Noise has long been a known source of hearing impairment. Music, while loud, was traditionally not considered that much of a risk but when our favorite rockers began to experience hearing loss the very same music that we all enjoy became a professional hazard plaguing musicians. Not only the music, but the crowds, blowing up drum sets, fireworks, and other bizarre activities designed to gain attention added to the exposure.
In defense of the musicians, however, the crude on-stage monitoring units used for decades significantly contributed to the problem. These old systems consisted of a monitoring speaker directed back at the musicians, allowing them to hear their own music so as to monitor their contribution to the song. These monitoring speakers, called “wedgies” needed to be loud enough to allow the musician to hear themselves over the other musicians on stage and, thus, the intensity could be substantial. The custom monitoring units popular now were not available to the 1960-70s rockers and even many of the 1980s rockers.
Sine (2006) quoted Gail Whitelaw, PhD, then President of the American Academy of Audiology, “they [the rockers] likely are suffering from mild to severe hearing loss, the kind of hearing loss that makes it hard to hear companions in a crowded bar.” When questioned about the similarity of a musicians noise exposure to industrial noise exposure; audiologist Dr. Michael Santucci (2010) states, “it’s similar, but there are important differences. This is a side of 
audiology that we’re not taught in school. Unlike industrial hearing conservation, hearing loss prevention for music is not regulated. Some people refer to it as recreational, but we call it non-regulated. You’re not going to convince Mick Jagger or Yo-Yo Ma that what they do is recreation. Danica Patrick is not driving for recreation, either. This is professional, it’s occupational, and it’s unregulated.
Santucci, founder of Sensaphonics in 1985 and a long time music audiology specialist from Chicago, has worked with virtually all of the famous bands of the past three decades. He says that “its not just the volume of the sound, its the exposure time that creates ear fatigue and can lead to long term hearing loss. Loud music can be a real rush, and there’s nothing wrong with that. My goal is to teach people to enjoy loudsounds without damaging their hearing.”
Obviously the performances can take their toll on performers, but the long time practice sessions often increase the exposure times, creating an even greater problem. Other situations such as attempts to out-do others in an anything-goes culture, such as the time Keith Moon blew up his drum kit and other band members in The Who destroyed their instruments….(Click on the picture for video). Pete Townsend credits the beginning the destruction of his hearing to Keith Moon’s famous exploding drum set during the Who’s 1967 appearance on The Smothers Brothers Comedy Hour.
What is an In-The-Ear Monitor
These days, rockers and other musicians use in-the-ear monitors or IEMs that wirelessly hook up to their equipmentand provide direct individual feedback to the performer. These monitors allow them to listen to a high quality mix of audio sources at safe intensities which can be enhanced by panning different elements to each ear.
While the IEMs can be distracting when singing, recent advances allow the user to incorporate an ambient feature, allowing them to listen to just the correct amount of ambient noise. The most common professional stage IEMs use a wireless system to send the mix to the performer. They contain a transmitter and a receiver pack worn by the musician with a transmitter for each monitor mix and a receiver for each IEM. The transmitters may put out either one stereo mix or two mono mixes.
The IEMs themselves are the last stage of the signal path in the system. The in-the-ear monitors are usually custom molded for comfort, allowing the sound to be sent directly into the user’s ear canal. This custom molding allows for a better seal resulting in a lower level of ambient noise presented to the user. Depending on the quality of the fit and length of the canal portion of the earpiece, a custom fit IEM will generally provide somewhere between 25 and 34 decibels of noise reduction.
Custom IEMs come in a variety of colors but are usually clear or the skin color of the performer. The IEM cable plugs into a 3.5 mm stereo jack on the receiver pack; 
typically clipped onto the belt, guitar strap, clothing of the performer, or placed in a pocket. Non-custom IEMs are also available and include a variety of universal foam and silicone tips that will fit into most people’s ears.
Tips from the Experts in Musicians Hearing Conservation
In an effort to conserve hearing in the unfriendly musical environment, Dr. Santucci and his colleagues suggest the following to their famous, infamous and amateur musicians:
- Get a baseline hearing test! This will tell you the current state of your hearing.
- See an audiologist annually to track possible changes to your hearing. Repeat testing is the true measure of success in your hearing conservation efforts.
- Use in-ear (personal) monitors on stage and in rehearsal. IEM systems isolate your ears from unwanted ambient sound, so that you hear only the monitor mix. By eliminating ambience, you increase the signal-to-noise ratio in the ear canal. As aresult, you can listen with greater accuracy at lower volume levels.
- In general, use isolating earphones. Soft, custom-fit earphones fully seal the ear canal, providing the best isolation against unwanted ambient sound.
- To add ambient stage sound into your IEM mix, consider an active ambient system with microphones embedded in the earphones. The next best choice is to set up ambience microphones and have the monitor engineer addthem to the IEM mix.
- Avoid so-called “ambient earphones” with vents or ports that allow uncontrolled sound into your ears. These designs eliminate the benefits of isolation, reducing the signal-to-noise ratio. This typically results in the need for higher IEM levels to compensate.
- Monitor at safe levels. Consult an audiologist who is equipped with the tools to measure your preferred listening levels. Only by direct measurement can you determine what these levels are, and whether they meet safety criteria for both exposure time and loudness level.
- Wear BOTH of your earpieces. Your perception of loudness is increased by 6 dB when wearing two earpieces instead of one. When using only one earpiece, the open ear is at risk from stage volume, and the ear using a monitor will need to be 6 dB louder than if you were wearing both. Wearing only one earpiece puts both your ears at risk!
- Use high fidelity earplugs when not using personal monitors. Professional earplugs eliminate the “muffled” sound of commercial earplugs, effectively reduce sound levels without significantly compromising sound quality.
- Be aware! Signs of excessive exposure to loud sounds include ringing in the ear(tinnitus), buzzing, or temporary loss or changes in hearing sensitivity (threshold shift). If you experience these symptoms or other noticeable changes in your hearing, see your audiologist immediately!
- It bears repeating: See your audiologist annually. The absence of symptom does not necessarily indicate a lack of hearing issues. Research indicates that 70% of people with noise-induced hearing loss NEVER experienced ringing.
References:
Jagger, M. (2008). Mick Jagger raises awareness on hearing loss. Hear the World (Vol 7). Retrieved March 21, 2016.
Santucci, M. (2010). Saving the music industry from itself. Page 10 (Mueller, G, Editor), Hearing Journal, Vol 63(6), June, 2010. Retrieved March 22, 2016.
Santucci, M. (2016). Sensaphonics Hearing Wellness (website). Retrieved March 21, 2016.
Santucci, M. (2016). Hearing conservation tips for musicians. Sensphonics.com Retrieved March 22, 2016.
Sine. R. (2006). Rolling Stones: how they keep on rockin’ Web MD. Retrieved March 21, 2016.
Images:
Adams, B. (2006). Hear The World, Issue 7. Retrieved March 21, 2016.
Videos:
Smothers Brothers Comedy Hour (1967). Keith Moons drumkit explodes. You tube.com Retrieved March 21, 2016.
