I have tried earplugs but they sound hollow. Also, I can’t really hear the high end. Are there better earplugs?
Because of the laws of physics, earplugs lessen (attenuate) the
sound energy for the higher pitches more than the lower bass notes.
Typically earplugs will cause a hollow sound without much high end.
In 1988, a company called Etymotic Research came out with
a “flat” earplug- one that lessens the sound energy for the high
pitched notes as much as for the low bass notes. These use a small
acoustic amplifier that puts back many of the high pitched sounds.
Musicians and music listeners then can hear their music unaffected,
except that it’s at a non-damaging level. These earplugs come in
several amounts of protection- 9 decibels of protection (ER-9), 15
decibels of protection (ER-15) and 25 decibels of protection
(ER-25). Different musicians use different earplug.
What ear plugs do you suggest for musicians?
There are three major types of ear plugs for musicians- the ER-15, the ER-25, and vented/tuned ear plugs. The ER-25 is generally only recommended for drummers. The ER-15 is the ear plug of choice for most other rock and blues instruments, as well as most classical instruments. The vented/tuned ear plugs are useful for those instruments that either do not have much treble sound energy (such as the acoustic bass and cello), or for those instruments that are not particularly damaging (such as the clarinet), but have to play near other noisy instruments, such as the drums. There is an article in the Publications section of this website with this information- “Musicians and the Prevention of Hearing Loss”.
Musician ear plugs, like the ER-15, can be obtained from anyone that makes hearing aids. I would contact an audiologist and they can either make the ear plugs for you, or send you to someone who specializes in musicians. Remember however, that while ear plugs are very important, they are only one of the many things that can be done to reduce music exposure. Environmental strategies (many of which are inexpensive) can be very useful. You should contact your state and provincial association for audiologists. Musicians' earplugs are not typically covered under any medical program and usually are about $300 a pair. There are also one-size-fits-all Musicians’ earplugs called ER20XS and these can be obtained for about $15.00.
This is a common problem. Prior to 1988 there were no earplugs that could successfully be used by musicians. Today’s earplugs (for example the ER-15) not only treat all sounds equally but minimize the occlusion (echoey) effect in the ears. Your band mates’ concerns are outdated. They should contact their local audiologist for an assessment and information session. Your band mates' concerns are based on old history and have no basis with today’s technology.
This is a commonly asked question. In the clinic I use a specially designed sound level meter that can be placed in the ear canal or in the vicinity of the musician. In popular media frequently stated are “peak” or maximum values. These may sound “news worthy” but tend to be alarmist. The “average” values may be quite different. There are a number of apps available on Smartphones which can provide estimates in the environment of average sound levels. As a rule of thumb iPhones (iOS platform) tend to provide more accurate information than Android based Smartphones since one cannot disable the “compression” software on the Android platform. This can reduce the actual measured sound level. Also, if one uses a Smartphone app as a sound level meter ensure that the microphone of the Smartphone is aimed at the music source- Smartphones are highly “directional”. Go to the “Publications” section of this website for exact information for each instrument.
Fathers are always right (I have three kids) but when it comes to MP3 players, there is nothing wrong with them as long as you follow the 80/90 rule. The 80/90 rule says that it is safe to listen to your MP3 player for 90 minutes each day at 80% volume, and this will give you half of your daily dose of music exposure. If your favourite song comes on, turn up the volume, but remember to turn it back down to a more moderate level after. This will still allow you to mow the lawn.
Headphones are no more damaging than listening to music from a loudspeaker. One will always adjust the volume to a comfortable listening level, and the ear doesn’t know whether the music is coming from headphones or a loudspeaker. The potential danger is in “portable music” where headphones are used in conjunction with MP3 players. Listening to music in a noisy environment can be damaging since one tends to turn up the volume over the background noise.
Well, let’s find out. We know that MP3 players generate about 85 decibels at about 1/3 volume control. Many yield about 95 decibels at half volume. Let’s do some math- 85 dB for 40 hours, is the same as 88 dB for 20 hours, which is the same as 91 dB for 10 hours, and this is the same as 94 dB for 5 hours each week. Therefore you can listen to your MP3 player safely at one half volume for about 5 hours each week.
Yes, it’s actually the “dose” of noise or music exposure that we should be concerned about. This is similar to an X-ray technician being exposed to many x-rays each day- there will come a time when this person needs to take a forced-vacation away from the x-rays. Music is like this as well. There is nothing wrong with going to a rock concert, as long as it is not too long (and you don’t go home and mow your lawn the next morning). There are app-based dosimeters that can provide exact numbers with statements such as “You can be exposed safely for X minutes”. One such dosimeter that I use is called SoundLog, and to date, because of limitations with the Android platform, all Smartphone based dosimeters are only available on the Apple iOS platform.
The two main factors are how intense the music or noise is, and how
long one has been exposed to it. We know from research that
prolonged exposure to 85 decibels (dB) or greater, over time will
cause a permanent hearing loss. A level of 85 dB is not particularly
loud- a dial tone on a telephone is about that! Even though it is
not loud, it is intense enough to be damaging. But, it also depends
on how long you are exposed to it. Research has found that the
maximum exposure each week should be less than 85 dB for 40 hours.
This is identical to 88 dB for only 20 hours. That is, for each
increase of 3 decibels, you can only be exposed for half as long.
Saying it differently, for every 3 decibel increase, your exposure
doubles. Other less significant factors are your hating of the
music, general health, and hereditary factors.
What happens when we get a music related hearing loss?
Most people reach the ripe old age of 50 without any hearing
problems, but others suffer a very slow and gradual hearing loss
that may not be noticed for years. Certainly working in a noisy
factory is one such cause. And listening to loud music is another.
The ear is made up of three parts- the outer ear, the middle ear,
and you guessed it, the inner ear. The inner ear is about the size
of a small finger nail and contains about 15,000 nerve endings,
called hair cells. When some of these hair cells are damaged, you
have a permanent hearing loss. Damage to the outer and middle ears
is usually temporary and can be treated by a doctor.
I play tenor sax in a loud band and wear ER-25 earplugs. Is the internal sound of myself playing loud potentially damaging?
This is a common concern for sax and clarinet players- instruments where the top teeth touch the mouthpiece. Sound can be generated from the instrument, through the teeth and by way of bone conduction, go directly to the ear. There are no studies that I know of about the exact sound level, but indirect evidence suggests that the sound can be quite intense. One can minimize the potential effect by ensuring that the earplug does not “trap” the sound in the ear. This is called the occlusion effect. As a sax player, unless the band is VERY loud, you should not be wearing an ER-25. At most, the ER-15 would be sufficient. I’m a clarinet player and I use the vented/tuned earplugs. These use a small hole that would let the bone conducted sound escape from the “trapped” ear.
Bagpipes are a fascinating instrument- the only “modern” instrument with no volume control! The output of bagpipes has been measured at 108 dB, and combine that with the drum corps to their rear and you can have a real problem. The hearing protection of choice is the ER-15 earplug if the piper is solo and the ER-25 earplug if drums are around. Of course, the same precautions/moderation should be taken as other woodwinds. You can check out the “Woodwind” fact sheet in the “Publications” section of this website for more information.
Indeed many piano tuners do suffer from hearing loss. Recall that it is not only the intensity of the sound that causes hearing loss, but also the duration. A piano tuner can spend many hours each day with various pianos and like most musically inclined people, tend to also visit night clubs and other loud venues. The total exposure can add up quickly. The ER-15 musicians’ earplug is the hearing protection of choice. It will protect the piano tuner, while still allow them to hear the music.
These are called in-ear monitors, and they are a form of a modified hearing aid. In fact, in most ways they are hearing aids- they have an amplifier, and typically several loudspeakers (called receivers). Musicians use them as their own monitoring system instead of the small “wedge” monitors on the floor of the stage. The wires are connected to the sound amplification system either directly or through a wireless transmitter. The musician can then hear their own music as well as that of the other musicians, but at a safe level. When musicians use in-ear monitors, the overall sound level on stage is typically much less than if they were using conventional wedge monitors.
Once an in-ear monitor is “open”- i.e., there is an air hole running through the monitor to your ear, there will be a significant loss of low-frequency sound energy as well as a loss of protection from intense low-frequency sounds in the environment. The advantage of course, would be to minimize the occlusion effect which causes one’s own voice to sound hollow and echoey. Other than creating an air hole, the major way of reducing the occlusion effect is to make the portion of the in-ear monitor that extends down the ear canal, as long as possible. This would also be useful for earplugs. When obtaining the in-ear monitors, or the musicians’ earplugs, ask that the person making the earmold impression, ensures that the bore will extend beyond the second bend in the earcanal.
He isn’t weird (… well, he might be…) but many percussionists hum and grunt. There is a small muscle in the middle ear that mother-nature gave us so that our own voice would not be too loud to ourselves (called the stapedial muscle). It has been shown that if one hums or grunts just prior to a loud sound and continues that hum through the sound, this muscle in the ear continues to contract, providing an attenuation (or lessening) of the sound energy. So your friend is actually protecting his hearing.
Tinnitus is a symptom of possible damage to the ear- possibly because of overexposure to loud music. However, the ear is very resilient and tinnitus typically recovers within a matter of 3 or 4 days (where a temporary hearing loss will typically resolve within 16-18 hours). If you frequently get a period of tinnitus after a loud set, if at all possible try not to play another gig for several days, and definitely consider wearing musician earplugs. Even the ER-15 earplugs can extend the amount of time you spend around loud music by a factor of 32 times.
Tinnitus is almost always associated with some hearing loss. Treating the hearing loss may result in “treating the tinnitus”. Most people find that some external noise (either from a hearing aid or from a “tinnitus masker”) tends to block out the tinnitus. That’s why many people with tinnitus do not find that it is as bothersome when there is background noise. Many musicians find that external noise allows them to play and enjoy their music. In fact, there is a type of tinnitus therapy called Tinnitus Retraining Therapy (TRT) that has been shown to be successful for many musicians.
Tinnitus is actually created in the brain- not the ear. The hearing loss (from too much loud music) causes the nerve endings in the ear to become damaged. The brain cells that receive the impulses from these nerve endings say “where is the sound??” These cells become “lonely” and start to generate their own sound. TRT is a method that involves counselling and the use of a noise generator (or masker). The cells in the brain say “Oh! Here is the sound” and gradually (after a year or so) stop producing their own noise. The tinnitus dies away (or at least becomes less bothersome and noticeable). Many audiologists offer this type of tinnitus therapy. You should consult your local audiologist for more information.
The ringing is called tinnitus. Actually, tinnitus refers to any noises that are heard in the head, that don’t come from the outside. Tinnitus comes in two flavours- objective and subjective. Objective tinnitus is tinnitus that can be heard by other people. This is very rare, and is usually related to blood vessel problems in the ear. Subjective tinnitus is much more common and refers to the type of tinnitus that only the person can hear. But, to answer your question. You are probably suffering from TTS from the concert.
What a good question! TTS stands for Temporary Threshold Shift. This is a fancy way of saying temporary hearing loss. After a loud concert, or a day in the factory, your hearing is temporarily reduced. After about 16 hours to 18 hours, this resolves and your hearing should return to the level it was before (hopefully normal). When the hearing is reduced, there is frequently tinnitus, which is especially noticed in quiet places such as when you are trying to sleep. The tinnitus and hearing loss (sometimes felt as a numbness in your ears) should completely resolve after 16 hours. BUT, it turns out that TTS may not be just a benign characteristic of too much noise or music. Recent research indicates that while the hearing loss (as measured with puretone beeps) returns to normal, that there can be permanent neural damage.
Indeed there is- it is called Temporary Hearing Loss Test app and is available on both the Apple iOS platform and the Android platform. One can use their Smartphone to measure one’s hearing at 6000 Hz (just above the top note on the piano) before a gig or a noisy event, and then after the gig or event. The difference is calculated and expressed as a green coloured screen if the TTS is minimal, an amber coloured screen if there is a greater TTS, and a red coloured screen if the TTS is significant enough to be concerned about.
The short answer is “yes” and “no”. It is true that the ear recovers after about 16 hours and can take on new challenges of loud music, but TTS is a warning signal of being exposed to too much music. If you go to a rock concert on Friday night, don’t mow your lawn until Sunday (or better yet, get someone else to do it!) However, once you have a music related (or noise related) hearing loss, it is permanent, so do whatever it takes to prevent it. Certainly moderation is one idea. Enjoy that loud song, but when it’s over, turn down the volume a bit to give your ears a rest.
Don’t panic- this is rather uncommon, but it does occur on occasion. There is almost always a hearing loss associated with the tinnitus. Using a small hearing aid (and there are some that fit invisibly into the ear canal) not only will help you hear better, but will tend to mask or block out the tinnitus in the majority of people. Being overly concerned about it is another problem. The last thing someone should do is become stressed as this may make the tinnitus more noticeable. There are therapy programs that serve to retrain the brain to ignore tinnitus and these can be very successful. Contact your local audiologist or doctor if this becomes a problem.
Health food stores frequently sell Gingko Biloba extract as a treatment for tinnitus. There is no scientific basis behind this. A recent study from England surveyed over 500 users of Gingko Biloba and found no significant tinnitus reduction benefit.
In some sense, hearing loss is the least of your worries. After all, it is very gradual, and only affects the very high pitched sounds… so you may not notice it for years to come. But, with hearing loss comes two other things that can be very annoying- or if you are a musician, can be career ending. They are pitch perception problems and permanent tinnitus. Pitch perception problems, as the name suggests, means that a person with a significant hearing loss may hear one note as another (and have limited understanding for speech). And can you imagine having a constant hum or whistle in your head day and night? This is what many people report with permanent tinnitus. So,… prevention of hearing loss is where it’s at.
People who cannot tolerate even moderately loud sounds can be suffering from hyperacusis. It can be associated with an inner ear hearing loss. That is, not only are soft sounds too soft, but loud sounds are too loud. If there is a hearing loss, special hearing aids can be recommended that not only make soft sounds louder, but more importantly, loud sounds softer. For those with normal or near normal hearing, there is some controversy in the field. Some feel that earplugs can be useful. Others feel that earplugs are bad since they can exacerbate the reduced tolerance for loud sounds. Type in “hyperacusis” to any search engine for more information or contact the American Tinnitus Association (www.ata.org).
Hyperacusis is an awful sounding word meaning an “abnormal sensitivity to loud sound”. People may complain that “medium sounds are OK but loud sounds that don’t bother most people, seem to bother me!” This is actually an early warning sign of hearing loss. That is, not only does sound have to be a bit louder in order to hear, but also the tolerance to loud sounds is reduced. Most modern hearing aids are specially designed to not only amplify softer sounds but make louder sounds softer. Many people with hyperacusis have a hearing loss. On rare occasions, some people with normal hearing have hyperacusis as well.
Pitch perception problems can be caused by either a significant inner ear problem or a problem in more central structures of the brain. Indeed, perfect pitch is a brain phenomenon, and has little to do with the hearing mechanism. Once there are pitch perception problems, little can be done to help the situation. Prevention is mandatory.
Diet is obviously critical to maintaining optimal health. Drinking plenty of fluids and eating healthy (vegetarian) meals can do a lot to extend your musical career, especially if you are on the road. Many 24 hour supermarkets stock easy to prepare frozen foods that can be heated up in the nightclub’s microwave. Try to keep caffeine and alcohol to an acceptable minimum- having two beers and not four. (And of course no beer if you are under age!). A recent series of investigations indicate that hearing can be maintained if stress is reduced- stress is not just deleterious to your cardiac system; it can also increase susceptibility for hearing loss from loud music or noise.
Smoking is obviously a no-no. Anybody working in a bar is getting way more smoke than their personal limit of second hand smoke, to begin with. Smoking tends to dry out your vocal chords and limits your singing range. Other than Rod Stewart, I can’t think of any other successful singer who can sing with damaged vocal chords. There is evidence that poor cardio-vascular function (commonly found in smokers) is linked to a greater propensity for hearing loss.
NO. All music (and noise exposure) manifests itself in the higher frequency region (with the greatest hearing loss being near the top note on the piano keyboard- being between 3000 Hz and 6000 Hz). If someone has a low frequency hearing loss it is either related to the outer and middle ears (e.g. wax, ear infection, or a stiffening of the bones in the middle ear) or by an unusual condition of the inner ear. In both cases, you should seek out the medical opinion of an ear, nose, and throat doctor (an otolaryngologist). Depending on where you live, you may require a referral from your family doctor.
This is called “acoustic trauma” and is quite rare. Unlike most types of hearing loss from loud noise or music which is gradual and happens over many years, a single intense blast can create a sudden permanent hearing loss at exactly the frequency of the insulting sound. A common example is a feedback squeal from a loud speaker- a permanent hearing loss can occur and will occur at exactly the frequency of the feedback squeal (e.g. 1500 Hz). This example is not a typical frequency tested by an audiologist so care needs to be taken to assess as many frequencies as possible during testing in order to rule this out.
Other than hearing loss associated with aging (called presbycusis), the single greatest cause is working around noise. The ear does not know the difference between loud noise and loud music. To the ear, noise and music are just vibrations in the air. Rarely, a person may suffer a permanent hearing loss from a virus or even a brain tumor. These usually have a sudden onset and may be accompanied by dizziness. Hearing loss from noise or music tends to be gradual in nature with no dizziness. If one experiences dizziness or a sudden hearing loss, one should contact their doctor.
Actually this is an important question. A few research studies concluded that some frequencies are “slightly” more damaging than others, but in reality, all frequencies are equally damaging. The reason we have our worst hearing in the 3000-6000 Hz region (around the top note of the piano keyboard) has more to do with the way our ear is made up, rather than the sound(s) that cause the hearing loss. For this reason, a flute and a bass player would have similar hearing losses.
Only hearing losses that are from the middle ear (where kids get ear infections) or from the outer ear (such as wax occlusion) can be treated. Rarely can a hearing loss be treated if it is from the inner ear. The inner ear is actually in the brain, so inner ear surgery is brain surgery! Having said all this, researchers are working on a range of “oto-protectants” that can be given to minimize inner ear hearing loss from loud noise and loud music. As these drugs become available (and as the FDA approves more of them) it is crucial to ensure that you are taking the correct dosage. More is not necessarily better. If dosage information is not available, it is best to stay away from these, possibly unregulated, drugs. To date, there is no reliable information suggesting that food supplements (such as beta-carotene and various vitamins) are useful in any way to prevent noise or music induced hearing loss.
Actually Beethoven was not deaf at all… at least not in the North
American sense. In Europe, any hearing loss, regardless of severity,
is called “deafness”. This even would apply to a mild temporary ear
infection. In North America, deafness is considered to be at a
profound level- one that would prevent normal verbal communication.
Beethoven, as far as we can tell, suffered from Otosclerosis and
perhaps some lead poisoning. Otosclerosis is a middle ear hearing
loss which today, is surgically treatable. At most, Beethoven would
have had a 60 decibel hearing loss- one that would still allow him
to hear the music quite well. In addition, otosclerosis has no pitch
problems associated with it, merely a decrease of the loudness of
the music. I haven’t seen Beethoven lately, but when I next see him
clinically, I will check this out, and also check for lead toxicity.
Are there hearing aids for musicians?
Much work has been done in the last several years to define “which is the best hearing aid for listening or playing music.” A website is maintained demonstrating that the wrong hearing aid can never be successfully programmed for music listening, if the technology is limited. This site can be found at www.Chasin.ca/distorted_music. Many hearing aids clip or distort the louder inputs of music and once this is done, no fancy hearing aid circuitry can improve things, so… the solution is to use a hearing aid that doesn’t clip or distort the louder inputs of music, and these hearing aids, or hearing aid modifications are available.
Believe it or not, but Classical music- or specifically playing classical music- can be more damaging than rock music. Research has shown that about 37% of rock musicians have a hearing loss, and about 52% of classical musicians suffer from this problem. The main difference is that classical musicians rehearse, perform, and teach more hours each week than typical rock musicians. And classical musicians tend to be clustered closer together than rock musicians. So even though the peak sound levels in a rock band may be higher than in an orchestra, the total weekly dosage of a classical musician is greater.
You mean, beyond the long hair? Although this next issue is highly variable, many classical musicians don’t like their music as much as rock musicians do. It is this disliking of the music that is partially responsible for the difference in susceptibility between rock and classical musicians. Research has shown (see some of the articles in the “Publications” section) that if you don’t like the music, it is actually more damaging than if you do like it. Classical or orchestra musicians may play the same piece of music countless times, and become bored with it. In addition, an orchestra musician has their music selected for them by a conductor or artistic director. They may not like the selected pieces. In contrast, a rock musician tends to play their own music- music that they love. This research has been replicated many different ways, always with similar results. So, go ahead and enjoy your music (in moderation), but don’t hate it.
Well, sort of… technically, it’s not so much that liking the music is good for us- it’s if we don’t like the music, it is worse. We’re not sure exactly why that happens, but there are two theories. One is that when you are under stress, certain hormones are released in your inner ear that makes it more susceptible to hearing loss. A second theory is related to the fact that there are a series of feedback loops from the brain back to the inner ear. These feedback signals can change the susceptibility of the inner ear to damage.
Wow! It’s as if I wrote this question myself! I see this clinically all of the time. You will also find some information on this in the articles in the “Publications” section. Many drummers use industrial strength earplugs, like those used in factories. These earplugs take off a lot of the sound of the high hat cymbal and rim shot of the drum. The drummer needs to hit harder in order to hear properly, with the result of wrist and arm damage. Using proper hearing protection will resolve this. Drummers should be using the ER-25 earplug- enough hearing protection to prevent further hearing loss, and enough audibility of the music, so that they will not overplay.
Unfortunately (for bass players) they usually stand near the
drummer. Many bass players (and drummers) use a special type of
loudspeaker called a “shaker”. These small hockey puck sized devices
are designed to enhance the very low pitched bass notes. Shakers are
plugged into the main sound amplification system. With this set-up,
the bass players and drummers have a better awareness of their own
music, and as such, do not have to play as loud. The overall sound
level is less, but everyone thinks they are playing louder. The
musicians are happy and the music is less damaging.
I teach music in a high school and the room is awful. Is there anything I can do to improve it? P.S. I don’t have much money.
there are several things you can do that are easy to accomplish and
inexpensive. Incidentally, there is a fact sheet on this topic in
the “Publications” section under “Musician Fact Sheets” entitled
“School band Teachers”. You can place the trumpet players on risers
as this will allow the higher pitched harmonics of the trumpet to
literally go over the heads of the other musicians “downwind”. You
can put up some drapes over the blackboard behind you while you are
playing in order to dampen the unwanted reflections. These drapes
can be pulled aside when you want to use the blackboard. Finally,
get the Art Department to make some 3-D relief art that can be
placed on the side walls. This will also help to lessen the unwanted
reflections. High school band teachers, because of the number of
hours each week that they must be in a band room should consider the
ER-15 earplugs. Teachers are at risk of hearing loss and have
successfully won cases with the Worker’s Compensation Board in the
I have seen some clear plastic shields up on stage in front of the drummer. What are these used for and do they work?
These are called baffles and are usually made of Plexiglas or Lucite. All baffles, because of the laws of physics, attenuate (or lessen) the higher pitched sounds more than the lower bass notes. These baffles are designed to lessen the energy for those high pitched high hat cymbals, and rim shot hits that a drummer may make. This protects the other musicians and helps to improve the balance of the music. Note that the low bass thumping sounds from the bass drum is not really affected. The only “trick” with baffles is that they should not extend up above the drummer’s ear. The last thing anyone would want is to cause more hearing loss in the drummer by being forced to hear his music, not once, but twice (the initial sound and the reflection off the back of the baffle).
These are typically used on the seats of violinists and viola players. In many cases, these musicians need to sit in front of the brass or percussion sections, and they serve to lessen the energy from these louder instruments. The only problem with a seat baffle is that it has to be within 7 inches (18 cm for Canadians, eh?) of the violinist’s ear. If it is further away, there is minimal benefit because of the reflections off the floor, ceiling, and music stands.
Loudspeakers do not send all sounds out equally. Typically the low pitched bass notes emanate from all parts of the loudspeaker- bass notes are equally loud from the back, front, top and sides. However, the higher pitched notes come out almost like a laser beam- in a straight line. If the loudspeakers can be tilted to aim towards your ears, you will hear a flatter, “higher fidelity” sound. And, more importantly, if the loudspeaker is aimed at your ears, the overall volume control level will be lower. In this way, even though the music will sound as loud, it will be less intense. That means it will be less damaging. Intensity is what causes hearing loss, whereas loudness is simply your impression of the sound. Some researchers suggest elevating the loudspeakers, and this can be useful, but be careful. Some loudspeakers are designed to be left on the floor. Check with the manufacturer before you elevate loudspeakers to see if this would be a problem.