Listen Up!

ears

The sound of the alarm clock buzzing the morning after a lengthy rehearsal or a night at the local club cuts through the early morning calm. Then you realize it’s not the alarm clock ringing – it’s your ears.

The sensation of ringing or buzzing (the medical term is tinnitus) in the ear after exposure to loud music is one that most rock musicians and fans have endured at least once.

Even those who prefer other types of music may have the same experience after riding the subway, or walking by a jackhammer or a shrieking car alarm. Just living in the modern world we are increasingly bombarded by grating sounds that can take a toll on one’s ears, but musicians place themselves at risk by prolonged and repeated exposure to amplified music.

Numerous rock legends have come forward with stories of hearing loss as a result of their practices before they realized that their ears and hearing were not invincible. Musicians as stylistically divergent as Ray Charles and Ted Nugent have gone public with their personal tales of hearing loss. Pete Townshend of The Who is an adamant supporter of the need for more education about hearing loss. His exposure to the amplified sounds of The Who permanently effected his future in music. “I have very severe hearing damage, manifested as tinnitus, ringing in the ears,” he says. “It hurts, and it’s frustrating when little children talk to you and you can’t hear them.”

Although anyone who plays with a band or frequents noisy venues can fall victim to tinnitus and hearing damage, drummers are particularly predisposed to encounter trouble with tinnitus. Drummers, and other band members, often complain that it is the high-end sounds of the cymbals and snare that have a noticeable, negative impact on their hearing.

It is the penetrating qualities of these instruments that make them most damaging to the sensitive ear. Repeated exposure, close proximity to the high-end culprits, and the drummer's inability to move away from the monitors during a set present a set of hazardous conditions for the ear. With all these factors, drummers should be on the alert for the warning signs of hearing loss.

Unlike other forms of bodily injury, hearing impairment is usually painless. It is also gradual, allowing those at risk to ignore the danger signals until permanent damage has occurred. Lars Ulrich, drummer for Metallica and a vocal supporter of the need for education about hearing loss, stressed this often unknown fact about the irreparable nature of this affliction. “Hearing is not like when you bite your nail off, and it grows back six weeks later,” he says. “Hearing is one of the few things that will not come back.”

Don’t give up all hope if your ears have rung all day after a particularly amplified session – chances are your hearing is not permanently damaged. Occasional exposure to extremely loud sounds won’t usually result in irreversible loss. The hair cells of the inner ear that perceive sound waves are actually fairly resilient when given a chance to spring back into the normal, upright position. Unfortunately, it is the repeated exposure to harmful sound levels that many active musicians encounter that can make even the hardiest hair cells literally stiffen and die. The receptor hair cells become brittle after frequent encounters with a barrage of sound, especially at higher frequencies. The muffled hearing and ringing that could once be relieved with a day’s rest are now permanent reminders that one has experienced more than the ears can tolerate.

Ears do give us warning signs that permanent hearing loss could be on its way if we are not careful. The most common sign of overexposure to dangerously loud noise is ringing or buzzing in the ears, the condition technically referred to as tinnitus. Tinnitus is the brain’s interpretation of a shock to the auditory system. The degree of tinnitus varies widely. Depending on the individual, it can worsen over time if repeated exposure to damaging decibel levels continues without protection. Tinnitus may manifest itself as a “white noise” hiss, only audible in complete silence, but it can also go to the other extreme, rising up to levels up to 70 decibels (dB), a piercing scream in the ears that never stops. There are various levels of annoyance and discomfort between these two extremes, but any awareness of ringing or buzzing is a sign that one’s hearing has been damaged, and that it can and will get worse if ignored and unprotected exposure to noise continues.

Hearing impairment is not the only way overexposure to loud music works against the physical well-being of the musician. That which has a negative effect on the ears can be transferred into the rest of body’s nervous system. This has shown up in recent studies where researchers discovered that there is a connection between repeated exposure to loud noise and a variety of physical disorders. Chronic headaches, insomnia sleep disruption, ulcers and high blood pressure are some of the ailments linked to exposure to high levels of noise, and although it may be difficult to exclude the role of other factors in these symptoms, it is logical to conclude that severe stress to one area of the body can lead to stress that is exhibited throughout the body.

The ear of the musician is as valuable as the skill acquired by years of practice on a particular instrument, and one should be alert to other danger signs, which may be more subtle than the hum of tinnitus. The first stages of noise-induced hearing loss are often revealed by the inability to detect sounds in the high-frequency range (those that cause the most damage to begin with). High pitches in music played quietly may be inaudible. But the symptom that most often provokes alarm is the difficulty in picking out specific words in normal conversation, especially in an environment with background noise. If you find yourself asking people to repeat themselves on a regular basis, you may want to assess your personal risk of hearing loss and the steps that can be taken to prevent the condition from becoming worse. Many professional musicians have taken steps to protect themselves after experiencing hearing loss of varying degrees. To do this, they have had to compromise their exposure to what is arguably the root appeal behind rock and roll – the powerful driving feel of amplified music – and their ability to hear any music in the future. When the discussion of hearing protection arises, the use of earplugs is usually dismissed as something that diminishes the experience of playing with the band and to the audience. Ulrich comments, “If you can’t feel what’s coming back from the audience, that can give you a really distorted sense of how you’re playing,” which is something no musician wants to experience.

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Despite Ulrlch’s acknowledgment that dampening the sound perceived between performers and audience can limit the musician’s ability to gauge his or her playing, the drummer has continued to support education about the use of hearing protection. During his career with Metallica, he has sustained hearing damage and suffers from tinnitus. “Being a drummer, the toughest thing was always hearing the constant high-pitched ringing of the cymbals in my ears,” he says. “It got to the point where it was really bothering me. I always have a mid-range tone [in my ears] I can hear when it’s completely silent.” Although he admits that it took a few weeks of “forcing himself” to wear earplugs, Ulrich has now become so used to earplugs and the protection they provide that he won’t play the drums without them. Not wanting to seem preachy about earplugs and their benefits, he still thinks it’s important to provide musicians and fans with the facts; that loud music can be damaging to your hearing and that you can protect your hearing with the use of earplugs. Provided with this knowledge, it’s then a matter of individual choice.

If you’re still reluctant to use earplugs, this may be due to past experience using the common brands of foam earplugs that can be purchased at the drugstore. Although these earplugs are quite sufficient in blocking out harmful decibel levels (up to 36 dB), they are usually rejected for use by musicians because they block out much of the high-end frequencies, leaving the lower frequencies to dominate the ear, which creates an imbalanced perception of music that discourages their use.

The problem of uneven attenuation between high and low frequencies has not gone unnoticed by earplug manufacturers, and several products have been developed that do much to alleviate this problem. The type of hearing protection that best meets the needs of the musician for evenly attenuated sound is a custom-fitted earplug that contains a filter that provides “nearly equal” attenuation at all frequencies. These filters, designed by Etymotic Research laboratories, come in two forms, the ER15 and the ER25, which attenuate sounds up to 15 and 25 dB respectively. Musician’s earplugs, as they are called, can only be obtained with a visit to an audiologist who takes an impression of each individual ear canal, sends them off to a lab where they are molded and then fitted with the special filter. Another advantage of the musicians’ earplugs (besides the clearer, less muffled protection they provide) is that filters of either attenuation can be used with the same earplug. If exposure to a noisier environment is anticipated, ER25s can be easily inserted in place of a ER15s.

With any use of hearing protection, there will be a period of adjustment before one adapts to the way music sounds with earplugs. There are many tactics recommended for those who are serious about consistently using plugs to protect their hearing. Like all worthwhile pursuits, it may not start easily. Some musicians advocate wearing heavy-duty protection when needed most at a rehearsal or performance, and use protection like the ER15 in quieter situations like individual practice. Or one may prefer the opposite approach and wear plugs for practicing while going without earplugs during a live performance to capture the exchange of energy so critical to the experience.

Using the earplugs before they’re needed is another way to compensate for the difference in perception between pre- and post-plug insertion. Wearing the plugs for a period of time before actually going on stage or to practice may reduce the muted feeling that occurs when the plugs are abruptly inserted. Be especially wary of not turning up the monitor to make up for what is cut out by the earplugs. Not only does this defeat the use of the plug by raising the decibel exposure, but it can cause a chain reaction with other band members turning themselves up in order to be heard, resulting in an even more ear-destructive environment.

Ear monitors are a new product introduced to the professional musician market 12 years ago. Excessive stage volume and feedback from conventional monitors systems have long been among the leading causes of hearing and vocal fatigue among performers. As competitive monitoring begins to take place on stage, performers can be subjected to ear-damaging sound levels. As performers push their vocal output to counter this situation, the increased strain can lead to permanent damage. Ear monitors place the performer in a controlled listening environment, free from feedback and acoustical variability typically associated with conventional wedge/sidefill monitor systems. Along with all of that great sound quality, the musician should be aware that the ear monitor could cause potential hearing damage if not used properly. It important to have your hearing checked by a hearing professional before you purchase the monitors.

Well-known musicians may be coming forth with their tales of hearing loss and the need for hearing protection, but the presence of extensive hearing damage among rock musicians and their fans may not be recognized by the medical community at large until it is too late for many who are at risk. It is not only the loud rock concerts that have some audiologists concerned, it’s the way some people treat their ears between concerts. One New York audiologist, Dr. Maurice H. Miller of Lenox Hill Hospital, was so concerned by the volume emanating from the personal stereo headphones on his own children that he took his decibel meter to the streets. Dr. Miller found that when the music can be heard by those next to the person wearing them, the decibel levels of music played directly into the ear may reach up to 115 dB. He also voiced concern about the tooth-rattling custom speaker systems of cars that can emit levels of sound beyond 130 dB, which is not much lower than a jet engine at takeoff. “We see casualties at our clinic all the time," Dr. Miller says, “people in their thirties and forties with the kind of hearing loss we used to see only in people past retirement.”

Kathy Peck is one person who is acutely aware of the dangers of over exposure to loud music. Former bass player for the San Francisco punk band the Contractions, Peck suffered hearing loss and tinnitus after a particularly loud show where they opened for Duran Duran. She went on to found Hearing Education and Awareness for Rockers (H.E.A.R.) with help from Dr. Flash Gordon, medical director from the Haight Ashbury Free Clinic, and other supportive members of the rock community. One of the notable stars to endorse H.E.A.R. was The Who guitarist Pete Townshend, who donated $10,000 to help H.E.A.R. provide information and services for hearing protection.

H.E.A.R. has come a long way from its early days when it was run from a former storage closet at the Haight Street clinic. Housed in the stately International Building in San Francisco, H.E.A.R. has expanded, bringing its message to the public in numbers that Peck could not have conceived of at the start of H.E.A.R.’s crusade to educate all music lovers about the dangers of hearing loss. The information age has aided H.E.A.R.’s cause tremendously. Their award-winning website, HEARNET (http://www.hearnet.com) provides both entertainment through Artist of the Month profiles and contests, along with extensive information on hearing loss, tinnitus, hearing protection, ear monitors and other hearing health issues. They also provide listings of HEAR affiliates, audiologists that are listed on the site as a means to help those all across the country (and the world) find a provider for hearing tests or musician’s earplugs. Back at home, H.E.A.R. provides these services at their clinics where the public can take advantage of lower nonprofit fees for hearing exams and custom-fit plugs. Always looking for new ways to bring the message to a wider audience, H.E.A.R. has launched HEAR Records, an independent label project that combines the support of established bands who have donated songs and/or public service announcements, as well as showcasing new talent. Their first CD release, Wear Your Damn Earplugs! Volume 1, will combine music, information on hearing loss and tinnitus with Public Service Announcements that can be played on regular CD players or on home computers. H.E.A.R. is expecting the album to reach even more people than H.E.A.R. has already educated.

The message of H.E.A.R and its supporters is clear: the next time you strain to hear the person across from you while talking at a club or bar, or the next time your ears ring after practice or after a show, take a moment to listen to your body and consider what steps you may want to take while you still can. Eventually, turning up the volume won’t be an option.

For more information on H.E.A.R. and HEAR Records, contact Kathy Peck at (415) 431-3277 or visit the HEARNET Web site at www.hearnet.com.