Presentation on theme: "HEARING AND HEARING CONSERVATION FOR MUSICIANS HEARING AND HEARING CONSERVATION FOR MUSICIANS Paul C Checkley MSc MSHAA Musicians’ Hearing Services Paul."— Presentation transcript:
HEARING AND HEARING CONSERVATION FOR MUSICIANS HEARING AND HEARING CONSERVATION FOR MUSICIANS Paul C Checkley MSc MSHAA Musicians’ Hearing Services Paul C Checkley MSc MSHAA Musicians’ Hearing Services International Federation of Musicians Conference 4 th – 6 th May 2011 International Federation of Musicians Conference 4 th – 6 th May 2011
Overview… Hearing and hearing loss Noise induced hearing loss Hearing health surveillance - The Musicians Hearing Passport
How do we hear?
The Organ of Corti
Noise damage and hearing protection
“Noise-induced hearing loss is the most common, permanent and preventable occupational injury in the world” World Health Organization
Noise Induced Hearing Loss Causes no pain Causes no visible trauma Leaves no visible scars Is unnoticeable in its earliest stages Accumulates with each over-exposure Takes years to diagnose Is permanent and 100% preventable
What’s the Risk? Evidence shows that continued exposure to high-intensity noise can result in permanent hearing damage Tinnitus Ringing in the ears Hyperacusis Reduced tolerance to loud sounds Hearing loss Reduction in hearing acuity (temporary & permanent) Diplacusis Distortion of pitch
The damage - audiometry
Temporary threshold shift – the warning signs… Temporary hearing loss following exposure to loud sounds Research shows that hair bundles are capable of rebuilding their structure from top to bottom over a 48-hour period (the common duration of temporary hearing loss). Researchers suggest that permanent hearing loss may occur when damage is so severe that it overwhelms the self-repair mechanism. Often accompanied by tinnitus M.E., Belyantseva I.A., Azevedo R.B., Kachar B. Rapid renewal of auditory hair bundles. Nature. 22 Aug (6900):
Hyperacusis Intolerance to loud sounds Can range from slight intolerance to extreme discomfort 86% of people with increased sensitivity to sound also report tinnitus (Jastreboff 2009) No clear model for causality Exacerbated by exposure to loud noise
Diplacusis Differences of pitch between ears (binaural) or in the same ear (monaural) Binaural is the perception of a tone of given pitch differently in right and left ears Monaural described as the generation of an “internal sound” in response to an external sound (Tyler 2000) Can result in significant distortion of the signal
TINNITUS Tinnitus facts Prevalence 15-20% of the general population 70-85% of hearing impaired individuals Majority (75%) report tinnitus is more of an “irritation” WIDEX LET’S TALK ABOUT TINNITUS 13/XX
TINNITUS Is a perception of sound Is involuntary Originates in the head McFadden, 1982 WIDEX LET’S TALK ABOUT TINNITUS 14/XX
TINNITUS Most common difficulties attributed to tinnitus Tinnitus is persistent – present “forever” Sleeping problems Speech understanding Inability to relax (stress) Depression / despair
TINNITUS GENERATION Large variety of suggested causes Generally accepted: Tinnitus involves some kind of neural activity, interpreted by the brain as sound Where the spontaneous activity originates is much in dispute WIDEX LET’S TALK ABOUT TINNITUS 16/XX
TREATMENT METHODS Large variety of suggested causes generate large variety of suggested treatment methods WIDEX LET’S TALK ABOUT TINNITUS 17/XX
Common elements of effective tinnitus management TREATMENT METHODS WIDEX LET’S TALK ABOUT TINNITUS 18/XX Education and counselling Sound stimulation Stress reduction Hearing aids
00 How is noise induced hearing loss treated?
“If minor hearing loss is neglected and the auditory system is not excercised, when the time comes that a HA is essential it may not be as effective as if treatment had been given earlier ” Dr Thomas Stuttaford
The ONLY way to avoid permanent noise damage is to protect your hearing?
Historically, hearing conservation strategies have rarely been implemented, or even considered in the entertainment industry
“The ringing usually goes away the next day so its not a problem” “I can always get a hearing aid” “I like it loud” “Wearing earplugs is uncool” “I feel blocked up and cut-off from the music” “I’ve got used to the loudness – it doesn’t bother me anymore” “I don’t care if I can’t hear when I’m 50” “Earplugs dont fit in my ears so I cant wear them” WHY? “I don’t play my kit very loudly, so I don’t think there is a problem”
Most hearing protection destroys the fidelity of the sound Can be cumbersome to wear Lack of appropriate protection products Lack of education and awareness to the dangers of high SPL’s What are the real reasons?
EN Standard 89/656/EG noise levels New changes in European legislation state that in the workplace when personal dose levels reach… 80 dB(A)-Risk assessment -Hearing protection available -Maintenance programme for equipment -Provide training 85 dB(A)-Programme of control measures, if not sufficient then: -Suitable hearing protection MUST be worn -Health surveillance programme implemented
How loud is loud? Sound examplesdB Rocket Launching180 Jet Engine140 Thunderclap, Air Raid Siren 1 Meter130 Jet takeoff (200 ft)120 Rock Concert, Discotheque110 Firecrackers, Subway Train100 Heavy Truck (15 Meter), City Traffic90 Alarm Clock (1 Meter), Hair Dryer80 Noisy Restaurant, Business Office70 Air Conditioning Unit, Conversational Speech60 Light Traffic (50 Meter), Average Home50 Living Room, Quiet Office40 Library, Soft Whisper (5 Meter)30 Broadcasting Studio, Rustling Leaves20 Hearing Threshold0
97 dB(A)0,5 hr + 94 dB(A)1 hr + 91 dB(A)2 hr + 88 dB(A)4 hr + 85 dB(A)8 hr Max. exposure time (hrs.) a day Risk level in dB(A) dB doubling effect
Much live music is typically measured at above 100dB(A) That means (according to noise regulations) that the safe exposure time is 15 mins At 103dB it’s 7 minutes and 30 seconds At 106dB it’s 3 minutes and 45 seconds At 109dB – Play the intro, take a bow and leave the stage!
The trouble with hearing protection loss of clarity ! Typical conventional hearing protection attenuation values 15dB reduction 25dB reduction 9dB reduction
Flat response earplugs (musicians’ earplugs) Developed to provide musicians with a flat reduction in on stage levels Tuned to replace lost ear canal resonance 3 levels of filters – 9dB, 15dB, 25dB Tested and certificated to conform to EN352-2 Custom moulded silicone earpieces
ER9, 15 and 25 filter attenuation curves
The good news with 15 dB reduction… 15dB of protection allows playing in 100dB safely for up to 8 hours 15dB of protection allows playing in 103dB safely for up to 4 hours 15dB of protection allows playing in 106dB safely for up to 2 hours 15dB of protection allows playing in 109dB safely for up to 1 hour In the same way that the safe listening time dramatically decreases as the sound level gets higher, if you’re able to put some viable protection in place, the safe listening time can be increased just as dramatically.
Why do we need a hearing passport? Helps to increases awareness of the risk of hearing damage Promotes the provision of health surveillance amongst freelancers Reduces the risk of hearing damage Promotes the use of hearing protection when necessary and ensures that hearing protection is used correctly
What happens when a musician enrols on the scheme? Audiological / medical history Full aural examination Overview of the CNAWR and the risk of hearing loss Advice and training on hearing protection Full audiogram, audiological assessment
Details on the MHS scheme and to enrol… musicianshearingservices.co.uk
Conclusions Understand the importance of limiting the intensity and exposure time Avoid exposure to levels above 90dB where possible Use custom made hearing protection whenever you are in noise Encourage musicians to have regular hearing health surveillance (e.g. The Musicians Hearing Passport)
If you protect your instrument in a case? Why not protect your ears with hearing protection? A final thought………