+

Basic Information on Hearing HealthStudents

+Sources of Information on Hearing Health

National Association of Schools of Music (NASM)

Performing Arts Medicine Association (PAMA)

American Academy of Audiology (AAA)

Occupational Safety and Health Administration (OSHA)

National Institute for Occupational Safety and Health (NIOSH)

American National Standards Institute (ANSI)

+Disclaimers:Information in This Presentation Information provided is generic and advisory.

Information is oriented toward musicians and lay persons.

Information does not substitute for professional judgments of medical or other experts.

Information is not to be considered medical advice.

Information does not supersede present and future empirical research.

Information does not serve as basis for NASM accreditation functions.

Information does not endorse accompanying reference materials.

+Responsibility for Hearing Health

Health and safety depend in large part on personal decisions of informed individuals.

This information does not relieve individuals of personal responsibility for avoiding risk and preventing injuries to self before, during, and after study or employment at any institution.

This information does not relieve the individual of personal responsibility for appropriate, prudent, and safe behaviors or actions.

This information does not shift responsibility or liability for consequences of inappropriate, imprudent, and/or unsafe behaviors in any instance or over time to any institution, to NASM, or to PAMA.

+Hearing Health: Important for Everyone, but Especially for Musicians Hearing loss can be the result of noise exposure. When

hearing loss is caused by overexposure to noise, it is called Noise Induced Hearing Loss (NIHL). Music is a type of noise for purposes of sound exposure. Music of any type or source at high volume that exceeds

daily exposure limits is dangerous. Preventive measures include information, applications of

information, and acoustically appropriate performance and rehearsal spaces.

50% of musicians may have problems with hearing loss to some degree.

Danger is calculated using scientific methods and instruments; individual perceptions are not a substitute for these.

+Basic Facts about NIHL

Any sound that is too loud or too loud for too long is dangerous to hearing health. Issues are: Loudness (also affected by proximity to source of sound) Duration

Sounds below threshold risk are not dangerous no matter how long the exposure time.

Hearing health can be affected by sounds other than music. Loud sounds from ALL SOURCES contribute 24/7 to daily exposure level.

Protecting hearing health depends on balanced applications of knowledge and skills and by decisions made by individual students, professionals, and amateur musicians every day.

+The Path of Hearing

Sound Vibrations Outer Ear

Middle Ear (little

bones)

Inner Ear(cochlea)

Brain

Sound waves travel through the outer ear and eardrum to the bones of the middle ear. When they arrive at the inner ear, they are converted into electrical signals that travel through neural passages to the brain. It is these signals that the brain “hears” as sound or music.

+Noise Induced Hearing Loss (NIHL)

Middle Ear Damage Sudden very loud noise

(like explosion) can perforate eardrum or dislodge miniature bones

Can be corrected by surgery

Inner Ear Damage Tiny hair cells help

transmit sound to brain Loud noises damage hair

cells Damage is permanent

Severity of Loss Depends on severity of

damage to inner ear hair cells

NIHL is painless and progressive

Initially NIHL reduces hearing sensitivity for high frequencies

With continued noise exposure, damage progresses to greater loss for sounds involved in speech and music perception

+Noise Induced Temporary Hearing Loss

Known as “Temporary Threshold Shift” or TTS

Reduces hearing ability temporarily

Normally lasts no more than 16 – 18 hours

May involve tinnitus (ringing, buzzing, or roaring in ears)

Series of temporary hearing losses may be precursor to permanent damage

Can be reversed with adequate rest and recovery time

+Noise Levels and Risk

Prolonged exposure to any noise or sound over 85 decibels (abbreviated dB) can cause hearing loss.

Decibel is defined as “a unit for expressing the relative intensity of sounds on a scale from 0 for the average least perceptible sound to about 130 for the average pain level” (Merriam-Webster’s Dictionary).

The longer one’s exposure to sounds over 85 dB, the greater the risk for hearing loss.

The closer one is to the source of the sound, the greater the risk for hearing loss.

Thus, duration and proximity, along with sound level from the source of sound, are key factors in risk assessment.

+Common Sounds and their Corresponding dB Levels

30 dB = A Whisper

50 dB = Moderate Rain

60 dB = The Average Conversation

70 dB = Passing Freeway Traffic

80 dB = Alarm Clock

85 dB = Potential Damage Threshold

90 dB = Blender, Food Processor, Blow-Dryer; The Subway

Safe, No maximum

Safe, No Maximum

Safe, No maximum

Safe, No Maximum

Safe, No Maximum

Damage Threshold

2 hours

Decibel LevelApprox. Max Rec. Daily

Exposure

+Common Sounds and their Corresponding dB Levels

100 dB = MP3 Players at Full Volume; Lawnmower, Snow blower

110 dB = Rock Concerts and Sporting Events; Power Tools

120 dB = Jet Planes at Take Off

130 dB = Sirens; Race Cars; Jackhammers

140 dB = Gun Shots; Fireworks

15 minutes

2 minutes

Unsafe, immediate risk

Unsafe, immediate risk

Unsafe, immediate risk

Decibel LevelApprox. Max Rec. Daily

Exposure

+General Rules of Exposure

The levels listed in the previous slides refer to: Continuous exposure at

constant dB levels Specific durations of time

Turn down the volume on your MP3 player or Smartphone 85 dB = 1/3 max. volume

of MP3 94 dB = ½ max. volume 100 dB = full volume

+Musicians and Risk of NIHL

Facts Acute hearing and aural

perception are essential for musicians.

NIHL is preventable.

Conclusions Musicians have basic

hearing health responsibilities.

Sound-level management is a critically important addition to the musician’s portfolio of essential disciplines.

+Musicians and Risk of NIHL: Considerations

Constant attention is required; hearing loss is usually a gradual, painless process.

Initial stage hearing loss may involve pitch perception problems and tinnitus (e.g., ringing, buzzing, or roaring in the ears). These can progress to the point they become career-ending.

Although musicians can be exposed to elevated sound levels while rehearsing and performing, exposure alone does not equal automatic risk.

+Noise Can Impact Your Hearing When You:

Attend concerts

Play your instrument, especially with others

Adjust the volume of your car stereo

Listen to your radio, CD player, MP3 player, or Smartphone

+Risky Sound Environments: Clues to Help You Know

An environment is risky when You have to raise your voice to be heard You can’t hear someone who is 3 feet away from you The speech around you sounds muffled or dull after you

leave a noisy area You experience pain or tinnitus (ringing, buzzing, or roaring

in your ears) after you leave a noisy area

+Major Variables in Risk of NIHL

Sound Level Variation—sound levels rise and fall in various environments—e.g., the practice room, the ensemble rehearsal hall, the concert hall

Settings—spaces for rehearsals and concerts need to have adequate cubic volume and acoustical treatment In-ear monitors and electronic amplification are particularly

risky factors

Distance—the closer the proximity to the source of the sound, the greater the sound level exposure

Length of Exposure—the duration of exposure is a critical factor in determining risk

+Basic Protective Devices for Musicians

Earplugs Often made of foam or

silicone Are inserted into the ear

canal to protect against loud noise

Some are designed for music applications

Earmuffs Two protective foam pads

connected by a headband or strap

Cover the wearer’s ears to protect against loud noises

+Basic Protective Behaviors for Musicians Avoid situations likely to pose

danger to your hearing health.

Refrain from activities that can endanger your hearing health.

Maintain a safe distance from sources of loud sound, including speakers and the stage at loud concerts.

Keep MP3 players and other personal listening devices at “safe” levels. 85 dB is normally about 1/3 of maximum volume for these devices.

See an audiologist or other qualified professional to learn safe practices for in-ear monitors before using them.

Develop a sense of your daily exposure levels of safe and unsafe volume and duration.

Take breaks from exposure during rehearsals.

Use earplugs or other protective devices in noisy environments and when using noisy equipment.

+What to Do if You Have Concerns About Damage to Your Hearing Health If you are having difficulty

hearing or experience symptoms of hearing damage (ringing, buzzing in ears, altered pitch perception, etc.), see a medical professional for assessment and any needed treatment.

If you have concerns about the overall volume level in your ensembles or other situations, speak with your instructor.