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Sound level measurements in music practice rooms
Abstract
A B S T R A C T Average sound levels and percentage of daily dose of noise expo- sure were measured in the practice rooms of a university school of music, with the primary objective of determining whether sound levels in student practice rooms were high enough to warrant concern for hearing conservation. A secon- dary objective was to determine whether any instrument group was at higher risk for music-induced hearing loss due to exposure levels. Students represent- ing 4 instrument groups were tested: brass, wind, string and voice. Measure- ments were taken using a dosimeter or DoseBadge clipped to the shoulder dur- ing 40 students' individual practice sessions. These readings provided average exposure levels as well as the percentage of total allowed exposure (dose) ob- tained during the practice session. The mean measurement time for this study was 47 minutes (SD = 22). Mean sound levels measured averaged 87-95 dB(A) (SD = 3.5-5.9). Mean average levels for the brass players were significantly higher than other instrument groups. Using the mean duration of daily practice reported by the participants to estimate dose, 48% would exceed the allowable sound exposure. Implications for professional musicians are discussed, includ- ing the need for 12-hour breaks and the use of musicians' earplugs. The im- plementation of a Hearing Protection Policy in the School of Music will also be discussed.
... However, maximum SPLs for musicians can be considerably higher, ranging from 83 to 112 dBA [17]. Similarly, Phillips and Mace [18] reported that college music students and faculty are typically exposed to SPLs between 80 and 104.5 dBA. ...
... Regarding sound exposure, Redman et al. [28] found that six out of eight voice teachers experience sound doses exceeding NIOSH recommendations. For vocal performance students not in choral settings, Phillips and Mace [18] reported noise doses of 88.4 dBA. These findings underscore the need for further research and preventative measures to protect the hearing health of vocal performers and teachers. ...
... The current literature exploring music exposure and MIHDs among vocal performers predominately centers on choral (or group) singing, with fewer studies delving into the effects of voice teaching or solo singing, respectively. Despite the discrepancy in volume of research, the current literature has revealed that vocal performers, like their instrumentalist counterparts, and regardless of the context, have an increased risk for MIHDs due to consistent music exposure [10,18,[25][26][27][28]30]. However, a gap remains in our understanding of how music exposure affects vocal performers' auditory system over an extended period. ...
The effects of music exposure on vocal performers remain relatively unknown. This study aimed to assess the immediate and long-term effects of music and singing practice on the peripheral auditory system of vocal performers using otoscopy, pure-tone audiometry, and noise dosimetry. The hearing status, sound pressure levels (SPLs), and sound doses of 12 vocal performers with normal hearing at the study’s onset were evaluated. Pre- and post-study questionnaires regarding the participants’ otologic health and music-making activities, as well as repeated hearing evaluations, were implemented. Additionally, noise dosimetry was conducted on each participant’s most vocally active day of the week. Audiometric assessments generally revealed normal hearing thresholds, with some exceptions. Half of the participants exhibited elevated low-frequency thresholds and over half of the participants displayed emerging audiometric “notches” at 6000 Hz. Noise dosimetry measurements indicated that most of the participants were consistently exposed to SPLs during music-making activities that exceeded recommended limits. Questionnaire responses highlighted that the participants often engaged in extra-curricular music-making activities, frequently with piano accompaniment, and with little to no use of hearing protection devices. A few of the participants reported histories of otologic issues and potential hearing problems.
... Abstract: Objectives: (1) To measure sound exposures of marching band and non-marching band students during a football game, (2) to compare these to sound level dose limits set by NIOSH,and (3) to assess the perceptions of marching band students about their hearing health risk from loud sound exposure and their use of hearing protection devices (HPDs). Methods: Personal noise dosimetry was completed on six marching band members and the band director during rehearsals and performances. ...
... High sound exposure among collegiate student musicians can exceed the recommended exposure limits specified by the National Institute for Occupational Safety and Health [1] on a daily basis [2][3][4][5][6][7][8]. Most of the hazardous sound exposure among these musicians occurs during rehearsals, individual practice, and other music activities [2,4,5,7]. ...
... Considering the popularity of marching band and drum corps-particularly in high schools and universities-and the dearth of research on sound exposure and hearing health-related knowledge among marching band members, it is important to examine the sound exposure levels experienced by this type of musician during the performances, as well as their perception of hearing health risk. The purposes of this study were (1) to measure sound exposure of marching band and non-marching band students during a football game, (2) to compare these to sound level dose limits set by NIOSH, and (3) to assess the perceptions of marching band students about their hearing health risk from loud sound exposure and their use of hearing protection. ...
Objectives:
(1) To measure sound exposures of marching band and non-marching band students during a football game, (2) to compare these to sound level dose limits set by NIOSH, and (3) to assess the perceptions of marching band students about their hearing health risk from loud sound exposure and their use of hearing protection devices (HPDs).
Methods:
Personal noise dosimetry was completed on six marching band members and the band director during rehearsals and performances. Dosimetry measurements for two audience members were collected during the performances. Noise dose values were calculated using NIOSH criteria. One hundred twenty-three marching band members responded to a questionnaire analyzing perceptions of loud music exposure, the associated hearing health risks, and preventive behavior.
Results:
Noise dose values exceeded the NIOSH recommended limits among all six marching band members during rehearsals and performances. Higher sound levels were recorded during performances compared to rehearsals. The audience members were not exposed to hazardous levels. Most marching band members reported low concern for health effects from high sound exposure and minimal use of HPDs.
Conclusion:
High sound exposure and low concern regarding hearing health among marching band members reflect the need for comprehensive hearing conservation programs for this population.
... Recent studies have included measuring sound pressure levels (SPL) and/or administering audiometric tests with professional classical instrumentalists and classical instrumental music students in performance, rehearsal, or practice. 26,[31][32][33][34][35][36] Other recent studies have included music teachers in schools and universities 5,9,21,30,37 and some of these have focused primarily on vocalists and vocal ensembles. 10,[38][39][40][41] Studies of music instructors that include voice instructors report audiometric evaluations and noise measurements. ...
... 10,37,42 Overall, studies that investigate the audiologic status of musicians support the hypothesis that a musician's working environment may contribute to greater hearing loss than the general nonmusician public or study control groups. 10,36,39 Isaac et al 10 reported that when controlling for age, years as a voice teacher is a statistically significant predictor of high frequency hearing loss. Other studies have found that most music teachers are exposed to excessive sound levels during their teaching periods, but it is undetermined whether these levels are at or above the Recommended Exposure Limit and what impact this may have. ...
... It has been recommended that future studies integrate measurements that include reverberation times, background noise of the classrooms, and voice use and hearing assessments, to capture a more complete understanding of the occupational environment. 9,30,36,43 The aim of this study is to provide an objectively informed representation of voice teachers' working environment, which research has shown may affect changes in voice and hearing. An additional goal of this study is to communicate the status of these parameters so that teachers can make informed decisions about improving their environment and conserving their health. ...
Purpose
Vocal instructors during their normal workday are exposed to high noise levels that can affect their voice and hearing health. The goal of this study was to evaluate the voice and hearing status of voice instructors before and after lessons and relate these evaluations with voice and noise dosimetry taken during lessons.
Methods
Eight voice instructors volunteered to participate in the study. The protocol included (1) questionnaires, (2) pre/post assessment of voice quality and hearing status, and (3) voice and noise dosimetry during lessons. Acoustic measurements were taken of the unoccupied classrooms.
Results
In six of eight classrooms, the measured noise level was higher than the safety recommendations set by National Institute for Occupational Safety and Health. The background noise level and the reverberation time in the classrooms were in compliance with the national standard recommendations. We did not find a clear pattern comparing pre- and post-measurements of voice quality consistent among genders. In all subjects, the Sound Pressure Levels mean increased, and the standard deviation of fundamental frequency decreased indicating association to vocal fatigue. Previous studies link these changes to increasing vocal fatigue. The audiometric results revealed seven out of eight instructors have sensorineural hearing loss.
Conclusions
The interaction of the acoustic space and noise levels can contribute to the development of hearing and voice disorders for voice instructors. If supported by larger sample size, the results of this pilot study could justify the need for a hearing and voice conservation program for music faculty.
... Professional musicians might begin their training at a young age, in most cases with personal classes. Subsequently, students integrate into secondary schools and higher education schools that provide additional musical education and, consequently, are exposed to loud music in the course of individual classes and ensembles, over a broad range of hours weekly and over several years (Yoshimura et al., 2006;Miller et al., 2007;Phillips & Mace, 2008). Further, long hours of practice at home and other activities outside of the school may increase students' sound levels exposure. ...
... Further, long hours of practice at home and other activities outside of the school may increase students' sound levels exposure. In fact, despite the importance of years of experience in the development of MIHL (Hoffman et al., 2006), few studies exist in that area that indicate that students are exposed to high sound levels, for a long time per week, and thus are at risk for MIHL Miller et al., 2007;Phillips and Mace, 2008;Phillips et al. 2010;Gopal et al. 2013). This may exert an important impact on students' future career as musicians. ...
... The results of this study showed that sound pressure levels during classes with instrument practice are significantly high in both music styles, exposing students to harmful noise levels during daily practice. These findings are in agreement with previous studies in school settings (Phillips and Mace, 2008). Further, the sound pressure levels found in this study are comparable to the sound levels observed for professional musicians for rehearsals and performances (Laitinen et al., 2003;Lee et al., 2005;MacDonald et al., 2008;O'Brien et al., 2008;Rodrigues et al., 2013;. ...
It is well recognized that professional musicians are at risk of hearing damage due to the exposure to high sound pressure levels during ensemble music playing. However, it is important to recognize that the musicians’ exposure may start early in the course of their training as students in the classroom and at home. Studies regarding sound exposure of music students and their hearing disorders are scarce and do not take into account important influencing variables. Therefore, this study aimed to describe sound level exposures of music students at different music styles, classes, and according to the instrument played. Further, this investigation attempted to analyze the perceptions of students in relation to exposure to loud music and consequent health risks, as well as to characterize preventive behaviors. The results showed that music students are exposed to high sound levels in the course of their academic activity. This exposure is potentiated by practice outside the school and other external
activities. Differences were found between music style, instruments, and classes. Tinnitus, hyperacusis, diplacusis, and sound distortion were reported by the students. However, students were not entirely aware of the health risks related to exposure to high sound pressure levels. These findings reflect the importance of starting intervention in relation to noise risk reduction at an early stage, when musicians are commencing their activity as students.
... There are some studies performed to investtigate the noise exposure of musicians according to their instruments. Phillips et al. (2008) carried out an assessment of the noise exposure level for music students in practice rooms [20]. The results implied that the students were exposed to different levels of noises depending to the instrument. ...
... There are some studies performed to investtigate the noise exposure of musicians according to their instruments. Phillips et al. (2008) carried out an assessment of the noise exposure level for music students in practice rooms [20]. The results implied that the students were exposed to different levels of noises depending to the instrument. ...
... The results implied that the students were exposed to different levels of noises depending to the instrument. For example, students played brass were exposed to the level of 95.2 dBA, string to 87.0 dBA, woodwind to 90.4 dBA, and percussion to 90.1 dBA [20]. Other studies for student musicians showed that the students were usually exposed to the noise exceeding 100 of does. ...
Noise is known that the physical risk factors defined as any unwanted sound. It can induce the health problems such as hearing loss or annoyance. The objective of this study was to assess the occupational noise exposure of nine groups for twenty peoples according to job characteristics and to compare the noise level by different variables. Personal noise levels were measured for three times using by dosimeters for each participant in Korea. The mean time weighted average noise level (TWA) of total was 73.2 ± 11.5 dBA by American conference of governmental industrial hygienists (ACGIH) standard. Especially, Korean classical music students were highly exposed to 93.2 ± 6.2 dBA but, office workers were 63.2 ± 6.6 dBA. In case of peak sound pressure level (Lpeak), Korean classical music students and firefighters were exposed to the highest level of 151.8 dBC and 145.8 dBC during playing and dispatching, respectively. The analysis of noise level showed that Leq had positive correlations between TWA by ministry of employment and labour (MOEL) (r = 0.98, p < 0.01) and TWA by ACGIH (r = 0.98, p < 0.01). Unlikely other groups, the noise exposure level of the Korean classical music students were exceeded the ACGIH standard. These results suggest that Korean classical music students were exposed high noise level and some solutions are need to reduce the noise exposure level such as using hearing protect device.
... However, some studies provide evidence that students of academies of music, similarly to professional musicians, are often exposed to sound at high levels (above 85 dBA) creating a risk of hearing impairment [15][16][17][18]. This is demonstrated both by the results of sound pressure level measurements during individual and collective classes and the attempts to evaluate the daily exposure based on fullday measurements using noise dosimeters, involving a typical schedule of students' classes [19][20][21]. ...
... In turn, Phillips and Mace [19] measured sound pressure levels (SPLs) among music students during individual classes in specially prepared rooms and found that singers and brass, wind and string players were exposed to averaged sound pressure levels of 87-95 dB-whereas, according to the data collected in this study the A-weighted equivalent continuous sound pressure levels during individual playing remained in the range from 81 to 98 dB (10-90th percentile range). ...
The objective of this study was to assess the hearing of music students in relation to their exposure to excessive sounds. A standard pure-tone audiometry, transient-evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were determined in 163 students of music academies, aged 22.8 ± 2.6 years. A questionnaire survey and sound pressure level measurements during solo and group playing were also conducted. The control group comprised 67 subjects, mainly non-music students, aged 22.8 ± 3.3 years. Study subjects were exposed to sounds at the A-weighted weekly noise exposure level (LEX,w) from 75 to 106 dB. There were no significant differences in the hearing thresholds between groups in the frequency range of 4000–8000 Hz. However, music students compared to control group exhibited lower values of DPOAE amplitude (at 6000 and 7984 Hz) and signal-to-noise ratio (SNR) (at 984, 6000, and 7984 Hz) as well as SNR of TEOAE (in 1000 Hz band). A significant impact of noise exposure level, type of instrument, and gender on some parameters of measured otoacoustic emissions was observed. In particular, music students having LEX,w ³ 84.9 dB, compared to those with LEX,w < 84.9 dB, achieved significantly lower DPOAE amplitude at 3984 Hz. Meanwhile, both TEOAE and DPOAE results indicated worse hearing in students playing percussion instruments vs. wind instruments, and wind instrument players vs. students playing stringed instruments.
... The American National Institute for Occupational Safety and Health [7] and the Canadian Centre for Occupational Health and Safety [8] recommend no more than eight-hours' exposure at 85dB(A) and they suggest that for every increase of three dB, the time limit for exposure be reduced by half [9]. Sound exposure measurements in musicians have confirmed levels over 85 dBA, either in the sound level produced by specific musical instruments or by the orchestra [10][11][12][13][14][15][16]. These studies have concluded that musicians are at risk for hearing loss due to the potentially noxious levels of sound exposure present in their working environment. ...
... These results are consistent with studies such as Schmidt and colleagues [6], which found no asymmetrical hearing losses. However, other studies have shown that asymmetrical hearing loss is common, usually with more loss in the left ear [14,49,50]. Many studies with musicians have found a link between this asymmetry and the instrument played: larger hearing loss in the left ear were found with violinists [23, 42-44, 51, 52], while larger hearing loss of the right ear was found among flautists [20,44], French horn players [20] and piccolo players [51]. ...
This study examined the hearing sensitivity of university music students (N = 53) and a control group (N = 54) between the
ages of 17 and 31. The two groups were compared for differences in hearing threshold levels, incidence of hearing loss
described by pure-tone average levels, and incidences of notches at 3, 4 or 6 kHz. Survey data were also used to explore
relationships between hearing sensitivity and gender, age, music lesson starting age, musical instruments played, number of
years playing that instrument, instrument type, use of hearing protection and personal music device listening time. No
significant differences in hearing threshold levels between the two groups was found. Overall prevalence of notches was
1.9% for music students versus 9.3% for the control group using the Niskar (2001) algorithm, or 20.8% for music students
versus 31.5% for controls using the Coles (2000) algorithm. Both algorithms identified more controls with notches, although
the difference between the two groups was not significant. Music students who use hearing protection had significantly more
incidences of notches, and there was a weak correlation found between hearing sensitivity and age. The other survey
parameters studied showed very little or no relationship with hearing sensitivity. The results do not show any increased
incidence of hearing loss among university music students as compared to a control group. However this does not imply that
music students are not at risk of hearing loss. It is possible that the measurement tools were not sufficiently sensitive to detect
early stages of hearing loss or that the effect of the exposure to music instrument playing will manifest itself a few years later.
... What is more, music students are not covered by the same regulatory framework as employees. For example, Phillips and Mace [13] have measured sound pressure levels (SPLs) among students of a University School of Music in USA and found that singers and brass, wind and string players during individual music classes were exposed to sounds at averaged A-weighted SPLs of 87−95 dB. Such levels are comparable to those measured in professional orchestral musicians [14−17]. ...
... Moreover, there were no significant differences between the standardized hearing threshold levels (relative to the non-noise-exposed population) at 4000 Hz, 6000 Hz and 8000 Hz between both groups, while SHTLs in the frequency range of 500-3000 Hz were lower in the music students compared to the control group, i.e., closer to hearing threshold levels in the highly screened otologically normal non-noise-exposed population. Furthermore, actual hearing loss in the music students was significantly higher (worse) than that predicted from the sound exposure level (according to ISO 1999ISO :2013 concerning young musicians and professional orchestral musicians [13][14][15][16][17]. ...
Objectives:
The aim of this study was to assess hearing of music students in relation to their exposure to excessive sounds.
Material and methods:
Standard pure-tone audiometry (PTA) was performed in 168 music students, aged 22.5±2.5 years. The control group included 67 subjects, non-music students and non-musicians, aged 22.8±3.3 years. Data on the study subjects' musical experience, instruments in use, time of weekly practice and additional risk factors for noise-induced hearing loss (NIHL) were identified by means of a questionnaire survey. Sound pressure levels produced by various groups of instruments during solo and group playing were also measured and analyzed. The music students' audiometric hearing threshold levels (HTLs) were compared with the theoretical predictions calculated according to the International Organization for Standardization standard ISO 1999:2013.
Results:
It was estimated that the music students were exposed for 27.1±14.3 h/week to sounds at the A-weighted equivalent-continuous sound pressure level of 89.9±6.0 dB. There were no significant differences in HTLs between the music students and the control group in the frequency range of 4000-8000 Hz. Furthermore, in each group HTLs in the frequency range 1000-8000 Hz did not exceed 20 dB HL in 83% of the examined ears. Nevertheless, high frequency notched audiograms typical of the noise-induced hearing loss were found in 13.4% and 9% of the musicians and non-musicians, respectively. The odds ratio (OR) of notching in the music students increased significantly along with higher sound pressure levels (OR = 1.07, 95% confidence interval (CI): 1.014-1.13, p < 0.05). The students' HTLs were worse (higher) than those of a highly screened non-noise-exposed population. Moreover, their hearing loss was less severe than that expected from sound exposure for frequencies of 3000 Hz and 4000 Hz, and it was more severe in the case of frequency of 6000 Hz.
Conclusions:
The results confirm the need for further studies and development of a hearing conservation program for music students. Int J Occup Med Environ Health 2017;30(1):55-75.
... Our results may be valid for the entire hearing frequency range as there is no known report in the literature suggesting that the ESRRb expression and functioning are different across the length of the cochlea. Previous research has shown that 48% of music students exceed the allowable sound level during daily practice sessions, and almost all of the music students are exposed to damaging sound levels on a regular basis (Phillips & Mace, 2008). Musicians with the CT genotype may acquire more TTS following their routine music exposure and/or recover slowly from TTS compared to musicians with the CC genotype, and subsequently may acquire audiometric notch phenotype. ...
... Recovery from noise exposure can be lengthier if the inefficient ESRRb protein is slower in responding to the cellular redox state. Our participants were music students, and almost all of them were exposed to high sound intensities on a regular basis (Phillips & Mace, 2008). We instructed our participants to avoid exposure to loud sounds for at least 12 hours before the data collection session. ...
Objective:
A non-synonymous single nucleotide polymorphism (rs61742642; C to T, P386S) in the ligand-binding domain of human estrogen-related receptor beta (ESRRβ) showed possible association to noise-induced hearing loss (NIHL) in our previous study.
Design:
This study was conducted to examine the effect of the ESRRβ rs61742642 T variant on temporary threshold shift (TTS). TTS was induced by 10 minutes of exposure to audiometric narrow-band noise centered at 2000 Hz. Hearing thresholds and distortion product otoacoustic emissions input output function (DP IO) at 2000, 3000, and 4000 Hz were measured before and after the noise exposure.
Study sample:
Nineteen participants with rs61742642 CT genotype and 40 participants with rs61742642 CC genotype were recruited for the study.
Results:
Participants with the CT genotype acquired a significantly greater TTS without convincing evidence of greater DP IO temporary level shift (DPTLS) compared to participants with the CC genotype.
Conclusion:
The results indicated that the ESRRβ polymorphism is associated with TTS. Future studies were recommended to explore molecular pathways leading to increased susceptibility to NIHL.
... Music researchers have collected sound exposure data using a variety of brands of noise dosimeters including Brüel & Kjaer, Larson Davis, Quest, Cassella, Cirrus doseBadge, Quest Edge and Etymotic. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Noise dosimeters that conform to ANSI S1. and are designated a type 2 noise dosimeter range in cost from $1500 to $4000. This high cost could deter music schools from purchasing a noise dosimeter and thus taking sound level measurements. ...
... Thomas' activities that day included a 3-h solo saxophone rehearsal session in a practice room. This result appears consistent with fi ndings from the Phillips & Mace study [23] in which mean sound pressure levels in university practice rooms were 87-95 dB(A). Future studies might investigate varying acoustic properties of practice rooms and what impact if any the acoustics play on noise doses. ...
This study investigated the accuracy, reliability, and characteristics of three brands of personal noise dosimeters (N = 7 units) in both pink noise (PN) environments and natural environments (NEs) through the acquisition of decibel readings, Leq readings and noise doses. Acquisition periods included repeated PN conditions, choir room rehearsals and participant (N = 3) Leq and noise dosages procured during a day in the life of a music student. Among primary results: (a) All dosimeters exhibited very strong positive correlations for PN measurements across all instruments; (b) all dosimeters were within the recommended American National Standard Institute (ANSI) SI.25-1991 standard of ±2 dB (A) of a reference measurement; and (c) all dosimeters were within the recommended ANSI SI.25-1991 standard of ±2 dB (A) when compared with each other. Results were discussed in terms of using personal noise dosimeters within hearing conservation and research contexts and recommendations for future research. Personal noise dosimeters were studied within the contexts of PN environments and NEs (choral classroom and the day in the life of collegiate music students). This quantitative study was a non-experimental correlation design. Three brands of personal noise dosimeters (Cirrus doseBadge, Quest Edge Eg5 and Etymotic ER200D) were tested in two environments, a PN setting and a natural setting. There were two conditions within each environment. In the PN environment condition one, each dosimeter was tested individually in comparison with two reference measuring devices (Ivie and Easera) while PN was generated by a Whites Instrument PN Tube. In condition two, the PN procedures were replicated for longer periods while all dosimeters measured the sound levels simultaneously. In the NE condition one, all dosimeters were placed side by side on a music stand and recorded sound levels of choir rehearsals over a 7-h rehearsal period. In NE, condition two noise levels were measured during a day in the life of college music students. Three participants each wore two types of dosimeters for an 8-h period during a normal school day. Descriptive statistical analyzes including means, standard deviation and Pearson product-moment correlation. The primary finding is that the dosimeters in this study recorded results within ±2 dB of either a reference measurement or within dosimeters in all four conditions examined. All dosimeters studied measured steady noise source accurately and consistently, with strong positive correlations across all instruments. Measurements acquired during choral rehearsals indicated a maximum of 1.5 dB difference across dosimeters. The Etymotic research personal noise dosimeters (ER200D) could provide individuals and schools of music with a relatively inexpensive tool to monitor sound doses. Findings from this study suggest that the three brands of dosimeters tested will provide reliable Leq levels and hearing dosages in both PN and natural settings.
... A drop in hearing sensitivity, often called a 'notch,' in the audiometric configuration between 3000–6000 Hz, characterizes NIHL. The loss is often asymmetric, usually with more loss in the left ear than the right ear (McBride & Williams, 2001; Nageris et al, 2007; Phillips et al, 2008). The operational definitions of NIHL reported in prevalence studies are variable. ...
... It may be that the sound exposures for these groups are low enough that those musicians who sustain a loss in these groups tend to be those who are predisposed; and hence they tend to show a bilateral loss. On the other hand, percussionists and brass players, whose exposure levels are known to be high (Phillips & Mace, 2008), have a high proportion of unilateral NIHL, which could mean that their losses are more related to exposure. Based on the inferences derived from these studies, therefore, bilateral notching may prove to be an early indication of vulnerability to NIHL that is not particularly dependent upon excessive noise exposure, but which could be exacerbated by continued exposure, as indicated by the relative severity of notches in college age students with bilateral NIHL who were seen in this study. ...
This study describes the prevalence and characteristics of noise-induced hearing loss (NIHL) in student musicians (N = 329) aged 18-25 years. Students completed a questionnaire regarding exposures before a hearing assessment. NIHL was defined by the presence of a notch 15 dB in depth at 4000 or 6000 Hz relative to the best preceding threshold. Overall prevalence of NIHL was 45%, with 78% of notches occurring at 6000 Hz. The proportion of the total population with bilateral notching at any frequency was 11.5%, mostly occurring at 6000 Hz. There was a significant increase in the frequency of notching in students who reported more than two hours per day of personal practice. There were no significant associations for instrument group or other noise exposures. The data suggest that susceptibility to NIHL among students of music is not uniform and cannot be ascribed solely to the instrument played and other exposures. Students with bilateral losses tend to have deeper notches and may represent a group that has an inherent predisposition to NIHL.
... A body of research highlights the risks musicians face in terms of hearing health. Phillips and Mace (2008) report that 48% of music students are exposed to harmful noise levels during daily practice. Similarly, O'Brien et al. (2013) found that 53% of musicians surpass the permissible daily noise exposure limits (see also Tufts & Skoe, 2018), a salient finding, as it does not include time spent in orchestral rehearsals and concert performances (i.e., only solitary practice was considered). ...
Hearing health, a cornerstone for musical performance and appreciation, often stands at odds with the unique acoustical challenges that musicians face. Utilizing a cross-sectional design, this survey-based study presents an in-depth examination of self-rated hearing health and its contributing factors in 370 professional and 401 amateur musicians recruited from German-speaking orchestras. To probe the nuanced differences between these groups, a balanced subsample of 200 professionals and 200 amateurs was curated, matched based on age, gender, and instrument family. The findings revealed that two-thirds of respondents reported hearing-related issues, prevalent in both professional and amateur musicians and affecting music-related activities as well as social interactions. The comparative analysis indicates that professionals experienced nearly four times more lifetime music noise exposure compared to amateurs and faced more hearing challenges in social contexts, but not in musical settings. Professionals exhibited greater awareness about hearing health and were more proactive in using hearing protection devices compared to their amateur counterparts. Notably, only 9% of professional musicians’ playing hours and a mere 1% of amateurs’ playing hours were fully protected. However, with respect to their attitudes toward hearing aids, professional musicians exhibited a noticeable aversion. In general, an increase in music-related problems (alongside hearing difficulties in daily life) was associated with a decrease in mental health-related quality of life. This research highlights the importance of proactive hearing health measures among both professional and amateur musicians and underscores the need for targeted interventions that address musicians’ specific hearing health challenges and stigmatization concerns about hearing aids.
... This indicates that MIDI note samples at high arousal and low valence can induce increased dynamics, duplicating previous studies that negative arousal is deeply related to sound intensity (Gomez and Danuser 2007;Hung et al. 2021;Weninger et al. 2013). Instrument classes also show meaningful pairwise differences in CC#1 values (p < 0.0001), where the brass class has the highest mean of CC#1 values (Phillips and Mace 2008). Track role, however, shows significant pairwise differences excluding accompaniment vs. main melody pair (p > 0.1), accompaniment vs. riff pair (p > 0.1), and bass vs. pad pair (p > 0.5). ...
One of the challenges in generating human-like music is articulating musical expressions such as dynamics, phrasing, and timbre, which are difficult for computational models to mimic. Previous efforts to tackle this problem have been insufficient due to a fundamental lack of data containing information about musical expressions. In this paper, we introduce MID-FiLD, a MIDI dataset for learning fine-level dynamics control. Notable properties of MID-FiLD are as follows: (1) All 4,422 MIDI samples are constructed by professional music writers with a strong understanding of composition and musical expression. (2) Each MIDI sample contains four different musical metadata and control change \#1 (CC\#1) value. We verify that our metadata is a key factor in MID-FiLD, exerting a substantial influence over produced CC\#1 values. In addition, we demonstrate the applicability of MID-FiLD to deep learning models by suggesting a token-based encoding methodology and reveal the potential for generating controllable, human-like musical expressions.
... Sound pressure can also be harmful during individual practice or practical studies (Phillips and Mace, 2008;McIlwaine et al., 2012;Washnik et al., 2016). Specifically for classical instruments, the estimated average exposure for daily practice can vary from 68 to 92 dB(a) (O'Brien et al., 2013a). ...
... When music is the cause of hearing loss, it is referred to as music-induced hearing loss (MIHL). A number of papers in the literature indicate that musicians are exposed to high-level sounds both when playing an instrument individually [5,6] and when playing in chamber ensembles and orchestras [7,8]. Most data focused on examining the risks associated with only one type of musical activity, most commonly playing in a large symphony orchestras, while there are few studies that take into account variety of musical activity as well as their duration throughout the day. ...
When playing instruments, musicians are exposed to loud sounds that can increase the risk of music-induced hearing loss (MIHL). The purpose of this study was to measure the sound exposure for a group of musicians playing classical music, and to examine how this exposure varies with the type of musical activity. Sound level was measured for a group of musicians using dual-channel noise dosimetry, with microphones attached near the right and left ear. The measurements were performed during individual practice and playing in musical ensembles. The equivalent sound level LAeq and daily sound exposure LEX,8h were measured separately for the right and left ear. In 74% of the measured samples the daily sound exposure (LEX,8h) exceeded 85 dB. The data indicated a significant risk of music-induced hearing loss in musicians performing classical music, especially when playing the flute, violin, viola, trombone, and saxophone. Musicians playing violin, viola, flute, and harp experienced asymmetric sound exposure with significant difference between the right and left ear.
... A large body of research has been devoted to the measurement of sound levels encountered during performances, rehearsals and individual music practice, (e.g. 8, [14][15][16][17][18][19]. The reports show that the levels are usually highest for brass instruments (85-105 dB), woodwinds (85-95 dB), and percussion (90-95 dB). ...
The sound exposure doses of musicians may significantly differ depending on the ensemble, repertoire and the intensity of their daily professional activity. In solo performance the sound levels are often asymmetric between the two ears, which mostly results from the directional characteristics of the instrument's sound radiation, with only a small effect of reverberation, as the player is exposed to the instrument's sound in the near field. In ensemble playing the sound of all the other instruments is usually the main factor influencing the sound exposure dose. In this study a two-channel noise dosimetry was used to assess the sound exposure doses in the left and in the right ear of music students. The measurements were conducted during rehearsals of chamber music ensembles, symphonic and wind instrument orchestras, big-band, and during individual practicing. The results show an interaural asymmetry in sound level, up to about 6 dB, in musicians playing instruments held asymmetrically to the player's head and in cases when the musicians were exposed to intense sound of the neighboring instruments. It also was observed that the spread of sound levels was larger during individual practicing (78-105 dBA) than in large ensembles (79-99 dBA).
... These regulations do not apply to music students, however, as they are not classed as employees (Shepheard et al. 2020). Yet music students may be particularly vulnerable to hearing damage as they progress through a period of intensive musical training and exposure, including personal practice, rehearsals and performances that are independent of their timetabled course of study (Phillips and Mace 2008;Tufts and Skoe 2018;Washnik, Phillips, and Teglas 2016). It has also been proposed that sound levels produced by student ensembles may be higher than professional ensembles because their technical skills are less well developed (Health and Safety Executive 2008). ...
Objective: The current study aimed to: i) determine the patterns of hearing protection device (HPD) use in early-career musicians, ii) identify barriers to and facilitators of HPD use, and iii) use the Behaviour Change Wheel (BCW) to develop an intervention to increase uptake and sustained use of HPDs.
Design: A mixed-methods approach using questionnaires and semi-structured interviews.
Study sample: Eighty early-career musicians (age range = 18-26 years; women n = 39), across all categories of musical instrument.
Results: 42.5% percent of participants reported using HPDs at least once a week, 35% less than once a week, and 22.5% reported never using HPDs for music-related activities. Six barriers and four facilitators of HPD use were identified. Barriers include the impact of HPDs on listening to music and performing, and a lack of concern about noise exposure. Barriers/facilitators were mapped onto the Theoretical Domains Framework. Following the systematic process of the BCW, our proposed intervention strategies are based on 'Environmental Restructuring', such as providing prompts to increase awareness of noisy settings, and 'Persuasion/Modelling', such as providing credible role models.
Conclusions: For the first time, the present study demonstrates the use of the BCW for designing interventions in the context of hearing conservation.
... Sound pressure can also be harmful during individual practice or practical studies (Phillips and Mace, 2008;McIlwaine et al., 2012;Washnik et al., 2016). Specifically for classical instruments, the estimated average exposure for daily practice can vary from 68 to 92 dB(a) (O'Brien et al., 2013a). ...
... Sound pressure can also be harmful during individual practice or practical studies (Phillips and Mace, 2008;McIlwaine et al., 2012;Washnik et al., 2016). Specifically for classical instruments, the estimated average exposure for daily practice can vary from 68 to 92 dB(a) (O'Brien et al., 2013a). ...
The World Hearing Center in Poland has a long history with teleaudiology, cochlear implants, and, more recently, hearing, vision, and speech testing. The efforts of multinational European working groups have resulted in a number of consensus statements providing a catalyst for hearing screening in children of all ages. These statements have also emphasized the use of modern technologies including teleaudiology as a means to provide the best access of hearing healthcare for children with hearing deficits. The World Hearing Center in Warsaw has developed the System of Integrated Communication Operations telehealth platform (for hearing, speech, and vision testing) and has used this platform to screen more than 1,000,000 children to date.
... Noise levels during school marching band rehearsals regularly exceed 100 dBA [24] and students may be exposed to these sound levels for hours at a time. University music students are exposed to sound levels that average 87-95 dBA with brass players averaging 5 dB higher levels, and 48% (n = 50) exceeding the 1998 National Institute for Occupational Safety and Health recommended duration for their level of sound exposure [25,26]. Ten orchestra students were found to have statistically significant bilateral notches at 6,000 Hz, indicative of NIHL. ...
Objective:
This study was aimed at determining the risk of developing noise-induced hearing loss (NIHL) in middle school band (MSB) and high school band (HSB) members.
Method:
Between-group comparison of hearing thresholds. Eleven MSB members and 6 MSNB controls, 20 HSB members and 5 HSNB controls.
Results:
Sixty-four percent of school-age band members presented with 15 dB HL or greater notch at 4,000 or 6,000 Hz in at least one ear. The high school students were slightly more likely to present with a notch.
Conclusions:
Results indicate that participation in band even as early as middle school increases the risk of developing NIHL, and that the longer the participation the higher the risk. Steps to insure hearing preservation in school-age band members are recommended.
... Nonetheless, in a review of some 32 papers, Behar et al. (2006) were hard-pressed to reach general conclusions about the occupational risks faced by musicians because of the inconsistency in methods across studies (both instrumentation and procedures) and variability in reported playing time. A number of studies have focused on exposure in the context of performance (Axelsson and Lindgren, 1981; Kahari et al., 2003; Royster-Doswell et al., 1991; Schmidt et al., 2011; Westmore and Eversden, 1981), while others have focused on exposure during practice, which can involve sub-optimal acoustic conditions such as those often faced in standard classrooms (Chesky, 2010; Phillips and Mace, 2008; Walters, 2009). Quian et al. (2011) conducted a noise exposure survey on musicians in the Canadian National Ballet Orchestra. ...
We reviewed 13 papers on noise exposure of orchestral musicians and found that the question of whether orchestra musicians are overexposed does not appear to have a clear answer. To find relevant papers, we researched three databases (Scholar, Scopos, and Medline), which yielded 6, 9, and 17 papers, respectively (including duplicates). A number of papers in the reviewed literature lacked basic descriptions concerning such issues as measurement technique and instrumentation. Rough data and calculation details were often not provided so that the conclusions could not be checked easily. The most serious problem was the estimated time that musicians performed in the orchestra. This information is crucial for the calculation of the normalized noise exposure levels (L EX), and is especially important as orchestra players do not perform year-round nor are they exposed to the same noise levels while performing different pieces of music.
... Examining young adults in a genetic association study facilitates identification of a potential notch phenotype by avoiding the complications caused by age-related hearing loss or loss brought upon by long-term exposure to sound or other risk factors; relatively early onset is often indicative of a genetic component for an adult condition or disorder (Hauser et al, 2003). While young student musicians are exposed to measured intensity levels in practice and rehearsal rooms that exceed the National Institute of Occupational Safety and Health (NIOSH) recommendations for safe listening, their exposure does not typically extend through an entire workday (Phillips & Mace, 2008;Walter, 2009). ...
Objective:
Noise-induced hearing loss (NIHL) is a worldwide health problem and a growing concern among young people. Although some people appear to be more susceptible to NIHL, genetic association studies lack a specific phenotype. We tested the feasibility of a bilateral 4000-6000 Hz audiometric notch as a phenotype for identifying genetic contributions to hearing loss in young adults.
Design:
A case-control-control study was conducted to examine selected SNPs in 52 genes previously associated with hearing loss and/or expressed in the cochlea. A notch was defined as a minimum of a 15-dB drop at 4000-6000 Hz from the previous best threshold with a 5-dB 'recovery' at 8000 Hz.
Study sample:
Participants were 252 individuals of European descent taken from a population of 640 young adults who are students of classical music. Participants were grouped as No-notch (NN), Unilateral Notch (UN), or Bilateral Notch (BN).
Results:
The strongest evidence of a genetic association with the 4000-6000 Hz notch was a nonsynonymous SNP variant in the ESRR- gene (rs61742642:C> T, P386S). Carriers of the minor allele accounted for 26% of all bilateral losses.
Conclusion:
This study indicates that the 4000-6000 Hz bilateral notch is a feasible phenotype for identifying genetic susceptibility to hearing loss.
... Sound exposure to orchestral musicians has been comprehensively studied, with most researchers agreeing sound levels both in the orchestra and in individual practice may pose a threat to the hearing, depending upon instrument type and repertoire. (1)(2)(3)(4)(5)(6)(7) In hearing health surveys, many studies have found noise-related hearing pathologies to be significantly more prevalent among orchestral musicians than those observed in the general population, (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) although a few studies report contradictory findings of limited evidence of hearing problems related to excessive noise exposure in working musicians. (1,19,20) Much attention been directed at developing control measures that protect the musicians' ears without interfering with their craft, with some professional orchestras using comprehensive strategies that include education programs tied to a range of administrative, engineered and personal controls. ...
ABSTRACT Orchestral musicians - an at-risk group for noise-induced hearing loss - have consistently reported great difficulty using hearing protection while performing or rehearsing, even when using earplugs specifically designed for musicians. A recent innovation in this field has been electronic earplugs that claim to deliver very high quality sound and only attenuate when sound levels become excessive. This study investigated these claims, aiming to determine whether professional orchestral musicians were able to use these devices and whether they were preferred to existing earplugs. Initially clinical and laboratory testing was carried out on the devices, indicating some spectral alteration of processed sound occurred, however claims of attenuation properties were validated. Following this, 26 orchestral musicians used the devices during rehearsals and performances for at least four weeks, providing feedback throughout this period. While musicians preferred the devices to previous earplugs, they identified issues including difficulty with orchestral balance, perception of dynamics and quality of sound provided by the devices. Results indicate these earplugs are a very positive step towards a usable hearing conservation tool for orchestral musicians to use in conjunction with other risk mitigation measures.
... Speech e even shouted speech e does not achieve a level that can be damaging to one's own hearing. The same cannot be said of music and many studies have demonstrated the potential for permanent hearing loss from long term exposure (see for example, Axelsson and Lindgren, 1981;Behar et al., 2006;Camp and Horstman, 1991;MacDonald et al., 2008;Phillips and Mace, 2008;Poissant et al., 2012;Royster et al., 1991;Schmidt, 2011). These examples are from classical non-amplified music and the deleterious situation can be further enhanced with amplified music (see for example, Axelsson and Lindgren, 1978;Clark, 1991;Flugrath, 1969;Hart et al., 1987). ...
... Nonetheless, in a review of some 32 papers, Behar et al. (2006) were hard-pressed to reach general conclusions about the occupational risks faced by musicians because of the inconsistency in methods across studies (both instrumentation and procedures) and variability in reported playing time. A number of studies have focused on exposure in the context of performance (Axelsson and Lindgren, 1981; Kahari et al., 2003; Royster-Doswell et al., 1991; Schmidt et al., 2011; Westmore and Eversden, 1981), while others have focused on exposure during practice, which can involve sub-optimal acoustic conditions such as those often faced in standard classrooms (Chesky, 2010; Phillips and Mace, 2008; Walters, 2009). Quian et al. (2011) conducted a noise exposure survey on musicians in the Canadian National Ballet Orchestra. ...
Noise exposure and hearing loss was assessed in different instrument groups of a professional ballet orchestra. Those instrument groups experiencing the highest levels of exposure also had the highest pure tone thresholds. Critically, we found that thresholds were not uniform across instrument groups. The greatest difference in thresholds was observed at test frequencies above 2000 Hz, peaking at 4000 Hz where the average difference between groups was as high as 15 dB. The differences could not be accounted for on the basis of age, years of playing, or years of playing professionally, and are thus most likely due to differences in occupational noise exposure. Nonetheless, measured losses for all instrument groups did not approach clinically significant levels. Relevance to industry: By combining noise exposure and hearing loss assessment, this study provides information that extends current understanding of the occupational risks faced by professional musi-cians playing in orchestras. This information may be particularly useful in the design and imple-mentation of hearing conservation programs.
... For example, Killion (2009) measured the peaks of a symphony orchestra in a concert hall at 114 to 116 dB (C), while Flugrath (1969) measured amplified rock music with levels of 114 dB (A). It must be noted that these peaks, especially for orchestral music, are very short in duration and are typically higher than the exposure levels that instrumentalists are subjected to on a longterm basis (Behar, Wong, & Kunov, 2006;MacDonald, Behar, Wong, & Kunov, 2008;Phillips & Mace, 2008;Poissant, Freyman, MacDonald, & Nunes, 2012;Royster, Royster, & Killion, 1991). Amplified rock music, however, can typically have a long-term average level that is higher than that for orchestral music (Clark, 1991). ...
Hearing instrument design focuses on the amplification of speech to reduce the negative effects of hearing loss. Many amateur and professional musicians, along with music enthusiasts, also require their hearing instruments to perform well when listening to the frequent, high amplitude peaks of live music. One limitation, in most current digital hearing instruments with 16-bit analog-to-digital (A/D) converters, is that the compressor before the A/D conversion is limited to 95 dB (SPL) or less at the input. This is more than adequate for the dynamic range of speech; however, this does not accommodate the amplitude peaks present in live music. The hearing instrument input compression system can be adjusted to accommodate for the amplitudes present in music that would otherwise be compressed before the A/D converter in the hearing instrument. The methodology behind this technological approach will be presented along with measurements to demonstrate its effectiveness.
Background Music-induced hearing loss (MIHL) is a critical public health issue. During music instruction, students and teachers are at risk of developing hearing loss due to exposure to loud and unsafe sound levels that can exceed 100 dBA. Prevention of MIHL in music students must be a desired action of all music educators.
Purpose To promote deliberate changes in music instruction and encourage more moderate sound creation and exposure during music education, it is essential to equip the instructors with live dynamic tools to monitor the overall sound intensities during music instruction. Equally important data to convey to the instructors are information regarding the intensity and duration of sounds at specific frequency regions in the music they are generating. Unfortunately, there are no feasible techniques to track cumulative live music exposures at various frequencies nor are there any guidelines for safe music exposure.
Research Design We created a visually appealing, user-friendly dashboard prototype system to display the accumulated time and intensity of sound exposure during live classes/rehearsals categorized into three frequency ranges. These visuals can be easily understood at a glance allowing musicians and instructors to make informed decisions about how to play music safely.
Experimental Approach and Results The dashboard included a collection of circular dial graphs that displayed in real time the accumulated sound exposure in the instructor's selected frequency range and showed the percentage of the maximum daily sound exposure based on the National Institute for Occupational Safety and Health Standards (NIOSH, 1998). Although NIOSH standards are not widely applied for music exposure, we propose that these standards can be used to provide initial guidelines to develop critical levels of music exposure. Additionally, the dashboard included a color-coded equalizer that displayed the instantaneous frequency distribution of sounds to indicate if sound levels at specific frequencies were too high even for short-term exposure.
Conclusion Less expensive than existing technology and more convenient to use, this dashboard will enable music instructors to make informed decisions on how to best adapt their teaching approaches to protect the hearing health of their students.
Noise and vibrations are both integral elements of our life. According to the 6th European Working Conditions Survey), carried out by Eurofound in 2015, 28% of employees in the 28 (at the time, currently 27) European Union Member States had been exposed at work to noise so loud that they needed to raise their voices to be heard among each other. According to the same data source, 20% of workers in the 28 European Union Member States in 2015 had been exposed at work to vibrations from hand tools, machinery and other sources. In Poland, on the other hand, according to Statistics Poland data, as many as 265.7 thousand persons were exposed to hazards arising from work environment in 2021 and noise was the most hazardous risk factor arising from work environment among them, affecting 182.2 thousand persons. The impact of vibrations affected 8.9 thousand persons. The most exposures were recorded in manufacturing. Industrial noise and vibration occur primarily during production processes in industrial halls, but they are also audible and felt in office spaces, the natural environment and the living environment. Due to the prevalence of noise and vibrations (they occur to varying degrees both in the living environment and in the human work environment), it is necessary to strive not only to limit their impact on human beings, but also to ensure adequate vibroacoustic comfort. For decades, techniques and methods have been developed to reduce noise emissions and minimize its impact on humans. These long-known and widely used techniques and methods have already been discussed many times in books and papers. However, the constant progress in the field of technology makes it possible to gradually develop and introduce into practice new techniques and methods in the scope of noise and vibration measurement, assessment and control. This monograph contains a selection of papers, presented at the Noise Control 2022 Conference). The event in question is the most important international conference on noise control, organized in Poland triennially. The 19th International Noise Control Noise Conference NOISE CONTROL 2022 took place in the Bishops' Castle in Lidzbark Warmiński between 26 and 29 June 2022. The Conference was organized by the Central Institute for Labour Protection – National Research Institute and the Committee on Acoustics of the Polish Academy of Sciences. This monograph allows the reader to get acquainted with the subject of the selected and yet the latest techniques and methods in the field of noise and vibration reduction and the improvement of vibroacoustic comfort. The techniques, solutions and results presented in this monograph, due to their interdisciplinary nature, may be interesting and useful to representatives of disciplines and scientific fields other than acoustics. I hope this monograph will be interesting and helpful in studies and work.
This chapter focuses on the hearing assessment of musicians as well as how to recommend and specify the exact parameters for hearing aid amplification for hard-of-hearing people who either play musical instruments or merely like to listen to music. Much of this is based on the differences between the acoustic features of music and of speech. Music is typically listened to, or played at, a higher sound level than speech and there are some spectral and temporal differences between music and speech that have implications for differing electro-acoustic hearing-aid technologies for the two types of input. This involves a discussion of some hearing aid technologies best suited to amplified music as well as some clinical strategies for the hearing health care professional to optimize hearing aids for music as an input.
Objective:
To examine the contribution of all daily activities, including non-music activities, to the overall noise exposure of college student musicians, and to compare their "noise lives" with those of non-musician college students.
Design:
Continuous week-long dosimetry measurements were collected on student musicians and non-musicians. During the measurement period, participants recorded their daily activities in journals.
Study sample:
22 musicians and 40 non-musicians, all students (aged 18-24 years) at the University of Connecticut.
Results:
On every day of the week, musicians experienced significantly higher average exposure levels than did non-musicians. Nearly half (47%) of the musicians' days exceeded a daily dose of 100%, compared with 10% of the non-musicians' days. When the exposure due to music activities was removed, musicians still led noisier lives, largely due to participation in noisier social activities. For some musicians, non-music activities contributed a larger share of their total weekly noise exposure than did their music activities.
Conclusions:
Compared with their non-musician peers, college student musicians are at higher risk for noise-induced hearing loss (NIHL). On a weekly basis, non-music activities may pose a greater risk to some musicians than music activities. Thus, hearing health education for musicians should include information about the contribution of lifestyle factors outside of music to NIHL risk.
Objectives:
The purpose of this investigation was to assess the effects of earplugs on acoustical and perceptual measures of choral and solo sound.
Methods:
The researcher tested the effects of musician's earplugs on choral and solo timbre and singer perceptions. Members of an intact women's university choir recorded Dona Nobis Pacem under two conditions, no earplugs and with earplugs over time. Approximately half of the choir members also participated as soloists, recording Over the Rainbow under the same two conditions. All recordings were analyzed using long-term average spectra (LTAS). After participating in each recording session, the participants responded to a questionnaire about ability to hear self (solo and choral context) and ability to hear others (choral context) under two conditions, no earplugs and with earplugs.
Results:
LTAS results revealed that wearing earplugs in a choral setting caused decreased mean signal energy (>1 dB), resulting in less resonant singing. LTAS results also indicated that wearing earplugs in a solo setting had less effect on mean signal energy, resulting in a mean difference <1 dB in 3 of the 4 weeks studied. Singer questionnaire responses showed that wearing earplugs had a greater effect on participants' ability to hear others than it did on their ability to hear themselves.
Conclusions:
In the context of this study, it seems that wearing earplugs had more effect on timbre and the ability to receive sufficient auditory feedback in a choral setting than it did in a solo setting. Findings from this study could provide important information when structuring hearing conservation strategies.
In conservatories and universities across the world, students prepare to be the next generation of performing professionals to entertain and enliven worldwide audiences. They pack numerous musical activities into each school day, from countless hours of personal practice to regular ensemble rehearsals to lessons and performances and other personal activities. Many of these activities expose the musicians to significantly high sound levels and potential threats to long-term hearing health. In order to understand the daily student musician noise experience, music majors at Brigham Young University were selected from various instrument categories to wear a Larson Davis noise dosimeter and their noise levels were recorded for two days. Each musician wrote a log of the times different activities took place as well as the location in which they were performed. Overall daily noise dosages and contributions to the noise dosage from each separate activity were calculated. Doses for each instrument type as well as each activity type were compared to identify which instruments and activities contribute most to noise overexposure.
The purpose of this study was 1) to examine the sound exposure of wind band members in a university setting during a week of typical rehearsals and 2) to assess whether that exposure changes depending on subjects' location within the rehearsal space. Because excessive sound exposure has a cumulative effect on the ear that can eventually lead to noise-induced bearing loss, it is important to determine whether university musicians are at risk. A 100% close of sound is the maximum daily exposure recommended by the National Institute of Occupational Safety and Health (NIOSH) for preventing noise-induced hearing loss. Twenty-four of 46 subjects (52%) experienced one or more rehearsals with sound levels high enough to produce >100% doses, and 17 subjects experienced a mean daily dose of sound in excess of 100% as compared to the NIOSH standards. Implications and suggestions for further research are discussed.
The great irony of being a musician is that the sound produced-the very essence of the musical experience - represents a long-term health risk to the artist. This overview examines the lack of sufficient evidence-based studies on this at-risk population, which is particularly important in light of the low level of compliance to hearing-loss prevention programs among musicians. The review explores the number of musicians at risk, the five most common types of hearing loss affecting them, and the necessary components of a hearing-loss prevention program, including measurement, education, and acoustic modifications to the work environment. Hearing protection devices designed specifically for performing musicians are explored in depth, including the proper use of spectrum-neutral high-fidelity earplugs with in-ear monitoring systems as tools to control sound levels without detracting from the quality of musical performance.
This collective case study documented university choral students' (N = 4) hearing doses, acquired through Etymotic Personal Noise Dosimeters (ER200D), as they rehearsed and performed a program of opera choruses during five time periods in three venues. Acquisition periods included one choir only rehearsal, two choir-orchestra-soloist rehearsals, and two public performances with choir-orchestra-soloists. Participants also responded to a brief survey that solicited their perceptions of hearing and singing voice status immediately following each acquisition period. Among primary results: (a) three of four participants acquired sound doses in one or more of these approximately one-hour time periods that exceeded National Institute for Occupational Safety and Health (NIOSH) recommendations for eight hours; (b) the soprano participant acquired the highest Leq dB(A) readings; (c) acquired sound doses varied according to context; and (d) participant surveys indicated that although these singers perceived slightly more than desired hearing and singing effort in one or more of the acquisition periods, they may not have been fully aware of the cumulative sound doses they acquired. Results were discussed in terms of recommendations for future research and hearing conservation awareness among choral conductors and teachers.
It is broadly acknowledged that professional orchestral musicians risk noise-induced hearing pathologies due to sound exposure in rehearsal and performance. While much has been published regarding orchestral sound levels, little is known of the sound exposure these musicians experience during solitary practice, despite the many hours they spend engaged in this activity. This study aimed to determine sound exposure during solitary practice of 35 professional orchestral musicians, representing players of most orchestral instruments. To allow cross-comparison, participants were assessed playing similar repertoire in a controlled environment, recording simultaneously at each ear to determine sound exposure levels. Sound levels were recorded between 60 and 107 dB LAeq, with peak levels between 101 and 130 dB LC,peak. For average reported practice durations (2.1 h per day, five days a week) 53% would exceed accepted permissible daily noise exposure in solitary practice, in addition to sound exposure during orchestral rehearsals and performances. Significant inter-aural differences were noted in violin, viola, flute/piccolo, horn, trombone, and tuba. Only 40% used hearing protection at any time while practicing. These findings indicate orchestral musicians at risk of noise-induced hearing loss in ensemble face significant additional risks during solitary practice. Data presented will enable more effective and targeted management strategies for this population.
The prevalence of hearing problems in the Western world has, due to aging of the population, doubled over the past 30 years. Thereby, noise-induced hearing loss is an important factor that worsens over time in addition to age-related hearing loss. Hearing loss is usually measured as an elevation of a person's hearing thresholds, expressed in decibel (dB). However, recent animal studies have unraveled a type of permanent cochlear damage, without an elevation of hearing thresholds. This subtle damage is linked to a permanent and progressive degeneration of auditory fibers that occurs in association with damage of the inner hair cell synapse. Afferent neuronal degeneration has been suggested to be involved in hyperacusis (over sensitivity to sound) and tinnitus (a phantom sound percept). Hyperacusis and tinnitus are potentially devastating conditions that are still incurable. The main risk factors to develop tinnitus or hyperacusis are hearing loss, social stress and age. Both tinnitus and hyperacusis have been discussed in the context of a pathological increased response gain in subcortical brain regions as a reaction to deprivation of sensory input. Novel studies confirm the involvement of peripheral deafferentation for tinnitus and hyperacusis, but suggest that the disorder results from different brain responses to different degrees of deafferentation: while tinnitus may arise as a failure of the brain to adapt to deprived peripheral input, hyperacusis may result from an 'over-adaptive' increase in response gain. Moreover, moderate and high stress levels at the time of acoustic trauma have been suggested to play a pivotal role in the vulnerability of the cochlea to acoustic damage and therefore for the development of tinnitus and hyperacusis.
This article is about whalesongs, hearing, musical brains, and a number of other topics explored over the past 35 years. Previous research is reviewed briefly, and more attention is given to recent efforts with an emphasis on collaborative research conducted with many wonderful colleagues. First is a brief account of the Institute for Music Research at the University of Texas at San Antonio, followed by more details on current projects at the Music Research Institute (MRi) at the University of North Carolina at Greensboro. Research at the MRi is divided into six topics: BioMusic, Music-Related Hearing Loss, Music Education, Music Performance, Ethnomusicology and Ecocriticism, and Neuromusical Research. The second half of the article is devoted to neuromusical research. This line of research includes earlier studies of pianists, conductors, and singers and more recent work on multisensory processing in musicians.
Previous population studies of hearing loss have been limited to children with moderate to profound impairment, and have reported that heritability accounts for at least 50% of congenital or early-onset cases. The present study was designed to assess genetic factors associated with late-onset hearing impairment in an adult population. A brief family history and audiologic questionnaire was sent to approximately 11,200 members of the consumer organization, Self Help for the Hard of Hearing, Inc., and 4,039 questionnaires were returned. All respondents reported having at least one previous audiologic exam. Reported data were verified against audiograms when available. Regardless of the reported causes, 49% of early-onset cases (⩽20 years of age) had one or two parent(s) with some form of hearing loss compared with 62% in later-onset cases. As expected, mean age at onset was substantially younger for cases with positive family histories than cases with negative family histories. Results from nuclear segregation analysis showed that fully recessive and dominant models failed to explain the early- or late-onset hearing loss data.
In this nationwide survey, the large proportion of cases with positive family histories clearly indicates the importance of genetic factors in adult-onset forms of hearing loss. Comparison with younger-onset cases will permit further delineation of differences in inheritance patterns. This study should identify more homogeneous groups of adult-onset families for further genetic study, and provide empiric information for use in genetic counselling.
Open Educational Resources (OER) are digital content that are accessible through web repositories. They are used as support tools for education, especially for higher education, and they promote equality and social justice by providing access to, applying, and generating knowledge. Until now OER's have been developed from the pedagogic perspective, without taking advantage of the recent developments in communication technologies. Integration of social tools improves the active participation of both the developers and users of the OER's. This promotes the rapid creation of content that is easily accessible via search engines linked to educational platforms and social networks. It also allows tagging, which gives users the ability to add descriptive metadata. Authorship is recognized through the use of intellectual property licenses that promote open use of the material so that it can be used and edited. And above all collaborative learning is promoted. In this article a new cycle of OER production is proposed that includes activities to incorporate social networks and semantic technologies. The phases of the production cycle are developed using the ADDIE instructional model. The purpose of each phase and the social and semantic components to be included are identified. And finally, application guidelines are presented that detail the strategies and expected results for each phase of the proposed cycle. We have determined that the primary reasons for developing a production cycle for OER's using social authorship are: to allow educators and students to develop resources collaboratively; to reduce the amount of time spent in resource development; and to provide for reutilization of quality OER's. Finally, it should be recognized that the success of the model and its application depends on the institutional context where it is implemented, as well as the policies related to content generation, authorship acknowledgement and distribution of the resources.
The identification of factors that compromise neurogenesis is aimed at improving stem cell-based approaches in the field of regenerative medicine. Interferon gamma (IFNγ) is a main pro-inflammatory cytokine and up-regulated during several neurological diseases. IFNγ is generally thought to beneficially enhance neurogenesis from fetal or adult neural stem/precursor cells (NSPCs).
We now provide direct evidence to the contrary that IFNγ induces a dysfunctional stage in a substantial portion of NSPC-derived progeny in vitro characterized by simultaneous expression of glial fibrillary acid protein (GFAP) and neuronal markers, an abnormal gene expression and a functional phenotype neither typical for neurons nor for mature astrocytes. Dysfunctional development of NSPCs under the influence of IFNγ was finally demonstrated by applying the microelectrode array technology. IFNγ exposure of NSPCs during an initial 7-day proliferation period prevented the subsequent adequate differentiation and formation of functional neuronal networks.
Our results show that immunocytochemical analyses of NSPC-derived progeny are not necessarily indicating the correct cellular phenotype specifically under inflammatory conditions and that simultaneous expression of neuronal and glial markers rather point to cellular dysregulation. We hypothesize that inhibiting the impact of IFNγ on NSPCs during neurological diseases might contribute to effective neurogenesis and regeneration.
The theoretical framework presented in this article explains expert performance as the end result of individuals' prolonged efforts to improve performance while negotiating motivational and external constraints. In most domains of expertise, individuals begin in their childhood a regimen of effortful activities (deliberate practice) designed to optimize improvement. Individual differences, even among elite performers, are closely related to assessed amounts of deliberate practice. Many characteristics once believed to reflect innate talent are actually the result of intense practice extended for a minimum of 10 years. Analysis of expert performance provides unique evidence on the potential and limits of extreme environmental adaptation and learning.
Hearing threshold and survey data collected over 3 years in a university school of music indicate that 52% of undergraduate music students show declines in high-frequency hearing at 6000 Hz consistent with acoustic overexposure. Declines at 4000 Hz have grown in number over the 3 years, from 2% the first year to 30% in the third year. These "noise notches" are seen in all instrument groups, including voice, and are seen more in the right ear than the left ear in all groups. Exposure to outside noise does not appear to be a determining factor in who develops these declines. It is concluded that genetic predisposition is a likely risk factor.
The theoretical framework presented in this article explains expert performance as the end result of individuals' prolonged efforts to improve performance while negotiating motivational and external constraints. In most domains of expertise, individuals begin in their childhood a regimen of effortful activities (deliberate practice) designed to optimize improvement. Individual differences, even among elite performers, are closely related to assessed amounts of deliberate practice. Many characteristics once believed to reflect innate talent are actually the result of intense practice extended for a minimum of 10 yrs. Analysis of expert performance provides unique evidence on the potential and limits of extreme environmental adaptation and learning. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
To test the hypothesis that noise exposure may cause hearing loss in classical musicians.
Comparison of hearing levels between two risk groups identified during the study by measuring sound levels.
Symphony orchestra and occupational health department in the west Midlands.
Hearing level as measured by clinical pure tone audiometry.
Trumpet and piccolo players received a noise dose of 160% and 124%, respectively, over mean levels during part of the study. Comparison of the hearing levels of 18 woodwind and brass musicians with 18 string musicians matched for age and sex did not show a significant difference in hearing, the mean difference in the hearing levels at the high (2, 4, and 8 KHz) audiometric frequencies being 1.02 dB (95% confidence interval -2.39 to 4.43).
This study showed that there is a potential for occupational hearing loss in classical orchestral musicians.
The purpose of the study was to determine how and when the personnel of the Finnish National Opera are exposed to noise and whether exposure depends on musical selection of repertoire. Additionally, an evaluation of sound exposure level due to individual rehearsals was included. The measurements were done using individual noise dosimeters and fixed-point measurements. From the measurements, annual noise exposure in the Opera was evaluated. The conductors, dancers, and double bass players were exposed to levels below 85 decibels, A-weighted, dB(A), which is the national action level. The choir members were exposed to sound levels of 92 and 94 dB(A). Within the orchestra, the highest sound exposure levels were found among percussionists, 95 dB(A); flute/piccolo players, 95 dB(A); and brass players, 92-94 dB(A). Other sound exposure levels among orchestra members varied from 83 to 89 dB(A). Soloists and rehearsal pianists are likely to be exposed to sound levels exceeding the national action level. From an exposure perspective, the individual rehearsals, 79-100 dB(A), proved to be as important as performances and group rehearsals, 82-99 dB(A), among orchestra musicians and choir singers. The ambient sound level for the lighting crew was 76 +/- 4 dB(A). However, the measured sound levels at the ear varied from 77 to 92 dB(A) due to the communication via headphones that had individual volume control. For the majority of personnel of the Finnish National Opera, sound exposure level exceeded the national action level value of 85 dB(A). Artists exceeded the action level during both individual and group rehearsals, as well as during performances. Hearing protection has been designed for musicians. Education/reinforcement is required to ensure it is worn.
In recent years studies on isolated hair cells have suggested that there is an inherent tuning of hair cells determined by their mechanical and electrical properties. However, tuning for mammalian cochleas appears to be much more complicated since there are typically two types of receptor cells (inner and outer hair cells) imbedded in a highly organized framework of supporting cells, membranes and fluids. The major neural output of the cochlea can be monitored by recording the activity of myelinated axons of spiral ganglion cells, not only under normal conditions, but also when the discharge patterns are altered by ototoxic drugs, acoustic trauma or olivocochlear bundle stimulation. A model system with two excitatory influences, one sharply tuned and highly sensitive, and a second, broadly tuned and relatively insensitive, can account for much of the existing data. Results from single-neuron marking studies support the notion that these two influences probably involve interactions between inner and outer hair cells. More global influences such as the endocochlear potential also can act on auditory-nerve fibers through the hair-cell systems. Thus, the inherent frequency selectivity of the receptor cell is only one of many factors that determine the tuning of mammalian auditory-nerve fibers.
Personal noise exposures of classical musicians in the Winnipeg Symphony Orchestra, Centennial Concert Hall, Winnipeg, Manitoba, Canada, were conducted to determine compliance with provincial standards. In Manitoba, a hearing conservation program is required where the equivalent sound exposure level (Lex 8-hour) exceeds 80 dB A-weighted sound pressure level [dB(A)]. In excess of 85 and 90 dB(A), standards require hearing protection and engineering or work practice controls. Approximately 10 percent of the musicians wore conventional or custom-molded earplugs. Dosimetry readings were taken in the rehearsal room, main stage, and orchestra pit during rehearsals and dress rehearsals. Quest model M-8B and Larson Davis model 700 dosimeters were used and the Canadian Standards Association procedure was applied. The mean Lex 8-hour for the rehearsal room surveys were 88 and 90 dB(A), for the pit were 85 and 86 dB(A), and for the main stage were 82, 84, and 88 dB(A). Instantaneous peak exposures were recorded in excess of 140 dB(A). Individual noise exposure data indicated that the musicians' Lex 8-hour decreased with distance from the woodwind and brass sections. Neither the playing environments (stage, pit, rehearsal room) nor the musical repertoire resulted in an appreciable difference in the mean Lex 8-hour exposure in a fully complemented orchestra. Noise exposures for musicians of the Winnipeg Symphony Orchestra were in excess of all three Manitoba standards.
To assess the risk of noise-induced hearing loss among musicians in the Chicago Symphony Orchestra, personal dosimeters set to the 3-dB exchange rate were used to obtain 68 noise exposure measurements during rehearsals and concerts. The musicians' Leq values ranged from 79-99 dB A-weighted sound pressure level [dB(A)], with a mean of 89.9 dB(A). Based on 15 h of on-the-job exposure per week, the corresponding 8-h daily Leq (excluding off-the-job practice and playing) ranged from 75-95 dB(A) with a mean of 85.5 dB(A). Mean hearing threshold levels (HTLs) for 59 musicians were better than those for an unscreened nonindustral noise-exposed population (NINEP), and only slightly worse than the 0.50 fractile data for the ISO 7029 (1984) screened presbycusis population. However, 52.5% of individual musicians showed notched audiograms consistent with noise-induced hearing damage. Violinists and violists showed significantly poorer thresholds at 3-6 kHz in the left ear than in the right ear, consistent with the left ear's greater exposure from their instruments. After HTLs were corrected for age and sex, HTLs were found to be significantly better for both ears of musicians playing bass, cello, harp, or piano and for the right ears of violinists and violists than for their left ears or for both ears of other musicians. For 32 musicians for whom both HTLs and Leq were obtained, HTLs at 3-6 kHz were found to be correlated with the Leq measured.
Symphony orchestra musicians from The Royal Danish Theatre (15 females and 80 males) aged 22 to 64 years were audiologically examined to elucidate the presence and the frequency of noise-induced hearing loss among classical musicians. Compared to a reference material (ISO 7029) the median hearing thresholds of the musicians were increased for all age groups. When using hearing sensitivity in one or both ears less than 20 dB HL as a criterion for normality, it was found the 58% of the musicians had a hearing impairment. 50% of the males and 13% of the females showed a typical audiogram with a notched curve at higher frequencies normally attributed to occupational noise exposure. Furthermore, a significantly poorer hearing on the left ear was found at higher frequencies among the violinists. It is concluded that symphonic musicians suffer from hearing impairment and that the impairment might be ascribed to symphonic music.
Hearing tests in classical musicians have been few and results inconsistent. Sound level measurements from the Lyric Theatre and Concert Hall in Gothenburg showed sound levels frequently exceeding hearing damaging levels. Equivalent sound levels for all performances showed values of 83-9 dB(A). Sound levels were slightly higher in the Lyric Theatre where musicians are crowded in an orchestra pit. Hearing tests of 139 male and female musicians from both theatres showed mean and individual pure tone thresholds indicating a sensorineural high tone loss, most frequently with a configuration consistent with an etiology of a noise-induced loss. Male musicians had poorer hearing than female musicians. The left ear demonstrated a greater loss than the right ear. Pure tone thresholds for age groups showed decreased hearing with age, particularly prominent for musicians older than 60 years of age. After age 50 a frequent finding was quite variable pure tone thresholds. In the individual analysis, 59 musicians (43%) showed worse pure tone thresholds than would be expected with regard to age. Of the different instrument groups, brasswind musicians exhibited the greatest loss. For individual instruments, French horn, trumpet, trombone and bassoon showed an increased risk of sensorineural hearing loss. Asymmetrical pure tone thresholds was a common finding both in musicians with normal hearing and sensorineural hearing loss. For these asymmetries it appeared that the violin influenced the left ear more than the right. The loudness discomfort level for pure tones was comparatively high for these musicians and a frequent finding was an unelicitable discomfort level at 120 dBHL. The acoustic reflex was also elicited at comparatively high levels. Pathologically increased levels were demonstrated in 40 musicians (approximately 30%). There is no obvious explanation for the high loudness discomfort level and for the elevated acoustic reflex levels. We suggest that the musicians' past history in working environments with widely varying sound levels may have affected the results of these audiological tests. Findings from pure tone temporary threshold shift measurements substantiated the suggestion of an ototraumatic influence of classical music. Temporary threshold shifts of moderate degree were demonstrated both after concerts and after individual musicians played their own instruments in the hearing test booth. Careful evaluation of each musician's history, in order to exclude other causes than music for the sensorineural hearing loss, indicated that participation in military bands and exposure to gunfire may have contributed to the sensorineural hearing loss. However, music was by far the most common etiological factor suggested for the 59 musicians with hearing loss. In conclusion, sound level measurements and hearing tests indicate the ototraumatic character of classical music by orchestras on a stage or in an orchestra pit. The finding is serious with regard to the unusual dependence of musicians on their hearing sensitivity.
Investigations into noise-induced hearing loss should consist of two parts: a mapping of the sound environment and a charting of hearing loss. This paper is the first part of such an investigation: a mapping of sound levels and sound spectra within the symphony orchestra. It was found that 'heavy' symphonic music exceeds the permitted dose for industrial noise equivalent to 85 dB(A) for a full working week. The permitted noise dose is reached for 'heavy' music after a working time of 10 hours per week in 'exposed' positions, such as in front of trumpets, and after 25 hours in 'normal' positions. A simple method to estimate the 'noise' exposure in equivalent sound level for combination of different sorts of music has been developed.
The question has recently been raised as to whether the performance of symphony orchestra music involves a risk of sustaining hearing impairment. The following investigation presents a population study of 417 musicians, of whom 123 were investigated twice, at an interval of 6 years. Median values of screened tone thresholds were compared with a reference material, according to Spoor & Passchier-Vermeer (1969). The tone thresholds measured did not differ from the reference values although the actual sound exposure in some situations exceeded the permitted sound levels applied to industrial noise. We suggest that the sound exposure criteria for industrial noise are not valid when discussing such sounds as are produced by acoustic instruments in a symphonic environment.
• Noise-induced hearing loss (NIHL) is well reported among devotees of rock 'n' roll music, but less attention has been focused on players of orchestral music. Sound pressure levels have been recorded from within orchestras during performances, and audiometry has been carried out on orchestral musicians. Short-lasting peaks of sound of high amplitude were found to occur, and some players had audiometric changes consistent with NIHL. However, in practice, there seemed to be no threat to the players' continued livelihood, although the additive effect of presbyacusis in later life poses a potential problem. The difficulties of prevention of NIHL and the attenuation of the high sound levels of orchestras do not seem to be completely soluble.
(Arch Otolaryngol 1981;107:761-764)
In 1975, the threshold hearing levels (HLs) of 83 Swedish and British pop/rock musicians were examined with pure tone audiometry. At that time we found 13% of the musicians with a hearing loss > 20 dB HL at a high frequency pure tone average (3, 4, 6, and 8 kHz). The aim of the present investigation was to conduct an audiometric follow-up study of these musicians 16 years after the first examination. Fifty-three of the 83 pop/rock musicians were retested in 1991 to 1992. They also filled in a questionnaire concerning occupational noise activities, leisure noise activities, general health problems and subjective symptoms related to loud music exposure. The median pure tone audiogram was within 20 dB HL at all test frequencies. On an individual basis, 63% had normal high high frequency pure tone average scores and another 15% had a very limited high frequency hearing loss (< or = 25 dB HL). It seems surprising that pop/rock musicians after performing for 26 years have such well-preserved hearing. There might be a protective effect by the generally positive attitude from the musicians toward their performance and their audience. Regarding the loud and more or less continuous sound levels over 85 dBA there might also be a protective effect from a continuous contraction of the stapedius muscle.
Using pure tone audiometry in 1995, a hearing reassessment was made in 56 classical musicians who participated in Axelsson & Lindgren's study 16 years earlier, in 1979. This study focuses on hearing development in these classical orchestra musicians, active in Göteborg, Sweden. The aim of the study is to evaluate the risk of progressive hearing loss during work in a classical orchestra. Another aim is to study possible hearing differences in females and males and to compare the high frequency pure-tone average values found in the study with two normal materials. The main findings were that the male, compared to the female musicians, showed a tendency toward a more pronounced, although not significant, hearing reduction in the high frequency region and higher threshold distribution within the 90th percentile than the females. This was found most often in the left ear. The median audiogram for all females showed a notch configuration at 6 kHz, compared to the males who had a high-tone sloping configuration. When comparing high frequency pure-tone average (HFPTA) values with ISO 7029, the females are distributed around the ISO 7029 median and well within the 90th percentile. The average among the males was equal with the median. Comparison with Davis normal population "all the sample, overall occupational group" showed a more even distribution of the HFPTA values around the median for both females and males on both occasions. This follow-up study showed no extended negative progress of the pure-tone hearing threshold values in spite of an additional 16 years of musical noise exposure.
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