Musicians can experience a number of health problems related to the practice and performance of music. [1] The differences in career paths, occupations and performance scenarios are some of the determinants of a wide range of possible health effects.
The most common injury type suffered by musicians is repetitive strain injury. A survey of orchestral performers found that 64–76% had significant repetitive strain injuries. [2] Other types of musculoskeletal disorders, such as carpal tunnel syndrome and focal dystonia, are also common. [3] [4] [5]
Non-musculoskeletal problems include:
They are also at an increased risk of having problems with the stomatognathic system, in particular the mouth and teeth, which may in some cases lead to permanent injuries that prevent the musicians from playing. [10]
There is little consistency across the hearing healthcare sector with respect to the care of musicians' hearing and the provision of hearing protection. [11] However, the American Academy of Audiology has published a consensus document regarding best practices for hearing loss prevention with musicians. [12]
Playing a brass or woodwind instrument puts the musician at greater risk of inguinal hernia. [13] Woodwind instrumentalists, in rare cases, suffer a condition known as hypersensitivity pneumonitis , also referred to as saxophone lung, caused by Exophiala infection. It is held that this can occur if instruments are not cleaned properly. [14]
The risks for disc jockeys working in nightclubs with loud music include noise-induced hearing loss and tinnitus. [15] Nightclubs constantly exceed safe levels of noise exposure, with average sound levels ranging from 93.2 to 109.7 dB. [16] Constant music exposure creates temporary and permanent auditory dysfunction for professional disk jockeys, with average levels at 96 dB, which is above the level at which ear protection is mandatory for industry. Three-quarters of disk jockeys have tinnitus [17] and are at risk of tenosynovitis in the wrists and other limbs. Tenosynovitis results from staying in the same position over multiple gigs for scratching motion and cueing; this would be related to a repetitive strain injury. [18] Gigs can last 4–5 hours in nightlife and the hospitality industry; as a result there are potential complications of prolonged standing which include slouching, varicose veins, cardiovascular disorders, joint compression, and muscle fatigue. [19] [20] It is also common for other staff to experience these, such as bartenders and security staff.
The World Health Organization launched the Make Listening Safe initiative as part of the celebration of World Hearing Day on 3 March 2015. [21] WHO reviewed existing noise regulations for various entertainment sites – including clubs, bars, concert venues, and sporting arenas and released a global Standard for Safe Listening Venues and Events as part of World Hearing Day 2022.
A repetitive strain injury (RSI) is an injury to part of the musculoskeletal or nervous system caused by repetitive use, vibrations, compression or long periods in a fixed position. Other common names include repetitive stress injury, repetitive stress disorders, cumulative trauma disorders (CTDs), and overuse syndrome.
Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to acquire spoken language, and in adults it can create difficulties with social interaction and at work. Hearing loss can be temporary or permanent. Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss. In some people, particularly older people, hearing loss can result in loneliness.
Tinnitus is a condition when a person hears a ringing sound or a different variety of sound when no corresponding external sound is present and other people cannot hear it. Nearly everyone experiences faint "normal tinnitus" in a completely quiet room; but this is of concern only if it is bothersome, interferes with normal hearing, or is associated with other problems. The word tinnitus comes from the Latin tinnire, "to ring". In some people, it interferes with concentration, and can be associated with anxiety and depression.
Ototoxicity is the property of being toxic to the ear (oto-), specifically the cochlea or auditory nerve and sometimes the vestibular system, for example, as a side effect of a drug. The effects of ototoxicity can be reversible and temporary, or irreversible and permanent. It has been recognized since the 19th century. There are many well-known ototoxic drugs used in clinical situations, and they are prescribed, despite the risk of hearing disorders, for very serious health conditions. Ototoxic drugs include antibiotics, loop diuretics, and platinum-based chemotherapy agents. A number of nonsteroidal anti-inflammatory drugs (NSAIDS) have also been shown to be ototoxic. This can result in sensorineural hearing loss, dysequilibrium, or both. Some environmental and occupational chemicals have also been shown to affect the auditory system and interact with noise.
Sensorineural hearing loss (SNHL) is a type of hearing loss in which the root cause lies in the inner ear, sensory organ, or the vestibulocochlear nerve. SNHL accounts for about 90% of reported hearing loss. SNHL is usually permanent and can be mild, moderate, severe, profound, or total. Various other descriptors can be used depending on the shape of the audiogram, such as high frequency, low frequency, U-shaped, notched, peaked, or flat.
Hyperacusis is an increased sensitivity to sound and a low tolerance for environmental noise. Definitions of hyperacusis can vary significantly; it often revolves around damage to or dysfunction of the stapes bone, stapedius muscle or tensor tympani (eardrum). It is often categorized into four subtypes: loudness, pain, annoyance, and fear. It can be a highly debilitating hearing disorder.
Tinnitus retraining therapy (TRT) is a form of habituation therapy designed to help people who experience tinnitus—a ringing, buzzing, hissing, or other sound heard when no external sound source is present. Two key components of TRT directly follow from the neurophysiological model of tinnitus: Directive counseling aims to help the sufferer reclassify tinnitus to a category of neutral signals, and sound therapy weakens tinnitus-related neuronal activity.
Noise health effects are the physical and psychological health consequences of regular exposure to consistent elevated sound levels. Noise from traffic, in particular, is considered by the World Health Organization to be one of the worst environmental stressors for humans, second only to air pollution. Elevated workplace or environmental noise can cause hearing impairment, tinnitus, hypertension, ischemic heart disease, annoyance, and sleep disturbance. Changes in the immune system and birth defects have been also attributed to noise exposure.
Noise-induced hearing loss (NIHL) is a hearing impairment resulting from exposure to loud sound. People may have a loss of perception of a narrow range of frequencies or impaired perception of sound including sensitivity to sound or ringing in the ears. When exposure to hazards such as noise occur at work and is associated with hearing loss, it is referred to as occupational hearing loss.
Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion, or they can arise from making the same motions repeatedly, or from repeated exposure to force, vibration, or awkward posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities. Examples of MSDs include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tension neck syndrome, and hand-arm vibration syndrome.
Don't Lose the Music is a national campaign launched by the RNID, the charity representing the 9 million deaf and hard of hearing people in the UK.
Hearing conservation programs are programs that should reduce the risk of hearing loss due to hazardous noise exposure, if implemented correctly and with high quality. Hearing conservation programs require knowledge about risk factors such as noise and ototoxicity, hearing, hearing loss, protective measures to prevent hearing loss at home, in school, at work, in the military and, and at social/recreational events, and legislative requirements. Regarding occupational exposures to noise, a hearing conservation program is required by the Occupational Safety and Health Administration (OSHA) "whenever employee noise exposures equal or exceed an 8-hour time-weighted average sound level (TWA) of 85 decibels (dB) measured on the A scale or, equivalently, a dose of fifty percent." This 8-hour time-weighted average is known as an exposure action value. While the Mine Safety and Health Administration (MSHA) also requires a hearing conservation program, MSHA does not require a written hearing conservation program. MSHA's hearing conservation program requirement can be found in 30 CFR § 62.150, and is very similar to the OSHA hearing conservation program requirements. Therefore, only the OSHA standard 29 CFR 1910.95 will be discussed in detail.
Diplacusis, also known as diplacusis binauralis, binauralis disharmonica or interaural pitch difference (IPD), is a hearing disorder whereby a single auditory stimulus is perceived as different pitches between ears. It is typically experienced as a secondary symptom of sensorineural hearing loss, although not all patients with sensorineural hearing loss experience diplacusis or tinnitus. The onset is usually spontaneous and can occur following an acoustic trauma, for example an explosive noise, or in the presence of an ear infection. Sufferers may experience the effect permanently, or it may resolve on its own. Diplacusis can be particularly disruptive to individuals working within fields requiring acute audition, such as musicians, sound engineers or performing artists.
Occupational hearing loss (OHL) is hearing loss that occurs as a result of occupational hazards, such as excessive noise and ototoxic chemicals. Noise is a common workplace hazard, and recognized as the risk factor for noise-induced hearing loss and tinnitus but it is not the only risk factor that can result in a work-related hearing loss. Also, noise-induced hearing loss can result from exposures that are not restricted to the occupational setting.
Acoustic trauma is the sustainment of an injury to the eardrum as a result of a very loud noise. Its scope usually covers loud noises with a short duration, such as an explosion, gunshot or a burst of loud shouting. Quieter sounds that are concentrated in a narrow frequency may also cause damage to specific frequency receptors. The range of severity can vary from pain to hearing loss.
World Hearing Day is a campaign held each year by Office of Prevention of Blindness and Deafness of the World Health Organization (WHO). Activities take place across the globe and an event is hosted at the World Health Organization on March 3. The campaign's objectives are to share information and promote actions towards the prevention of hearing loss and improved hearing care. Any individual or organization can participate in various ways, by sharing campaign materials and organizing outreach actions. Examples are provided in the World Hearing Day annual activities reports. For participation to be recognized, one needs to register and report on their activity.
Occupational hazards in dentistry are occupational hazards that are specifically associated with a dental care environment. Members of the dental team, including dentists, hygienists, dental nurses and radiographers, must ensure local protocols are followed to minimize risk.
Causes of hearing loss include ageing, genetics, perinatal problems, loud sounds, and diseases. For some kinds of hearing loss the cause may be classified as of unknown cause.
Safe listening is a framework for health promotion actions to ensure that sound-related recreational activities do not pose a risk to hearing.
Computational audiology is a branch of audiology that employs techniques from mathematics and computer science to improve clinical treatments and scientific understanding of the auditory system. Computational audiology is closely related to computational medicine, which uses quantitative models to develop improved methods for general disease diagnosis and treatment.
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