Musicians and hearing loss

Written by Diana Randolph, AuD, CCC-A. Posted in Health and Beauty

What do Pete Townshend, Eric Clapton, Phil Collins, Ozzy Osbourne, and Barbara Streisand have in common? Other than being rock stars/musicians, they all have hearing loss and/or tinnitus due to being around loud music. While noise exposure from factory work or firearm use is more common, hearing loss due to loud music is more common than you think.

Noise exposure of any kind will cause hearing loss. The loss occurs when the noise (whether it’s an impulse noise like a gun blast or long-term noise exposure like factory work) damages the delicate hair cells in the inner ear. These hair cells move according to the frequency of a sound. Noise will damage these hair cells to the extent that they die. When the hair cell is dead, hearing loss and/or tinnitus can occur. Unfortunately, there is no cure for damaged or dead hair cells. Tinnitus and noise exposure are quite common together. According to the Hearing Health Foundation, musicians are 57% more likely to develop tinnitus.

It’s not only the “rockers” that can get hearing loss and tinnitus due to loud music; classical musicians can also. A Finnish study among classical musicians found that 15 percent of the musicians in the study suffered from permanent tinnitus, in comparison to 2 percent among the general population. Temporary tinnitus affected another 41 percent of the musicians in group rehearsals and 18 percent of those in individual rehearsals. It is estimated that 15 percent of the general population experience tinnitus temporarily. Classical musicians are exposed to high levels of noise for five to six hours daily. The sound level from a double bass, for example, may reach 83 decibels (dB), and a flute or the percussion instruments produce as much as 95dB of noise. This is significantly above the 85dB maximum recommended noise exposure limit in a workplace, established by the World Health Organization, WHO ( The Occupational Safety and Health Administration (OSHA) requires hearing protection to be worn in any work environment where noise is 85dB or higher for an 8-hour work shift.

For the musicians who are regularly subjected to this kind of noise, the resulting problems can be devastating. Symptoms begin with losing the ability to hear high-frequency sounds and tones. In many cases, this causes problems for musicians and singers who must be able to hear and play high notes as well as low ones in order to play or sing along with other orchestra members. Often, a musician who suffers from loss of high-frequency hearing will try to compensate by playing louder at high-pitched notes, which leads to an artistically unacceptable performance.

As the problem grows, the musician might react oversensitively—suffering from increased blood pressure, headaches, and fatigue or experiencing some sounds or instruments as being painfully loud, a state that often leads to tinnitus.

“Noise can hurt you, even if it’s music," says Kathy Peck, executive director of HEAR (Hearing Education and Awareness for Rockers), a nonprofit she founded in 1988 with a San Francisco physician after both attended an exceptionally loud concert. "You don’t realize that the high or rush you’re getting from music can damage your hearing."

Peck, a former bass player for the Bay Area all-female rock band The Contractions, experienced hearing damage while performing in 1984 and developed tinnitus. She launched HEAR with assistance from such musical luminaries as Townshend, Metallica drummer Lars Ulrich, and promoter Bill Graham, as well as MTV, medical organizations, and music trade groups.

"It’s always a great idea to have hearing protection at a concert," Peck says. "Cheap earplugs are good in a pinch, but customized earplugs stop the progression of hearing loss."

HEAR is particularly concerned about teens "who think they’re invincible," Peck says. But the organization also recognizes that huge numbers of older musicians and fans have not abandoned their passion for blaring rock.

"People in their 60s and 70s are still playing music and going to shows," Peck says. "And so many of them are suffering mild to moderate hearing loss. It’s a wide problem. But it’s never too late to start protecting yourself" (AARP July 2018).

There is no cure for music-induced hearing loss, so prevention is the key. For many musicians, the use of ear plugs or in-ear monitors is recommended. Though most standard ear plugs reduce mostly the treble or high-frequency sounds, making music sound like it has too much bass, there are ear plugs especially designed for musicians called musician plugs. These plugs are custom made and have a filter in them to decrease sound equally over all the frequencies, so music still sounds normal, just softer. In-ear monitors can be used by musicians, and these isolate the musician from the loud volumes on stage. Also, they supply greater accuracy, having only those instruments one wishes to hear in the monitor mix without anything unwanted bleeding in from adjacent monitors or instruments.

Musician plugs and in-ear monitors are custom made by an audiologist who takes an impression of the ear so the fit is just right. In-ear monitors can also be a universal-fit type. These have a foam or rubber tip, and you choose the one that fits the tightest. At Northwest Ohio Hearing Clinic, we can advise any musician on the hearing protection that is most appropriate for them and make the impression if needed. It is also recommended that all musicians—members of a band, choir singers, or even high school band directors—get their hearing tested annually. Call us to schedule an appointment with one of our audiologists.

Dianna Randolph, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).