Larry Krantz Flute Pages: Flutes/Piccs Could Harm Hearing - S.A. Wicks
FLUTES OR PICCOLOS COULD HARM YOUR HEARING

How to Protect Your Hearing When Playing Your Musical Instrument
By
Steven A Wicks

INTRODUCTION.

Most of us naturally think of our flutes and piccolos as the instruments of beauty and artistic expression. And, because they allow us to make such beautiful music we might have difficulty thinking them capable of harming us in any way, perhaps not even our hearing. In fact, they are doing just that to many of us. The cause is the loudness of the sounds they produce.

What you are about to learn could be somewhat disconcerting. Since the damage is permanent, it might even take some reflection to understand fully the implications for your current goals and routines. In any case, with the evidence about to be presented, we should no longer ignore the fact that the loudness of our instruments makes them potentially damaging to our ears. Do not let the beauty of your instrument's tone mislead you or cause you to make choices you may regret later in life.

Please take a few minutes to learn about the causes of hearing damage in musicians and how you can protect yourself, your children or students. Here is what you will find:

THE NEED FOR CONCERN ABOUT HEARING LOSS
* How Hearing Losses Affect Musicians
* Musicians and Others with Damaged Hearing
* Why Our Instruments Have Become So Loud

CAUSES AND WARNING SIGNS OF HEARING LOSSES
* The Cause Of Hearing Loss In Musicians
* How Can I Tell If My Instrument is Harming My Hearing?

PLAYING IT SAFE
* How Loud Are Our Instruments?
* Maximum Sound Levels * Recommendations For Common Playing Situations

HEARING PROTECTION
* Sorting Out Your Hearing Protection Needs
* How to Select Adequate Hearing Protection

REFERENCES AND BIBLIOGRAPHY WITH WWW LINKS

THE NEED FOR CONCERN ABOUT HEARING LOSS
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HOW HEARING LOSSES AFFECT MUSICIANS.

We may assume as long as we can hear our instruments and other people's voices that our hearing is healthy enough. We should be aware that hearing damage does occur in many segments of instrumental music. Hearing damage in musicians is from loud sounds and can be a painless, progressive process, going undetected for many years. It would not be until many of us reach the point of hearing muffling of voices, begin asking for clarifications in conversations, or develop a ringing in our ears that we might discover the full degree of our loss.

Hearing loss from loud sounds affects judgement of loudness, pitch and tone, which, of course, are major ingredients of our artistic endeavors. Losses begin in the higher frequencies, so higher pitched sounds are perceived as less loud compared to lower pitched sounds. As it progresses it would become increasingly more difficult to produce any aspect of our instrument's tone, such as the upper partials, since we could not adequately hear them. We would lose our judgement of balance between the higher and lower frequencies making comparisons of relative loudness more difficult. It would affect our judgement of the relative loudness of our own instrument with others in ensembles. Then, our pitch discrimination, even in those with perfect pitch, would be degraded. Those with only moderate losses do seem to develop compensating techniques, but their innate abilities are measurably reduced compared to fully hearing-capable individuals. As if that is not enough, those with hearing losses tend to be more stressful and reclusive, too.

MUSICIANS AND OTHERS WITH DAMAGED HEARING.

Of the 250 million people in the U.S., a staggering 28 million are estimated to be suffering from hearing losses and at least 10 million of those are known to have suffered some losses from loud sounds. Some researchers believe these numbers are far too low, that perhaps most of us have lost some hearing from exposure to the loud sounds that fill our modern world. Already in a number of studies of musicians, from rock through classical, hearing damage has been revealed. In most studies of orchestras, just about HALF the musicians have hearing damage from loud sounds and may have been exposed to sound levels that exceed sound safety standards by many times, daily(1)(2). Additionally, the damage could exist in many thousands of semi-professional musicians, students, conductors, and band directors, who also are known to have high daily exposures.

Responsible adults, parents, and teachers need to take the lead in protecting those too young to understand the dangers of loud sounds. Because of the early onset of damage in a series of exposures, younger players may sustain losses before becoming mature or informed enough to take the proper precautions for themselves.

WHY OUR INSTRUMENTS HAVE BECOME SO LOUD.

As flutists and piccolo players we should be especially aware that our instruments easily produce sounds loud enough to cause hearing damage even when played alone. We may recognize that their loudness is on a par with other orchestral instruments, but we tend to ignore the fact that they are only six inches from our ears while they make those loud sounds. That closeness makes them quite a bit louder. Then, some of us play in ensembles or use PA systems that raise sound levels further, all of which adds to the burden our ears must sustain.

Lately, our modern world thrives more and more on loud sounds. Loudness has become almost a requirement for successful, or even acceptable, performances. Very likely, over the years instrumentalists have also preferred instruments that are louder, choosing ones that "speak" easier, or that respond to a lighter playing technique. In recent years, orchestras and artists have discovered audiences more often prefer louder, more brilliant or dynamic sounds. They have responded by playing louder pieces more often, and other pieces more loudly. Manufacturers have responded by providing louder instruments to meet growing demands. Then, musicians just naturally played them louder as time passed, in a sort of mezzo-forte-creep, up the dynamics scale. Adding to the increase in loudness is the fact that as general loudness of all sounds increases, so do hearing losses. Those with progressively increasing losses will naturally tend to play louder to compensate. Increasing general loudness can be a possible sign of increasing hearing loss. By middle age the average male in the US has lost 25 to 30 dB in the higher frequencies.

CAUSES AND WARNING SIGNS OF HEARING LOSSES
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THE CAUSE OF HEARING LOSS IN MUSICIANS.

Loud sounds from any source, including music, can cause musicians to lose their hearing. Whether from music, noise, machinery, headset radios, gunshots, etc., the intensity of loud sounds causes a breakdown of the delicate mechanisms and tissues of the inner ear. The first exposures may produce only a temporary desensitization and allow a return to normal hearing after resting. With repeated exposures, however, at least a portion of the damage becomes permanent. Audiologists and hearing conservationists call such losses Noise Induced Hearing Loss (NIHL). Since there is no known cure we need to take a cautious approach to conserving our hearing. It cannot be reclaimed, later.

Those suffering from NIHL often think they are "getting used to hearing loud sounds," but they are simply well on their way to becoming "hard of hearing." They have a NIHL related dip in their hearing response between 3000 and 6000 Hz. In the initial progression of the loss, audiograms, used to diagnose hearing ability, begin to show a dip around 4000 Hz. With continued exposures the dip widens and deepens. It may take as little as one to ten years to show significantly. The rate of development depends on the loudness, regularity and length of the individual exposures, and our individual genetic sensitivity to such damage.

Since most of the damage from a series of exposures occurs in the earlier years, it is all the more important to detect and stop it, before it progresses too far. Putting off protective procedures or diagnoses of suspected damage, will only lead to more severe damage. Although the rate of progression is often related to the level of the sound, damage continues until hearing is destroyed, as long as the exposures continue. There is a tendency in those suffering from it to expose themselves to higher than normal sound levels; they often turn up the volume on PA systems, hi-fi's and headphones, thereby accelerating the rate of destruction.

A primary warning sign of NIHL is a temporary loss of hearing sensitivity, called a Temporary Threshold Shift (TTS), according to the Hearing Conservation Program Training Manual of the Centers for Disease Control (CDC)(6). We can sense a TTS as a tired, ringing, buzzing or dull feeling in our ears following an exposure to loud sounds. Our ears need rest between exposures -- some say as much as 14 hours -- but even with rest, permanent damage can still occur. We need to quickly recognize and avoid ear-tiring situations to prevent permanent damage.

We should also realize that when both ears are exposed equally, we lose a great deal of our ability to judge how tired our ears have gotten. Exposing both ears causes us to lose our reference to the rested condition of our hearing. Therefore, developing a mental awareness of the loudness of sounds is what is required. Waiting for physical sensations in our ears to warn us may be too late.

You may be thinking that your instrument does not make your ears very tired. To see how rapidly they do tire, try this one-ear test. Wait until your ears are well rested, say, overnight. Insert an earplug (one with an NRR above 20 dB works best) in just your left ear. Play your instrument normally. The earplug will allow your left ear to act as a "rested reference" for your right ear. If your hearing is normal, your right ear will begin to feel tired within a surprisingly short time.

HOW CAN I TELL IF MY INSTRUMENT IS HARMING MY HEARING?

You need to have your hearing tested to know its condition. An audiogram is the standard diagnostic tool used by medical professionals and audiologists. We all should have audiograms taken regularly to detect any bad practices we may have developed in regard to loud sounds. They can also detect the effects of diseases that might be curable. However, be aware that waiting until damage shows up on your audiogram may be too late. At least a portion, if not all, of the measured loss could have become permanent. If you see the NIHL dip appear in your audiogram around 4000 Hz, you need to get a medical opinion. If it appears to be NIHL, you need to cut your exposures. A combination of prevention AND audiometric testing is still the best course of action.

Anyone experiencing dullness, ringing, muffling, beating, or other unusual effects in either ear very often, should get a medical diagnosis. They can be warning signs of advancing hearing loss, and may also be caused by a number of diseases. However, if you have any of these effects after a loud sound exposure you are unnecessarily endangering your hearing. Remember, NIHL is permanent. You cannot decide to do something to restore your hearing, later. Not even hearing aids can restore the function of destroyed tissues and nerve endings in your ears.

PLAYING IT SAFE
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HOW LOUD ARE OUR INSTRUMENTS?

The following table lists the loudness of a number of common sounds, as well as, showing the ranges of flutes and piccolos. It shows the destructive potential of the sounds, as measured in A-weighted decibels, dB(A). The A-weighting in this case tells us how potentially damaging the various loud sounds are, not exactly how loud all of them are to our ears. Sounds heavy in low frequency components will tend to seem louder than indicated, but may not be as destructive.

As the table shows, flutes and piccolos at mezzo-forte rival the destructive loudness of a train whistle only 500 feet away, even though the train whistle seems louder to our ears. They can easily exceed the destructive level of the whistle, too. In fact, the top dynamic of a flute or piccolo is at least several times louder in terms of destructive potential and may even seem as loud in terms of actual loudness.

However, when we say a sound is several times louder than another we are discussing our perception of it. Doubling the perceived loudness of a sound generally requires a 6 to 10 dB increase, depending on whose ears we are testing. However, the middle and inner ears are stressed by the physical intensity of the sound, in proportion to the motion of the air molecules on our eardrums, not necessarily by our perception of it. Those stresses increase by a factor of ten for each 10 dB increase in the frequency ranges of flutes and piccolos(3)(4)(5).

Let's compare the top-end dynamic of a flute to the sounds we would hear far away from most other manmade sounds, like at the Home in the Country, as shown in the following table. The environment there is a quiet 30 dB(A). If we played our flute, some of us would perceive the top-end dynamic, at 105 dB(A), to be at least hundreds of times louder. No doubt, this is a lot, but the physical sound on our eardrums is actually 32 MILLION TIMES more intense. For a piccolo, the top end is 158 MILLION TIMES more intense. When we compare those figures to normal conversation at three feet, which is only 3200 times more, we begin to see how really intense some manmade sounds have become. Use the table to compare your flute or piccolo to some common sounds and to recommended maximum exposure durations listed in CAPS.

LOUDNESS OF FLUTES AND PICCOLOS COMPARED TO OTHER SOUNDS

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As can be seen in the table, we often are subjected to loud sounds when we are pursuing recreational or work activities in our modern world. Some of the biggest offenders, not shown, are headphone radios, thriller movies, home theater systems, concerts, sporting events, machinery, recreational vehicles, lawn care equipment, and snowblowers, to name just a few. Even sitting next to the window in a jetliner can give you more than the safe daily dose of loud sound, all in a single cross country flight, and without even playing a single note of music.

The Flute and The Guitar - A Contrast.

Contrast the destructive potential of a flute in the upper mezzo-forte range, 88 dB(A) average, with that of an acoustic guitar, which generates a mere 75 dB(A) at the same dynamic. Flutists are subjected to 13 dB greater potential. As a result, flutes place 20 times the destructive stress on our ears and require cutting the maximum exposure by 20 times. If an acoustic guitarist played loud enough to reduce her or his safe exposure time to 10 hours, a flutist would run out of safe playing time in as little as 30 minutes at the same dynamic. If this makes playing of our flutes and piccolos seem a bit more daring than we once thought - it should. The closeness to our ears makes our flutes and piccolos louder, but more importantly, in this case, they are also pitched in the range where the most damage is done to our ears the quickest.

MAXIMUM SOUND LEVELS.

There is no doubt that the subject of hearing conservation is complex when tackled all at once. There are technical terms and physiological concepts to learn. However, it is no different than other important health related issues in that respect.

In the following material many of the complexities have been reduced to guidelines. In reality, the human body seldom responds to any potentially harmful process in exactly the way stated by guidelines. Guidelines necessarily understate the physiological complexities involved. It will take an evolving awareness on the part of each individual to understand how sounds affect their hearing. In addition, sound, being invisible and complex, is difficult for the casual observer to adequately characterize. Some skill needs to be acquired to perceive situations where dangers exist and to apply appropriate protective measures.

Since everything about hearing loss is not fully understood, even by the experts, we need to stay abreast of new developments to stay safe. For example, over the past several years, recommended exposure times for loud sounds have been cut dramatically as the result of re-evaluations of existing programs and hearing loss data.

Hearing Conservation Concepts.

There are two basic methods for protecting oneself from loud sounds. For most musicians the final result will not be all that different regardless of the chosen method. The recommended, and by far the easiest choice, is simply to use hearing protection. The other method requires one to know the sound levels to which they are exposed and to learn how to manage exposures to them. As was seen in the previous section, without adequate measurements, called sound surveys, this can complicate matters considerably. In either case, most musicians, from intermediate level through professional, will likely find they must use hearing protection for at least a portion of their playing. Understanding both methods will make selecting hearing protectors much easier. Both have the same starting point so we will begin our discussion by defining safe sound levels.

Experts say that below about 75 dB(A), sounds of almost any duration are safe, for most people(8). This level is just about twice as loud as normal conversation from 3 feet away. We must realize this sound level is not very loud compared to sounds encountered in our modern world and certainly not loud enough to accommodate the playing of our flutes and piccolos much above piano or mezzo-piano levels. In order to have exposures to louder sounds we can either use hearing protection or we can consult published exposure tables. The tables are used to trade exposure time for increased loudness and could be used if the sound levels are known.

According to The National Institute of Occupational Safety and Health (NIOSH), hearing damage begins at 85 dB(A), after 8-hours of daily exposure. This assumes repeated exposures over extended periods, perhaps as long as 30 to 40 years. This corresponds to approximately the sound level generated at a player's ears by a flute at an average mid-mezzo-forte dynamic.

Since we obviously need to play at higher dynamic levels, too, exposure tables say for each just detectable increase of 3 dB in sound level over 85 dB(A), the allowable exposure time is cut in half. At a sound level of 88 dB(A), the maximum time is cut to 4 hours, for 91 dB(A) it is cut to 2 hours, and so on(7). Times derived from this guideline are all MAXIMUMS, where damage is KNOWN to begin. There are some drawbacks to using this scheme. It is based on data for exposures primarily to continuous sounds and many of the time-trading rules for the higher sound levels are based on theories or animal studies, not totally on experience with humans.

The exposure trading scheme, presented above, is one of the most conservative to be proposed, but still may result in hearing damage in some sensitive people. One reason for this is our music has an impulsive sound characteristic, not a continuous characteristic. It has sound peaks that considerably exceed the average due to its natural, expressive dynamics. Peaks may exceed the average sound level by 8 to 16 dB. It is not known from experience with humans if maximum exposure times derived from this scheme will truly protect against the impulsive nature of music, particularly over a person's entire lifetime. Projections say that roughly eight percent of those exposed in this manner for 40 years will suffer losses significant enough to show on audiometric charts. Also, flutists may have longer playing careers than the one on which this guideline is based, but better data is just not available. Of course, cautious persons will not want to push the limits, but before we ponder the implications of this too much, we need to be aware of a "catch-all" safety net inserted by NIOSH. This safety net will be our primary, recommended method.

Method 1 - The Use of Hearing Protection.

NIOSH recommends that anyone exposed to sound levels of 85 dB(A), or above, for any duration during a day, should wear hearing protection. The protectors should reduce the sound level at our eardrums to 82 dB(A), 8-hour TWA, or below. We will show how this works in some detail, in a moment, but be aware that nearly all flutists and piccolo players would be included by virtue of the loudness of their playing. Only beginners with less developed tones might escape it, even though they perhaps should not desire to do so. The rest of us would require hearing protectors simply because we would equal or exceed 85 dB(A) average sound level at our ears when we play at mezzo-forte, or above. Audiometric testing is also required.

In addition, the absolute maximum sound level of 115 dB(A) must be observed. Beginning between 115 dB(A) and 120 dB(A), instantaneous damage occurs in many people. Damage is no longer proportional to the duration of a sound, but depends only on the level. It is not likely that such levels could be generated by flutes and piccolos playing alone, but in ensembles or through the use of PA systems such levels could be reached, routinely. Orchestras playing loudly can exceed 120 dB(A), for example. Hearing protection will keep most loud sounds from reaching this level.

Let's review Method 1. Most of us, if not all, are advised by NIOSH to use hearing protectors and to have periodic audiometric exams. Beginners might not need protection, but should be advised of the need as soon as they progress enough to have well developed tones or begin to play in the higher dynamics. Then, we should not expose ourselves to greater than 115 dB(A) levels, on any occasion, for any duration, in order to avoid instantaneous damage. It is possible to manage exposure times using a sound meter, but the management of trades between time and sound level may prove to be more risky.

Genetic Variations Affecting Hearing Conservation.

Before moving into Method 2, we need to point out that each individual, not surprisingly, has a genetically determined sensitivity to hearing damage. This means it is not even possible to say with complete certainty that any particular sound level, 75 dB(A), 80 dB(A) or 85 dB(A), for example, is the safe exposure limit for all individuals. It is still a good idea to have periodic checkups to be certain that your hearing is being protected by any guideline. Individual susceptibilities to damage may differ by as much as 30 to 50 dB, which is a huge variation. Some of us may not suffer ill effects at all at fairly high levels, but the process of proving it may needlessly endanger a portion of one's hearing.

In light of all the limitations on exposure times from loud sounds, it is easy to get the impression that neither the playing of our instruments or their design should in any way be thought of as having been genetically ordained safe. Many of us are pushing hard on our physiological limits by playing them without adequate hearing protection. Since most hearing programs are designed to get someone through a 30 to 40 year career, those who started young and intend to play a flute or piccolo, perhaps for 60 years or more, needs to be particularly conservative.

Method 2 - Exposure Limiting.

This method will allow trading exposure time for higher sound levels. The basic concepts were covered in the previous sections, and involve reducing exposure times above 85 dB(A) by half for each 3 dB increase in level. The information in this section is primarily for Method 2, but will be useful as background safety information for those planning to use Method 1. There will undoubtedly be times when those using Method 1 will be caught without their earplugs.

The next chart shows the maximum recommended daily sound exposures based on concepts developed by NIOSH(7). It uses 75 dB(A) as a safe level for any duration and 85 dB(A) as the maximum for 8 hours daily. The maximum durations at various sound levels are in the first two columns. The music dynamics have been added to illustrate APPROXIMATE playing levels. They CANNOT accurately substitute for sound measurements taken near your own ears, so you should only use them to help see the need for sound measurements or for exercising caution. This simply means if you are at all close to any limit you should either back off, make sound meter measurements or use hearing protection. The Hearing Protector columns were also added to help in choosing an adequate protector when open ear exposures are too short.

All stated exposure times are maximums for full 24 hour days, to be followed by 14 hours of rest. Sound exposures at various levels or for various activities must be totaled as percentages of the maximums to determine your Total Dose (covered in Figuring Your Daily Sound Dose, below). Sound levels should be measured at the ear using a calibrated sound meter or dosimeter (see Sound Meters, below).


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Cautions:

    * Dynamic indications are for illustrative purposes only and will not necessarily predict your own sound levels accurately. They are for solo players. Sound levels in ensembles could be significantly higher at each dynamic level.

    ** Music average or peak levels exceeding 115 dB(A) may cause permanent instantaneous damage regardless of exposure time. Some ensembles and PA systems can generate these levels on music peaks.

Figuring Your Daily Sound Dose.

All individual, daily, loud sound exposures must be totaled to give your Total Dose, including, practices, performances and recreational activities. A Total Dose of 100 percent is the maximum for each 24-hour day. To get the Total Dose for a set of exposures, figure the percentages for individual exposures, based on their maximum exposure times, and sum the percentages. Remember to use percentages of each maximum time in figuring your Total Dose, for example: 15 minutes of a 30 minute maximum is 50 percent, not 15 minutes. Those desiring more safety will not push toward the maximum times or a Total Dose of 100 percent.

Examples:

    * An Open Ear (without earplugs) exposure at 91 dB(A) for 2 hours (100 percent dose) uses up your entire daily allowance for all loud sounds above 75 dB(A). Earplugs that would reduce all other playing to below 75 dB(A) would be required for all other loud sound exposures. Use the NRR columns to find suitable earplugs based on the level and duration of the remaining sounds.

    * An Open Ear exposure at 97 dB(A) for 15 minutes (50 percent dose), followed by 4 hours at 85 dB(A) (50 percent dose) will use up your entire daily allowance for all sounds above 75 dB(A). Earplugs that would reduce all other playing to below 75 dB(A) would be required for all other loud sound exposures. Use the NRR columns to find suitable earplugs based on the level and duration of the remaining sounds.

    * An Open Ear exposure at 91 dB(A) for 1.5 hours (75 percent dose) is desired. However, you need to play at lower levels for longer than the remaining 25 percent of Total Dose will allow. You could use earplugs to reduce the exposure at the higher levels and have sufficient Total Dose left for the other playing, with Open Ears (see How To Select Adequate Hearing Protection).

RECOMMENDATIONS FOR COMMON PLAYING SITUATIONS.

In all of the following discussions, the conclusion likely will be that hearing protection makes the most sense. There are many variations of playing style possible, but all are dominated by the same overriding factor: the short maximum exposure times at the higher sound levels. In the forte range, for example, Total Dose gets used very rapidly, as the chart shows. If you find your other exposures too limited by this, you should be using hearing protection, either all the time or at least when practical, to conserve Total Dose. If you experience any of the hearing effects in Warning Signs, below, you need to cut exposures more. Everyone should see Room Acoustics, Warning Signs and Piccolo Players.

Beginners and Casual Players.

Beginners and more casual players who do not play above mezzo-forte have up to two hours of open ear playing time each day (without earplugs). This might be extended if a sound meter could be used to verify an average level of 85 dB(A), or lower. Those who play at higher dynamics should be using hearing protection.

Intermediate through Professional Players.

More advanced or intense players who spend very much time at higher dynamic levels will find they will use their Total Dose quickly, leaving too little safe exposure time for the rest of their playing. For example, either 15 minutes at forte (97 dB(A)) or 1.5 minutes at double-forte (106 dB(A)), would use 50 percent of your Total Dose (for the entire day). In effect, either exposure would cut all other times in The Maximum Sound Exposure Chart in half. It is unlikely that the remaining 50 percent would allow enough time to finish your daily playing. If it is not enough time, earplugs will be required, at least for a portion of your playing. See the next section on using a sound meter to verify your levels at the higher dynamics.

Sound Meters.

A sound meter would be required to measure your sound level, which becomes more important at the higher dynamics where the maximum times are measured in minutes. Small changes in loudness can have a large effect on the exposure time and Total Dose. However, unless your routines are fairly stable, a sound meter is not very handy to use. It can help you learn how loudly you are playing specific or representative pieces, drills, etudes, and scales, in some venues. In other venues, acoustical variations make measurements too tedious. The sound meter will not be very handy in many actual performance situations, which would have to be estimated from experience.

Using A Sound Meter.

Select a sound meter that will average sound levels over a period of at least several minutes. Measure average sound levels, not peaks or maximums. Mount your sound meter on a camera tripod quite near your right ear. Set it for A-weighting and take averages over the length of entire pieces, preferably over the entire playing period. Look up the sound levels in the chart and figure your dose in percent using the time over which you averaged the sound. If this is not equal to your total playing period, adjust the dose accordingly. Be sure your meter is calibrated and add the meter tolerance to the measured values to err on the side of safety.

Playing More Softly.

Playing more softly may be an option for some who exceed the exposure limits. If you are a solo player or can convince your ensemble to cooperate, this is a good first step toward safer playing. The 6 dB NRR column in The Maximum Sound Exposure Chart shows how the exposure times are increased for playing at half loudness. Half loudness will extend your maximum time by a factor of about four.

Amplification and Playing Softly.

If you use amplification, you can play more softly and turn up the PA system to compensate. To be effective, ALWAYS avoid sitting in front of your PA loudspeakers and keep monitor speaker levels low, too. Use a sound meter to determine if you are operating safely. Room acoustics will likely require you to take new measurements in each venue. If you must sit in front of the loudspeakers, use hearing protection.

Larger Ensembles.

Ensemble players are often at risk. Orchestra members typically have the greatest hearing losses of acoustic musicians. The high combined sound levels in medium to large ensembles may be in the mid-90 dB range, or higher, even at mezzo-forte. Even in orchestra pits small ensembles can reach these levels, too. Due to the inherent, expressive dynamics of music, peak sound levels can exceed 115 dB(A), the absolute maximum sound level. Instantaneous hearing damage begins to occur above that level. Your group's management should take responsibility for sound surveys, which most likely will point to the need for hearing protection. The sound surveys will be useful in selecting earplugs. If possible, have audio professionals take readings at the ears of most of the players in the various sections, especially those in or near the brass and percussion sections. Be aware that the plastic, sound-deflecting screens used in many orchestras provide varying amounts of protection from minimal to significant, and should not be rearranged without confirming their continued effectiveness by sound measurements. Be sure to include your practices, rehearsals, and recreational exposures in figuring your Total Dose.

Smaller Ensembles.

If you play in a smaller ensemble, and you do not sit in front of or too near a loud instrument, you need at least to consider the contribution of the room acoustics. If the sound level is significantly higher in ensemble than when you play alone you need to use a sound meter to determine how safe you are. If the sound level is only perceptibly louder in ensemble, cut the exposure times by two to four in the Open Ear or NRR columns. This will likely cut the times too much to be practical and require the use of earplugs. If your group or band has brass or percussion instruments, you should be concerned with the possibility of music peaks exceeding 115 dB(A), the absolute maximum sound level. Instantaneous hearing damage begins to occur above that level. Groups heavy in brass and percussion instruments will have significantly higher average sound levels, too.

Music Teachers, Conductors and Band Directors.

Music teachers, conductors and band directors are also likely to exceed their daily maximum sound exposures due to the combined sounds of multiple instruments. There exists a multitude of possible variations in room acoustics and ensemble configurations, making it very difficult to predict the combined sound levels at your ears without using a sound meter. Estimates place the levels about one entire dynamic level higher for the combined ensemble those shown in the chart for single instruments. Room acoustics could raise it further, producing pockets of higher sound levels.

Teachers who sit in medium to small practice rooms with only one or two students should cut the maximum exposure times in at least half and limit the time spent at higher dynamics. If you spend an entire day in such quarters it would be hard to not exceed the limits. Be cautious if you are in a small, live room. With multiple instruments or small rooms sound measurements are recommended.

Room Acoustics.

Room acoustics have varying effects on the sound that reaches our ears. Practicing in a dead room (with carpets, drapes or stuffed furniture to absorb the sound) will often cause us to play louder. This raises the sound level at the ears of flute and piccolo players, since most of the sound comes directly from the instrument in most surroundings. For solo players, cut the maximum exposure times at least in half for dead rooms. If you play in a live room, unless it is very small, use the chart values (see advice for music teachers, above). The small live room raises the sound level at your ears even though you may be playing slightly softer.

Piccolo Players.

Piccolo players are perhaps in more danger than flutists and most other players. Their top dynamic is very loud and they are pitched where the most damage is done the quickest. Those who sit next to them are also subjected to very high sound levels. Sound levels three feet away may range from 5 dB lower to equal to those measured at the player's ears, depending on acoustics. A piccolo is capable of producing such loud sounds at double-forte that the player could exceed maximum exposures within just 1 to 7.5 minutes. Such short exposures rapidly use up your daily Total Dose, even on shorter passages. You are advised to use hearing protection.

Warning Signs.

Musicians with ringing, buzzing, muffling, harshness, beating or any other odd sensations in either ear should see a medical practitioner or licensed audiologist, soon. Some players with sensitive ears may even experience warning signs at most sound levels above even 75 dB(A). They definitely should be using earplugs. Have audiograms made and look for NIHL patterns. Keep copies of audiograms for future comparisons. If you have tinnitus (continuous ringing) or any other chronic condition, in either ear, and it worsens with an exposure, you are exceeding your limits.

HEARING PROTECTION
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HOW TO SELECT ADEQUATE HEARING PROTECTION.

Earplugs will very likely be the correct choice for you and especially if you cannot perform adequate sound surveys in all venues. They are recommended by NIOSH for sound levels typically produced by most players of flutes and piccolos, as pointed out in Method 1, above. Unless you are a beginner or casual player who does not often play above mid-mezzo-forte, or are one of a very few amplified players, you will need them, even for use in limiting exposures in Method 2, above. Remember, a good hearing conservation program will protect your hearing for your lifetime, not merely expend a portion of it over a period of your career.

Basic Types of Hearing Protectors.

There are two basic types of earplugs, noise suppression and "hi-fi." As the name implies, the hi-fi type has a flatter response, with less roll-off (decrease) in the higher frequencies. Noise suppression earplugs can have a greater Noise Reduction Rating (NRR), but the roll-off is usually greater. There are earmuff protectors, although not hi-fi, that could be used in the studio and are handy when they must be removed and replaced, often, as in teaching. Wearing any device that does not have a stated Noise Reduction Rating (NRR), such as, any materials found around the home is not recommended for any loud sound exposure, including: audio headphones, cotton, paper or cigarette filters. They often do not have the required high frequency reduction. Be safe.

Choosing a Noise Reduction Rating (NRR).

The Maximum Sound Exposure Chart shows that for most of us, the controlling factor in choosing a Noise Reduction Rating (NRR) is the time spent in the higher loudness levels. For most of us, playing alone, the exposure times afforded by 12 dB NRR earplugs will be sufficient in the mezzo-forte to mid-forte range (8 to 24 hours), having extended our playing time by up to 16 times. For those who spend more time in the higher dynamics or in ensembles, higher NRR's may be required. The goal is to reduce the level at our eardrums to 82 dB(A), or below, for the equivalent of 8 hours per day. The four NRR columns in the center of the Maximum Exposure Chart are based on meeting that requirement.

Derating NRR's.

Earplugs receive a Noise Reduction Rating based on testing in a laboratory. It should tell us how well a hearing protector will perform when we use it. Protectors often do not perform as well in real life situations as they did in the laboratory and the stated NRR on the package may not be what your will experience. The correctness of fit and the amount of bone conducted sound through the face and head varies between individuals, causing some to experience less attenuation of the sound than others. NIOSH recommends derating the manufacturer's NRR's as follows:

    * Earmuffs: reduce to 75 percent
    * Formable earplugs: reduce to 50 percent
    * All others: reduce to 25 percent.
For example, a formable, foam earplug with a rating of 30 dB would be derated to 15 dB. You may get better performance than is indicated here, if you take time to read the use instructions carefully and to apply your protector conscientiously.

You can use The Maximum Sound Exposure Chart to see how your proposed earplugs will extend your playing time. The central columns show earplug NRR's of 6, 12, 18, and 24 dB. If the NRR of your earplugs, after derating, is not shown, use the next lower NRR in the chart. For example, for 25 dB NRR, formable earplugs, use the 12 dB column. If you have any doubt about the fit of the earplugs, or their effectiveness, due to wear-and-tear, you should replace them as soon as possible.

Is a Higher NRR Always Better?

Most of us will not prefer to use earplugs that exceed our basic requirements by very much. As we lower the proportion of the sound coming through our outer ear, bone conducted sound in our face and head becomes a major contributor to the sound we perceive. For some players, bone conduction emphasizes the lower frequencies, even with good quality, hi-fi earplugs. Using earplugs that are adequate for the required daily exposures will minimize this effect. Of course, when doing activities like mowing the lawn, and for all other non-critical listening activities, use the maximum NRR.

Choosing a Type of Earplug.

If you want the best quality earplugs, with a minimum of distortion and a broad range of NRR's, you will need to visit an audiologist. If you need high NRR's, as for piccolos, you will probably need to do so also, as the noise reduction earplugs (with the highest NRR's, as shown below) will not be nearly as satisfying. If you are looking for good quality earplugs that may suffice at a lower cost, try the hi-fi, standard fit types. If you need the highest NRR's in a low cost earplug, the noise suppression types are the only choice, at present. Audiologists should know of the latest types available in the widest range of NRR's.

Getting Used to Wearing Your Earplugs.

Once you have your earplugs, allow a couple of weeks, or more, to adjust to them. Plan to make the transition when your performance schedule best allows it. You will have to relearn how your instrument sounds at the new, safer levels. Periodically check your tone with and without the earplugs and make the necessary adjustments. If you are not satisfied with the resultant effects on your tone, move up to higher quality earplugs or work with an audiologist to get what you need. Before giving up on a particular earplug, have someone check your tone at a distance, say equal to the distance to your average audience, under similar acoustic conditions, if possible. Some sounds that are prominent at the player's ears do not project very far. This is especially true when using hearing protectors.

Typical Earplugs.

The following earplug listing is a representative list of types. There are many other brands available, but this list should allow comparing various types for beginning your search. You can enter the keyword, "earplug," in an Internet search facility to see more choices. The author does not endorse any particular brand for any purpose and the data below may change without notice. If you have questions about which earplugs are appropriate, you should consult a licensed audiologist or medical professional.

Noise Reduction Types, with high NRR.

    E-A-R, Model PL-102, Cabot Safety Corp., formable, soft foam earplugs. About US$2 per three pair or US$5 per 12 pair. Intended for noise reduction. NRR on package is 29 dB. Flatness: about 20 dB roll-off at higher frequencies.

    Flents, Model #150, Flents Products, Inc., formable, soft earplugs. About US$2 per package. Intended for noise reduction. NRR on the package is 29 dB. About 20 dB roll-off at higher frequencies.

    Flents, Model #195, Flents Products, Inc., formable, soft earplugs. About US$3 per 5 pair. Intended for noise reduction. NRR on the package is 22 dB. Estimated 20 dB roll-off at higher frequencies.

    MABCO, Quiet Space, Model 21612, formable, soft earplugs. About US$4.25 per 6 pair. Intended for noise reduction. NRR on the package is 31 dB.

    Silaflex 2, Model 903, formable earcaps. About US$3 per 3 pair. Intended for noise reduction. NRR on the package is 21 dB.

Hi-Fi Types, with moderate NRR.

    E-A-R, Model ER-20, Cabot Safety Corp., Hi-Fi, soft plastic triple tips. About US$20 per pair. Intended for musicians. NRR on the package is 12 dB. Flatness: stated 15 dB at low frequencies, with approx. 10 dB roll-off at higher frequencies.

    Etymotic, Model ER-15, (data not available at the time of writing).

Hi-Fi Types, higher quality, with various NRR's.

    Consult an audiologist for options. Prices are US$100, and up.

Earmuffs.

Noise control types are available at home improvement centers, hardware stores (medium NRR's) and gunshops (higher NRR's). They range in price from about US$10 to US$30. NRR's range from about 15 dB to 29 dB.

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REFERENCES AND BIBLIOGRAPHY WITH WWW LINKS
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References.

1 Teie, Paul U., M.M., M.S., F.A.A.A., Noise-induced hearing loss and symphony orchestra musicians: risk factors, effects, and management, Maryland Medical Journal, 1998, pp 13-18.

2 Daum, Miriam C., P.T., M.P.H., Hearing Loss in Musicians, Center for Safety in the Arts, New York, NY, 1988. See WWW site: http://tmn.com:70/0/Artswire/csa/arthazards/performing/musnoise

3 Everest, F. Alton, The Master Handbook of Acoustics, 3rd Edition, TAB Books, New York, 1994, Audibility of Loudness Changes, p. 49.

4 Davis, Gary, and Ralph Jones, Sound Reinforcement Handbook, Second Edition, Hal Leonard Corp., Milwaukee, 1990.

5 Pierce, John R., The Science of Musical Sound, Revised Edition, Loudness, pp. 123-7, W. H. Freeman and Company, New York, 1992.

6 Centers for Disease Control, Hearing Conservation Program, Appendix A, Noise - Training Information, Noise, Sections A and D. See WWW site: http://www.cdc.gov/od/ohs/manual/hearing.htm#Sec 3

7 Criteria for a Recommended Standard, Occupational Noise Exposure, Revised Criteria 1996, DHHS (NIOSH) Publication No. 96­XXX, National Institute of Occupational Safety and Health, 1996. See WWW site: http://www.cdc.gov/niosh/noisecd.html

8 National Institutes of Health, Consensus Development Conference Statement, 76. Noise and Hearing Loss, January 22-24, 1990. See WWW site: http://text.nlm.nih.gov/nih/cdc/www/76txt.html

Bibliography and WWW Links.

Environmental Protection Agency (EPA), Part 211, Product Noise Labeling. See WWW site: http://www.epa.gov/docs/epacfr40/chapt-I.info/subch-G/40P0211.pdf

Hamernik, Roger P. and William A. Ahroon, , Interrupted noise exposures: Threshold shift dynamics and permanent effects, Plattsburgh State University of New York, 1997. See WWW site: http://137.142.42.15/ARL/Recent/Hamernik_1997b/Hamernik_1997b.html

The Health & Safety Executive, UK, The Noise at Work Regulations, 1989. See WWW site: http://www.measure.demon.co.uk/docs/The_Noise_at_Work_Regulations_1989.html

H.E.A.R. (Hearing Education and Awareness for Rockers), HEARNET web site: http://www.hearnet.com/text/mainframe.html

Hearing Health Institute, Music/Audio, 1997. See WWW site: http://www.hei.org/hei/music.htm

National Hearing Conservation Association, Guidelines for Audiometric Baseline Revision Recommended by the National Hearing Conservation Association, February 24, 1996. See WWW site: http://www.globaldialog.com/~nhca/pos1.html

National Hearing Conservation Association, NHCA Greets New Director of OSHA: Suggests Strengthening OSHA Noise Policy, March 2, 1994. See WWW site: http://www.globaldialog.com/~nhca/pos7.html

National Hearing Conservation Association, Position Statement on National Institute for Occupational Safety and Health, 1995. See WWW site: http://www.globaldialog.com/~nhca/pos2.html

National Hearing Conservation Association, Position Statement on OSHA, and the OSHA Noise Standard and Hearing Conservation Amendment 1910.95, October 12,1995. See WWW site: http://www.globaldialog.com/~nhca/pos3.html

National Hearing Conservation Association, Position Statement on the Quiet Communities Act of 1997, March 19, 1997. See WWW site: http://www.globaldialog.com/~nhca/pos4.html

National Hearing Conservation Association, Recommendations of the NHCA Task Force on Hearing Protector Effectiveness, March, 1995. See WWW site: http://www.globaldialog.com/~nhca/pos6.html

National Institute of Occupational Safety and Health, Occupational Noise and Hearing Conservation, Selected Issues. See WWW site: http://www.cdc.gov/niosh/noise2a.html#PAR1

Occupational Health and Safety Administration, Standards - 29 CFR, 1910.95, Occupational Noise Exposure. See WWW site: http://www.osha-lc.gov/OshStd_toc/OSHA_Std_toc_1910_SUBPART_G.html

Olsen, Harry F., Music, Physics, and Engineering, Second Edition, Dover Publications, Inc., New York, 1967.

Oshex Associates, Inc., The OSHA Noise Standard, 1996. See WWW site: http://www.oshex.com/oshanois.htm

SAFTEK Information Services, Noise in the Music Entertainment Industry, Basic Concepts, 1998. See WWW site: http://www.saftek.net/worksafe/noise_e2.htm

University of Washington, Protect your ears from loud noise to hold on to your hearing, 1994-1998. See WWW site: http://www.hslib.washington.edu/your_health/hbeat/hb950418.html

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Copyright 1998, by Steven A Wicks. This document contains copyrighted information. No further publication, in whole or part, without the written permission of the author: Steven A Wicks, 3901 Zenako Street, San Diego, CA, USA, 92122-3429. Version 980526.

BE HEARING YOU.


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