Remember, it’s all about total dose.

35. Arms-Length RuleArms-Length Rule
If you have to shout to be heard from 3 feet
away, then the noise (music) is too loud.
Turn down the volume or wear hearing
protection.

36. E Earplugs/earmuffs
A Avoid loud sounds
R Reduce the volume
S Shorten the time in noise

37. FactsFacts
 Any type of music can cause
permanent hearing loss and
ringing in the ears.
 It is intensity level and length of
exposure that matters.
 The type of hearing loss people
get from sound exposure is
permanent.
 The loss starts in the high
frequencies and progresses. It
causes difficulty
communicating in noisy
situations and impacts how
music is perceived.
 Sound exposure also may
cause ringing in the ears
(tinnitus).
 Some musicians need to
wear hearing protection
when they are practicing
alone.
 All musicians need to
wear hearing protection
when they are playing in a
group (band, orchestra) if
they want to avoid hearing
loss.