Experienced occupational disease practitioners will be well aware of the dangers of noise exposure for orchestral musicians with Goldscheider v Royal Opera House [2019] EWCA Civ 711 remaining fresh in the memory.

This interesting paper[1] which recently appeared in Nature, the scientific journal, considers the nature of the noise exposure, together with the associated risk to orchestral musicians when compared to the general population and what musicians, both amateur and professional, think about it.

There are clearly different considerations for noise control in an orchestral setting, compared to a typical workplace.  Noise exposure is normally an unwanted byproduct of another (wanted) process.  For musicians, though, the sound they produce is their very purpose. Likewise, the ability to hear is the more important for those seeking to perform within a large orchestral group. Nonetheless, this clearly can be a ‘noisy’ occupation.

Overview

Hearing health is an obvious concern for both professional and amateur musicians. The unique occupational hazards of creating music expose them to high sound pressure levels that can lead to ‘noise’ induced hearing loss.  While many musicians are aware of these risks, real barriers remain which hamper effective prevention. 

Understanding the Risk - Noise-Induced Hearing Loss

Professional and amateur musicians alike are frequently exposed to sound levels that exceed safe thresholds, whether during practice, rehearsals, or performances. Studies indicate that musicians are nearly four times as likely to develop Noise-Induced Hearing Loss (NIHL) compared to the general population. Issues such as tinnitus, hyperacusis, and difficulties in hearing speech or music are commonly reported, with nearly 39% of professional musicians experiencing some degree of hearing loss, and 26% suffering from tinnitus.

Despite this risk, regular use of hearing protection remains low. Only about 58% of professionals and an even smaller 9.7% of amateurs reported wearing hearing protection, and many do so inconsistently. There is a clear difference between awareness and action.

Barriers to Hearing Protection Use

Musicians cite several reasons for avoiding hearing protection:

Impact on Performance Quality: Many perceive earplugs or other protective devices as detrimental to their ability to perceive nuances in pitch, tone, and balance - critical aspects of performance. Adjusting to these devices can take time and may initially interfere with what they see as their artistic expression.

Social Pressures and Stigma: In orchestral settings, hearing aids and protection can be stigmatised. Colleagues may view those using them as less capable or unsuited for the demands of professional music-making.

Technical Limitations: Wind and brass players often face specific challenges, such as the occlusion effect, where internal sounds are amplified, disrupting their ability to perform.

Lack of Guidance and Awareness: Particularly among amateur musicians, a lack of education about hearing risks remains.  Many rely on others (employers or educators) for information, but this is not consistently provided.

Positive Trends and Insights

While the challenges are significant, there are some positive findings.  Professionals are more likely than amateurs to recognise the necessity of hearing protection, with many regularly undergoing hearing assessments.  It seems that both professional and amateur musicians express a strong desire for more resources and education on hearing health.

Bridging the Gap

To improve hearing health outcomes for musicians, this paper considers that further work is necessary:

Education and Training: Incorporating hearing health literacy into music education can ensure that young musicians develop good habits early in their careers.

Improved Hearing Protection Technology: Advances in customised earplugs and devices designed specifically for musicians can address many technical concerns.

Promoting a Cultural Shift: Reducing stigma around hearing health requires conversations within orchestras and ensembles.

Employer Responsibility: Orchestras and institutions should provide access to high-quality hearing protection and regular hearing assessments (the same being a legal requirement of course if noise levels are exceeded).

Continuous Use of Hearing Protection: Rather than intermittent use, musicians should be encouraged to wear hearing protection consistently.  Acclimatisation can reduce the initial discomfort and challenges that many experience.

Conclusion

The study highlights similar issues to those that many occupational disease practitioners will have seen in other forms of employment for many years.  That, in this context, the noise is ‘wanted’ rather than ‘unwanted’ seemingly results in different dynamics as to finding solutions.

[1] Schurig, E., Hake, R., Birke, M., Derks, D., Siedenburg, K., & Kreutz, G. (2024). Hearing health literacy among professional and amateur musicians. Scientific Reports, 14(28441). https://doi.org/10.1038/s41598-024-79875-1