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FAQ

Welcome to the Hearing Loss FAQ section of our web site. Here you will find answers to commonly asked questions related to hearing loss.

The first twenty or so questions will provide a good overview of the state of knowledge in the field and together can be used as a primer, or "short course" in "Musicians and the Prevention of Hearing Loss".

The research backing up the answers can be found in the "Articles" section.

To ask a question that has not already been posted, please click on the link at the bottom of the page to send us an e-mail with your question.

What happens when we get a music related hearing loss?
Most people reach the ripe old age of 50 without any hearing problems, but others suffer a very slow and gradual hearing loss that may not be noticed for years. Certainly working in a noisy factory is one such cause. And listening to loud music is another. The ear is made up of three parts- the outer ear, the middle ear, and you guessed it, the inner ear. The inner ear is about the size of a small finger nail and contains about 15,000 nerve endings, called hair cells. When some of these hair cells are damaged, you have a permanent hearing loss. Damage to the outer and middle ears is usually temporary and can be treated by a doctor.

What are some other causes of permanent hearing loss?
Other than hearing loss associated with aging (called presbycusis), the single greatest cause is working around noise. The ear does not know the difference between loud noise and loud music. To the ear, noise and music are just vibrations in the air. Rarely, a person may suffer a permanent hearing loss from a virus or even a brain tumor. These usually have a sudden onset and may be accompanied by dizziness. Hearing loss from noise or music tends to be gradual in nature with no dizziness. If one experiences dizziness or a sudden hearing loss, one should contact their doctor.
 

Can my hearing loss be treated with medicine or surgery?
Only hearing losses that are from the middle ear (where kids get ear infections) or from the outer ear (such as wax occlusion) can be treated. Rarely can a hearing loss be treated if it is from the inner ear. The inner ear is actually in the brain, so inner ear surgery is brain surgery! Having said all this, researchers are working on a "vacination" that can be given to reverse inner ear hearing loss- as more information becomes available, look in the "What's New" section of this website.

I went to a concert last night and my ears are still ringing. Will this stop?
The ringing is called tinnitus. Actually, tinnitus refers to any noises that are heard in the head, that don't come from the outside. Tinnitus comes in two flavours- objective and subjective. Objective tinnitus is tinnitus that can be heard by other people. This is very rare, and is usually related to blood vessel problems in the ear. Subjective tinnitus is much more common and refers to the type of tinnitus that only the person can hear. But, to answer your question. You are probably suffering from TTS from the concert.

Well, ... thank you for that, but what is TTS?
What a good question! TTS stands for Temporary Threshold Shift. This is a fancy way of saying temporary hearing loss. After a loud concert, or a day in the factory, your hearing is temporarily reduced. After about 16 hours to 18 hours, this resolves and your hearing should return to the level it was before (hopefully normal). When the hearing is reduced, there is frequently tinnitus, which is especially noticed in quiet places such as when you are trying to sleep. The tinnitus and hearing loss (sometimes felt as a numbness in your ears) should completely resolve after 16 hours.

If my tinnitus goes away after 16 hours, is it safe to go to another concert after?
The short answer is "yes" and "no". It is true that the ear recovers after about 16 hours and can take on new challenges of loud music, but TTS is a warning signal of being exposed to too much music. If you go to a rock concert on Friday night, don't mow your lawn until Sunday (or better yet, get someone else to do it!) However, once you have a music related (or noise related) hearing loss, it is permanent, so do whatever it takes to prevent it. Certainly moderation is one idea. Enjoy that loud song, but when its over, turn down the volume abit to give your ears a rest.

What else can happen as my hearing gets worse?
In some sense, hearing loss is the least of your worries. After all, it is very gradual, and only affects the very high pitched sounds... so you may not notice it for years to come. But, with hearing loss comes two other things that can be very annoying- or if you are a musician, can be career ending. They are pitch perception problems and permanent tinnitus. Pitch perception problems, as the name suggests, means that a person with a significant hearing loss may hear one note as another (and have limited understanding for speech). And can you imagine having a constant hum or whistle in your head day and night? This is what many people report with permanent tinnitus. So,... prevention of hearing loss is where its at.

So what can be done if I do have tinnitus that won't go away?
Don't panic- this is rather uncommon, but it does occur on occasion. There is almost always a hearing loss associated with the tinnitus. Using a small hearing aid (and there are some that fit invisibly into the ear canal) not only will help you hear better, but will tend to mask or block out the tinnitus in the majority of people. Being overly concerned about it is another problem. The last thing someone should do is become stressed as this may make the tinnitus more noticeable. There are therapy programs that serve to retrain the brain to ignore tinnitus and these can be very successful. Contact your local audiologist or doctor if this becomes a problem.

I understand that rock music can be damaging to my hearing, but I can't believe that Mozart or Beethoven can be bad for me.
Believe it or not, but Classical music- or specifically playing classical music- can be more damaging than rock music. Research has shown that about 37% of rock musicians have a hearing loss, and about 52% of classical musicians suffer from this problem. The main difference is that classical musicians rehearse, perform, and teach more hours each week than typical rock musicians. And classical musicians tend to be clustered closer together than rock musicians. So even though the peak sound levels in a rock band may be higher than in an orchestra, the total weekly doseage of a classical musician is greater.

Are there any other differences between classical musicians and rock musicians besides the obvious?
You mean, beyond the long hair? Although this next issue is highly variable, many classical musicians don't like their music as much as rock musicians do. It is this liking of the music that is partially responsible for the difference in susceptibility between rock and classical musicians. Research has shown (see some of the articles in the "Articles" section of this website) that if you like the music, it is actually less damaging than if you don't like it. Classical or orchestra musicians may play the same piece of music countless times, and become bored with it. In addition, an orchestra musician has their music selected for them by a conductor or artistic director. They may not like the selected pieces. In contrast, a rock musician tends to play their own music- music that they love. This research has been replicated many different ways, always with similar results. So, go ahead and enjoy your music (in moderation).

Let me get this straight. If I like my music, it is less damaging to my hearing?!
Well, sort of... technically, its not so much that liking the music is good for us- its if we don't like the music, it is worse. We're not sure exactly why that happens, but there are two theories. One is that when you are under stress, certain hormones are released in your inner ear that makes it more susceptible to hearing loss. A second theory is related to the fact that there are a series of feedback loops from the brain back to the inner ear. These feedback signals can change the susceptibility of the inner ear to damage. If the music is pleasureable, the feedback from the part of the brain corresponding to hearing, reduces the susceptibility.

So what are the factors affecting hearing loss?
The two main factors are how intense the music or noise is, and how long one has been exposed to it. We know from research that prolonged exposure to 85 decibels (dB) or greater, over time will cause a permanent hearing loss. A level of 85 dB is not particularly loud- a dial tone on a telephone is about that! Even though it is not loud, it is intense enough to be damaging. But, it also depends on how long you are exposed to it. Research has found that the maximum exposure each week should be less than 85 dB for 40 hours. This is identical to 88 dB for only 20 hours. That is, for each increase of 3 decibels, you can only be exposed for half as long. Saying it differently, for every 3 decibel increase, your exposure doubles. Other less significant factors are your liking of the music, general health, and hereditary factors.

I listen to my Walkman at about half volume. Is this level OK?
Well, lets find out. We know that Walkmans generate about 85 decibels at about 1/3 volume control. Many Walkmans yield about 95 decibels at half volume. Let's do some math- 85 dB for 40 hours, is the same as 88 dB for 20 hours, which is the same as 91 dB for 10 hours, and this is the same as 94 dB for 5 hours each week. Therefore you can listen to your Walkman safely at one half volume for about 5 hours each week. If your favourite song comes on, turn up the volume and enjoy, but be sure to turn it back down after. There is an interesting case study in the "articles" section of this site by Brian Fligor. Take a look at it!

I have tried earplugs but they sound hollow. Also, I can't really hear the high end. Are there better earplugs?
Because of the laws of physics, earplugs lessen (attenuate) the sound energy for the higher pitches more than the lower bass notes. Typically earplugs will cause a hollow sound without much high end. About a decade ago, a company named Etymotic Research came out with a "flat" earplug- one that lessens the sound energy for the high pitched notes as much as for the low bass notes. These use a small acoustic amplifier that puts back many of the high pitched sounds. Musicians and music listeners then can hear their music unaffected, except that its at a non-damaging level. These earplugs come in several amounts of protection- 9 decibels of protection (ER-9),15 decibels of protection (ER-15) and 25 decibels of protection (ER-25). Different musicians use different earplug.

I'm a drummer and sometimes when I wear earplugs, my wrists hurt. What is happening here?
Wow! Its as if I wrote this question myself! I see this clinically all of the time. You will also find some information on this in the articles in the "Articles" section. Many drummers use industrial strength earplugs, like those used in factories. These earplugs take off alot of the sound of the high hat cymbal and rim shot of the drum. The drummer needs to hit harder in order to hear properly, with the result of wrist and arm damage. Using proper ear protection will resolve this. Drummers should be using the ER-25 earplug- enough ear protection to prevent further hearing loss, and enough audibility of the music, so that they will not overplay.

I've seen musicians on TV wearing what look like hearing aids connected to small wires. What are these?
These are called in-the-ear monitors, and they are a form of a modified hearing aid. Musicians use them as their own monitoring system instead of the small "wedge" monitors on the floor of the stage. The wires are connected to the sound amplification system either directly or though a wireless transmitter. The musician can then hear their own music as well as that of the other musicians, but at a safe level. When musicians use in-the-ear monitors, the overall sound level on stage is typically much less than if they were using conventional wedge monitors.

I play the bass in a band, but can't really hear myself play because the drummer is so loud. Is there anything that I can do?
Unfortunately (for bass players) they usually stand near the drummer. Many bass players (and drummers) use a special type of loudspeaker called a "shaker". These small hockey puck sized devices are designed to enhance the very low pitched bass notes. Shakers are plugged into the main sound amplification system. With this set-up, the bass players and drummers have a better awareness of their own music, and as such, do not have to play as loud. The overall sound level is less, but everyone thinks they are playing louder. The musicians are happy and the music is less damaging.

I practice in a small room. What changes can I make to reduce the sound levels. P.S. I don't have much money.
There are some inexpensive changes you can make. Wall coverings and floor coverings are the two easiest things you can do. If there is nothing on the walls, try putting up some heavy drapes. These will absorb many of the undesireable reflections. Also, carpeting will serve the same purpose for those reflections from the floor. A drop ceiling is starting to get abit costly, but this will also help. Finally, you should be using ear protection such as the ER-15 or ER-25. These will let you hear your music, but at a safe level.

I have seen some clear plastic shields up on stage in front of the drummer. What are these used for and do they work?
These are called baffles and are usually made of Plexiglas or lucite. All baffles, because of the laws of physics, attenuate (or lessen) the higher pitched sounds more than the lower bass notes. These baffles are designed to lessen the energy for those high pitched high hat cymbals, and rim shot hits that a drummer may make. This protects the other musicians and helps to improve the balance of the music. Note that the low bass thumping sounds from the bass drum is not really affected. The only "trick" with baffles is that they should not extend up above the drummer's ear. The last thing anyone would want is to cause more hearing loss in the drummer by being forced to hear his music, not once, but twice (the initial sound and the reflection off the back of the baffle).

I have also seen some baffles hooked onto the back of some seats at the symphony. What are these used for?
These are typically used on the seats of violinists and viola players. In many cases, these musicians need to sit in front of the brass or percussion sections, and they serve to lessen the energy from these louder instruments. The only problem with a seat baffle is that it has to be within 7 inches (18 cm for Canadians, eh?) of the violinist's ear. If it is further away, there is minimal benefit because of the reflections off the floor, ceiling, and music stands.

Can I do anything with my loudspeakers to hear better and to protect myself from further hearing loss?
Loudspeakers do not send all sounds out equally. Typically the low pitched bass notes emanate from all parts of the loudspeaker- bass notes are equally loud from the back, front, top and sides. However, the higher pitched notes come out almost like a laser beam- in a straight line. If the loudspeakers can be tilted to aim towards your ears, you will hear a flatter, "more true" sound. And, more importantly, if the loudspeaker is aimed at your ears, the overall volume control level will be lower. In this way, even though the music will sound as loud, it will be less intense. That means it will be less damaging. Intensity is what causes hearing loss, whereas loudness is simply your impression of the sound. Some researchers suggest elevating the loudspeakers, and this can be useful, but be careful. Some loudspeakers are designed to be left on the floor. Check with the manufacturer before you elevate loudspeakers to see if this would be a problem.

When I go to a concert in a large venue, the band is set back from the edge of the stage. Is this to protect them from the fans?
How observant you are! It may be to protect them, but there is an acoustic reason as well. The lip of the stage in front of the band or orchestra acts as an acoustic mirror. That is, the higher pitched sounds of the band not only come off the stage to the audience but also reflect off the lip of the stage, thereby enhancing the higher pitched sounds. The band members don't have to play as loud up on stage in order for the people in the audience to hear it better. Not only are the musicians performing at a safer level, but the potential for arm and wrist injuries are lessened.

My friend is a drummer and whenever he practices, he hums and grunts. Is he weird or is he doing this for a reason?
He isn't weird (... well, he might be...) but many percussionists hum and grunt. There is a small muscle in the middle ear that mother nature gave us so that our own voice would not be too loud to ourselves (called the stapedial muscle). It has been shown that if one hums or grunts just prior to a loud sound and continues that hum through the sound, this muscle in the ear continues to contract, providing an attenuation (or lessening) of the sound energy. So your friend is actually protecting his hearing. For more information on this, look at the article entitled "Musicians and the Prevention of Hearing Loss" in the "Articles" section.

I teach music in a high school and the room is awful. Is there anything I can do to improve it? P.S. I don't have much money.
Actually there are several things you can do that are easy to accomplish and inexpensive. Incidentally, there is a fact sheet on this topic in the "Articles" section under "Musician Fact Sheets" entitled "School band Teachers". You can place the trumpet players on risers as this will allow the higher pitched harmonics of the trumpet to literally go over the heads of the other musicians "downwind". You can put up some drapes over the blackboard behind you while you are playing in order to dampen the unwanted reflections. These drapes can be pulled aside when you want to use the blackboard. Finally, get the Art Department to make some 3-D relief art that can be placed on the side walls. This will also help to lessen the unwanted reflections. High school band teachers, because of the number of hours each week that they must be in a band room should consider the ER-15 earplugs. Teachers are at risk of hearing loss and have successfully won cases with the Worker's Compensation Board in the past.

Do you have any specific information or suggestions for bagpipers?
Bagpipes are a fascinating instrument- the only "modern" instrument with no volume control! The output of bagpipes has been measured at 108 dB, and combine that with the drum corps to their rear and you can have a real problem. The hearing protection of choice is the ER-15 earplug if the piper is solo and the ER-25 earplug if drums are around. Of course, the same precautions/moderation should be taken as other woodwinds. You can check out the "Woodwind" fact sheet in the "Articles" section of this website for more information.

What caused Beethovan's deafness?
Actually Beethovan was not deaf at all... at least not in the North American sense. In Europe, any hearing loss, regardless of severity, is called "deafness". This even would apply to a mild temporary ear infection. In North America, deafness is considered to be at a profound level- one that would prevent normal verbal communication. Beethovan, as far as we can tell, suffered from Otosclerosis. Otosclerosis is a middle ear hearing loss which today, is surgically treatable. At most, Beethovan would have had a 60 decibel hearing loss- one that would still allow him to hear the music quite well. In addition, otosclerosis has no pitch problems associated with it, merely a decrease of the loudness of the music. I haven't seen Beethovan lately, but when I next see him clinically, I will check this out.

What ear plugs do you suggest for musicians?
There are three major types of ear plugs for musicians- the ER-15, the ER-25, and vented/tuned ear plugs. The ER-25 is generally only recommended for drummers. The ER-15 is the ear plug of choice for most other rock and blues instruments, as well as most classical instruments. The vented/tuned ear plugs are useful for those instruments that either do not have much treble sound energy (such as the acoustic bass and cello), or for those instruments that are not particularly damaging (such as the clarinet), but have to play near other noisy instruments, such as the drums. There is an article in the articles section of this website with this information- "Musicians and the Prevention of Hearing Loss".

Where can I get musician ear plugs?
Musician ear plugs, like the ER-15, can be obtained from anyone that makes hearing aids. I would contact an audiologist and they can either make the ear plugs for you, or send you to someone who specializes in musicians. Remember however, that while ear plugs are very important, they are only one of the many things that can be done to reduce music exposure. Environmental strategies (many of which are inexpensive) can be very useful. If you have difficulty finding an audiologist that specializes in musicians (we are rare!), drop us a line and we'll help to locate one. You can leave your email address in the "Do you have a question?" section below.

I have had tinnitus for two years. Is my drumming career over?
Tinnitus is almost always associated with some hearing loss. Treating the hearing loss may result in "treating the tinnitus". Most people find that some external noise (either from a hearing aid or from a "tinnitus masker") tends to block out the tinnitus. That's why many people with tinnitus do not find that it is as bothersome when there is background noise. Many musicians find that external noise allows them to play and enjoy their music. In fact, there is a type of tinnitus therapy called Tinnitus Retraining Therapy (TRT) that has been shown to be successful for many musicians.

So what is Tinnitus Retraining Therapy (TRT)?
Tinnitus is actually created in the brain- not the ear. The hearing loss (from too much loud music) causes the nerve endings in the ear to become damaged. The brain cells that receive the impulses from these nerve endings say "where is the sound??" These cells become "lonely" and start to generate their own sound. TRT is a method that involves counselling and the use of a noise generator (or masker). The cells in the brain say "Oh! Here is the sound" and gradually (after a year or so) stop producing their own noise. The tinnitus dies away (or at least becomes less bothersome and noticeable). Many audiologists offer this type of tinnitus therapy. You should consult your local audiologist for more information. Also, click on the "links" section of this website and click on the link for the American Academy of Audiology Tinnitus Position Paper. It is an excellent overview of everything we currently know about tinnitus. Also, click on the link to the American Tinnitus Association for more information.

Which are more damaging: low or high frequencies?
Actually this is an important question. A few research studies concluded that some frequencies are "sligthly" more damaging than others, but in reality, all frequencies are equally damaging. The reason we have our worst hearing in the 3000-6000 Hz region (around the top note of the piano keyboard) has more to do with the way our ear is made up, rather than the sound(s) that cause the hearing loss. For this reason, a flute and a bass player would have similar hearing losses. For more information see the FAQ near the top on "factors affecting hearing loss".

I play tenor sax in a loud band and wear ER-25 earplugs. Is the internal sound of myself playing loud potentially damaging?
This is a common concern for sax and clarinet players- instruments where the top teeth touch the mouthpiece. Sound can be generated from the instrument, through the teeth and by way of bone conduction, go directly to the ear. There are no studies that I know of about the exact sound level, but indirect evidence suggests that the sound can be quite intense. One can minimize the potential effect by ensuring that the earplug does not "trap" the sound in the ear. This is called the occlusion effect. As a sax player, unless the band is VERY loud, you should not be wearing an ER-25. At most, the ER-15 would be sufficient. I'm a clarinet player and I use the vented/tuned earplugs. These use a small hole that would let the bone conducted sound out of my ear.

Where can I find someone to make ER-25 or ER-15 earplugs?
You should contact your state and provincial association for audiologists or hearing aid dispensers. They can put you in touch with an audiologist or a hearing aid dispenser that specializes in musicians. They can also be found in the phone book under "Audiologist" or "Hearing Aid Dispenser". They are not covered under any medical program and usually are about $185 a pair in Canada, and about $150 in the US.

I am a piano tuner. Can piano tuning lead to hearing loss and should I be wearing ear protection?
Indeed many piano tuners do suffer from hearing loss. Recall that it is not only the intensity of the sound that causes hearing loss, but also the duration. A piano tuner can spend many hours each day with various pianos and like most musically inclined people, tend to also visit night clubs and other loud venues. The total exposure can add up quickly. The ER-15 musicians' earplug is the ear protection of choice. It will protect the piano tuner, while still allow them to hear the music.

Are there any "open air" type in-ear monitors that would reduce "occlusion" effect?
This is an excellent question. Once an in-ear monitor is "open"- i.e., there is an air hole running through the monitor to your ear, there will be a significant loss of low-frequency sound energy as well as a loss of protection from intense low-frequency sounds in the environment. The advantage of course, would be to minimize the occlusion effect which causes one's own voice to sound hollow and echoey. Other than creating an air hole, the major way of reducing the occulsion effect is to make the portion of the in-ear monitor that extends down the ear canal, as long as possible. This would also be useful for earplugs. When obtaining the in-ear monitors, or the musicians' earplugs, ask that the person making the earmold impression, ensures that the bore will extend beyond the second bend in the earcanal.

How did you figure out the dB output of musical instruments?
This is a commonly asked question. I use a specially designed sound level meter that can be placed in the ear canal or in the vicinity of the musician. Frequently stated are "peak" or maximum values. The "average" values may be quite different. Go to the "articles" section of this website for exact information for each instrument.

Can tinnitus (ringing in the ears) be treated with ginkgo biloba?
Health food stores frequently sell Gingko Biloba extract as a treatment for tinnitus. There is no scientific basis behind this. A recent study from England surveyed over 500 users of Gingki Biloba and found no significant tinnitus reduction benefit.

What about hyperacusis?
Hyperacusis is an awful sounding word meaning an "abnormal sensitivity to loud sound". People may complain that "medium sounds are OK but loud sounds that don't bother most people, seem to bother me!" This is actually an early warning sign of hearing loss. That is, not only does sound have to be abit louder in order to hear, but also the tolerance to loud sounds is reduced. Most modern hearing aids are specially designed to not only amplify softer sounds but make louder sounds softer. Most people with hyperacusis have a hearing loss. On rare ocassions, some people with normal hearing have hyperacusis as well.

Are pitch perception problems caused by damage to the inner, middle or outer ear? Are they permanent?
Pitch perception problems can be caused by either a significant inner ear problem or a problem in more central structures of the brain. Indeed, perfect pitch is a brain phenomenon, and has little to do with the hearing mechanism. Once there are pitch perception problems, little can be done to help the situation. Prevention is mandatory.

How can I scare my band mates into using earplugs? They refuse to use them.
This is a common problem. Prior to 1988 there were no earplugs that could successfully be used by musicians. Today's earplugs (for example,the ER-15) not only treat all sounds equally but minimize the occlusion (echoey) effect in the ears. Your band mates' concerns are outdated. They should contact their local audiologist for an assessment and information session. Your band mates concerns are based on old history and have no basis with today's technology.

Could low-frequency hearing loss be caused by music?
NO. All music (and noise exposure) manifests itself in the higher frequency region (with the greatest hearing loss being near the top note on the piano keyboard- being between 3000 Hz and 6000 Hz). If someone has a low frequency hearing loss it is either related to the outer and middle ears (eg. wax, ear infecion, or a stiffening of the bones in the middle ear) or by an unusual condition of the inner ear. In both cases, you should seek out the medical opinion of an ear, nose, and thoat doctor (an otolaryngologist). Depending on where you live, you may require a referral from your family doctor.

Can headphones damage hearing?
Headphones are no more damaging than listening to music from a loudspeaker. One will always adjust the volume to a comfortable listening level, and the ear doesn't know whether the music is coming from headphones or a loudspeaker. The potential danger is in "portable music" where headphones are used in conjuction with Walkman-like radios. Listening to music in a noisy environment can be damaging since one tends to turn up the volume over the background noise.

I am an electric guitarist playing in bands who now has Tinnitus. Do I have to stop playing now?
Tinnitus is a symptom of possible damage to the ear- in your cases, because of overexposure to loud music. However, the ear is very resillient and tinnitus typically recovers within a matter of 3 or 4 days (where a temporary hearing loss will typically resolve within 16-18 hours). If you frequently get a period of tinnitus after a loud set, if at all possible try not to play another gig for several days. And if definitely consider wearing musician earplugs. Even the ER-15 earplugs can extend the amount of time you spend around loud music by a factor of 32 times.

What about hypersensitivity to noise as a result of exposure to loud music?
People who cannot tolerate even moderately loud sounds can be suffering from hyperacusis. It can be associated with an inner ear hearing loss. That is, not only are soft sounds too soft, but loud sounds are too loud. If there is a hearing loss, special hearing aids can be recommended that not only make soft sounds louder, but more importantly, loud sounds softer. For those with normal or near normal hearing, there is some controversy in the field. Some feel that earplugs can be useful. Others feel that earplugs are bad since they can exacerbate the reduced tolerance for loud sounds. Type in "hyperacusis" to any search engine for more information or contact the American Tinnitus Association (see link in the "Links" section of this website.

I really want an i-pod but my dad says its bad for my hearing.
Fathers are always right (I have three kids) but when it comes to ipods or other MP3 players, there is nothing wrong with them as long as you follow the 120/60 rule. There is actually a powerpoint presentation about ipods in the links section under "Marshall's power point presentations". The 120/60 rule says that it is safe to listen to your ipod for 120 minutes each day at 60% volume, and this will give you half of your daily dose of music exposure. If your favourite song comes on, turn up the volume, but remember to turn it back down to a more moderate level after. This will still allow you to mow the lawn.

Are there hearing aids for musicians?
Much work has been done in the last several years to define which is the best hearing aid for listening or playing music. There is a power point presentation(along with audio files) in the links section under "Marshall's power point presentations" on this very issue. Many hearing aids clip or distort the louder inputs of music and once this is done, no fancy hearing aid circuitry can improve things, so... the solution is to use a hearing aid that doesn't clip or distort the louder inputs of music, and these hearing aids, or hearing aid modifications are available.

Can a single, short duration sound cause permanent hearing damage? If so at what level?
This is called "acoustic trauma" and is quite rare. Unlike most types of hearing loss from loud noise or music which is gradual and happens over many years, a single intense blast can create a sudden permanent hearing loss at exactly the frequency of the insulting sound. A common example is a feedback squeal from a loud speaker- a permanent hearing loss can occur and will occur at exactly the frequency of the feedback squeal (eg. 1500 Hz). This example is not a typically frequency tested by an audiologist so care needs to be taken to assess as many frequencies as possible during testing in order to rule this out.

Are noise cancelling earbuds/headphones better for your hearing?
Portable or recreational music exposure such as those from ipods can be potentially damaging simply because people listen in noisy everyday environments. The tendency is to turn up the volume over the background noise, and this is where the danger lays. Using either noise cancelling headphones or "isolation" earphones that lessen the environmental noise means that you don't need to turn up the volume as much. So, yes, these earphones can be very useful. BUT beware of not being as able to hear a car coming up behind you!

I'm a rock singer and I use custom molded In Ear Monitors. Should I be worried about the occlusion effect ?
Most ear monitors (custom made loudspeakers that fit in the ear) are made with a long bore, or portion that goes deep in to the ear canal. This long bore, will serve to minimize the occlusion (or echoey) effect. If your ear monitors give you this echoey sound, there are three things that can be done: (1) set the input to the ear monitors to have LESS bass sound, (2) have the hearing health care professional that made it for you, drill a small hole called a vent, or (3) send the ear monitors back to the manufacturer with a new ear mold impression and have them make the bore as long as possible. All three of these things will serve to minimize the "echoey" sensation that you might get.

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