Musicians and Hearing Loss:
Comparison to a non-noise exposed population
Incidence and Risk Factors
Shanda Brashears-Morlet1, Michael Santucci2, Thierry G.
Morlet3
1 – Department of Genetics, Louisiana State University Health Sciences Center, New
Orleans, Louisiana
2 – Sensaphonics Hearing Conservation, Chicago, Illinois
3 – Auditory Physiology and Psychoacoustics Laboratory, Alfred I. duPont Hospital for
Children, Wilmington, Delaware
Aims



Examine the hearing of a large group of
musicians as compared to a non-noise
exposed normative population.
Determine the incidence of high frequency
hearing loss.
Analyze various risk factors for hearing
loss among musicians.
Methods


1018 musicians completed tympanometry,
audiometry and a case history / life styles
survey.
Those with conductive hearing loss,
positive history for ototoxic meds, acoustic
neuroma or significant exposure to noise
other than music were eliminated from
threshold and risk factor analysis leaving
887 subjects.
Results

537 (52.8%) reported using hearing protections
prior to participation



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358 foam or rubber
97 custom musicians’ plugs
22 paper, cotton, or bar napkins
17 muffs or earphones
22 didn’t answer as to the type of protection
110 (10.8%) reported that they perceive they
have a hearing loss as compared to 19.5% who
actually did have a hearing loss
Musicians vs. Non-Musicians

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Musicians’ thresholds were compared to
the ISO 7029:2000 standard for 250 –
8kHz.
Musicians’ thresholds were consistently
worse for all frequencies except 8000 Hz.
The largest difference between musicians’
thresholds and norms were for 2000,
3000, 4000 and 6000 Hz.
Audiometric Configuration
Comparison of men in their 20s
250
500
1000
2000
3000
4000
6000
8000
-5
0
5
10
Musicians
RE
Musicians
LE
ISO AU
15
20
25
30
N=415
Audiometric Configuration
Comparison of men in their 30s
250
500
1000
2000
3000
4000
6000
8000
-5
0
5
10
Musicians
RE
Musicians
LE
ISO AU
15
20
25
30
N=263
Audiometric Configuration
Comparison of men in their 40s
250
500
1000
2000
3000
4000
6000
8000
-5
0
5
10
15
20
25
Musicians
RE
Musicians
LE
ISO AU
30
N=145
Incidence of High Frequency
Hearing Loss Among Musicians
Minimal Hearing Loss
%
%
%
%



of
of
of
of
men RE
men LE
women RE
women LE
44.3
58.2
29.9
28.3
Hearing Loss
20.3
34.8
12.0
10.8
Noise Notch
54.2
66.5
49.6
45.0
Minimal high frequency hearing loss defined as any threshold above
1KHz of 20 dB HL or worse in either ear.
High frequency hearing loss defined as any threshold above 1KHz of
30 dB HL or worse in either ear.
High frequency noise notch defined as 10 dB or better thresholds
one octave above and below any frequency above 1500 Hz in either
ear, degree of hearing level not withstanding.
Incidence of Asymmetries
and Tinnitus
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
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39.0% of musicians had at least one
frequency over 1500 Hz with thresholds
15 dB apart or more.
60.0% reported at least occasional
tinnitus.
77.1 % had at least one sign of hearing
damage, either minimal hearing loss,
noise notch, asymmetry and / or tinnitus.
Factors Impacted Hearing Status
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Age and gender seemed to have the biggest impact high
frequency hearing loss (p<.005).
Years of experience independent of age was significant
for the right ear (p=.018) and nearly so for the left
(p=.060).
Hours / week of exposure (p=.087 right ear; p=.122 left
ear)
Right ears were better than left, but not significantly
(p=.110).
Prior use of hearing protection did have a positive effect
on high frequency hearing (p=.116 right ear; p=.035 left
ear).
Factors With No Apparent Effect
The following factors did not appear to
impact high frequency hearing:
genre (i.e. rock vs. classical vs. jazz),
hours since exposure, use of headphones,
family history, dizziness, diabetes, high
blood pressure and use of tobacco,
alcohol, caffeine, or aspirin.
Factors Related to Hearing
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Those with an asymmetry had significantly worse
thresholds than those with symmetrical hearing
(p<.001 for right and left ears).
Similarly, the presence of a noise notch was
associated with higher high frequency pure tone
averages (p<.001 for right and left ears).
Surprisingly, those who reported tinnitus were not
any more likely to have a hearing loss.
Conclusions


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Musicians had poorer thresholds, especially at 3,
4 and 6K Hz than the ISO standard.
A noise notch effect was seen in all age groups
and became more pronounced with age.
The incidence of hearing loss was high, but
comparable with previous studies such as
Axelsson et al. (1995) and Kaharit et al. (2003).
The factors which had the most apparent effect
on hearing status were age, gender, years of
experience, hours / week of exposure, and prior
use of hearing protectors.
References
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
Axelsson A, Eliasson A, Israelsson, B. (1995) Hearing in
pop-rock musicians: A follow-up study. Ear Hear
16(3):245-254.
Kaharit K, Zachau G, Eklof M, Sandsjo L, Moller C. (2003)
Assessment of hearing and hearing disorders in rock/jazz
musicians. Int J Audiol 42(5):279-88.
Acknowledgements
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This study was funded by Shure Inc.
Thank you to …. and all the staff of Sensaphonics
Hearing Conservation
Additional thanks to Charles Berlin, Linda Hood, and
Bronya Keats of the Kresge Hearing Research Lab