We spoke with Fiona Butterworth, Clinical Lead at Harley Street Hearing and the Musicians' Hearing Services, to learn more about hearing health and the importance of protecting your ears. Outside of her work in audiology, Fiona is also a musician. She currently enjoys singing in a local choir as well as playing bassoon and contrabassoon in London-based ensembles. Fiona draws on her experience in these sound-rich musical environments when educating others about hearing health.

Harley Street Hearing and Musicians' Hearing Services offer musicians access to audiological assessments, expert advice, and discounted hearing protection through the Musicians' Hearing Health Scheme. In this article, you'll find essential information on what to look out for, what steps to take if you have concerns, and the best practices for protecting your ears.

Musicians' Hearing Health Scheme

As a musician, what are the risks to my hearing?

Being a musician, you're often in sound-rich environments that will contribute to your cumulative noise exposure, and some of these levels will be unsafe. The louder the sound, the shorter the time you can safely be in that environment before you risk damage to your hearing. Without well-fitting and appropriately chosen hearing protection, you risk exposure to harmful sound levels that can lead to permanent hearing damage. Common risks include noise-induced hearing loss, tinnitus, hyperacusis, and diplacusis.

After exposure to unsafe levels of sound, there is the potential for a temporary change in your hearing. In most cases, the hearing will typically return in the 12 to 14 hours following exposure, provided there is no further exposure. Repeated exposure to unsafe sound levels can lead this temporary change to become a permanent hearing loss.

Perhaps the symptom that musicians most commonly talk about, is tinnitus. In the 2015 Musicians Survey carried out by Help Musicians, tinnitus was selected as “What type of hearing problem do you have?” in over 57% of participants. Tinnitus is an involuntary perception of sound in the ear(s) and/or head in the absence of any external source of sound. Many people will experience this as a ringing or buzzing sound in the ears and have likely experienced this after performing or attending loud gigs. In this case, the tinnitus is likely linked to the temporary change in hearing following noise exposure, and you should consider this your warning sign that the environment you were in has the potential to permanently damage your hearing.

Some can experience hyperacusis which is a change in your hearing sensitivity, where every-day sounds seem much
louder than they should. Diplacusis is when a single pitch can be perceived to be different between the ears, or even
sometimes in the same ear.

What symptoms should I look out for?

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Any change in your hearing should be taken seriously. Pay attention to any differences in how you hear, and make sure to have regular hearing tests (ideally every 1-2 years) to monitor any changes.

This advice applies to everyone, not just musicians! If you notice changes like reduced hearing, sounds feeling muffled, or blocked ears, you should seek advice from your GP, ENT consultant, or Audiologist. Trouble hearing in noise places, difficulty understanding the television, or needing people to repeat themselves in conversations are also signs that you should seek professional guidance. These symptoms, along with the risks mentioned previously, temporary hearing loss, permanent hearing loss, tinnitus, hyperacusis, and diplacusis, should not be ignored.

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What steps can I take to protect myself against hearing loss?

There are several things you can do to protect yourself against hearing loss due to noise exposure.

1. Turn the volume down.
Where possible, lowering the volume of the sound source is the easiest step you can take. If you're using headphones or earphones, try to keep the volume below 60% of the maximum level on your device.

2. Use hearing protection.
Hearing protection is one of the best ways to manage your noise exposure in situations where lowering the volume isn't an option. There are different styles of hearing protection, ranging from universal-fit foam types, to custom-moulded earplugs designed for musicians (available through the Musicians' Hearing Health Scheme). With hearing protection, you can personally reduce your cumulative noise exposure without needing to change the environment around you.

3. Consider your schedule.
Plan your time carefully to account for the sound levels of the environments you'll be in. Be sure to schedule quiet periods to give your ears a break from the noise.

4. Change your set-up.
If you're working on stage and still using traditional on-stage monitoring speakers, consider upgrading to custom-made in-ear monitors (IEMs). This can help reduce the overall sound level on stage, allowing each musician to choose a comfortable volume level rather than trying to match the loudest request.

What should I do if I'm concerned about hearing damage?

If you’re concerned about hearing damage in a particular environment, it's best to remove yourself from the area if possible. If leaving isn't an option, use hearing protection to reduce sound levels and move further away from the noise source.

If you think hearing damage has already occurred, the first step is to have an audiological assessment. This will help assess your ear health, check for any wax in the ear canals, and conduct a hearing test to evaluate your hearing. The audiologist will explain the results and identify any areas of potential hearing loss.

Even if you have no current concerns, it's important to schedule regular hearing tests to monitor your hearing. This helps to identify any issues early and ensure that your hearing protection remains effective. While symptoms of hearing damage can be permanent, there are many ways to manage them, allowing you to continue enjoying the music you love. Consulting a professional ensures you receive the most appropriate and up-to-date information.

As mentioned earlier, there are a wide range of earplugs available. Foam earplugs, while effective in an emergency, are not designed for musicians and aim to block out as much sound as possible. Many earplug manufacturers now offer off-the-shelf or universal-fit styles specifically designed for musicians. These provide better sound clarity while protecting hearing and are an affordable option. However, due to their one-size-fits-all design, they may not provide a perfect fit for every ear.

The best option for hearing protection is custom-made musician's earplugs that you can access through the Musicians' Hearing Services. These offer a comfortable, efficient seal in the ear canal, ensuring sound is directed through optimised filters that provide flat reduction across all frequencies. This results in a more natural and enjoyable listening experience for musicians.

Conclusion

Hearing damage from exposure to loud sounds can be permanent, but it is 100% preventable with the proper use of hearing protection. If you have concerns about your hearing, don’t wait for it to improve on its own. While many cases may not be serious, taking prompt action and consulting an expert, whether it’s an audiologist, ENT consultant, or GP, puts you in a much better position to address any issues.

Since 2016, Harley Street Hearing and Musicians' Hearing Services, in collaboration with Help Musicians, have been providing professional musicians in the UK with affordable access to specialist hearing protection and assessments. For a subsidised cost of £50, you can receive an audiological assessment, expert guidance on hearing protection, and a set of custom earplugs—delivered by professionals who understand musicians' needs.

To apply for the Musicians' Hearing Health Scheme and check eligibility, click here.

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