title: Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras.
abstract: OBJECTIVE
  An investigation of the hearing status of musicians of professional symphony orchestras. Main questions are: (1) Should musicians be treated as a special group with regard to hearing, noise, and noise related hearing problems (2) Do patterns of hearing damage differ for different instrument types (3) Do OAE have an added value in the diagnosis of noise induced hearing loss (NIHL) in musicians.
  
  
  METHODS
  241 professional musicians, aged between 23-64 participated. A brief medical history and the subjective judgment of their hearing and hearing problems were assessed. Musicians were subjected to an extensive audiological test battery, which contained testing of audiometric thresholds, loudness perception, diplacusis, tinnitus, speech perception in noise, and otoacoustic emissions.
  
  
  RESULTS
  Most musicians could be categorized as normal hearing, but their audiograms show notches at 6 kHz, a frequency that is associated with NIHL. Musicians often complained about tinnitus and hyperacusis, while diplacusis was generally not reported as a problem. Tinnitus was most often localized utmost left and this could not be related to the instrument. It was usually perceived in high frequency areas, associated with NIHL. In general, musicians scored very well on the speech-in-noise test. The results of the loudness perception test were within normal limits. Otoacoustic emissions were more intense with better pure-tone thresholds, but due to large individual differences it can still not be used as an objective test for early detection of NIHL.
  
  
  CONCLUSIONS
  Musicians show more noise induced hearing loss than could be expected on the basis of age and gender. Other indicators, such as complaints and prevalence of tinnitus, complaints about hyperacusis and prevalence of diplacusis suggest that musicians' ears are at risk. Continuing education about the risks of intensive sound exposure to musicians, with the emphasis on the possible development of tinnitus and hyperacusis and the need for good hearing protection is warranted.
authors.affiliation: ENT-Audiology, Academic Medical Center Amsterdam, Amsterdam, AZ, Netherlands. noor.jansen@amc.nl
authors.forename: E J M
authors.initials: EJ
authors.lastname: Jansen
authors.forename: H W
authors.initials: HW
authors.lastname: Helleman
authors.forename: W A
authors.initials: WA
authors.lastname: Dreschler
authors.forename: J A P M
authors.initials: JA
authors.lastname: de Laat
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods; D001309:Auditory Threshold / Q000145:classification / Q000502:physiology; D005260:Female; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D012001:Hyperacusis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009146:Music; D009622:Noise / Q000009:adverse effects*; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D055815:Young Adult