Larry Krantz Flute Pages: Flute Hearing Concerns


** A classical loss of hearing **
** While modern mythology has demonized rock 'n' roll as **
** the great deafener, research suggests that symphony **
** orchestra players risk more hearing **
** problems than their heavily amplified musical brethren **

BY STEPHEN STRAUSS, Science reporter, Toronto

AFTER 40 years of being seated near the braying brass section in the Chicago Symphony Orchestra, first violinist Fred Spector was struck with a potentially career-ending occupational disability when he couldn't hear the violins on his left. The 71-year-old musician, who began playing at the age of 4, says over the telephone, "Believe it or not, I am having trouble hearing you."

While this elicits a raising of the caller's voice level, from a clinical point of view it is hard to believe a long-time orchestral musician would not have a hearing problem. But the extent of the damage that occurs is surprising.

While modern mythology has demonized the deafening nature of rock 'n' roll, research suggests that orchestra members may end up with more hearing problems than their heavily amplified rock brethren.

Numerous European and U.S. studies over the past 25 years show that while 5 to 30 per cent of rock-pop musicians sustain some form of permanent hearing loss, the rate jumps to 4 to 52 per cent among classical musicians.

Hearing problems are not a subject orchestra members like to discuss, for the good reason that theirs remains an occupation in which hearing loss is often not simply an affliction but a firing offence.

The reason Mr. Spector is on the phone from Chicago is that he will proudly and openly discuss his use of a new type of hearing aid specially designed with musicians in mind. He will, and his Canadian counterparts won't.

Calls to all major symphony orchestras in Canada, notices in musicians' union halls, a personals ad in The Globe and Mail, a posting on a San Francisco Internet site devoted to dealing with the problems of musicians with hearing loss, and requests by a do willing to talk.

"I probably have been the most outspoken person in North America about musicians' health," says Kathy Peck, a former bass player who operates Hearnet, the San Francisco-based Internet site. "But if I were wearing a hearing aid and you asked about it, I would tell you to take a hike. It would be like a neurosurgeon telling you he was losing feeling in his hands."

Jan Kocman, principal flutist with the Winnipeg Symphony Orchestra, who wears a specially designed musician's earplug to protect his ears, echoes the job-loss fears. "Word travels fast and before you know it you have an orchestra director who is an ass and he starts saying, 'Why do you have to wear hearing aids? Can't you hear? Maybe he can't play as well as he should because he can't hear as well as he should.'

To gauge the danger level of sound for human ears, scientists employ the decibel scale. On this measurement of sound intensity, a reading of 95 decibels, for example, means your ears have been exposed to 10 times more sound energy than at 85 decibels. The danger point of sound for the human ear has been determined by long-term studies of the relationship of decibel levels and exposure times.

For a variety of reasons, audiologists disagree as to which rule applies when permanent hearing loss occurs. But no matter, they know that loud music, like industrial noise, can affect hearing.

Workplace sound regulations of the U.S. Environmental Protection Agency are based on the observation that little permanent hearing loss occurs in people exposed to 85 decibels for eight hours a day - its recommended daily maximum - for 40 years. How loud is 85 decibels? A jackhammer at 15 metres produces that intensity.

What most people don't appreciate is how often classical music reaches sound levels significantly higher than 85 decibels. Perhaps the most intense, prolonged sounds occur during Wagner's 15-1/2-hour extravaganza, the Ring Cycle. When movements such as the Gotterdammerung are played, orchestra sounds of 110 decibels - roughly equal to the noise of a car horn heard at six metres - are attained. In practice, this means that some classical musicians receive 187 per cent of their recommended daily noise dose while creating a Wagnerian sound fantasy.

It is true that other types of music can be quite clamorous. Jazz, blues and country have typical sound intensities in the 80-to-101 decibel range, and hyperkinetic Japanese drum bands can create levels of 125 dB - akin to the racket of cars speeding round a racetrack.

Nor has Wagner cornered the market on loud. Trumpeters playing Mahler's Ninth Symphony produce passages of 112 decibels - levels well in the range of the buzz heard near a power saw.

As to rock, an early U.S. study suggested that in live concerts the music level of groups may average 105 decibels and sometimes hit 120 decibels or more.

Yet there is not much solid evidence that regular listeners of rock and pop music severely damage their ears. While record players and portable radios can produce extremely loud music - e.g. 114 decibels - numerous studies show that most young people prefer to listen in the rather soothing 85-to-90 decibel range.

A long-range study reported last year by Alf Axelsson and his colleagues at the University of Gothenburg in Sweden found that among 53 Swedish and British pop/rock musicians who had played for an average of 26 years, 63 per cent still had normal hearing and 15 per cent had only a small hearing loss.

So, why is classical musicians' hearing affected more than that of their louder, amplified cousins? Numbers of reasons are offered.

First, there is the direction of the sound. While rock musicians play loudly, they also tend to blast their music through loudspeakers out to the audience. In contrast, the sound-generating technology of orchestras - the instruments - are both aligned in rows and create sounds that go right into musicians' ears. The results are legendary. "The glockenspiel produces sounds that are beyond belief. Your ears can ring for a day," says Steve Gaetz, a timpani player with Symphony Nova Scotia.

In a more quantitative vein, a 1983 study of two Stockholm orchestras by scientists at the Karolinska Institute in Stockholm found that musicians seated in front of the noisy brasses received their recommended weekly industrial dose of noise in 10 hours. This rose to 25 hours when they sat in a less exposed position.

Other classical musicians are forced by the nature of their instruments to hold them in positions that maximize the effect on the players' ears. For example, when Dr. John Chong and audiologist Marshall Chasin, both of Hamilton, Ont., measured the sound intensity at the right shoulder of a piccolo player in the National Ballet of Canada orchestra, they took a reading of 126 decibels - again a speedway sound level.

Other scientists suggest that classical musicians have more hearing problems because they play and rehearse for longer periods than other musicians. However, rehearsal time and instrument position may not explain everything.

In a just-released book, Musicians and the Prevention of Hearing Loss (Singular Publishing Group, San Diego), Mr. Chasin points to research suggesting that the level of enjoyment influences the effect sound has on our ears.

For example, Swedish researchers exposed two groups of people to 95 decibels for 30 minutes. They found that there was significantly less temporary threshold shift - numbness or dullness or ringing in the ears - when the noise was presented as a reward for succeeding at a task as opposed to punishment for failing the same task.

The argument then becomes that the reason symphony musicians' hearing is so much more affected is that they play the same music over and over, and the activity becomes more a punishment than a reward.

While scientific evidence warns musicians that they should protect themselves from their instruments' sounds and should wear hearing aids where damage already has occurred, the greatest inducement for them to take action may be technological.

In the past decade "high fidelity" earplugs have appeared on the market. Older plugs muffled all sounds and musicians complained that using them was like playing with their heads in a bucket of water. The new plugs contain a resonator, a device similar to a passive speaker cone in a loudspeaker, which causes an equal reduction across all ranges of sound. A musician wearing the plugs hears everything with the same clarity.

An equally important advance for those with hearing loss is a new kind of hearing aid that accomplishes the same sound-filtering process as the ear plug but does it electrically. This aid, which is so small it can be hidden in the ear, is the type Mr. Spector uses.

The new hearing aids are wonderful, says Dr. Chong, who has fitted 25 of them from his Hamilton clinic. It's our experience that you either use these or you can't work."

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Getting my new earplugs
Kathy Russell

From FLUTE Email discussion group - July 1999

For the last few years, I've learned a lot about hearing protection by reading postings from various experts and experienced folks on this list. (Thanks, everyone.) Based on their comments, I decided to take the plunge and have a set of proper musicians' earmolds made, for use while playing piccolo (I play in a flute choir, not a band, so I only need to protect myself from myself, at least so far). Here's how the experience has gone so far, for the benefit of others who may still be sitting on the fence on this issue.

First, why get 'em in the first place?

I've been playing with one drugstore plug (Hearos) in the right ear, and that has been a great help. My playing has improved since I can now properly support the tone in the upper register. In short, it doesn't hurt to play correctly. Unfortunately, these plugs are not very comfortable, because for a plug to be "one size fits all," it must press harder against the inside of the ear. For me, even with a touch of Vaseline, drugstore plugs range from mildly uncomfortable to downright painful, depending on how often I need to insert them.

They're also difficult to insert properly -- I need to reach around behind my head, and pull the ear out with one hand, while inserting the plug with the other. Of course, this motion is not quick, and is guaranteed to make me the center of attention in any concert situation. I am fortunate to have a very supportive director.

Finally, I know I'll get better sound quality and flexibility with proper filters. The Westone plugs come with two different levels of protection filters: one for sound levels of 105 decibels or less, and one for 105 to 120 decibel situations. The base price includes one set of filters, and you can purchase the additional set if necessary. The plugs can also be worn without the sound filter in place, providing a lower level of sound protection. So I can mix different levels of protection. For example, I can't hear the other players with a drugstore plug in both ears. But I could choose to wear an unfiltered plug in the left, and a filtered one in the right.

The downside, of course, is cost.

Drugstore plugs cost about $6 a pair, and these Westone musicians' molds run about $150. But I've gotten to the point where I can't imagine playing piccolo "unplugged." And I know I'll want more protection if and when I wind up in another concert band, sitting in front of the brass. I figure that my instruments are worth as much as a used car, so I might as well budget a fraction of that for my hearing.

Actually getting the plugs

That has been a very simple process. First, I researched the plugs on the Westone site, then called the local Westone office. After graciously giving me lots of information, they told me that I needed to purchase the plugs through any local audiologist (obvious once I thought about it). The fitting appointments are included in the total price.

Next step, phone book. I simply made an appointment with an audiologist who advertised that she handled custom hearing protection. A week later I was sitting in the waiting room, looking at the many samples of lovely, discreet hearing aids. A real reminder of why I was doing this!

Now for the fun part. The audiologist used a fun high-tech fiber-optic light-and-camera gizmo to look WAY down inside my ears. For her information, and my amusement, this image was displayed on a TV screen. This is fascinating but, if you haven't yet had lunch, I don't recommend viewing a high magnification of an audiologist fishing out your ear wax. I was comforted by the knowledge that she has seen far worse in her career, and resolved to toss out all my Q-tips. However, I did go around the rest of the day with the fresh-washed glow of having professionally-cleaned ears.

Having now verified that my ears contained no sprouting seeds, live animals, or old drywall compound, it was time to take an impression of each ear canal. This is done by squirting some quick-setting plastic goop into each ear. To keep the goop from going too deep, and to give the audiologist a way to get it out, she inserted a small piece of cotton anchored to a pull-thread that hangs out of the ear. The goop is cool and squishy, and things get very quiet as the second ear fills up. But it sets surprisingly fast; I brought a book to read during this part, and hardly finished one page.

That was it for that appointment. Total elapsed time: about 20 minutes.

A week later, I returned for my finished plugs. They're made of flesh-colored plastic (caucasian, in my case). A thin flexible clear-plastic rod extends about a half-inch from each plug, to serve as a handle for insertion and removal. A small red dot identifies the right-ear plug. You can see them if you look for them, but I don't think most people would notice them when they're inserted.

Since my ears are a bit twisty inside, a small bit of lubricant (provided) is necessary for insertion. But not much. I practiced inserting and removing, asked a few questions about maintenance, forked over the cash, and I was out of there in another 15 minutes.

The verdict: Boy, they're nice.

These plugs are almost worth it for comfort alone. When in, they feel like they're hardly there. I can quickly insert each plug with one hand, without making a big obvious production out of it.

Since a piccolo can crank sound levels up to about 120 db, we ordered the stronger set of filters. However, Westone sent the lighter set of filters by mistake. I'm not mad at all -- I'll have a chance to try both sets this way (I'll just bring my piccolo to the audiologist's office when the new filters come in. Bound to make me popular with the people next door!)

I haven't had a chance to practice much with the plugs, even with the light-duty filters (I just picked them up yesterday), so I'll post a followup when I've worked with them awhile.

Kathy Russell
President, Pikes Peak Flute Choir
Technical writer: print, online, web

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