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The audiograms of fifty-seven musicians from four Danish symphony orchestras were determined in connection with an interview about their working experience. Measurements of sound levels and noise dose were performed during rehearsal and during concerts in the four orchestras with the measurement equipment placed in various instrument groups. The average audiogram showed a decrease at higher frequencies similar to an age-related hearing loss. Each audiogram was corrected for the age of the person by means of the median from ISO 7029 and the average audiogram from these age-corrected individual audiograms showed no signs of hearing loss. The audiograms were also compared to the expected audiograms from ISO 1999, which takes account of the number of years at work, the number of playing hours per week, and the average sound level in the orchestra for the instrument group. In almost all cases the measured audiograms looked better than the predictions from ISO 1999. It may be concluded from this investigation that musicians cannot be expected to get pronounced audiometric hearing losses from playing in a symphony orchestra. It should be noted, though, that the data material is limited, and that the subjects have not been selected in a systematically or representative way. Keywords: Hearing ability, musicians, audiometry
How to cite this article:
Obeling L, Poulsen T. Hearing ability in Danish symphony orchestra musicians. Noise Health 1999;1:43-9 |
| Introduction | |  |
A general debate about possible hearing loss in musicians has taken place in recent years in Denmark. In close connection with discussions about tinnitus among musicians it has been argued that hearing loss and tinnitus are the natural and inevitable results of playing in an orchestra. Investigations from the literature show a somewhat muddy picture, as no clear hearing loss risk is seen (Bremmelgaard and Obeling, 1996). Some investigations show a risk (e.g. Axelsson and Lindgren (1981), Karlsson, Lundquist and Olaussen (1983), Johnson et al. (1985), Ostri et al. (1989), Royster, Royster and Killion (1991)) while others do not show a risk (e.g. Lipscomb (1976), Axelsson and Lindgren (1977), Axelsson, Eliasson and Israelsson (1995)). The risk is partly depending on the type of orchestra (symphony or rock band). Some investigations concentrate on audiogram determinations and others on sound level measurements. Generally it seems that the noise limits which are set for industry noise may not be correct in relation to the risk of hearing loss from music.
Based on the literature study by Bremmelgaard and Obeling (1996) it was decided to concentrate the present investigation on classical symphony orchestra musicians and contact was made to four professional Danish symphony orchestras. In order to avoid any misunderstandings the contact was made through the musicians' own organisation and representatives. The orchestras were The Danish Radio Symphony Orchestra, Sjaellands Symphony Orchestra, Aarhus Symphony Orchestra and SOnderjyllands Symphony Orchestra. The investigation comprised an interview with the musicians, determination of their pure tone audiogram and sound level measurements in the orchestras during rehearsal and concerts. The audiograms would then be compared to the median agerelated audiogram from ISO 7029 (1984) for the same age and gender. The sound level measurements - combined with the information from the interviews - would be used to compare the audiogram with the calculated noise-related hearing levels from ISO 1999 (1990).
| Materials and Methods | | |
Prior to the measurements the musicians were informed about the investigation by their representatives and they were strongly asked to participate as this was a special opportunity to a check of the their hearing. Subjects who have been exposed to loud non-musical noise sources were excluded from the investigation. This was also the case for persons with known hearing problems e.g. middle ear infections. No other selection of the subjects was performed and thus all subjects participated voluntarily in the investigation. The subjects were interviewed about various topics which were expected to be important for their hearing ability such as work experience, normal working hours, music playing during spare time, spare time activities, military activities, etc. Fifty-seven musicians took part in the investigation. The fifty-seven persons were in the age range from 22 to 65 years and comprised 26 female and 31 male persons.
The pure tone audiograms of the fifty-seven musicians were determined in the frequency range from 125 Hz to 8 kHz. A manual audiometer (Madsen Electronics Midimate 602) equipped with Sennheiser HDA 200 earphones was used. The HDA 200 earphones have a very good attenuation of the background noise compared to the conventional TDH 39 earphones which made it possible to perform the threshold determinations in a quiet room near the concert hall. The audiometer was calibrated according to recent investigations of the reference equivalent sound pressure level (RETSPL) for these earphones (Han & Poulsen, 1998). This calibration ensured that the measured audiograms could be compared to the median age-related audiogram data in ISO 7029.
Measurements of the sound level were performed during rehearsals where a Sound Level Meter (Bruel & Kjaer type 2231) was positioned in various instrument groups. The Sound Level Meter was positioned on a tripod with the microphone close to the ear of a musician. The body of the Sound Level Meter was horizontal and the microphone pointed towards the musician. The distance to the ear was kept as short as practically possible (without interfering with the musician) but the distance was not constant as a musician usually moves a little while playing his instrument. A Noise Dose Meter (Bruel & Kjaer type 4436) was used both during rehearsals and during concerts to evaluate the dose perceived by specific orchestra members. The Noise Dose Meter was carried in a pocket (typically) and the microphone opening (rubber tube) was positioned on the shoulder 10 cm from the ear of the musician.
| Hearing Level Results | | |
The average audiogram of the 57 musicians is shown in [Figure - 1]. A decrease at higher frequencies similar to an age related hearing loss is seen. The variability in the data is illustrated with the curves showing plus and minus one standard deviation from the mean values.
In order to extract the age effect from the data, the individual audiograms were corrected according to the age of the person by means of the median from ISO 7029. The average audiogram from these age corrected individual audiograms show no signs of hearing loss. See [Figure - 2].
If the data are divided into instrument groups the same no-loss picture is seen in almost all cases.
In [Figure - 3] this is illustrated for four viola players who usually sits in front of the brass players. The average audiogram for these four viola players looks as a quite normal audiogram with a slight decrease at 6 kHz and at 8 kHz.
In [Figure - 4] the average audiogram (age corrected) for twelve violin players is shown.
In [Figure - 5] the average audiogram from three kettledrum players is shown. In this case a small dip is seen on the left ear.
Sound Level measurements
The results of the measurements performed with a sound level meter in different instrument groups are given in [Table - 1] and the results of the measurements performed with a noise dose meter at specific musicians are given in [Table - 2]. In both tables the duration of the measurement is given in minutes. The levels are similar to the levels found in Axelsson and Lindgren (1981), Royster, Royster and Killion (1991), Mikl (1995).
Based on the LAeq data in the two tables the various instruments were divided into three level groups around 85 dB, 90 dB and 95 dB respectively. This grouping was used to compare the measured audiograms with the theoretical audiograms one could expect from ISO 1999. This comparison took into account the musicians information about the number of years at work, number of playing hours per week and average sound level in the orchestra for the instrument group. This means that the LAeq levels were normalised to an 8 hours working period. Examples of the measured audiograms and the expected audiograms are shown in [Figure - 6] and [Figure - 7]. In almost all cases the audiograms looked better than the predictions from ISO 1999.
| Conclusion | | |
Based on the measured audiograms it may be concluded that musicians can not expect to achieve pronounced hearing losses from playing in a symphony orchestra. It should be noted though that the data material is limited and that the subjects have not been selected in a systematically or representative way.
From the present investigation it may also indirectly be concluded that the audiogram is not the right tool for early detection of hearing loss.[13]
| References | | |
| 1. | Axelsson A, Lindgren F (1977) Does pop music cause hearing damage? Audiology 16, 432-437  |
| 2. | Axelsson A, Lindgren F (1981) Hearing in classical musicians. Acta Oto-Laryngol (Stockh.) suppl 377, 3. |
| 3. | Axelsson A, Eliasson A, Israelsson B (1995) Hearing in pop/rock musicians: A follow-up study. Ear & Hearing, 16(3), 245-253 |
| 4. | Bremmelgaard C, Obeling L (1996) Music and Hearing Loss - a literature study (In Danish). Department of Acoustic Technology, Technical University of Denmark, 102 pages. |
| 5. | Han L A, Poulsen T (1998) Equivalent Threshold Sound Pressure Levels (ETSPL) for Sennheiser HDA 200 earphone and Etymotic Research ER-2 insert earphone in the frequency range 125 Hz to 16 kHz. Scand Audiol 27, 105-112 |
| 6. | ISO 1999 (1990): Acoustics - Determination of occupational noise exposure and estimation of noiseinduced hearing impairment. International Organisation for Standardisation, Geneva |
| 7. | ISO 7029 (1984): Acoustics - Threshold of hearing by air conduction as a function of age and sex for otologically normal persons. International Organisation for Standardisation, Geneva |
| 8. | Johnson DW, Sherman RE, Aldridge J, Lorraine A (1985) Effects of instrument type and orchestral position on hearing sensitivity for 0.25 to 20 kHz in the orchestral musician. Scand Audiol 14, 215-221 |
| 9. | Karlsson K, Lundquist PG, Olaussen T (1983) The hearing of symphony orchestra musicians. Scand Audiol 12, 257-264 |
| 10. | Lipscomb DM (1976) Hearing loss of rock musicians. Audio, March issue,, 32-36 |
| 11. | Mikl K (1995) Orchestral music: An assessment of risk. Acoustics Australia 23(2), 51-55 |
| 12. | Ostri B, Eller N, Dahlin E, Skylv G (1989) Hearing impairment in orchestral musicians. Scand Audiol 18, 243-249 |
| 13. | Royster JD, Royster LH, Killion MC (1991) Sound exposure and hearing thresholds of symphony orchestra musicians. J Acoust Soc Am 89 (6), 2793-2803 |
Correspondence Address:
Lise Obeling
Department of Acoustic Technology, Technical University of Denmark, Lyngby
Denmark
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 12689507 
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7]
[Table - 1], [Table - 2] |
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