Janet Horvath  

Hear No Evil

Janet Horvath
April 16, 2019

Editor's Abstract (Click to Hide)

One of our most precious assets, as musicians, is our hearing, yet we are constantly endangering our hearing merely by going to work. Janet Horvath, Minnesota Orchestra cellist, describes some of the most common hearing injuries and offers some excellent advice as to what you can do to protect your hearing.

- Ann Drinan

Let’s talk about something scary; something musicians are even more reticent to talk about than overuse injury. Hearing loss is on the rise and is a danger to all of us. Our world is becoming toxically noisy and we who are musicians must be particularly vigilant. Symphony orchestras are loud, and our own instruments are loud. Violins and violas can reach 100 decibels – comparable to the sound of a major sporting event. Brass instruments reach 114 decibels – the level of a chain saw and a loud band in a bar. Symphonic music at its peak can reach 130 decibels – the level of a jackhammer.

But life is loud too! Over the last several years, environmental noise has doubled each decade. It seems that wherever you go, volumes are cranked up: notice the volumes at movies, of your iPods, of power tools, lawn mowers and snow-blowers, and the background music in restaurants, grocery stores and clothing stores, let alone discos, rock concerts and high-decibel recreational events. Over 28 million Americans have hearing loss and that number is dramatically rising.

Like many overuse injuries, hearing loss is cumulative, but unlike overuse injuries, hearing loss is permanent. Noise-induced hearing loss is our biggest concern and is on the rise, even among very young people. Sometimes noise-induced hearing loss occurs so slowly over time that we don’t even realize that damage is occurring until it is too late. The ear is just like any other part of our body: use it too much and it can be damaged.

Have you ever experienced reduced hearing, ringing in your ears, and/or a hot heavy feeling in your ears after a loud rehearsal or performance? This is called a temporary threshold shift. Usually a period of 16 hours of rest will allow the ear to recover from a particularly loud performance. Those of us in professional symphony orchestras know that sometimes that amount of time off is difficult. But too many occurrences of threshold shift can result in a permanent hearing injury.

Are young people immune? NO! Children and young people are at risk too. In fact, in a recent survey on MTV’s website of nearly 10,000 people under the age of twenty-one, two-thirds had experienced ringing in the ears or hearing loss, although only 8% of respondents reported that they were concerned about hearing loss.

Sometimes a hearing injury can occur without hearing loss. I would like to discuss two very devastating and life changing hearing injuries: tinnitus and hyperacusis.


Nearly 50 million Americans suffer from tinnitus, or “ringing” in the ears or head that only you can hear, and of these sufferers, 13 million are under the age of 18. The sounds can be intermittent or continuous, in one or both ears. It can be one pitch, or it can be a roar described by some sufferers as a sound like a jet taking off or a train. It is more pronounced at night in bed when there are no other ambient sounds. Exposure to loud noise is the leading cause of tinnitus and can be, but is not always, accompanied by hearing loss. There are other causes of tinnitus as well, such as high blood pressure, a tumor, diabetes, thyroid problems, an injury to the head or neck, and taking certain medications. It is important, therefore, to see an otolaryngologist to determine the cause of your tinnitus.

In many cases tinnitus is incurable. Treatment options include cochlear implants to mask the sounds you hear internally with electrical stimulation or white noise (i.e., broadband sound that is a combination of all sound frequencies at very low levels). This is called tinnitus-retraining therapy. Sometimes the severity of the tinnitus symptoms can be reduced by decreasing the intake of salt and caffeine, keeping blood pressure levels controlled, exercising daily to improve circulation, using relaxation techniques, avoiding fatigue and stress, quitting smoking, and especially avoiding exposure to loud sounds.

Sufferers may become paranoid and depressed about their condition. They may be tempted to avoid any situations that may be loud, and may be tempted to isolate themselves from normal social interactions as well as noisy locations.

It is paramount that musicians protect themselves from this condition by careful preventative techniques. A few suggestions follow in this article.

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Comments (Click to Hide)

The reference to in-ear headphones is completely misinterpreted. On the contrary, in-ear noise isolating headphones are generally recommended by most studies, including Fligor's who concluded that users tend to exceed much less the recommended levels when using in-ear noise isolating headphones. In-ear headphones are more dangerous only if you listen at loud volume levels, but the purpose of noise-isolating headphones is completely the opposite: to allow users to turn down the volume and actually listen at safer volume levels than with normal headphones!

Even the article you mentioned says in fact:

"Five Ways to Save Your Ears

3. Get better headphones: Those that shut out external noise allow you to turn down the tunes. In-ear phones like Etymotic's ER6 ($139) and Shure's E4C ($299) go deep into the ear canal to block pretty much all outside noise".

And at http://www.physorg.com/news80304823.html :

"In a separate study to be presented at the conference, Fligor and Ives observed the listening habits of 100 doctoral students listening to iPods through earphones. When the students were in a quiet environment, they found that only 6 percent of them turned their players to risky sound levels. When in a noisy environment, a dramatically higher 80% of the students listened to the music at risky levels. When they used an "in-the-ear" earphone designed to block out background noise, only 20 percent exceeded sound levels considered to be risky. This suggests, Fligor says, that seeking out quiet environments and using "isolator" earphones designed to block out background noise help listeners avoid the tendency to play music at sound levels that can pose risks to their hearing."
zamolxis on April 16, 2019 at 9:55 AM

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