Hear The Music Hearing Loss Prevention For Musicians PDF
Hear The Music Hearing Loss Prevention For Musicians PDF
Hear The Music Hearing Loss Prevention For Musicians PDF
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CONTENTS
www.musiciansclinics.com
Preface
Hear the Music Hearing loss prevention for musicians
is really three books in one, intended for musicians. The first
book is comprised of Chapters 1, 2, and 3. It is a detailed
explanation of those factors that affect hearing loss, and those
strategies that can be used to prevent hearing loss. While the
book is written in an easy-to-read, non-technical manner, the
information is correct and is well supported by research. The
second book is in Chapters 4 and 5, and is an accessible
summary of those issues and data that are discussed in the first
part. Chapter 4 has five summary sheets for various classes of
musical instruments and Chapter 5 is written in a Frequently
Asked Question format. The third book is made up of an
additional 5 full-pages of more technical information that is
optional. The interested reader will gain much from these
pages, but skipping them will in no way affect the completeness of this book. These 5 pages have a solid line rectangle
around the page and are well marked. They are about the
decibel, resonances, the occlusion effect, two laws of physics,
and more detailed information on in-the-ear monitors.
Hear the Music has been written for musicians and represents more than 20 years of clinical work with musicians at
the Musicians Clinics of Canada. Hearing loss prevention in
musicians is something that has evolved from a fringe, barely
acceptable concept, to a central one. Musicians are now, more
than ever aware of the importance of protecting their hearing.
Another book of mine called Hearing Loss in Musicians
(2009), published by Plural Publishing (www.pluralpublishing.com) was intended for those who work with musicians.
vi
For those who find this book interesting, but would like more
information, I would certainly recommend it.
I would like to thank my wife Joanne and three children,
Courtney, Meredith, and Shaun for putting up with me while
I was writing. Finally, I would like to thank another Sean
Sean OConnor who has taught me most of what I know
about music, and who tried to teach me the essence of a II,
V, I turnaround.
For the interested musician, a website has been developed
by the Musicians Clinics of Canada. The URL is www.
musiciansclinics.com. This website was intended for the
high school garage band but older musicians will find it
interesting as well.
Education about the effects of music exposure on hearing is a
cornerstone to any hearing loss prevention program. To support these efforts, the proceeds of this book will go to support
educational activities of the Musicians Clinics of Canada.
Dr. Marshall Chasin, Aud., M.Sc., Reg. CASLPO, Aud(C),
Audiologist
Director of Auditory Research
Musicians Clinics of Canada
340 College Street, Suite 340
Toronto, Ontario, Canada, M5T 3A9
[email protected]
www.musiciansclinics.com
January 2010
F5 (699 Hz)
D5 (587 Hz)
A4 (440 Hz)
E4 (330 Hz)
Figure 1-1: Treble clefs with some notes
4 CHAPTER 1
Table 1-I
Loudness Level
ppp
pp
p
mf
f
ff
fff
dB SPL
40 - 50
45 - 55
50 - 60
55 - 70
70 - 80
80 - 90
90 - 110
What is a decibel?
The decibel is an artificial device that allows us to talk reasonably
about the range of intensities that humans can hear. If we merely
measure the size of the vibration in the air, the most intense one we
can tolerate is about 100,000 times as large as the softest sound that
we can hear. The decibel uses logarithms (or logs) to compress this
100,000 range to one of about 100 dB. A measure of intensity such
as a dB is crucial because it is the intensity that corresponds to hearing loss and not our subjective impression of it (namely loudness).
The decibel is given by 10 X log (magnitude/reference).
Like the temperature scale (F or C), the zero reference is 32 F or
0 C. Similarly with decibels, different references can be chosen.
For measuring many forms of noise, speech, or music, the Sound
Pressure Level (SPL) is used. The reference for this decibel scale
is 0.0002 dynes/cm2. We just need to measure the magnitude of
the sound or music with reference to this value. Typically a sound
level meter is used which converts vibrations in the air to numbers
expressed in decibels. Other reference values are used for other
types of decibel measures, and the reference point is usually added
to the end of the decibel reading, as 90 dB SPL. In this book, the
SPL has been left off for convenience and clarity.
Please see page 6
6 CHAPTER 1
frequency energy. That is, the outer ear serves to make the
highest octave on the right hand side of the piano keyboard
(above 2000 Hz) more intense.
The pinna effect creates a high-frequency boost of sound
energy above 2000 Hz. We can exaggerate this phenomenon
by cupping our hands behind our ears. There is a definite
boost for the higher frequency treble sounds. The physics of
this effect are simple and relate to the shorter high-frequency
wavelengths reflecting from the pinna back to the opening of
the ear canal. The higher frequency sounds not only go in to
the ear initially, but are further enhanced by reflecting off the
pinna and re-entering the ear. In contrast, the lower frequency
energy range, which has longer wavelengths, is not affected
by the presence of the pinna and, therefore, is not reflected
back to the ear canal entrance. Figure 1-3 shows this net
high-frequency boost due to the presence of the pinna, as well
as the ear canal resonance. The total effect is also shown.
8 CHAPTER 1
Pinna Effect
Ear Canal Resonance
Total Effect
Resonance
All tubes and chambers possess resonances, or best frequencies- frequencies that are amplified or enhanced by the container. A pop bottle
has a Helmholtz resonance that can be heard when we blow across
the top of it. This resonance is caused by the interaction between the
characteristics of air in the neck of the bottle and the volume of air
beneath it. The ER-series of musician earplugs use such a resonance
to re-establish the high-frequency sound, in order to make a flat or
uniform attenuator.
In contrast, another type of resonance exists called a quarter wavelength resonator. This only happens when a tube is open at one end
and closed at the other. When we say the vowel [a] as in father our
vocal tract is closed at the vocal chords and open at the open end
of the mouth. Another example involves our ear canal. It is about
28 mm in length and is closed at the ear drum and open at the
opening of the ear canal on the outside. Some musical instruments
such as the clarinet and trumpet function as a quarter wavelength
resonator. A clarinet has a register key that increases the frequency
one and one half octave.
There are also half-wavelength resonators where the tube is either
closed at both ends or more often open at both ends. Many musical instruments, such as the flute and saxophone function as a half
wavelength resonator. These are instruments with an octave key.
The main characteristic of a wavelength resonator is that the longer
it is, the lower will be its resonant frequency. The mouth, when wide
open resonates at 500 Hz, and the ear canal (being much shorter)
resonates at about 3000 Hz. This means that a 3000 Hz sound, is
amplified or made more intense by almost 20 dB by the time it hits
the ear drum!
Blocking the tube with your tongue if it is your mouth, or by blocking it with an earplug, will destroy the natural resonance of that
tube. French horn players can do this with their hand. This is why
all earplugs give more protection in the higher frequencies- the
natural ear canal resonance that serves to boost the intensity of the
higher frequency sound energy, is lost. The ER-series of earplugs
re-establishes this lost energy using a Helmholtz resonator. And,
the less expensive, non-custom ER-20/HI-FI earplug does this with
a quarter wavelength resonator.
10 CHAPTER 1
11
12 CHAPTER 1
swallows, the tube opens, allowing the air pressure to equalize between the environment and the middle ear. When a
person has a cold, swelling occurs in the mucous membrane,
thus closing the eustachian tube. Pressure equalization is
therefore very difficult during such a time and a temporary
mild hearing loss may occur.
However, this pressure release can work both ways. Not only
can the middle ear pressure be equalized with the environment,
but positive middle ear pressure relative to the environment
can be established by extreme effort during lifting. Forceful
air pressure from the lungs, such as that necessary to lift heavy
objects, can cause air to be forced up through the eustachian
tube into the middle ear space. This is called the Valsalva
maneuver. Such a pressure differential can cause a slight
temporary hearing loss that can actually benefit musicians by
acting as a mild earplug. This is frequently noted for woodwind and brass players who have to continually blow against
a reed or mouthpiece.
Problems with the outer or middle ear (such as ear wax
buildup, tympanic membrane perforation, middle ear infection, or a stiffening of the middle ear bones) lead to conductive
hearing losses. With a few exceptions, conductive hearing
losses are medically treatable. Hearing loss related to the inner ear and associated neurological structures is referred to as
a sensorineural hearing loss and, with a very few exceptions,
is not medically treatable.
The inner ear (or cochlea) is a fluid-filled, snail-shaped structure about the size of the small fingernail. Running the length
of the inner ear, over the full two-and one-half spiral turns,
is a thin sheet called the basilar membrane. Sitting upon this
membrane is the Organ of Corti that contains approximately
15,500 nerve endings or hair cells. The structure of sound
transduction in the inner ear is similar to that of a piano keyboard: low-frequency sounds are transduced on one end while
the higher frequency sounds are transduced from the other
end. Specifically, in the inner ear, high-frequency sounds are
transmitted by those hair cells nearer to the stapes (nearest to
the middle ear), while those that transmit the lower frequency
sounds are found in the innermost turns of this snail-shaped
organ. There is approximately a one octave change every 1.25
mm along the basilar membrane (about 30 mm in length in
adults) in the inner ear.
One quarter (about 3,500) of the nerve fibers are called inner
hair cells and three quarters (about 12,000) are called outer
hair cells. Almost all of the inner hair cells take sound up to
the brain , and almost all of the outer hair cells receive sound
back from the brain. The inner ear presents us with a startling
irregularitythe majority of the hair cells are connected to
nerve fibres that return from the brain, and only a small minority take sound up to the brain!
Up until the late 1970s, the physiology of these commonly
found nerve fibers that return from the brain, was not understood, but recent research indicates that they function as a
feedback loop modulating the function of the inner ear. They
alter the inner ear in, as yet not well understood ways that may
make the inner ear more or less susceptible to music or noise
exposure. As will be seen in Chapter 2, disliking the music
slightly increases the potential for music induced hearing loss,
and not the way it is now.
13
14 CHAPTER 1
Most people with normal or near normal hearing have emissions emanating from the outer hair cells in the inner ear.
These otoacoustic emissions can be measured in the outer
ear canal (using a very sensitive microphone) and have been
used as indicators of hearing function. An interesting finding
is that hearing damage from music or noise exposure occurs to
the outer hair cells prior to inner hair cell damage. Therefore,
an abnormal otoacoustic emission test result may be observed
before a measurable hearing loss is detected utilizing conventional pure-tone hearing testing.
It is not clear why outer hair cells are more prone to damage
than inner hair cells. One possible reason may be related to
the physical location of the hair cells in the inner ear. The
inner hair cells sit at the edge of a bony shelf (osseous spiral
lamina) so they are not as affected by the motion of the basilar
membrane as are the outer hair cells, which sit directly on
this moving base. It is possible that this constant movement
of fluid and structures of the inner ear eventually causes the
outer hair cells to lose their transducing properties before the
inner hair cells do.
As discussed above, the inner ear has a complicated neurological structure associated with it that includes feedback loops.
In addition to this structure, is the auditory cortex where
much of auditory cognition or understanding occurs. It is this
central area that is related to an individuals ability to be able
to attribute a pitch to a sound. Approximately one person in
1,500 can perform this task with amazing accuracy (called
perfect or absolute pitch) and this is thought to be related to
the organization of the central structures. People with perfect
pitch generally retain this ability despite significant inner ear
damage. Recent evidence suggests that this is also the site
of many forms of tinnitus which will be discussed in more
detail later in this chapter.
125
250
500
1K
2K
4K
8K 10K -10
0
10
10
20
20
30
30
40
40
50
50
60
60
70
70
80
80
90
90
100
100
110
110
120
120
Figure 1 -4: Audiogram showing a music or noiseinduced hearing loss, (0 = right ear and
x = left ear).
dB HTL
15
16 CHAPTER 1
Audiometric Notch
Why does music or noise-induced hearing loss cause an audiometric notch? Several explanations have been proposed
for this notch. These include (a) a poor blood supply to the
part of the inner ear that corresponds to the 3000 to 6000 Hz
region; (b) a greater susceptibility for damage of the supporting structures of the hair cells in this region; (c) the orientation
of the stapes footplate into the inner ear is such that its primary
force aims toward those hair cells in this region, with the effect
of eventual failure because of the constant hydromechanical
action; and (d) permanent noise exposure has its greatest effect
approximately one-half octave above the peak frequency of
the noise spectrum. Since all music (and noise) spectra are
enhanced at 3000 Hz by the outer ear canal resonance, the
greatest loss will be one half octave higher- in the 4000 to
6000 Hz region. Because of these phenomena, hearing losses
due to music and noise exposure are relatively easy to spot.
A bass player and a picollo player may have similar hearing
losses measured on an audiogram, despite these instruments
have different sounds.
A flat audiogram at 0 dBwhich is a graphic measure of
hearingwould indicate normal hearing. A 30 dB hearing
loss in the hearing at 6000 Hz (an audiometric notch), that is
frequently observed in musicians (and industrial workers),
implies that individual has lost 30 dB of sensitivity for sounds
with energy at 6000 Hz. Such a mild hearing loss however,
would not be readily noticed by a musician. It should only
be thought of as an early warning indicator and not as the end
of ones ability to play music.
Otoacoustic emission testing (measuring changes in the feedback loop to our inner ear with very sensitive microphones)
can also be thought of as a very early warning indicator and if
our clinical function is to warn our patients of any impending
damage, then otoacoustic emission testing should be part of
the audiometric battery.
17
18 CHAPTER 1
Clearly not all music is equally intense. Rock and roll is more
intense than classical, and both are more intense than jazz or
blues. This is generally true, however there is much overlap.
The Ring Cycle by Wagner is considered to be one of the most
intense classical pieces ever written and indeed, it has been
21
22 CHAPTER 2
23
24 CHAPTER 2
3000-6000 Hz regionnear the top note of the piano keyboard. Above this region, the hearing would return to normal.
Therefore a musician with a very significant hearing loss at
4000 Hz, may have excellent hearing at 15,000 Hz or even
20,000 Hz (the upper range of hearing for humans). This is
one reason why hearing is not routinely tested at these ultrahigh frequencies. There is no diagnostic information up in
that rarified region.
The relationship between TTS and PTS is not well defined.
A musician or concert goer that has a large temporary hearing
loss (e.g., a muffled feeling) after a concert is not necessarily
more prone to a future permanent hearing loss than someone
else who only experiences a slight temporary hearing loss.
However, researchers can say that if music or noise does not
cause TTS, then it will also not cause PTS.
If you look at the physiology of what exactly happens in the
cochlea with TTS and PTS we see that there are different
mechanisms involved. TTS derives from several mechanisms
that may included an overabundance of a chemical called
glutamate. High levels of glutamate can be toxic to the ear
and until the body carries this away, there may be a temporary
loss. Permanent hearing loss derives from other mechanisms
such as a destruction of hair cells and understandably this
would be permanent. So it is not surprising that TTS and
PTS would not be highly correlated.
How loud does music have to be in order to be
damaging?
This is an area where the subjective impression of the intensity,
known as loudness, may mislead us. Recall (from Chapter 1)
that it is intensity that is related to hearing loss and not loudness. Whereas intensity is a measure of the physical vibration
in the air, loudness is merely our subjective impression of the
25
26 CHAPTER 2
PasschierVermeer
Robinson
Baughn NIOSH
ISO
R-1999
85 dBA
90 dBA
15
12
14
11
11
95 dBA
23
18
17
20
21
sical piece, the orchestra size, and ones exact position in the
orchestra pit or stage, there may be some relief from hearing
loss by the intermittent nature of music. Certainly musicians
in smaller groups such as quartets would receive a greater
relief from the intermittent nature of the music than would
musicians in a large orchestra or rock band. Those in rock
bands may never achieve an effective quiet level.
Whether the full benefit of intermittent noise or music can be
achieved by that individual or not, undoubtedly some relief
is provided to musicians that is not shared by those people
working in a noisy factory. A major reason why intermittent
sound, like music, is less damaging than factory noise exposure is related to the function of the stapedial reflex which
reduces the music intensity in the middle ear.
A major difference between noise and music exposure is that
music is presumably enjoyable. This preference for music is
Frequency Effective Clarinet
Quiet (dBA) (dBA)
(Hz)
Violin
(dBA)
Trumpet
(dBA)
250
77
72 - 82
75 - 84
75 - 98
500
75 - 85
73 - 84
75 - 87
76 - 98
1k
81 - 82
69 - 81
71 - 78
70 - 87
2k
77 - 78
66 - 74
70 - 74
66 - 77
4k
74 - 76
56 - 62
59 - 65
60 - 67
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28 CHAPTER 2
the source of some interesting findings with respect to temporary hearing loss or TTS. In a landmark study, a German
researcher named Hrmann studied the emotional effects on
TTS at 4000 Hz. One group of subjects was given a 95 dB
noise for 30 minutes as a reward for performing a task and
another group was given the same noise as a punishment.
The TTS for the punishment group was 18.1 dB but that for
the reward group was only 12.8 dB. That is, the noise exposure was the same but one group viewed it positively and
the other, negatively. The group that viewed it negatively had
a greater temporary hearing loss! This type of study has been
performed many times over the years with noise and music
of equal energy, and with comparing groups of subjects who
loved or hated a certain type of music. The results are always
the same: The group that disliked the music had more TTS
than those who liked it.
Although, to date we have little physiological evidence to
explain these findings, the answer may be related to the
feedback (or outgoing) neurological pathways that go from
the brain, to the outer hair cells in the inner ear (see Chapter
1) as well as the chemistry of the outer hair cells in the inner
ear. It is also felt that there may be a change in the circulation in the inner ear on a hormonal basis if music was felt to
be beautiful versus terrible. For example, it was found that
emotional stress in guinea pigs created increased levels of
catecholamines that may reduce the level of available oxygen
in the inner ear. Reduced oxygen levels (anoxia) in the inner
ear has been suggested as a mechanism for temporary and
even permanent hearing loss.
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30 CHAPTER 2
Chapter 3: Strategies to
Reduce Music Exposure
Hearing Protection
33
34 CHAPTER 3
35
36 CHAPTER 3
out that a function of the outer ear was to provide amplification for the higher frequency sounds. If the outer ear canal is
plugged up, there is a loss of this natural high-frequency boost,
much like a French horn player when they partially plug up
the bell with their hand or the trumpet player who uses a mute.
One solution would be to incorporate a specially designed
amplifier that puts back the higher frequencies, such that the
net effect at the eardrum is a flat or equal attenuation for all
of the various frequencies. One such amplifier ear plug
uses an acoustic network (i.e., no batteries) and is called the
ER-15 earplug.
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38 CHAPTER 3
Attenuation (dB)
The design of the ER-15 earplug (and its partner, the ER-25
earplug that provides approximately 25 decibels of uniform
attenuation) is remarkably simple. Essentially, a buttonsized element (that functions as an acoustic compliance, for
those that like physics) is connected to a custom ear mold.
The resulting interaction between the button-sized element
and the volume of air in the earplug creates a resonance (or
amplification) that replaces much of the high-end sound that
would be lost with conventional earplugs. The ER- button
element is manufactured by Etymotic Research, Inc. but the
custom made silicone earplug is made at a local ear mold
manufacturing laboratory. Ensuring that the custom made
Frequency (Hz)
Violin playing A
(440 Hz)
Same note with
the ER-15
earplug
Frequency (Hz)
Figure 3-3: Musician playing A(440 Hz) with
(black) and without (top) the ER-15 earplug. Note
that the 2 curves are parallel, indicating no change in
the balance of the music.
39
40 CHAPTER 3
41
42 CHAPTER 3
Auditory Danger
Reeded
Woodwinds
Flutes
Small Strings
Large Strings
Brass
Vented/tuned
Percussion
ER-25
Vocalists
Solo
Non-solo
Vented/tuned
ER-15
Speakers/monitors
ER-15
Amplified Instruments
Earplug(s)
ER-15
Vented/tuned
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44 CHAPTER 3
Since different musicians find themselves in differing environments, the strategies to reduce the effects of music exposure
may be different. The following is organized around seven
musical instrument categories, even though there is some
overlap. Chapter 4 has some fact sheets summarizing this information, but this will serve as the basis for those summaries:
1) small strings, 2) large strings, 3) brass, 4) woodwinds, 5)
percussion, 6) amplified instruments, and 7) vocalists.
1) Small Stringed Instruments
The instruments in this category include the violins and the
violas. The ear protection of choice is the ER-15 earplug,
as this will provide broadband uniform attenuation that is
ideal for these musicians. The violins and violas generate
significant low and high-frequency sounds and more importantly, these musicians need to hear the balance between these
sounds. Sound levels in excess of 110 dB have been measured
even when played at an average, or mezzo forte, loudness.
A very important factor is the positioning of this musician.
Violin and viola players should never be placed under an overhang that is within 1 meter of their heads. Such poorly constructed overhangs in performance pits are commonplace
at many theater, ballet, and opera venues. Space limitations
Two Laws of Physics continued
45
46 CHAPTER 3
47
48 CHAPTER 3
3) Brass Instruments
Typical instruments of this category are the trumpet, French
horn, trombone, and assorted bass instruments such as the
tuba and baritone. Two important characteristics are that brass
instruments are directional for higher frequency energy and
that this high-frequency energy is significantly more intense
than the lower frequency fundamental energy. The instrument
that can generate the most intense music in this category is
the trumpet and for this reason it will be used as the example.
The trumpet (and other brass instruments) generates sound that
emanates from the end of the bell. Strictly speaking however,
this is only true for the higher frequency treble notes. In fact,
these treble notes come out of the trumpet bell almost like a
laser beam. If measured just below or just above the playing plane of the trumpet, this high-frequency sound energy
would not be as intense as if measured directly in front of it.
Figure 3-9: Low-frequency bass notes leak out of the trumpet in every direction. However, higher frequency notes
emanate in a straight line almost like a laser beam. This is
very similar to what happens in a loudspeaker.
49
50 CHAPTER 3
51
52 CHAPTER 3
53
54 CHAPTER 3
Figure 3-11: Picture of seat (bass) shakers that are lowfrequency emphasis speakers designed to improve monitoring of percussion and electric bass. Courtesy of Future
Sonics, Inc.
as wedge speakers. Figure 3-12 shows a schematic of a custom earphone system. Several manufacturers market such a
system, and while they can be costly, custom earphones are
gaining popularity. One such earphone system is shown in
Figure 3-13.
A less costly hard-wired system can be used by joining a
pair of broad band hearing aid receivers to standard (body aid
style) earmolds and connecting this to an equalizer/amplifier
that can be adjusted for overall gain and frequency response
shaping. This has been very useful for percussionists who
only need improved monitoring to hear a click track.
Some recent research has indicated that people still need to
be aware to turn down the volume when they wear in-the-ear
monitors. It turns out that quieter, less damaging levels, are
more acceptable by those who wear the monitors (versus stage
monitors) but that unless counselled, people may still wear
them at a higher, potentially damaging levels.
55
56 CHAPTER 3
Figure 3-13: A custom earphone is made up of a manufactured earpiece with a cable that can be connected to either a
wireless FM system or hard-wired to the amplifier directly.
Picture courtesy of Ultimate Ears, Inc.
57
58 CHAPTER 3
Nonsolo vocalists, typically found in pop bands, are susceptible to the same sources of music exposure than their
instrumental colleagues. Because of the wide range of music
sources on stage, the wide band ER-15 earplug is the form of
ear protection of choice. As in the case of the solo performer,
a slight degree of occlusion may be useful, and it is therefore
recommended that the ER-15 earplugs be made with short
canals. Nonsolo vocalists will also gain an improved monitoring (as well as some hearing protection from the various
sources of music) by using the custom earphones as shown
in Figures 3-12 and 3-13.
In-the-ear Monitors
In-the-ear monitors are small custom made loudspeakers that are
designed to fit into a musicians ear, much like a small hearing
aid. The monitors are fit binaurally (in both ears) and can either
be connected directly to the amplifier by a cable (frequently used
in this fashion by drummers) or by a wireless FM route.
The advantage of such a monitor is that it replaces the various
wedge monitors up on stage as well as the need for side wash
from speakers aimed sideways up on stage to improve the monitoring of the musicians own sound. Using in-the-ear monitors
means that the environment is controlled and the overall level up
on stage is less damaging.
In-the-ear monitors come in two forms- a custom made one and a
non-custom one. The non-custom ones uses a foam, one size fits
all plug that joins it to the ear. An advantage of the non-custom
monitor is that the same piece of hardware can be used for different
people at different performances- only the replaceable foam plug
needs to be changed. A modification of this is to use an inexpensive
earmold that is custom made for an individual. The more expensive
loudspeaker can connect with this custom made ear earmold which
may improve wearing comfort.
In contrast, custom made in-the-ear monitors are made like hearing aids. An earmold impression is taken by a hearing health care
professional, such as an audiologist, and sent to a special earmold
laboratory. A hard custom made shell is made that fits that individual musicians ear precisely and a miniature loudspeaker is
installed in the shell. The in-the ear shell is then connected to a
cable that can either be connected directly to the amplification
system with an extension cord, or by way of a wireless FM system.
When fitting in-the-ear monitors, there are two issues to consider.
One is whether the monitor yields a flat response like the ERseries of earplugs and the other is related to the amount of attenuation or protection that the monitor will provide. The in-the-ear
monitor will not necessarily have a flat response, but since it is
an electrical system, its output can be run through an equalizer to
Please see Resonance, pg 60
59
60 CHAPTER 3
ensure any desired response. As far as the attenuation or protection provided, as a rule of thumb, the softer the material in
contact with the ear, the greater will be the attenuation. A noncustom monitor that uses a disposable foam plug or one where
an individual musician has had a custom made soft earplug will
provide the greatest attenuation of stage sound. The hard shell
custom in-the-ear monitors will provide less overall protection
from the stage noise than the softer non-custom ones. Using
clinically available probe tube microphones, an audiologist can
measure precisely what the response and the attenuation of an
individuals in-the-ear monitor are, in order to ensure optimal
listening and hearing protection.
Earplug
dBA
113
104
103
61
62 CHAPTER 3
What about those people who are reading this book too late
in their musical careers, or are getting up there in age and
have a hearing loss? Hearing aids are devices that amplify
only certain sounds that are lost. Hearing aids are quite sophisticated in that they make soft sounds louder and almost
as importantly, make loud sounds softer. Unfortunately it
turns out that hearing aids of 20 years ago were better for
music than the more modern digital hearing aids. Hearing aids of the 1990s were quite capable of re-establishing
the dynamics and quality of louder inputs such as music.
Modern digital hearing aids are actually better for hearing
speech, especially in the presence of background noise, but
unfortunately cannot handle louder inputs such as music as
well as the older hearing aid technology. Modern digital
hearing aids have a great difficulty handling inputs over
about 95 decibels and tend to distort.
Engineers are working feverishly to resolve this problem
and some improvements have been made. If hearing aids
are required one should consult their audiologist or other
hearing health care professional to determine, not only the
best hearing aids, but the best strategies to use them for the
listening to, or the playing of music.
65
66 CHAPTER 4
The human ear is much like any other body parttoo much
use and it may be damaged. The ear takes about 16 hours to
reset. After attending a rock concert or a loud session, you
may notice reduced hearing and/or tinnitus (ringing) in your
ears. And if your hearing was assessed immediately after the
concert, one would find a temporary hearing loss. After 16
hours however, your hearing should return to its baseline
(hopefully normal) level. After a loud session or concert,
dont practice for 16-18 hours. Also, its a good excuse not
to mow your lawn for a day or two!
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The human ear is much like any other body parttoo much
use and it may be damaged. The ear takes about 16 hours to
reset. After attending a rock concert or a loud session you
may notice reduced hearing and/or tinnitus (ringing) in your
ears. And if your hearing was assessed immediately after the
concert, one would find a temporary hearing loss. After 16
hours however, your hearing should return to its baseline
(hopefully normal) level. After a loud session or concert,
dont practice for 16-18 hours. Also, its a good excuse not
to mow your lawn for a day or two!
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Chapter 5: Twenty-Five
Frequently Asked Questions
1) What happens when we get a music related
hearing loss?
Most people reach the ripe old age of 50 without any hearing
problems, but others suffer a very slow and gradual hearing
loss that may not be noticed for years. Certainly working in a
noisy factory is one such cause. And listening to loud music
is another. The ear is made up of three parts- the outer ear,
the middle ear, and you guessed it, the inner ear. The inner
ear is about the size of a small finger nail and contains about
15,500 nerve endings, called hair cells. When some of these
hair cells are damaged, you have a permanent hearing loss.
Damage to the outer and middle ears is usually temporary
and can be treated by a doctor.
2) What are some other causes of permanent
hearing loss?
Other than hearing loss associated with aging (called presbycusis), the single greatest cause is working around noise.
The ear does not know the difference between loud noise and
loud music. To the ear, noise and music are just vibrations
in the air. Rarely, a person may suffer a permanent hearing
loss from a virus or even a brain tumor. These usually have a
sudden onset and may be accompanied by dizziness. Hearing
loss from noise or music tends to be gradual in nature with no
dizziness. If one experiences dizziness or a sudden hearing
loss, one should contact their doctor.
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Twenty Five Frequently Asked Questions
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a lot of the sound of the high hat cymbal and rim shot of the
drum. The drummer needs to hit harder in order to hear properly, with the result of wrist and arm damage. Using proper
ear protection will resolve this. Drummers should be using
the ER-25 earplugenough ear protection to prevent further
hearing loss, and enough audibility of the music, so that they
will not overplay. (For further information, see Chapter 3).
16) Ive seen musicians on TV wearing what look
like hearing aids connected to small wires. What
are these?
These are called in-the-ear monitors, and they are a form
of a modified hearing aid. Musicians use them as their own
monitoring system instead of the small wedge monitors on
the floor of the stage. The wires are connected to the sound
amplification system either directly or though a wireless
transmitter. The musician can then hear their own music as
well as that of the other musicians, but at a safe level. When
musicians use in-the-ear monitors, the overall sound level on
stage is typically much less than if they were using conventional wedge monitors.
17) I play the bass in a band, but cant really hear
myself play because the drummer is so loud. Is
there anything that I can do?
Unfortunately (for bass players) they usually stand near the
drummer. Many bass players (and drummers) use a special
type of loudspeaker called a shaker. These small hockey
puck sized devices are designed to enhance the very low
pitched bass notes. Shakers are plugged into the main sound
amplification system. With this set-up, the bass players and
drummers have a better awareness of their own music, and as
such, do not have to play as loud. The overall sound level is
less, but everyone thinks they are playing louder. The musicians are happy and the music is less damaging.
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