Tinnitus (Ringing in the Ear)

One well-known effect of overexposure to noise is hearing loss, or the inability to hear certain sounds. But another risk is a phenomenon that is just the opposite: perceiving sounds when there are none. This perception of sound when no external sound is present is called tinnitus, or "ringing in the ear." 

What Does Tinnitus Sound Like? 

People with tinnitus hear noises in their ears. Each person with tinnitus experiences it differently. "Tinnitus" is from the Latin word for "ringing," and to some people the noise does indeed sound like ringing. Others describe their ear noise as roaring, rushing, hissing, chirping, beeping, buzzing, whistling, or clicking. The sound might be high-pitched, low-pitched, or multi-toned, or it might sound like static. It might seem to be in one ear, both ears, or inside the head. The sound might be constant, or it might come and go. It might be just barely noticeable, or it might seem screamingly loud. 

Nearly everyone experiences ear noise; in total silence, most people will report hearing faint buzzing, pulsing, or whirring sounds, the normal compensatory activity of the nerves in the hearing pathway. It's when these sounds are intrusive that it becomes tinnitus. 

What Causes Tinnitus? 

Tinnitus may be caused by various drugs, ear disorders, infections, injuries, or psychiatric disorders, but the most common cause by far is loud noise, such as from explosions, gunfire, amplified music, farm machinery, or emergency sirens. Many rock musicians develop tinnitus, and it is common among combat veterans. Ninety percent of people with tinnitus also have some degree of hearing loss. 

Like hearing loss, tinnitus can occur temporarily, brought on by an episode of too much noise, or it may happen after years of overexposure to noise. It can appear suddenly or gradually. 

What Is It Like to Have Tinnitus? 

Tinnitus is a subjective experience. Similar to the experience of pain, the annoyance of tinnitus cannot be measured objectively. Some people hardly notice the noise unless they consciously turn their attention to it. For others it may disrupt sleep and concentration, and can cause depression and emotional shifts. According to the American Tinnitus Association, about 25% of those with tinnitus find it disturbing enough that they seek medical attention for it, and for about 4% of sufferers, it is so debilitating that it seriously interferes with normal daily functioning. For a few people the experience is so agonizing that they are driven to consider suicide. 

How Is Tinnitus Treated? 

Tinnitus is a symptom, not a disease, and there is no cure. Even in some cases where the auditory nerves have been severed (during the removal of a tumor from the inner ear, for example), so that the patient loses all physical hearing, tinnitus can persist. 

There are a range of treatment options for chronic tinnitus; no one treatment works for everyone. Many treatments focus on helping the person learn to coexist with it, using a variety of stress management and relaxation techniques, counseling, and sometimes antidepressants or other drugs. Some people find it helpful to mask the ringing in the ear by using white noise, and there are in-ear white noise devices made for this purpose. 

Two treatments, tinnitus retraining therapy and Neuromonics, combine directive counseling with white noise or music that is individually engineered for the patient's audiological profile, to teach the brain circuitry to filter out the tinnitus signals. These treatments take six months to two years and cost several thousand dollars. 

Temporary Ringing in the Ear? 

If you experience temporary ringing of the ears from an exposure to loud noise, consider it a warning sign. First, immediately leave the loud environment, or put in ear plugs if that is not possible. Next, rest your ears for 24 hours, meaning no loud sounds at all, to give your ears a chance to recover. And lastly, next time you are in a similar environment in the future, be sure to wear hearing protection. There are plenty of tinnitus sufferers who will tell you that you don't want their nightmare. 

From NoiseHelp

Hearing loss in musicians - Is there a problem?

There are several unique reasons to be concerned about sound exposure and its effect on musicians’ hearing. First of all, musicians’ working hours are usually quite varied as compared to most employees, especially during performance weeks. Also, musicians spend a varied amount of time practicing, playing solo and as a member of different groups, and enjoying the music of others. One review article suggested that classical musicians play an average of 25 hours per week (Palin 1994), but this could vary widely from week to week, and from person to person.

Most people are aware that loud noises are bad for your ears, and might lead to hearing problems down the road. Since listening to music is a positive, pleasant, and desirable activity for many people, it may come as a surprise that music can have a negative effect on hearing too.

Work-related hearing loss is quite a different problem for those in the music industry than it is for industrial workers. Musicians and DJs regard themselves as having superior hearing, specially trained to detect nuance or tone, and consider that their hearing is their livelihood (Axelsson and Lindgren 1981; Early and Horstman 1996). A slight hearing loss that may not bother an industrial worker may cause difficulties for a musician. In addition, controlling musicians’ exposures poses a different challenge than it does for other types of employees.

Even though sound levels can be exceedingly high at music venues, very few investigations on the hearing of musicians had actually taken place as of the early 1980’s (Axelsson and Lindgren 1981). An early study on the hearing of orchestral musicians at an opera house found that 42% of participants had hearing loss that was greater than expected for their age (Axelsson and Lindgren 1981). Many other studies, including both classical and pop musicians, have found similar results: musicians have worse hearing than would be expected based on their age (Lebo and Oliphant 1968; Westmore and Eversden 1981; Jansson and Karlsson 1983; Hart, Geltman et al. 1987; Ostri, Eller et al. 1989; Royster, Royster et al. 1991; Fearn 1993; Jaroszewski and Rakowski 1994; Jaroszewski, Fidecki et al. 1998; Eaton and Gillis 2002; Kahari, Zachau et al. 2003).

Other researchers report no difference between musicians and other workers (Arnold and Miskolczy-Fodor 1960; Karlsson, Lundquist et al. 1983; Johnson, Sherman et al. 1985; McBride 1992; Kahari 2001); this difference in finding may be due to varying definitions of what constitutes hearing loss, difficulties in quantifying leisure noise exposure, or poor study quality (Sataloff 1991).

The general consensus in the literature suggests that hearing loss is a problem for musicians, and this varies across type of music played (i.e. – rock or jazz or classical),and type of instrument played (Palin 1994; Mikl 1995). It has been suggested that since sound pressure levels (SPL) produced by music can be (and often are) well above the recommended 85 dB, we have good reason to be concerned about musicians’ hearing.

Another complaint from some musicians (but more typically of industrial workers) is a disease called “tinnitus”, which is a permanent ringing in the ears caused by chronic exposure to loud noises (Axelsson and Ringdahl 1989; Axelsson and Prasher 2000; Lockwood, Salvi et al. 2001). More research needs to be done on the musician’s experience with this often highly debilitating disease.

Info accessed at ActSafe

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Association of Adult Musicians with Hearing Loss (AAMHL)

Proving the loss of hearing does not equal the loss of music!

AAMHL's mission is to:

1. Create opportunities for adult musicians with hearing loss to discuss the challenges they face in making and listening to music.
2. Create opportunities for public performance either individually or in groups by adult musicians with hearing loss who might not otherwise have access to these opportunities
3. Provide ongoing feedback to hearing health professionals, hearing researchers, manufacturers of hearing assistive technology, music educators and others to improve hearing device technology relative to music performance and enjoyment
4. Provide educational opportunities to enable hard of hearing and deaf adults to appreciate and make music in ways not previously available

AAMHL's initiatives include:

• Print and mail informational brochures about AAMHL
• Create hearing-accessible conferences and workshops on making music with a hearing loss
• Produce hearing accessible concerts by both hearing and hearing impaired musicians
• Produce recordings of performances by hearing-impaired musicians
• Produce informational materials on listening to music with a hearing loss and listings of hearing-accessible performance venues

If you're interested, please visit http://www.aamhl.org/joomla10/

Músicos de Rock: profissionais em risco

O ruído é um dos principais agentes físicos presentes nos ambientes de trabalho pelo que se torna um dos maiores focos de atenção por parte dos profissionais de higiene e segurança da saúde do trabalhador.

Todos os sons têm potencial de serem descritos como ruído, pois a classificação de ruído trata-se de algo subjectivo, sendo a sua distinção referente ao facto de ser ou não desejável. Todavia, a denominação ruído é utilizada para descrever um sinal acústico aperiódico, originado da superposição de vários movimentos de vibração, com diferentes frequências, as quais não apresentam relação entre si.

A música é considerada como um som agradável. Sons prazerosos (como a música) são menos perigosos do que os sons não desejados (como o ruído industrial), mas não deixam de ser um factor de risco para perdas auditivas.

O estudo de Pfeiffer, Rocha, Oliveira & Frota (2007) tem como objectivo verificar a mudança temporária do limiar de audição em músicos durante um concerto de rock. Foram avaliados seis músicos, componentes de uma banda de rock, do sexo masculino, com idades variando entre 20 e 30 anos. Constatou-se que a exposição a elevados níveis de pressão sonora leva à ocorrência de certos efeitos físicos, como a insónia após o trabalho, a perda auditiva temporária e aparecimento do zumbido, apontados pelos músicos da amostra do estudo após o concerto.

Em 2004, foi estudada a diminuição da audição em DJ’s, por meio da audiometria tonal e da aplicação de um questionário. A pesquisa foi realizada com o objectivo de constatar a mudança temporária de limiar desses profissionais após uma noite de trabalho. Comprovou-se que estes profissionais devem ser inseridos no grupo de trabalhadores com risco de perda auditiva induzida por níveis de pressão sonora elevados.

Nesta pesquisa, foi possível encontrar uma diferença estatisticamente significante dos níveis mínimos de audição antes e após o concerto. Tais diferenças revelam que a configuração das perdas auditivas induzidas por música aparenta uma alteração primária nos limiares entre 3000 Hz e 6000 Hz. Assim, compreende-se que os músicos podem apresentar mudanças temporárias de limiar auditivos, isto é, a alteração do reflexo acústico e redução na capacidade das células auditivas captarem e decifrarem a energia sonora que as atinge. Esta situação, a longo prazo poderá tornar-se numa perda auditiva induzida por ruído (PAIR), podendo verificar-se lesões que afectem algumas ou mesmo todas as estruturas do aparelho auditivo.

Por estas razões, os músicos devem ser considerados profissionais de risco para perda auditiva ocupacional. Sendo a perda auditiva ocupacional irreversível, mas passível de prevenção, torna-se necessária a divulgação desta informação entre estes profissionais.

Embora este estudo tenha sido feito com um número restrito de músicos, focando apenas um determinado tipo de música, considera-se que foi um passo na compreensão desta temática. Apesar disso, é necessário realizar mais pesquisas com uma amostra maior e envolvendo outras modalidades musicais.

Texto reduzido e adaptado a partir de:

Pfeiffer, M.; Rocha, R.; Oliveira, S.; Frota, S. (2007) Intercorrência audiológica em músicas após um show de rock. Revista CEFAC vol.9 no.3 São Paulo

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