Objectives-To test the hypothesis that noise exposure may cause hearing loss in classical musicians.Design-Comparison of hearing levels between two risk groups identified during the study by measuring sound levels.Setting-Symphony orchestra and occupational health department in the west Midlands. Main outcome measures-Hearing level as measured by clinical pure tone audiometry.Results-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).Conclusions-This study showed that there is a potential for occupational hearing loss in classical orchestral musicians. IntroductionThe association between exposure to noise and occupational hearing loss has been recognised for well over a century, but only recently leisure noise, and particularly music, has attracted attention as a possible cause of deafness. The law in Britain requires that specific steps be taken to safeguard workers' health,' including their hearing.2 Classical musicians may not be a group in which occupational hearing loss would be suspected, but a recent review emphasised that high sound levels may be found within symphony orchestras.3 This suggests that noise exposure should be assessed. Studies of noise induced hearing loss in musicians have been descriptive and have not estimated the importance of the hearing losses found.4 We

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