Tag Archives: hearing loss

Health, Resources

You Can’t Hear What You Can’t Hear

A Musician’s Perspective: Gaelen McCormick, Local 66 (Rochester, NY)

For more than 20 years, I was a double bassist with the Rochester Philharmonic Orchestra, and for at least 10 of those years I sat directly in front of the brass section. They were on risers and their bells pointed at the back of my head. Pretty early in my career I started to lose some hearing in the higher frequencies on the right side. The left ear was spared by the shielding effect of my skull as the sound hit my right ear sooner and with more intensity. While my brass colleagues are wonderful musical players, there is simply no avoiding the full impact of their sound. I was fitted with a custom earplug for the right ear and although the sound was uneven—the left ear is open, while the right ear is “filtered”—over time, I adjusted.

I wouldn’t have known that I had suffered hearing loss had it not been for an unusual experience flying back from a gig. My ears never “popped” or returned to regular pressure after that flight. After a week of trying all the tricks I knew, I gave up and went to the audiologist for help. A hearing screening, which was part of the workup at the clinic, revealed an audiometric notch in my right ear.

Because I developed Meniere’s disease in my left ear (the “good” one), louder sounds became increasingly painful. It was time to get a second custom earplug. At this point I realized that I needed to practice more often with earplugs so that I didn’t feel isolated or “underwater” when I was on stage. But honestly, with the filters that come with the custom plugs, there is only slightly less volume, and the clarity of sound is still there.

I do get regular hearing screenings because of Meniere’s disease. What’s more, routine monitoring has been helpful to confirm that the custom plugs are, in fact, helping and I am not experiencing additional hearing loss on the right side. This disease has already caused deafness on one side, and I know too well the stigma of hearing loss in the music community. My advice is to get a baseline hearing test now. To maintain a long and healthy career, be proactive and work to conserve your hearing by using hearing protection throughout your career.

An Audiologist’s Perspective: Heather Malyuk, AuD

I’ve been a specialized music audiologist for nearly a decade and part of the music industry for most of my life. It was providence that led me to the field of audiology when I was looking for a new career path. I saw an online advertisement for a Doctor of Audiology program. Yes, it took looking for a new career to lead me to hearing health.

What’s striking about that statement is that I have a music degree, I was in three youth orchestras growing up, and worked for a number of years as a professional musician. When I think back on my early musical life, despite being surrounded by wonderful teachers, hearing was never discussed.

As soon as I began playing, or at least as soon as I started youth orchestra, I should have learned about the sense of hearing and audiology. Why? Ear training. If I had the chance to practice with hearing protection while developing my listening skills, it wouldn’t be so difficult to wear earplugs now.

In nearly a decade of clinical practice, a resounding comment from players, especially classical orchestral musicians, is: “I love my earplugs, but wish I’d known about them when I was learning to play. I have so little time to practice with them and get used to them now.”

Earplug sound quality is not the same as the open ear canal and training with earplugs is a bit like becoming bilingual (or “bi-aural”). It’s a skill more easily honed as a youth. An additional bonus to early training with earplugs is preservation of hearing and staving off music-induced hearing disorders (MIHD). Sound injury to ears is permanent. As such, an ounce of ear training is worth a pound of cure.

The primary goal of hearing conservation is to prevent MIHD such as tinnitus (ringing), distortion, pitch perception issues, sound sensitivity, and hearing loss. Research shows that musicians are at risk for these disorders regardless of musical genre. Sound-induced hearing loss primarily occurs in two frequency regions: 3000-6000 Hz and above 9000 Hz. This is different from typical age-related hearing loss, which tends to affect only higher frequencies of hearing.

Unfortunately, musicians who have hearing loss without accompanying disorders can often “ear train” to the loss and work effectively until it becomes severe. This can be dangerous, as hearing loss from sound occurs gradually. Without annual hearing evaluations, it can go undetected for years.

Too often I see musicians who are beginning to have difficulty with timbre, pitch perception, or hearing in general, who have not been tested in over a decade. In some instances, the loss could have been prevented entirely. There are other factors of hearing loss, either caused by genetics, disease processes, medications and medical treatment, viruses, and more. For these, it’s essential to have an audiologist who is specializes in hearing as it relates to music and associated needs.

What’s the bottom line? Every musician should have annual hearing tests, early adoption of protection, and a relationship with an audiologist. Audiologists are the gatekeepers to every musician’s main instrument: the auditory system.

—Gaelen McCormick of Local 66 (Rochester, NY) is a double bassist who was a member of the Rochester Philharmonic Orchestra from 1995-2017. She is program manager of Eastman Performing Arts Medicine. Heather Malyuk, AuD, owns and directs Soundcheck Audiology.

IEMs
Recent News

Safe Sound in an Age of Living Loud: Correct and Safe Use of In-Ear Monitors

IEMsIn a loud stage environment, musicians become accustomed to hearing their monitor mix at high volume. Some use in-ear monitoring systems (IEMs) to reduce the impact, but if the volume on the device is not regulated and lowered, it’s no solution. IMEs are only considered protective devices if they are used at safe levels.

IEMs are in demand because they isolate the ear from ambient noise and artists can hear the intended signal clearly, at a much lower volume. Critical to the equation, though, says Michael Santucci, Au.D., a researcher and expert who specializes in hearing conservation, is much lower volume. It requires modifying user behavior and listening patterns.

Look no further than the iPod. Studies have shown, in case after case (especially with teenagers), that there was irreversible damage because of volume and prolonged listening. Do most musicians use ear protection? “No,” says Santucci, “Are attitudes changing? Absolutely.” 

It’s like sun exposure, he explains: it’s both how strong it is and how long you’re exposed. In music, it’s personal susceptibility, how loud, and how many hours you’re in it. “We do pit crews for Broadway plays. Is it terribly loud? Not always, but they’re doing it six hours a day.” Nowadays, Santucci frequently works with orchestras because they are featuring more pop stars. The added decibel (dB) quotient can be deafening to orchestra members. Santucci says, “Risk goes up with volume and length of exposure.”

A recent study out of Vanderbilt University showed that, regardless of whether they used floor wedges or IEMs, subjects turned them up to their usual listening level. Everybody had three days of in-ear and three days of floor wedges at different times and in different venues. Every musician turned to exactly the same loudness every day.

“If you’ve been practicing guitar for years at 110 dB with wedges, the natural tendency will be to turn your IEMs to 110 dB, even if it’s not needed,” Santucci says. “And until the audiologist says you need to turn it down to here, their brains tell them to go back to the level they’re used to.”

The good news is that the second part of the study showed that musicians can recalibrate their brains to listen at a lower level. After a couple of weeks, it becomes the norm. Santucci says, “It’s habit—like the timbre of your instrument, pitch—it’s all because you’ve done it a million times. Loudness goes right along with it.”

Adding Ambient Sound

Some musicians say they feel disconnected from the band and the crowd with IEMs. This can be addressed in a few ways. The trick, Santucci says, is to do so without compromising the isolation of the IEM system. A simple remedy is for the sound engineer to set up audience mikes to add to the monitor mix so the artist can get a feel for the room. “Some musicians take out one IEM, which is very damaging to hearing. They end up turning up the side with the ear monitor even louder, plus they have an open ear not protected by anything.”

For a natural, but more robust, method of adding ambient sound into the IEM mix, Santucci recommends 3D active ambient IEM systems that allow the musicians to control how much ambient sound is heard. “What I do not recommend is porting the earphone to let ambient sound leak. Porting effectively eliminates the benefits of isolation and cannot be controlled, it has the potential for the user to turn up the volume of the system to unsafe levels.” 

Safe Listening

For hearing conservation benefits of in-ear monitors, refer to OSHA and NOISH guidelines to determine exposure times for safe use. Shows of less than one or two hours are less of a problem. For a club band, whose shows may go on for several sets of three or more hours, volume levels must be much lower and should average no more than 95 to 97 dB.

The problem is being able to accurately determine the decibel level coming from the in-ear monitors. Currently, the only method to measure these levels is with ear-probe microphone technology used during rehearsals or sound checks by an audiologist. From these readings, a volume level can be recommended based on the length of a show.

Tinnitus and Hearing Loss

If your ears ring or if you have trouble hearing after a concert, you are definitely in danger of noise induced hearing loss (NIHL). Santucci cautions, “Even if your ears don’t ring, if you think it’s safe, you’re wrong. Research shows that, of those suffering from NIHL, only 30% experienced ‘ringing’ as a warning sign. In other words, if your ears ring after a performance, you’re too loud. But if they don’t ring, there’s a 70% chance you may still be damaging your ears, if levels exceed OSHA safe exposure limits.”

For additional information, visit the websites: www.osha.gov/SLTC/noisehearingconservation or www.cdc.gov/niosh.

Other Hearing Protection Tips:

  • Invest in superior hearing protection,
    custommade ear molds with dampening filters.
    Preferably use musicians’ earplugs, which offer flat attenuation vs. traditional earplugs, which tend to filter sound from higher frequencies, resulting in a muffled sound.
  • Protect your ears consistently every time you may be exposed to loud music and/or sounds, not just when you are performing.
  • Better yet, avoid noise as much as possible when you are not performing.
  • Invest in high-quality in-ear monitors and train your ears to use the lowest level that’s feasible.
  • Drummers should use dampening pads when possible.
  • Sound travels in a straight line so it’s louder directly in front of or behind a speaker. Spread out so you are not being blasted by the musician next to you. Move away from on-stage monitors and amplifiers.
  • If moving away is not an option, look into using baffles to protect yourself.
  • Take breaks of 15 minutes in between sets of music or rehearsals to give ears a rest. During rest periods go outside or somewhere quiet.
  • Whenever possible, practice at lower volume
    or play your electrified instrument unplugged.
  • Use smaller amps when possible.
  • Avoid ear buds and other direct-injection earphones for recreational listening, especially in loud environments.
  • Have your hearing tested frequently by an audiologist.
  • If it’s not possible to have regular professional sound-level assessments, at least use a sound meter app to check your exposure level.
  • Avoid signing up for repeated live gigs at loud clubs. If possible, give your ears some recovery time in between.

Michael Santucci, Au.D. works with the Audio Engineering Society (AES), where he is vice chair of the Technical Committee on Hearing and Hearing Loss Prevention. He operates a Musicians Hearing Clinic and works on hearing conservation through Sensaphonics: In-Ear Monitoring Systems.

Health, Resources

Huh? You May Already Have Hearing Loss

Following a recent live music event, I interviewed a longtime musician who joked that his years of gigging have made it more difficult to carry on a normal conversation. I patiently repeated my questions, trying to speak in an abnormally loud voice. When I asked if he’d ever considered using musicians’ earplugs the man laughed at the absurdity of such an idea. Unfortunately, hearing loss really is no laughing matter, especially for musicians.

The auditory system is one of the body’s most delicate sensory systems, and when you are frequently exposed to excessive sound levels, the system can be easily damaged. Though many people associate musician hearing loss with rockers (20% of whom have some hearing loss according to one Norwegian Institutt for Klinisk Medisin study), any type of musician is at risk. Often, only when noticeable hearing loss has already occurred, do musicians take the problem seriously.

The National Institute for Occupational Safety and Health (NIOSH) sets guidelines for the maximum time you can safely be exposed to various sound pressures measured in decibels (dB). Below is a table with approximate ranges of safe exposure for various instruments.

Hearing Loss chart

CLICK TO ENLARGE

As you can see from the table, the dangers are real and occur with a wide range of instruments and genres of music. Following are some tips to reduce the danger of hearing loss.

  •   Purchase and wear musicians’ earplugs. They are superior to traditional earplugs because they offer “flat” attenuation, while traditional earplugs tend to filter more sound from higher frequencies, resulting in a muffled sound.
  •   As you can see from the table, each instrument has a wide volume range. When possible, practice more softly, or play your electrified instrument “unplugged.”
  •   To reduce your overall exposure to sound, take precautions in your daily life. Avoid any environment where you need to raise your voice to be heard. Wear earplugs or earmuffs when mowing the lawn or operating other loud machinery, and turn down the volume on your television and iPod.
  •   During rehearsals take frequent, 15-minute silence breaks.
  •   When you have a break during your gig, take a moment to step outside and give your ears a rest.
  •   Spread out so you are not being blasted by the musician next to you. Also, move away from on-stage monitors and amplifiers.

For more information on musician hearing loss and additional tips visit House Research Institute at www.hei.org or Hearing Education and Awareness for Rockers (HEAR) at www.hearnet.com.