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Home » Resources » Health » Hear the Music: A Guide to Hearing Loss Prevention

Hear the Music: A Guide to Hearing Loss Prevention


“The ear is an amazing organ that causes one to suspect that evolution had music and musicians in mind,” writes Dr. Marshall Chasin in his book Hear the Music: Hearing Loss Prevention for Musicians. The two most common causes of inner ear hearing loss are noise/music exposure and hearing loss associated with aging. While being 75 years old is not preventable, Chasin’s book offers musicians tips to reduce their exposure to loud music.

Specialized Earplugs—When musicians talk of traditional earplugs they often have two complaints: the occlusion effect—the echoey and hollow sound that occurs when sound becomes trapped in the ear canal, and secondly, muffled music with no “high-end.” Fortunately, with new technology found in modern earplugs these problems have been solved.

Among modern hearing protection devices are “amplifier earplugs” that put back higher frequencies, such that the net effect at the eardrum is flat or equal attenuation for all frequencies. One example is the ER-15 from Etymotic Research. The 15 stands for approximately 15 decibels (dB) of attenuation over a wide range of frequencies. In other words it makes the sounds equally quieter by about 15 dB. Similarly the ER-25 provides approximately 25 decibels of uniform attenuation. For simplicity, these two models will be used to indicate “amplifier ear plugs” throughout this article.

Vented/tuned earplugs have minimal acoustic effect in the lower frequencies and a significant high-frequency attenuation, allowing musicians to hear the lower and mid-frequency sound energy of their own instrument while providing significant attenuation for high frequency sounds nearby. Chasin’s recommendations for earplugs and other hearing protection vary according to what instrument is played, and typical arrangements of musicians.

Small Strings—For instruments such as violins and violas ER-15 earplugs are ideal because the instruments generate significant low- and high-frequency sounds and the musicians need to hear the balance between those sounds. Also, small string instruments should never be placed under an overhang that’s within one meter of their heads because the high frequency components of the instruments can be absorbed in the overhang, causing musicians to overplay to re-establish the correct harmonic balance.

Large Strings—For the cello, bass, and harp, the sound levels generated are not excessive, however, the brass section is often located in the immediate rear and is a source of potential hearing loss. Vented/tuned earplugs are a good choice because they allow most of the higher-frequency harmonic energy of the instruments with minimal alteration in spectrum. Also, placing the trumpet section on risers makes damaging, high-frequency energy go over the players heads. Another possibility is to use an acoustic monitoring device combined with an earplug to transduce low-frequency energy from the cello or bass directly to the ear.

Brass—Brass instruments are directional for higher-frequency energy. Their higher frequency is much more intense than their low-frequency energy, and trumpets are the most intense. Because the instruments are directional, not all brass players need hearing protection. The ER-15 is a good choice for its flat attenuation response. French horn players can also use a reflective baffle to their rear that is angled back at 45 degrees to the floor to reflect high frequency components of their music to the audience and also protect trumpet players who are often placed behind the French horn.

Woodwinds—Clarinets, saxophones, flutes, oboes, and bassoons are used in a wide range of venues. In an orchestra, where they are often in front of the percussion sections, vented/tuned earplugs are recommended to attenuate the high-frequency music energy from instruments to the rear, and in jazz or blues setups, where they may be in front of speakers or near the drum, an ER-15 is recommended. Because sound emanates even from uncovered finger holes of woodwinds, placing these musicians in an unobstructed location allows a direct path for their sound and avoids overplaying. In a blues or jazz setting, woodwinds should be parallel to a speaker, rather than to the front or rear, to gain some protection from the speaker enclosure wall.

Amplified Instruments—Amplified environments provide the most flexibility as musicians often have some control over instrument set-up. Musicians should either be situated away from loud speakers or parallel to speaker enclosure walls. If loudspeakers are oriented toward musicians to obtain “side-wash,” they should be elevated. Musicians in amplified environments should use ER-15, except for drummers who should use ER-25.

Percussion—There is little flexibility in hearing protection for percussionists and ER-25 earplugs are recommended. For a full drum kit the high-hat cymbal can be the greatest potential threat to hearing. For this reason, using a closed position high-hat or muffled high-hat during practice is a good idea.

One alternative to earplugs are personal earphones to listen to music that is mixed by the sound engineer and transmitted back. The effect of the background is minimized making the sound levels the ear receives significantly lower than with conventional monitoring systems. Drummers can also use their stapedial reflex—a small muscle in the middle ear space that contracts in response to sound. If a loud sound, such as a cymbal crash, is about to occur, they can begin humming to elicit the reflex and provide additional temporary ear protection.

Vocalists—For vocalists concerned about vocal strain, an earplug that creates a slight occlusion effect can help. For solo vocalists accompanied by relatively quiet instruments a vented/tuned earplug is most appropriate to provide high-frequency attenuation combined with a slight increase in the loudness of one’s own voice. Nonsolo vocalists, often found in pop bands, are susceptible to the same sound exposure as instrumental colleagues. If there are many sound sources, the wide band ER-15 is a good choice.

—Dr. Marshall Chasin is an audiologist and director of auditory research at the Musicians’ Clinics of Canada. For more information on hearing protection for musicians or to request a free pdf copy of Dr. Marshall Chasin’s book, Hear the Music: Hearing Loss Prevention, send him an e-mail at or visit the Musicians’ Clinics of Canada website:

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