I lay on the hotel bed, flat-out wasted. I'd spent the day
walking around the 2001 Winter NAMM convention (the annual trade
show for all kinds of musical gear), so my feet hurt. Far worse,
I'd spent the evening with Spinal Tap, proudly known as England's
loudest rock band.
I'd brought my trusty custom-fitted earplugs to the concert, of
course, and I had beamed approvingly at the ticket takers who
offered foam plugs from big bowls at the door. Nevertheless, Spinal
Tap lived up to its reputation (Nigel's amp was definitely at
“11”), and my pocket SPL meter routinely clocked the
sound at 118 dB. I was plugged, it was great fun, but it was loud!
By the time I crashed, my ears were ringing — roaring like
surf on the residue of too much noise.
Most bands don't approach Spinal Tap's dizzying decibels, but
these days 100 dB or higher is normal for smaller rooms. That's
more than enough to do real damage during the typical three- or
four-hour club gig. If you regularly perform at these levels,
you're at serious risk for hearing loss. But before you hear the
bad news about permanent injury — and the good news about
increasingly affordable, high-quality protection — it's
important to understand the exquisite yet vulnerable ear.
ANATOMY LESSON
Scientists divide the human auditory system into three areas:
the outer, middle, and inner ears (see Fig. 1). These
components form a delicate instrument that transforms acoustic
energy into electrical impulses that the brain interprets as
sound.
The outer ear gathers and directs sound through the ear canal to
the eardrum or tympanic membrane. The eardrum vibrates in response
to the acoustic energy and transmits this vibration to a series of
three tiny bones, called the ossicular chain, in the middle ear.
The last bone in the chain sends the vibration into the
fluid-filled inner ear, or cochlea, a structure coiled like a snail
shell.
Extending the entire length of the cochlea is a small, flat
structure called the basilar membrane, covered with more than
30,000 microscopic hair cells (see Fig. 2). Think of a
fuzzy carpet on a coiled, spiral-shaped ramp. Each hair cell
responds to a particular frequency, depending on its location
between the base of the spiral (high frequency) and the end or apex
(low frequency). The hair cells are also connected to sensory nerve
fibers.
As the incoming vibrations travel through the cochlear fluid,
they stimulate different areas of the basilar membrane to vibrate,
depending on which frequencies the sound contains. The hair cells
in each area generate electrical impulses in the corresponding
nerve endings. The fibers of the auditory nerve then transmit these
electrical signals to the brain.
In addition to frequency, the intensity or amplitude of the
sound is encoded into the electrical impulses. However, when the
intensity is too great for too long a period, it can damage the
hair cells. Once hair cells collapse or die, contact with the nerve
fibers is broken, and the perception of a particular frequency
range is reduced or lost entirely.
Noise-induced hearing loss (NIHL) is the most common
occupational injury, according to government statistics. In
activities such as mining, manufacturing, and woodworking, NIHL is
a side effect that may not interfere with the primary task. But for
musicians and audio professionals, it distorts and then destroys
the most important tool of your trade.
Overexposure to high sound levels can also lead to tinnitus, a
debilitating ringing, buzzing, or roaring in the ears. An hour with
Spinal Tap after a day at NAMM (with instruments and sound gear
blaring from almost every booth) gave me some moderate tinnitus,
which fortunately went away by morning. But if I worked in such a
loud environment for a long time, I could develop permanent
problems.
NIHL is insidious and irreversible, but it is also preventable.
Like cigarette smoking or unsafe sex, exposure to high sound levels
brings real dangers. So don't sacrifice your future musical
enjoyment — and your livelihood — for a quick
bone-buzzing blast. Take the long-range view and play it safe.
Protection is up to you.
WORK RULES
Damage to the hair cells of the inner ear occurs with long-term
exposure to sound-pressure levels (SPL) of 90 dB and above. The
Occupational Safety and Health Administration (OSHA) defines
long-term as eight hours per day for ten years. However, the higher
the sound level, the faster the damage accumulates (see Fig.
3).
The OSHA standard cuts the safe exposure time in half for every
5 dB above 90. In other words, 95 dB is considered safe for four
hours, 100 dB is safe for two hours, 105 dB is safe for one hour,
110 dB is safe for half an hour, and so on. In other countries,
these guidelines are 5 to 10 dB lower, and studies show that at 85
dB long-term exposure will definitely cause hearing loss in a
certain percentage of those exposed.
Consider that rock concerts at sustained levels above 100 dB can
easily last three hours or more, placing everyone's hearing at
risk. Last year, in a series of articles in the Bay Area Reporter
on the blaring levels at dance clubs, journalist Ed Walsh
documented music as high as 115 dB at the loudest club in San
Francisco. That's not quite as bad as Spinal Tap, but it's worse
than sandblasting. If this club were a factory, workers would
legally be allowed in for only 15 minutes a day. Yet very few
patrons or employees were observed wearing hearing protection of
any kind.
MUFFLER SHOP
NIHL does not reduce hearing response evenly across the
frequency spectrum. Typically, problems are first noticed in the 3
to 4 kHz range, although losses at higher frequencies may already
exist. Boosting overall levels to compensate — or just
pushing the high end as you lose sensitivity there — is like
having whiskey for breakfast to blot out a hangover. It makes
matters worse in the long run, and if you're rocking the house that
loudly all the time, it also hurts everyone around you.
NIHL comes on slowly, so how do you know you're in trouble? You
may notice temporary effects after a gig, such as ringing in your
ears or the sense that everything sounds muffled, or you may notice
that you hear better with one ear than the other on the phone.
Often soft, high-frequency sounds (such as the fizzing when you
open a can of soda) disappear entirely.
These symptoms may come and go at first as the hair cells in
your cochlea struggle to recover from each onslaught. But with
repeated exposure, things get worse. Eventually the perception of
all frequencies is permanently reduced, and additional ongoing
symptoms, such as tinnitus or hyperacussis (hypersensitivity to
sounds), may bring further discomfort and distress.
In addition, keep in mind that the frequency range from 3 to 5
kHz contains most spoken consonants — so with the onset of
NIHL, normal speech may seem mumbled. (See the sidebar “DIY
Hearing Test” for a simple early-warning test that uses
speech sounds on the radio.) When guitarist Pete Townshend went
public with his hearing problems in 1987, he said the saddest part
was not being able to hear his children speak to him.
Prevention, protection, and early detection of hearing problems
are essential for a long-term music career. Simple measures, such
as avoiding nonmusical noise, can make a big difference. Any
situation in which you must shout to be heard is likely to cause
damage. Alcohol consumption, cigarette smoke, and marijuana have
been shown to reduce the ear's resiliency, so cleaning up your act
in those areas may benefit your hearing as well.
TAKE THE TEST
Where should you begin? Michael Santucci, president of
Sensaphonics, a manufacturer of custom in-ear monitors (IEMs) and
earplugs, explains that the cornerstone of hearing conservation is
a thorough assessment by an audiologist, including an interview
about your health history, musical habits, and other sources of
noise exposure, such as outdoor hobbies or past military service.
The audiologist will also ask about symptoms such as ear pain,
temporary decreases in hearing sensitivity, or tinnitus.
He or she will then test you to establish a pure-tone hearing
profile or audiogram that reveals the softest level or threshold at
which you respond to various frequencies (see Fig. 4).
(OSHA regulations specify that such a test is valid only if
preceded by at least 14 hours of quiet time, so don't schedule your
audiology appointment for the morning after a late, blasting gig!)
If the interview or audiogram indicates that you have a problem
that requires medical follow-up, the audiologist will refer you to
an ear, nose, and throat physician.
It's a good idea to schedule an annual checkup even if you don't
notice any symptoms. These tests can catch subtle problems early,
and if your hearing turns out to be normal, you'll have a baseline
for future comparisons — and you'll feel a sense of relief.
Keep in mind that the typical hearing test goes up only to 8 kHz;
you should shop around for an audiologist whose equipment can
measure response to frequencies as high as 12, 16, or even 20
kHz.
Hearing Education and Awareness for Rockers (HEAR), a San
Francisco-based nonprofit organization, offers evening clinic
appointments staffed by volunteer audiologists. Its Web site also
provides a nationwide list of affiliated audiologists and doctors
specializing in hearing conservation and tinnitus treatment who
will understand your particular needs as a musician. (All
audiologists on the HEAR Web site use equipment that tests above 8
kHz; those with a university affiliation may have access to
research equipment that tests up to 20 kHz. See “Onstage
Hotlinks” for this and other Web resources.)
DITCH THE HALL MONITOR
In rehearsal and performance, musicians need to hear themselves.
But not everyone wants to hear everything, and cranking your own
axe over the others just leads to competitive, potentially painful
mush. So for musicians who want to maintain safe sound levels, an
IEM system should be top priority.
According to Marty Garcia, president of IEM manufacturer Future
Sonics, the first IEMs were developed in the mid-'80s in response
to a different concern: vocal fatigue. Professional rockers needed
to hear their singing over the rest of the mix to avoid blowing out
their voices. Touring artists also wanted consistent monitor sound,
independent of the acoustics in each hall.
These personal monitors were originally simple ear-bud
headphones, a concept later refined into custom-molded earpieces,
similar to those made for hearing aids. Garcia reports that in the
early '90s Steve Miller recognized that as a bandleader (employer),
he could be held legally liable for hearing damage to his entire
crew, and he invested in research indicating that IEMs have the
potential to offer better hearing protection than room monitors.
(They can also cause more damage if misused.) Miller also required
his band members to get annual hearing tests, and he specified in
his contracts that house levels be kept under 90 dB.
Other pro musicians soon picked up the idea, with drummers among
the earliest converts. According to Stephen Ambrose, another
pioneer in the development of IEMs, country musicians were also
especially receptive early on, because a lower-intensity, clearer
monitor mix suited delicate instruments, such as the mandolin and
fiddle, as well as their lyric-oriented material and typically
smaller venues.
For the first time, musicians also had individual control of
what they heard, using belt packs connected to the mixer with
cables or wireless transceiver systems. (Companies such as Shure,
Sennheiser, Nady, and AKG offer wireless systems.) Still, it
quickly became clear that given the chance, players tended to
listen at potentially damaging levels. In fact, an IEM in the ear
canal has the potential to be even louder and more damaging than a
stage monitor. To prevent that, Garcia explains, sound engineers
must learn to set a safe peak limit, and each musician can then set
his or her own level between 80 and 100 percent of that limit.
Custom-molded IEMs include the Westone Labs Ultimate Ears ($500
to $750), Sensaphonics ProPhonic ($650 to $850), and Future Sonics
Ear Monitor brand ($798). Westone and Sensaphonics offer several
models within their respective lines, including single- and
dual-driver designs. To obtain a set, contact one of these
companies for a referral to an audiologist in your area who can fit
you for the product. (The prices quoted here are for the earpieces
only — expect to spend considerably more on the other
hardware components of your IEM system.)
When fitting you for custom-molded IEMs, the audiologist first
determines if you have excessive wax in your ear canals; if so, it
must be removed. (Some audiologists do this themselves, or you
might need to see a doctor.) Once your canals are clear, the
audiologist squirts a thick silicone goo into each ear, which
hardens after a few minutes into impressions of your ear canals.
The audiologist then sends these impressions to the manufacturer,
which makes the IEMs.
Custom-molded IEMs are relatively expensive, so several
companies offer universal models. Future Sonics recently developed
a universal IEM in collaboration with Sennheiser; called the EM3
($200), it includes a covering of expandable foam, which provides a
semicustom fit at a more affordable price. Other universal IEMs
include the Etymotic Research ER-4 MicroPro ($330) and the Shure E1
single-driver ($193.80) and E5 dual-driver ($601.80).
Keep in mind that gear alone won't save your hearing. As
Sensaphonics' Santucci puts it, “The biggest problem is that
people think they're safe because they use IEMs. But you still have
to be responsible and not turn them up too loud.” Garcia
recommends that musicians use stereo monitoring because they can
achieve greater clarity and separation at a lower overall SPL than
with a mono system.
Dave Denny, a musician and engineer who has worked with Steve
Miller and the Grateful Dead, makes an additional suggestion: add
one or two mics pointed away from the stage and feed a bit of the
audience sound into your monitor mix. This can overcome a
performer's sense of being isolated and sealed off from the house
ambience.
Audiologist and recording engineer Rachel Cruz emphasizes that
musicians must maintain careful habits. “IEMs can be great
for hearing conservation, or they can be a significant source of
hearing loss,” she says. “It all depends on how you use
them.” (For more on in-ear monitors, see “Stick It in
Your Ear” in the April 2000 issue.)
LEAKS, SQUEAKS, AND PLUGS
If you can't afford IEMs, there are less expensive ways to
protect yourself onstage. To reduce the SPL reaching your ears from
floor monitors, get a pair of musician's earplugs, specially
designed to provide relatively flat attenuation across the audible
spectrum (see Fig. 5a). Keep your plugs handy for other
loud environments, such as concerts, dance clubs, and movie
theaters.
As with IEMs, you can choose between universal plugs, such as
Etymotic Research's ER-20 ($10), and the custom-molded variety,
which can cost around $150. Sensaphonics, Westone Labs, and Future
Sonics offer custom musician's earplugs with interchangeable
filters from Etymotic Research that attenuate 9, 15, or 25 dB. As
with custom IEMs, contact one of these companies for a referral to
an associated audiologist in your area.
Ordinary foam plugs from the drugstore are better than nothing,
but they do not provide flat attenuation; in particular, they tend
to cut the highs much more than the lows (see Fig. 5b).
Compared to the rest of what you probably spend on gear, quality
earplugs are a reasonable investment.
Many musicians complain that IEMs and earplugs can feel odd; for
one thing, your own voice sounds different when your ear canals are
blocked, a phenomenon called the occlusion effect. At quiet
moments, the sounds of your own breathing, swallowing, and even
blood circulation can become distracting head noise.
One common attempt to solve these annoyances is to add a vent to
the earpiece. But venting destroys the plug's protective effect
— it's like poking a hole in a condom. Instead, audiologists
recommend that you experiment with different filters for different
situations, using the lowest attenuation necessary to protect
yourself adequately. After a while you'll get used to the new
sensations, just as you once had to get used to the feel of your
drumsticks, keys, or strings. You'll reap the reward of clear sound
at safe levels, and you'll get home from a gig or a night on the
town without suffering from muffled conversation or ringing in your
ears.
Try not to worry about being seen as a wimp for taking these
precautions. You're actually on the leading edge of a trend.
Everyone I spoke with at NAMM said sales of safe-hearing products
have grown phenomenally in the past few years. Baby boomers hitting
midlife with as much hearing loss as retirees now take the problem
seriously, but so do many in today's health-conscious younger
generation.
At NAMM, Daniel East, marketing director for Future Sonics,
described fitting the preteen members of a bubblegum-pop group with
earplugs and IEMs. The kids had just signed a record deal, and
their parents wanted to make sure they had hearing protection built
in to their careers from the start. To make hearing protection more
fashionable, Etymotic Research markets the ER-20 universal plugs in
an assortment of bright colors.
Perhaps the niftiest gizmo I saw at NAMM eliminates the
potentially harmful zap — to gear as well as ears —
that occurs when you unplug a cord from a live amp. Made by
Sensonics, the Silenzer snaps onto the end of any plug and grounds
it during unplugging; when the cord is in use, this safety wire
slips out of the way. It's an elegant solution that its inventor,
Stephen Ambrose, hopes will become an industry standard for safety
and convenience.
AFTER THE RAIN
What if you're already dealing with significant hearing loss?
First of all, it's important to protect the hearing you have left.
In addition, talk to your audiologist about hearing aids. According
to Dr. Jillian Barrett of California State University at Hayward,
the new fully digital hearing aids have a wide frequency response
and extensive programmability so that they can closely match your
particular area of loss. Some new analog aids, also designed with
the musician in mind, may be more affordable.
Unfortunately, tinnitus sufferers have fewer options; coping
strategies are the main focus of tinnitus-oriented Web sites and
support groups. The most common suggestion is to mask the internal
roar with white noise, especially if you have trouble falling
asleep. The easiest way to do this is to tune a radio between
stations.
If you have significant hearing loss, do your part to educate
your less-afflicted colleagues. My most memorable encounter at NAMM
was with a drummer in his mid-30s who already suffers from
permanent, serious tinnitus. “Get the kids to pay
attention,” he urged me. “They think that they're
invincible and that hearing loss only hits grandparents. Ten years
ago I thought that too, but my ears were already damaged, and I
just didn't know it. Now, it's hard for me to sleep, it's hard to
be anyplace quiet. I'm still young, and I can't enjoy music like I
used to.”
So listen up — use your common sense and the available
resources to take care of your ears. It's the only way to make sure
you'll enjoy a lifetime of listening and playing, studio gigs and
concerts, and all the hotel rooms in between.
Joanna Cazden is a voice coach in Burbank, California,
who often writes about musicians' health issues. You can contact
her online at www.voiceofyourlife.com.
onstage•hotlinks
www.asha.org
American Speech-Language Hearing Association
www.ata.org
American Tinnitus Association
www.audiology.org
American Academy of Audiology
www.earmold.com
Westone Labs
www.etymotic.com
Etymotic Research
www.futuresonics.com
Future Sonics
www.hearingconservation.org
National Hearing Conservation Association
www.hearnet.com
Hearing Education and Awareness for Rockers
www.hei.org
House Ear Institute
www.sensaphonics.com
Sensaphonics
DIY Hearing Test
On the way to your next gig or practice session, set your car
radio to a talk station. Once you've parked, keep the radio on and
turn the volume down to the softest level at which you can still
understand the words. Turn off the car without changing the radio's
volume.
After the session, listen to the radio at the same volume
setting. Can you still hear it? Can you understand the words as
clearly as before, or do you have an urge to turn up the treble to
make the sound more crisp?
If your aural perception has changed in this relatively short
time, you have a form of short-term hearing loss known as a
temporary threshold shift. With repeated exposure to high
sound-pressure levels, you will be at significant risk for
permanent hearing loss. See an audiologist for formal testing, and
talk to your bandmates about playing at safer levels.
— Adapted from “Sound Check” on
www.hearnet.com
