1. Musicians and Hearing Loss: Comparison to a non-noise exposed population Incidence and Risk Factors Shanda Brashears-Morlet 1, Michael Santucci 2, Thierry G. Morlet 3 1 – Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, Louisiana 2 – Sensaphonics Hearing Conservation, Chicago, Illinois 3 – Auditory Physiology and Psychoacoustics Laboratory, Alfred I. duPont Hospital for Children, Wilmington, Delaware

2. Aims Examine the hearing of a large group of musicians as compared to a non-noise exposed normative population. Examine the hearing of a large group of musicians as compared to a non-noise exposed normative population. Determine the incidence of high frequency hearing loss. Determine the incidence of high frequency hearing loss. Analyze various risk factors for hearing loss among musicians. Analyze various risk factors for hearing loss among musicians.

3. Methods 1018 musicians completed tympanometry, audiometry and a case history / life styles survey. 1018 musicians completed tympanometry, audiometry and a case history / life styles survey. Those with conductive hearing loss, positive history for ototoxic meds, acoustic neuroma or significant exposure to noise other than music were eliminated from threshold and risk factor analysis leaving 887 subjects. Those with conductive hearing loss, positive history for ototoxic meds, acoustic neuroma or significant exposure to noise other than music were eliminated from threshold and risk factor analysis leaving 887 subjects.

4. Results 537 (52.8%) reported using hearing protections prior to participation 537 (52.8%) reported using hearing protections prior to participation 358 foam or rubber 358 foam or rubber 97 custom musicians’ plugs 97 custom musicians’ plugs 22 paper, cotton, or bar napkins 22 paper, cotton, or bar napkins 17 muffs or earphones 17 muffs or earphones 22 didn’t answer as to the type of protection 22 didn’t answer as to the type of protection 110 (10.8%) reported that they perceive they have a hearing loss as compared to 19.5% who actually did have a hearing loss 110 (10.8%) reported that they perceive they have a hearing loss as compared to 19.5% who actually did have a hearing loss

5. Musicians vs. Non-Musicians Musicians’ thresholds were compared to the ISO 7029:2000 standard for 250 – 8kHz. Musicians’ thresholds were compared to the ISO 7029:2000 standard for 250 – 8kHz. Musicians’ thresholds were consistently worse for all frequencies except 8000 Hz. Musicians’ thresholds were consistently worse for all frequencies except 8000 Hz. The largest difference between musicians’ thresholds and norms were for 2000, 3000, 4000 and 6000 Hz. The largest difference between musicians’ thresholds and norms were for 2000, 3000, 4000 and 6000 Hz.

6. Audiometric Configuration Comparison of men in their 20s N=415

7. Audiometric Configuration Comparison of men in their 30s N=263

8. Audiometric Configuration Comparison of men in their 40s N=145

9. Incidence of High Frequency Hearing Loss Among Musicians Minimal Hearing LossHearing LossNoise Notch % of men RE44.3 20.3 54.2 % of men LE58.2 34.8 66.5 % of women RE29.9 12.0 49.6 % of women LE28.3 10.8 45.0 Minimal high frequency hearing loss defined as any threshold above 1KHz of 20 dB HL or worse in either ear. Minimal high frequency hearing loss defined as any threshold above 1KHz of 20 dB HL or worse in either ear. High frequency hearing loss defined as any threshold above 1KHz of 30 dB HL or worse in either ear. High frequency hearing loss defined as any threshold above 1KHz of 30 dB HL or worse in either ear. High frequency noise notch defined as 10 dB or better thresholds one octave above and below any frequency above 1500 Hz in either ear, degree of hearing level not withstanding. High frequency noise notch defined as 10 dB or better thresholds one octave above and below any frequency above 1500 Hz in either ear, degree of hearing level not withstanding.

10. Incidence of Asymmetries and Tinnitus 39.0% of musicians had at least one frequency over 1500 Hz with thresholds 15 dB apart or more. 39.0% of musicians had at least one frequency over 1500 Hz with thresholds 15 dB apart or more. 60.0% reported at least occasional tinnitus. 60.0% reported at least occasional tinnitus. 77.1 % had at least one sign of hearing damage, either minimal hearing loss, noise notch, asymmetry and / or tinnitus. 77.1 % had at least one sign of hearing damage, either minimal hearing loss, noise notch, asymmetry and / or tinnitus.

11. Factors Impacted Hearing Status Age and gender seemed to have the biggest impact high frequency hearing loss (p<.005). Age and gender seemed to have the biggest impact high frequency hearing loss (p<.005). Years of experience independent of age was significant for the right ear (p=.018) and nearly so for the left (p=.060). Years of experience independent of age was significant for the right ear (p=.018) and nearly so for the left (p=.060). Hours / week of exposure (p=.087 right ear; p=.122 left ear) Hours / week of exposure (p=.087 right ear; p=.122 left ear) Right ears were better than left, but not significantly (p=.110). Right ears were better than left, but not significantly (p=.110). Prior use of hearing protection did have a positive effect on high frequency hearing (p=.116 right ear; p=.035 left ear). Prior use of hearing protection did have a positive effect on high frequency hearing (p=.116 right ear; p=.035 left ear).

12. Factors With No Apparent Effect The following factors did not appear to impact high frequency hearing: The following factors did not appear to impact high frequency hearing: genre (i.e. rock vs. classical vs. jazz), hours since exposure, use of headphones, family history, dizziness, diabetes, high blood pressure and use of tobacco, alcohol, caffeine, or aspirin. genre (i.e. rock vs. classical vs. jazz), hours since exposure, use of headphones, family history, dizziness, diabetes, high blood pressure and use of tobacco, alcohol, caffeine, or aspirin.

13. Factors Related to Hearing Those with an asymmetry had significantly worse thresholds than those with symmetrical hearing (p<.001 for right and left ears). Those with an asymmetry had significantly worse thresholds than those with symmetrical hearing (p<.001 for right and left ears). Similarly, the presence of a noise notch was associated with higher high frequency pure tone averages (p<.001 for right and left ears). Similarly, the presence of a noise notch was associated with higher high frequency pure tone averages (p<.001 for right and left ears). Surprisingly, those who reported tinnitus were not any more likely to have a hearing loss. Surprisingly, those who reported tinnitus were not any more likely to have a hearing loss.

14. Conclusions Musicians had poorer thresholds, especially at 3, 4 and 6K Hz than the ISO standard. Musicians had poorer thresholds, especially at 3, 4 and 6K Hz than the ISO standard. A noise notch effect was seen in all age groups and became more pronounced with age. A noise notch effect was seen in all age groups and became more pronounced with age. The incidence of hearing loss was high, but comparable with previous studies such as Axelsson et al. (1995) and Kaharit et al. (2003). The incidence of hearing loss was high, but comparable with previous studies such as Axelsson et al. (1995) and Kaharit et al. (2003). The factors which had the most apparent effect on hearing status were age, gender, years of experience, hours / week of exposure, and prior use of hearing protectors. The factors which had the most apparent effect on hearing status were age, gender, years of experience, hours / week of exposure, and prior use of hearing protectors.

15. References Axelsson A, Eliasson A, Israelsson, B. (1995) Hearing in pop-rock musicians: A follow-up study. Ear Hear 16(3):245-254. Axelsson A, Eliasson A, Israelsson, B. (1995) Hearing in pop-rock musicians: A follow-up study. Ear Hear 16(3):245-254. Kaharit K, Zachau G, Eklof M, Sandsjo L, Moller C. (2003) Assessment of hearing and hearing disorders in rock/jazz musicians. Int J Audiol 42(5):279-88. Kaharit K, Zachau G, Eklof M, Sandsjo L, Moller C. (2003) Assessment of hearing and hearing disorders in rock/jazz musicians. Int J Audiol 42(5):279-88. This study was funded by Shure Inc. This study was funded by Shure Inc. Thank you to …. and all the staff of Sensaphonics Hearing Conservation Thank you to …. and all the staff of Sensaphonics Hearing Conservation Additional thanks to Charles Berlin, Linda Hood, and Bronya Keats of the Kresge Hearing Research Lab Additional thanks to Charles Berlin, Linda Hood, and Bronya Keats of the Kresge Hearing Research Lab Acknowledgements