According to the World Health Organisation, noise induced hearing loss is the most common work-based injury and by the nature of our work, musicians are especially vulnerable to prolonged exposure to loud noise.  Injury of any kind can be devastating for musicians and the British Trombone Society are delighted to have been offered the following advice from various professionals in the industry, to help advise you on how best to look after your hearing.

British trombone player Liam Kirkman, Vice-President of the BTS, has been kind enough to share his story about hearing loss and how this has affected his playing…

“It was certainly a gradual thing that crept up on me over ten years or more which I foolishly did nothing about...until it was too late. Noise related hearing loss is irreversible and whilst it doesn't cause me too many problems playing, it's a real problem keeping up with conversations in (not so) noisy places. Distinguishing single voices with clarity is typically difficult if there is any background noise. Consonants are lost and then guess work takes place with often embarrassing outcomes!

“As musicians often working freelance, we tend to slip between the safety nets of company employers and so need to take responsibility for our own hearing protection. In my own experience (albeit with existing damaged hearing) expensive custom plugs offer little more than cheap foam plugs. I have a set of moulded plugs costing £150-£200 with interchangeable attenuation filters and with their fixed design they are simultaneously too effective and too aggressive to play in. Cheaper squishy plugs can be pushed as far into the ear canal as needed to maintain a better awareness around you. I have spent the majority of my career sat in front of four trumpets and in close proximity to a drum set so it is hardly surprising in my case but there are plenty of other factors, such as in-ear headphones and riding motorcycles (wind noise inside a helmet above 35mph is around 115db).

“So the result of this is two NHS hearing aids costing roughly £4000 if bought privately. Do I like them? No. Should I wear them more often? Definitely. Do they come anywhere close to the natural sound of decent hearing? Nowhere near.

“We are all different and some people are more susceptible to things than others. A certain proportion of my own hearing loss is hereditary (occurring below 1kHz) but coupled with noise related damage (around 2kHz) then the result is not ideal. 

“I try and get my hearing checked every year to monitor any decline and am happy it is mostly settled where it is. You do not need to spend a fortune on custom earplugs and in my own case I prefer the cheaper foam variety. 

“Once it's gone, it’s gone!” 

Musicians’ Hearing Services, part of Harley Street Hearing, specialize in all aspects of hearing and provide hearing protection, tests and advice on tinnitus or hearing loss. We spoke to Matthew Allsop about protecting our hearing.

1.     When should you be protecting your ears? What sort of sounds and what levels should you protect yourself from. 

In short, all of the time.  The Control of Noise at Work Regulations (2005) has a two-tiered system.  When sound pressure levels reach 80dB then employers must provide information and training on keeping ears and hearing healthy. If the levels reach 85dB then appropriate hearing protection must be provided by the employers. The volume of a trombone can range from 90-106dB at a three  metre distance.  In the world of musicians, however, it is as much the responsibility of the musician as it is the venue to protect your ears, particularly for a freelancer.   

2.     What options are there available and what are the differences between them? Some players have talked about the sensation of playing with earplugs in, and how uncomfortable they can be when your jaw moves. Do you have any advice on what type of protection may be suitable?  

There are many types of ear protection. This makes it difficult to choose, and often people end up leaving it completely. For orchestral players I would recommend ‘ER’ earplugs.  These are custom made and have filters that reduce the levels of sound, whilst maintaining the fidelity of the music.  The filters can be interchanged, so should you feel that you need a greater or lesser reduction they can be easily changed.  The choice of filter can come down to your position in the pit and also your preference. Being custom made, ERs should provide a tight seal to protect your ears whilst at the same time remaining comfortable with jaw movement. 

3.     What are the signs of hearing damage? Is this damage reversible?

Most of us will have experienced ringing ears and tinnitus after a loud concert.  This can result in a temporary threshold shift in your hearing.  The hair cells in the inner ear become temporarily damaged and can take up to a week to recover.  If this happens repeatedly it can cause permanent damage to the auditory system.  If you experience this and your hearing has not returned after two weeks you should consult an audiologist or your GP.

4.        Is it worth spending as much as you can afford on protection? We are often provided with complimentary foam earplugs. What are your opinions on these? How effective are they? What is the best way to use them?  

Custom hearing protection is worth the money.  Alternatively, generic earplugs are better than nothing.  It is at least worth having some protection until custom hearing protection can be organised.  Some venues provide complementary earplugs which again are good to have if you no alternative.  The only downside is they occlude everything.  Some musicians find that this can make playing and listening to music seem unnatural and it puts them off wearing ear protection all together.  

5.       Can certain protection interfere with you being able things like conductors or even the players around you?  

Some musicians report that they aren’t fond of ear protection as it makes them feel detached from their instrument, the rest of the orchestra, and the audience.  The key with this is to not just wear them at concerts.  Wear them at home, when practicing, in fact, wear them as much as possible when playing your instrument to get used to how things sound.  When you have acclimatised to listening with earplugs, playing begins to sound more natural.

            Musicians’ Hearing Services is a specialized firm that works in partnership with both the Incorporated Society of Musicians and the Musicians’ Union.  MU Live Performance Organiser, Dave Webster highlights the importance of the availability of hearing protection.

"The MU are delighted to be working with Musicians’ Hearing Services.  Our Musicians’ Hearing Passport scheme provides our freelance members with the ability to monitor and protect their hearing and to purchase bespoke hearing protection. It is important for freelance musicians to be able to have this service. In an employed situation the duty of care lies with the employer. However, if you are a freelance, then it is in your best interest to take steps to ensure you protect yourself. All musicians are vulnerable although for brass players who have to contend with reflective screens and perhaps close proximity to other players in orchestra pits, concert stages, bandstands, or studio booths, hearing protection is a particularly serious issue."

Our hearing is central to our work and it is incredibly important to protect ourselves from potential injury as best we can. We must consider the exposure we have away from work as well as the responsibilities we have during our practice, rehearsals and performances. If you suspect you are having difficulty or merely want to protect yourself from possible future problems, please make use of the fantastic help available to you. There are numerous services that are dedicated to dealing with the challenges our industry presents.  Please refer to the resources listed below for just some of the places that can offer you help in finding what protection suits you best. 

BAPAM www.bapam.org.uk - ISM www.ism.org - MU www.musiciansunion.org.uk - Sound Advice www.soundadvice.info - Help Musicians UK www.helpmusicians.org.uk/get-advice///musicians-health - Musicians’ Hearing Services www.musicianshearingservices.co.uk - Production Safety Limited www.productionsafety.co.uk - Action Hearing Loss www.actiononhearingloss.org.uk

Jane Salmon (The Trombonist, Autumn 2015)