The Importance of Hearing Damage Prevention in Musicians’ Work

In summer 2021, as the music industry shutdown eased across the UK and the musicians still standing dusted off their instruments to play the venues still trading, you didn’t have to search hard for sobering statistics. Having polled 929 professional musicians in August – a month after restrictions were lifted – the Help Musicians charity revealed that 83% still couldn’t find regular work, 90% were earning under £1,000 per month and 22% were considering leaving the industry. That October, UK Music’s This Is Music 2021 report made for bleaker reading still. It found that 69,000 jobs – a third of the workforce – had been lost, while the industry’s economic contribution had withered by 46%.

When it comes to ensuring the health and wellbeing of professional musicians, few factors are quite as critical as hearing.

Anecdotes are abound of musicians who have had their hearing irreparably damaged in live and studio settings; musicians across all genres are affected. In recent decades, there has been a growing awareness of the dangers of excessive and prolonged exposure to noise in the workplace and the need for musicians to protect their hearing. But there is still much work to do. 

The MU and its partners Help Musicians, the Musicians’ Hearing Services, and the British Association of Performing Arts Medicine (BAPAM) offer a wealth of advice and support as well as fast access to advice, specialist medical treatment and hearing protection. All of these organisations recognise that only by musicians taking early action to protect their own hearing can they avert serious problems down the line.

Musicians are at a high risk of hearing loss

According to a report by US organisation the Hearing Health Foundation, musicians are four times more likely to develop noise-induced hearing loss (NIHL) as the general public and 57 per cent more likely to develop tinnitus. Another survey, by UK charity Help Musicians, found that 40 per cent of professional musicians across a range of genres have experienced some type of hearing loss as a direct result of their work.

As clinical director of Musicians’ Hearing Services, Dr Paul Checkley is all too aware of the prevalence of hearing damage in the music profession. “Musicians have a better and more in-depth relationship with sound than an average person, so any small change in their hearing has a much larger impact on their life and livelihood,” he says. “Tinnitus, noise-induced hearing loss, hyperacusis, and diplacusis are some common conditions… It spans all musical genres and disciplines, and the most important factor is the loudness of the sound in relation to how long the exposure lasts.”

Coping with hearing loss

For those who have already incurred damage, the biggest challenge is how to deal with it. Paul Gray, bassist and former MU Regional Organiser for Wales and the South West, has suffered from profound tinnitus and hearing loss since the early 1990s. He says he first noticed the early signs of the condition back in the late 70s when he was playing with seminal Canvey Island band, Eddie & The Hot Rods.

“The tinnitus levels gradually crept up over time without me fully realising, starting in the late 70s with a slight ringing after shows that would disappear after a day or two,” he says. “We all got it and wore it as a badge of honour, as you do when you’re young and think you’re invincible. More so than live shows, what really damaged my ears was writing music into the night in my home studio on headphones. It’s so easy to get carried away and keep turning the levels up when your ears get tired and by the early 90s I’d developed a full-blown multi-frequency ringing 24/7 in both ears that has never left.”

Balancing hearing damage with work as a performer

Gray says it was a massive screech of feedback through an onstage monitor that really tipped him over the edge. He was forced to stop touring and recording and says he became a virtual recluse for three years. In addition to tinnitus, he also has profound hearing loss and the conditions hyperacusis and recruitment.

“It doesn’t matter if you’re playing death metal or classical,” he says. “Onstage volumes and earbuds or headphones are usually way louder and more damaging than you may realise. I’m a living testament to that.

Plug in and plug up or one day your ears may ring and never stop. Twenty seven years for me now and frankly it’s bloody awful. It affects your wellbeing, ability to sleep properly and your whole social life.

Despite these hurdles, Gray is now back playing live with his long-standing band The Damned, who in 2022 supported Blondie on an extensive US tour.

Balancing his hearing damage with live performance is a huge challenge. Onstage, Gray and the band wear high-end in-ear monitors (IEMs), which he sets to as low a volume as possible. He augments these with a device called the Rev33, which he says helps reduce ear fatigue. “I get by, but my tinnitus is always louder than anything else.”

Prevention of hearing damage is key

The key to reducing the prevalence of hearing damage among musicians is to simply prevent it happening in the first place. “Like most body ailments, prevention is key,” says Checkley. “The more musicians understand the impact on noise exposure, the more they can protect their hearing and their hearing future.”

The MU, Help Musicians and Musicians’ Hearing Services are committed to raising awareness of hearing conditions. As such, the three organisations have created the Musicians Hearing Health Scheme, which aims to provide all professional musicians in the UK with access to specialist hearing assessments and protection.

The assessments are heavily subsidised by Help Musicians and the MU provides a further subsidy, so the price of the package is reduced for MU members.

The package includes an audiological assessment and ear check-up from a specialist in musicians’ hearing. MU members will also receive one free set of custom-made, specialist musicians’ ear plugs, and optional follow-up assessments every two years for a reduced price.

Freelance musicians need to protect their hearing

Salaried musicians’ employers generally provide regular hearing checks. Checkley says the MHS’s audiologists work regularly with many orchestras and West End musical managements. But the MU recognises that there is no requirement for the self-employed and freelancers to have their own health surveillance. As such, the MU strongly advises all self-employed and freelance musicians to arrange their own hearing health surveillance if they think their exposure levels regularly exceed the Second Action Value, if they regularly have to wear hearing protection, or they have other concerns about their hearing.

Encouragingly, there are signs that the advice is starting to get through. “Both musicians and employers are now more aware,” says Checkley. “The most common appointment at MHS is a musician coming in for regular check-ups and custom hearing protection to make sure that they are doing all that they can to protect their ears before any damage can be done.”

Getting ear protection early on

One such musician is Matt Jolliffe, who sought help early from Musicians’ Hearing Services (MHS). Jolliffe is a producer and DJ in FOAMA, a duo from Poole in Dorset who use synths, keyboards and drum-pads for their productions, performing on CDJs and a mixer when playing live.

“The club environment is always loud and you constantly have to turn up the booth monitors to hear over rowdy crowds,” explains Jolliffe. “I would often return from our gigs and occasional concert visits with the usual ringing ears. However, I noticed that every now and again this ringing would return at random times on other days. I was a little concerned… Stupidly, I decided that ignoring the problem would make it go away. It definitely did not.”

Jolliffe learned about MHS via a TikTok video from another DJ. When his ears were tested, he found to his relief that there was no damage, and that his hearing was much better than average. But the experience prompted him to get proper custom-made ear plugs to protect his hearing.

Anyone who has ever used generic hearing protection on stage will know that the resulting sound can be compromised, but Paul Checkley says this is not the case with custom-made ear plugs. “There are some generic attenuating ear plugs on the market, but protection is limited as the fit will never be exact as they are not bespoke to your own ear shape. Proper musicians’ hearing protection can give the musician the loudness, clarity and thrill of the experience, while still ensuring their hearing is appropriately protected.”

It’s a view reinforced by Jolliffe, who was fitted for custom-made ear plugs following his consultation at MHS’s clinic. “The great thing I have found about my ACS earplugs is that since they are customised and the filters are of such a high quality, I can still hear every detail of what I’m doing behind the decks and still have conversations with tech crews and others without having to shout.”

Safe noise levels and employer responsibilty

It’s worth noting that some cases of injury to musicians’ hearing are caused by employers simply failing to ensure safe noise levels. Consequently, there are growing calls for concert promoters, record labels, orchestra managers, event organisers, theatrical producers and contractors to better protect the hearing of the musicians employed by them.

Most have a legal responsibility to do this. The MU is advising employers to review their health and safety procedures and believes it is crucial that noise risk assessments are carried out in workplaces and that a resulting action plan is also undertaken.

Proactive steps to protect your hearing

For musicians meanwhile, taking proactive steps to protect their hearing in the workplace is key. Paul Gray is currently in discussions with a US company that has developed new IEMs technology, which effectively creates a “second eardrum”. Gray says this is the same technology that enabled AC/DC singer Brian Johnston to tour again. “It’s early days but could be a game-changer for myself and others in the near future,” he says.

For Matt Jolliffe, the worry that he might have damaged his hearing was a real wake-up call that prompted him to take action. “As musicians and artists your hearing is key to everything you do, and the main tool that you use everyday for your job,” he says. “If you can, turn your monitor levels down and invest in your hearing protection. You are investing in your future and protecting the most valuable piece of equipment that you own.”