Health problems of musicians

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Musicians can experience a number of health problems related to the practice and performance of music. The differences in career paths, occupations and performance scenarios are some of the determinants of a wide range of possible health effects.

Contents

Health conditions

The most common injury type suffered by musicians is repetitive strain injury (RSI). A survey of orchestral performers found that 64–76% had significant RSIs. [1] Other types of musculoskeletal disorders, such as carpal tunnel syndrome and focal dystonia, are also common. [2] [3]

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. [8]

There is little consistency across the hearing healthcare sector with respect to the care of musicians' hearing and the provision of hearing protection. [9] However, the American Academy of Audiology has published a consensus document regarding best practices for hearing loss prevention with musicians. [10]

Playing a brass or woodwind instrument puts the musician at greater risk of inguinal hernia. [11] 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. [12]

The risks for DJs working in nightclubs with loud music include noise-induced hearing loss and tinnitus. [13] Nightclubs constantly exceed safe levels of noise exposure, with average sound levels ranging from 93.2 to 109.7 dB. [14] Constant music exposure creates temporary and permanent auditory dysfunction for professional DJs, with average levels at 96 dB, which is above the level at which ear protection is mandatory for industry. Three-quarters of DJs have tinnitus [15] 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. [16] 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. [17] [18] 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. [19] 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.

See also

Related Research Articles

<span class="mw-page-title-main">Disc jockey</span> Person who plays recorded music for an audience

A disc jockey, more commonly abbreviated as DJ, is a person who plays recorded music for an audience. Types of DJs include radio DJs, club DJs, mobile DJs, and turntablists. Originally, the "disc" in "disc jockey" referred to shellac and later vinyl records, but nowadays DJ is used as an all-encompassing term to also describe persons who mix music from other recording media such as cassettes, CDs or digital audio files on a CDJ, controller, or even a laptop. DJs may adopt the title "DJ" in front of their real names, adopted pseudonyms, or stage names.

<span class="mw-page-title-main">Hearing loss</span> Partial or total inability to hear

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 variety of sound that is heard when no corresponding external sound is present. Nearly everyone experiences faint "normal tinnitus" in a completely quiet room; but it 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.

<span class="mw-page-title-main">Sensorineural hearing loss</span> Hearing loss caused by an inner ear or vestibulocochlear nerve defect

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.

An otoacoustic emission (OAE) is a sound that is generated from within the inner ear. Having been predicted by Austrian astrophysicist Thomas Gold in 1948, its existence was first demonstrated experimentally by British physicist David Kemp in 1978, and otoacoustic emissions have since been shown to arise through a number of different cellular and mechanical causes within the inner ear. Studies have shown that OAEs disappear after the inner ear has been damaged, so OAEs are often used in the laboratory and the clinic as a measure of inner ear health.

Hyperacusis is an increased sensitivity to sound and a low tolerance for environmental noise. Definitions of hyperacusis can vary significantly, but 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.

<span class="mw-page-title-main">Health effects from noise</span> Health consequences of exposure to elevated sound levels

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.

Listener fatigue is a phenomenon that occurs after prolonged exposure to an auditory stimulus. Symptoms include tiredness, discomfort, pain, and loss of sensitivity. Listener fatigue is not a clinically recognized state, but is a term used by many professionals. The cause for listener fatigue is still not yet fully understood it is thought to be an extension of the quantifiable psychological perception of sound. Common groups at risk of becoming victim to this phenomenon include avid listeners of music and others who listen or work with loud noise on a constant basis, such as musicians, construction workers and military personnel.

<span class="mw-page-title-main">Noise-induced hearing loss</span> Medical condition

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.

Don't Lose the Music is a national campaign launched by RNID, the charity representing the 9 million deaf and hard of hearing people in the UK.

<span class="mw-page-title-main">Hearing conservation program</span>

Hearing conservation programs are designed to prevent hearing loss due to noise. 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.

Auditory fatigue is defined as a temporary loss of hearing after exposure to sound. This results in a temporary shift of the auditory threshold known as a temporary threshold shift (TTS). The damage can become permanent if sufficient recovery time is not allowed before continued sound exposure. When the hearing loss is rooted from a traumatic occurrence, it may be classified as noise-induced hearing loss, or NIHL.

<span class="mw-page-title-main">Occupational hearing loss</span> Form of hearing loss

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.

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.

<span class="mw-page-title-main">Safe listening</span> Avoiding hearing damage from intentionally heard sounds

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.

References

  1. ↑ Mitchell T (2010). Longyear S (ed.). "A painful melody: repetitive strain injury among musicians" (PDF). Pittsburg State University.
  2. 1 2 Heinan M (April 2008). "A review of the unique injuries sustained by musicians". JAAPA. 21 (4): 45–6, 48, 50 passim. doi:10.1097/01720610-200804000-00015. PMID   18468369. S2CID   36408486.
  3. ↑ Blanco-Piñeiro, Patricia; Díaz-Pereira, M. Pino; Martínez, Aurora (2017). "Musicians, postural quality and musculoskeletal health: A literature's review". Journal of Bodywork and Movement Therapies. 21 (1): 157–172. doi:10.1016/j.jbmt.2016.06.018. ISSN   1532-9283. PMID   28167172.
  4. ↑ https://www.audiology.org/sites/default/files/publications/resources/Musicians%20Consensus%20Doc_Final_1.23.20.pdf
  5. ↑ Kardous CA, Themann CL, Morata TC, Reynolds J, Afanuh S (2015). "Workplace Solutions: Reducing the Risk of Hearing Disorders among Musicians" (PDF). National Institute for Occupational Safety and Health. Retrieved 12 July 2016.
  6. ↑ Behar A, Chasin M, Mosher S, Abdoli-Eramaki M, Russo FA (2018). "Noise exposure and hearing loss in classical orchestra musicians: A five-year follow-up". Noise & Health. 20 (93): 42–46. doi: 10.4103/nah.NAH_39_17 (inactive 31 January 2024). PMC   5926315 . PMID   29676294.{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link)
  7. ↑ Di Stadio, Arianna; Dipietro, Laura; Ricci, Giampietro; Della Volpe, Antonio; Minni, Antonio; Greco, Antonio; de Vincentiis, Marco; Ralli, Massimo (2018). "Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review". International Journal of Environmental Research and Public Health. 15 (10): 2120. doi: 10.3390/ijerph15102120 . ISSN   1660-4601. PMC   6209930 . PMID   30261653.
  8. ↑ Rodríguez-Lozano FJ, Sáez-Yuguero MR, Bermejo-Fenoll A (September 2011). "Orofacial problems in musicians: a review of the literature". Medical Problems of Performing Artists. 26 (3): 150–6. doi:10.21091/mppa.2011.3024. PMID   21987070.
  9. ↑ McGinnity, Siobhan; Beach, Elizabeth Francis; Mulder, Johannes; Cowan, Robert (2018). "Caring for musicians' ears: insights from audiologists and manufacturers reveal need for evidence-based guidelines". International Journal of Audiology. 57 (sup1): S12–S19. doi:10.1080/14992027.2017.1405288. ISSN   1708-8186. PMID   29192525. S2CID   24276596.
  10. ↑ "Musicians and Music Industry". Audiology. 19 November 2019. Retrieved 13 October 2020.
  11. ↑ Okoshi, Kae; Minami, Taro; Masahiro, Kikuchi; Tomizawa, Yasuko (2017). "Musical Instrument-Associated Health Issues and Their Management". The Tohoku Journal of Experimental Medicine. 243 (1): 49–56. doi: 10.1620/tjem.243.49 . PMID   28931767 . Retrieved 31 December 2020.
  12. ↑ Lallanilla M (8 November 2013). "What Is Saxophone Lung?". Live Science. Retrieved 16 January 2017.
  13. ↑ Potier, M.; Hoquet, C.; Lloyd, R.; Nicolas-Puel, C.; Uziel, A.; Puel, J. L. (2009). "The risks of amplified music for disc-jockeys working in nightclubs". Ear and Hearing. 30 (2): 291–3. doi:10.1097/AUD.0b013e31819769fc. PMID   19194290. S2CID   21433591.
  14. ↑ Santos, L.; Morata, T. C.; Jacob, L. C.; Albizu, E.; Marques, J. M.; Paini, M. (2007). "Music exposure and audiological findings in Brazilian disc jockeys (DJS)". International Journal of Audiology. 46 (5): 223–31. doi:10.1080/14992020601188575. PMID   17487670. S2CID   41798256.
  15. ↑ Bray, A.; Szymański, M.; Mills, R. (2004). "Noise induced hearing loss in dance music disc jockeys and an examination of sound levels in nightclubs". The Journal of Laryngology and Otology. 118 (2): 123–8. doi:10.1258/002221504772784577. PMID   14979949. S2CID   19542748.
  16. ↑ Suttle, A. L.; Wallace, E. A. (2011). "Disc jockey tenosynovitis". The American Journal of Medicine. 124 (4): e1. doi:10.1016/j.amjmed.2010.09.025. PMID   21435409.
  17. ↑ Waters, T. R.; Dick, R. B. (2015). "Evidence of health risks associated with prolonged standing at work and intervention effectiveness". Rehabilitation Nursing. 40 (3): 148–65. doi:10.1002/rnj.166. PMC   4591921 . PMID   25041875.
  18. ↑ Bahk, J. W.; Kim, H.; Jung-Choi, K.; Jung, M. C.; Lee, I. (2012). "Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men". Ergonomics. 55 (2): 133–9. doi:10.1080/00140139.2011.582957. PMID   21846281. S2CID   6791057.
  19. ↑ Shrivastava, SaurabhR; Shrivastava, PrateekS; Ramasamy, Jegadeesh (2015). "Joining hands with World Health Organization initiative Make Listening Safe". Noise and Health. 17 (76): 173–174. doi: 10.4103/1463-1741.155854 . ISSN   1463-1741. PMC   4918650 . PMID   25913558.
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