Hearing for Musicians

Information from the Hearing Health Foundation

Professional musicians are nearly four times as likely to develop noise-induced hearing loss (NIHL) as the general public. They are also more likely to experience tinnitus or ringing in the ears. Hearing damage can affect everyone in the music industry, including church musicians—especially where music is played loudly and in enclosed spaces.

Hearing loss can develop from repeated exposure to loud sounds. Over time, loud sounds will irreparably damage the sensory hair cells of the inner ear that send sound information to the brain to interpret. There is also evidence that loud sound disrupts how cells transmit information via synapses, leading to hidden hearing loss because traditional hearing tests do not easily detect it. NIHL from sudden loud sounds, such as gunfire or fireworks, can also occur.

NIHL is the permanent and most common cause of hearing loss from prolonged exposure to high noise levels. However, it is also the only preventable cause of hearing loss, so protecting our ears and hearing is essential.

Research by the National Institutes of Health and the Centers for Disease Control and Prevention shows that nearly one in four adults exhibits signs of NIHL. In addition, evidence suggests that noisy leisure activities plus the increased use of personal listening devices with headphones contribute to what the World Health Organization has warned is a global public health emergency, with 1.1 billion young people potentially at risk for NIHL.

Tips for Musicians

Get your hearing checked annually to monitor your hearing health. Ask to be tested on a range of 125 to 20,000 hertz, as the high frequencies often show a loss first. See your doctor immediately if you experience a sudden change in hearing or ear pain. Tinnitus, or ringing in your ears, indicates damage is being done.
Use customized earplugs designed for musicians. These allow you to hear your music without needing it to be at the highest volume.
Turn down the volume and limit your exposure. The Centers for Disease Control and Prevention says sound intensity over 70 decibels will damage hearing. When performing, try to position yourself where the maximum sound is not hitting you directly. If you use personal listening devices like headphones, aim for the Mayo Clinic's 60/60 rule—60 percent of the maximum volume for no more than 60 minutes—and then rest your ears.
Keep track of the volume using a sound level meter app to give you a decibel reading on your phone. An example from the National Institute of Health.
Give your ears sound breaks. Like your muscles need to rest after a workout, so do your ears. In an ideal world, aim for 5 to 10 minutes every hour. If you are at a loud concert, occasionally step away from the stage or outside the venue to rest your ears.
Use in-ear monitors onstage and during rehearsal. These allow you to hear the music directly in your ears. Work with an audiologist to select the best ones for your needs and learn to use them properly for maximum protection.

Musicians can significantly lessen their risks of hearing loss and tinnitus by using protective measures that preserve the sounds and harmony of the music. For example, a hearing specialist can recommend custom musician's earplugs or in-ear monitors to protect your hearing without compromising your musical performance or experience.

Some reasons to consider custom-made earplugs: Typical foam earplugs mute speech and music by lessening noise primarily in the high-frequency range rather than in the mid-to low-frequency range. There the music and voices can sound unnatural and unclear. Custom-fit earplugs lower sound more smoothly across frequencies while reducing decibel levels, thereby maintaining the all-natural quality of speech and music.

In addition, with foam earplugs, the user will hear a hollowed-out sound in their speech when speaking, singing, or playing a musical instrument. This unnatural, muffled sound is called the "occlusion effect." Custom-fit earplugs are molded to the ear, producing a seal that helps prevent this distracting sound.

For more tips from music enthusiasts with hearing loss, see Music Gear From the Pros.

Music and Hearing Loss

Music sounds much softer for a person with hearing loss, especially in the range where people sing and most instruments are heard. As a result, music sounds muffled and dull and loses much of its excitement.

Lost in the music's general texture is how a particular instrument or combination of instruments sound. It can be hard to pick out a specific instrument or singer from the background; some people lose the ability to hear musical pitch properly, making it hard to sing or even recognize a melody.

Hearing loss also creates a serious problem with loudness or the subjective impression of the intensity of sounds. Many people with hearing loss hear nothing if the sounds are not intense enough; sounds that would be at a comfortable volume for people with typical hearing are barely audible.

However, as sound levels increase, sounds are heard as becoming louder at a rate much faster than they do with typical hearing. As a result, the change in intensity between "barely audible" and "unbearably loud" is reduced.

Problems with pitch, texture, and loudness perception are not separate problems. Hearing loss is often most significant in the frequency range where most instruments sound, the area where the most significant problems with loudness occur. For people with hearing loss, this messy interaction can make listening to music—let alone playing music—very challenging.

Hearing Aids and Music

A 2016 report from British hearing researcher Brian Moore, Ph.D., titled "Effects of Sound-Induced Hearing Loss and Hearing Aids on the Perception of Music," implies that modern hearing aids can help to some extent. However, much needs to be learned to improve their musical effectiveness. Everyone's hearing is different, so some will benefit more from hearing aids than others. But there are some problems that no technology has yet been able to correct.

Hearing aid technology that improves speech understanding and loudness perception does not work so well when it comes to music. For instance, low-frequency sounds are not amplified at the same level as high-frequency sounds, so a tuba or cello sounds soft and tinny and lacks the impact it should have. Music also gets distorted when heard through hearing aids designed to improve understanding of speech in noise.

Many hearing aids provide specific presets for live music listening, but Moore's research confirms my own experience that they are often not that helpful. And when streaming recorded music into a hearing aid via Bluetooth, the sound, to me at least, resembles an old transistor radio rather than a high-fidelity system.

While there are speech-centric techniques that could transpose, for example, high flute notes, to a lower range, Moore reports that in practice, this produces mixed results. Electronically transposing music significantly distorts the content and texture, making it sound increasingly distorted, robotic, and unpleasant with greater transposition. As for those hearing losses where musical melody becomes unrecognizable, unfortunately, no current technology can correct such a problem. ■