The early signs of hearing loss can be subtle and are not always immediately associated with a deterioration to hearing. Some of the early signs and symptoms include but are not limited to:
- Difficulty in understanding what people are saying, particularly in places with external noise
- Having to concentrate to hear others or watching their lips to gain a better understanding
- Asking others to repeat themselves
- Listening to music or television loudly without being aware
- One ear noticeably better than the other on the phone
- Becoming overly sensitive to sound in comparison to others
- Ringing or whooshing in the ears
- Being told that you speak too loudly
It is important to note that, when considering exposure to sound that it is not only the measurable volume but the proximity (or closeness) to the sound and the duration (or how long) that a person is exposed to the sound. A logical way to think about exposure is that the higher the intensity, the less time you can safely spend in that environment. For example, at 85dB you can expect to safely manage 8 hours. However, for every 3dB the decibel level rises, that time cuts in half. Therefore, raising the decibel level to 88dB brings the safe exposure time to 4 hours, and 91dB reduces is to two hours. (Jones, Heyman p.193)
Prevention and treatment for hearing loss and disorders
The following actions (especially when combined) can be powerful weapons for preventing noise-induced hearing loss and/or managing an existing hearing disorder:
Ear plugs: ranging from the disposable foam plugs that are often given away at gigs to sophisticated bespoke plugs that are moulded to the user’s inner ear, the use of ear plugs may be the single-most effective method of preventing long-term hearing issues. Ironically, some musicians are reluctant to use them as they affect their ability to hear the complete sonic range (and corresponding subtleties) of the music they are playing. In fact, some musicians will have a propensity to actually play louder when wearing plugs, creating a vicious cycle of spiralling volume between themselves and the rest of an ensemble. A potential solution to this is for ear plug users to wear their plugs outside of a gig or rehearsal for at least 30 minutes to an hour before they play, allowing time for them to get used to a new aural environment within their own head.
Rehearsal strategies: Depending on the acoustics of the room and the length of a session, musicians are often more at risk of exceeding safe hearing thresholds when they are rehearsing that then actually performing. When rehearsing, a musician may be exposed to extremely loud music in a relatively small space for long periods of time. Therefore, the length of rehearsal and the type of venue being rehearsed in should be carefully considered. Reducing exposure by taking regular breaks throughout the day gives the ears a break, as well as all of the musicians being willing to play at reduced volume levels for at least part of the session.
Hearing aids: While they have some obvious benefits, a historical problem when being fitted for hearing aids is that a normal audiogram (hearing test) may not reveal damage to the inner ear that has created difficulty in discriminating the wide range of frequencies needed to perceive music well. Additionally, multi-channel hearing aids can flatten the spectrum of the musical signal, making it difficult to identify instruments and even tell where the sound is coming from. However, the technology in hearing aids is moving on rapidly, in one recent study by Marshall Chasin, AuD it was shown that recent digital advances are allowing hearing aid users to hear music at higher levels of volume (circa 110 dB SPL) and across a broader frequency range without appreciable distortion.
Mindfulness meditation: Being able to focus clearly on the present moment with awareness and acceptance is a skill that can be of great use when trying to reframe the unhelpful and irrational thought processes that can come with any pain or suffering, with hearing disorders being no exception this.
Heyman, Lucy and Jones, Rhian (2021) Sound Advice: The Ultimate Guide to a Successful and Healthy Career in Music. Pp 186-197. Shoreditch Press, London