Symphony orchestra musicians′ use of hearing protection and attenuation of custom-made hearing protectors as measured with two different real-ear attenuation at threshold methods

Abstract

Despite a high level of sound exposure and a fairly large selection of earplugs available, musicians have often been reported to use personal hearing protectors only seldom. For better hearing conservation, it is important to identify and eliminate the causes for the low motivation to use hearing protection. We explored the usage rate of custom-molded musician's earplugs (ER-15) among 15 symphony orchestra musicians with a questionnaire, and measured the attenuation properties of their earplugs with a Real-Ear Attenuation at Threshold (REAT) procedure in a sound field. Earplug use was found to be low, and the musicians reported that earplugs hampered listening to their own and their colleagues' playing; earplugs affected either timbre or dynamics, or both. Additionally, several reasons related to discomfort of use were itemized, but the musicians who consistently used their earplugs did so in spite of problems with use. The REAT values obtained in sound field were relatively close to the manufacturer's nominal specifications, being 13.7 dB, on average. In the frequency range studied (0.125-8 kHz), individual variation in REAT was, however, up to 15 dB across the measured frequencies. Fluctuation in attenuation might be related to low use of hearing protectors, and REAT measured at fixed center frequencies may be too robust a method to uncover it. We therefore tested 10 additional subjects to find out whether a sweeping signal used in Bιkιsy audiometry would bring more detailed information on earplug attenuation. Mean attenuation was found to be somewhat closer to the nominal attenuation of the ER-9 and ER-15 earplugs up to about 1 kHz, whereas REAT measurements in sound field revealed more even attenuation at frequencies between 1 and 6 kHz. No significant association was found between earplug attenuation properties and earplug use. It was concluded that support and determination to get accustomed to hearing protector use are important factors in hearing conservation.

Factors Influencing Use of Hearing Protection by Trumpet Players

“…There have been some clinical reports that some musicians, and in particular trumpet players, have difficulty using Musicians Earplugs. ™ Huttunen et al (2011) reported actual usage in symphony orchestra musicians ranged from 6% to 52%, depending on country, and that 80% of one group reported complaints that their ER15 earplugs "distorted the timbre and/or dynamics of music in the orchestra." Similarly, Mendes et al (2007) reported only 43.7% of their study group accepted hearing protection.…”

An Acoustical Analysis of the Frequency-Attenuation Response of Musician Earplugs

“…Thus, MEPs do not attenuate musical stimuli in a way that reduces levels equally across frequencies. These results help explain why musicians 1) complain that the ER-15 distorts the timbre of music [9], 2) report the most important factor for non-use is sonority of their own instrument [8], 3) don't like the ER-15 because they change the natural sound of the instrument [12], and 4) can't communicate musically when using the ER-20 [11]. This also offers an important hypothesis regarding why the spectral characteristics of musical output changes when musicians use and perform using ER-15 earplugs [13].…”

“…A literature review examining these special claims suggests that musicians rate the use of these products negatively [8][9][10][11][12]. In addition to problems with pressure, pain, and discomfort, musicians report low-usage rates of MEPs due to interference with playing ability, distortion of timbre, sonority, and dynamics of the music they and others are playing.…”

Hearing Loss Prevention Education Using Adopt-a-Band: Changes in Self-Reported Earplug Use in Two High School Marching Bands

“…Flat-attenuation earplugs are designed to reduce many of these issues; however, feedback on flat-attenuation earplugs has also been mixed in studies including musicians as participants. Spectrum and level differences for music produced with and without earplugs have been reported (Kozlowski, Zera, & Mlynski, 2011), as well as distortion while listening (Huttunen, Sivonen, & Poykko, 2011). In contrast, data from Chasin and Chong (1992) have suggested similar spectra for openear measurements of music compared with music spectra measured in ears that are occluded with ER-15 Musician earplugs (as reprinted in Chasin, 1996).…”