In part 1 of this blog we discussed the NRR as a single-number rating system for hearing protection that is required by the EPA for all non-custom hearing protection equipment. In part 2 we talked about a failed attempt to establish a two-number rating system and a new one was proposed. This proposition was based on the essential difference between musicians and their industrial colleagues.
In the occupational noise field, workers are frequently provided with hearing protection on the floor of their work environment, far from the auspices of an audiology clinic. In contrast, musicians tend to follow a more professional route and often seek advice and hearing protection from a hearing health care professional such as an audiologist.
Even though both industrial workers and musicians should be wearing hearing protection, lumping them together as one population may be erroneous.
Music and noise have many similar spectral and temporal acoustic features, but really that is where the similarities end. Rock musicians tend to have a gig on Friday night for 2 or 3 hours and then not pick up their instrument for a week or two until their next gig. They may or may not practice in between. Classical musicians tend to play more regularly than their Rock colleagues, as well as practice solo and in groups, and teach students.
In some sense, if we were forced to make a comparison, from an exposure perspective classical musicians tend to have more exposure, and exposure that is more similar to that of their industrial colleagues, than is the case with their Rock and Roll friends.
This variability found in the various musical genres and work environments is what characterizes the amazing field of hearing loss prevention among musicians. Extending the arguments of the last blog, let’s look at the question of whether musicians should be treated the same as industrial workers.
When it comes to hearing protection, the only thing that is similar between factory workers and musicians is that the devices they wear over or in their ears are both called hearing protectors. Other than that, there really is no similarity.
In the last blog we discussed the possible labeling of the hearing protectors using a paradigm that is more suited to musicians than to factory workers. Why should there be identical labeling (i.e., the NRR) other than for administrative reasons? It is obviously easier for the EPA to demand one type of labeling, but to group a musicians’ earplug in with a polymeric foam earplug is simplistic, albeit expedient.
Expediency is not what our clients want from us. Musicians (and our hard of hearing clientele) want and deserve personalized service and an optimal type of hearing protection, along with a discussion of other hearing loss prevention strategies.
As a minimum requirement, I would suggest that the real ear attenuation of a hearing protector be measured, taking into account the need for a more intense (70 dB SPL) stimulus level during the testing. It would also be nice to have data on how this hearing protector functions in a 2 cc coupler, or other well-defined simulator. This difference is analogous to the RECD used with hearing aids.
In short, I would advocate for a clinical treatment of a musician that is identical to that of a hard of hearing client. This can be easily accomplished clinically and have all of the associated benefits that we and our clients obtain when being fit with amplification. I see no difference between amplification and attenuation- there is merely a + or – sign in front of the corresponding dB level.
Taking the musician out of the factory and placing them in our clinics, and treating them with the same care as we provide to our hard of hearing clients, in my view, is the correct way to go.
