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Musicians and Hearing Loss

1. See an audiologist. An audiologist can provide the musician with a comprehensive diagnostic analysis and a complete hearing conservation program. The program should include the following: A comprehensive case history, a diagnostic audiometric evaluation, educational presentation of the function of the human ear, the damaging effects of loud sound on hearing and related factors that increase risk of hearing damage.

2. Use ear plugs. In 1989, Etymotic Research introduced the ER-15 high fidelity, custom earplug for musicians. The ER-15 is the first and only earplug that reduces all frequencies in a uniform manner. Conventional earplugs reduce high frequencies more than lows resulting in a muffled sound quality. Today, the ER custom earplugs are available with interchangeable filters that reduce sound evenly by 9 dB, 15 dB or 25 dB. These custom plugs are used by symphony, jazz, rock, country, rap, and pop musicians with great success. The ER custom plus range from $125 to $175 per set. For those on a tight budget, a universal fit hi-fi earplug, the ER-20, sells for $10. I recommend that ear plugs be worn not only when performing but also while attending concerts, riding motorcycles, using power tools, lawnmowers or any time a musician is exposed to high sound levels.

3. Use in-ear monitors carefully. In-ear monitors are not hearing protection devices by design. Unlike earplugs, in-ear monitors are capable of producing sound levels equal to or even higher than floor monitors. Unfortunately for the concerned musician, guidelines for safe use is often limited to ''don't turn them up too loud.''

To properly use in-ear monitors as hearing protection tools, one must refer to the damage/risk criteria for hearing loss from the Occupational Safety and Health Administration (OSHA) to determine allowable A-weighted loudness levels, which are directly related to time of exposure. The longer the show (exposure time), the lower the volume (dB output of the in-ear monitor) must be.

If this technology is not practical for the in-ear user to employ for reasons such as expense (the audiologist will typically bill for this service) or availability, here are some suggestions for the concerned musician:

Test and retest hearing every three to six months. Changes in hearing should be reported to and investigated by your audiologists immediately. Obviously, if the musician experiences tinnitus (ringing in the ears) or decreasing in hearing following in-ear monitor use, they're probably damaging hearing. Caution! Do not use the absence of tinnitus after in-ear use as the measuring stick for safety. Research has indicated that of all those who have lost hearing from noise exposure, only 30% have experienced ringing.

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