The Sound of Danger

by Jon Scaccia March 17, 2025

Picture the powerful crescendo of a symphony, the electrifying guitar solo at a rock concert, or the driving beat of a jazz performance. For musicians, sound is their medium, their passion, and their livelihood. But what if the very thing that defines their art is also putting their hearing at risk?

A new scoping review has investigated the prevalence of noise-induced hearing loss (NIHL) among professional musicians, shedding light on an often-overlooked occupational hazard. The findings? Musicians across genres—whether playing classical music in an orchestra or performing in a high-energy rock band—are at an increased risk of hearing damage. However, the data remains fragmented, leaving many questions unanswered.

Music as an Occupational Hazard

Hearing loss is the most commonly recognized occupational disease in Germany, affecting workers exposed to prolonged loud noise. The World Health Organization (WHO) attributes 16% of global hearing loss to workplace noise exposure. Yet, music is not just any noise—it is carefully crafted and essential to musicians’ careers. Unlike industrial workers who might wear heavy-duty ear protection, musicians often avoid hearing protection due to concerns about sound distortion or interference with their performance.

The scoping review analyzed 79 studies that examined musicians’ hearing through audiometric tests. The data showed that prolonged exposure to high-decibel sound—often exceeding legal workplace limits—contributes to measurable hearing loss. The studies found that classical musicians tend to experience hearing damage in the 4,000–6,000 Hz range, while rock, pop, and jazz musicians show damage across a broader spectrum of 3,000–8,000 Hz. Marching band and military musicians, as well as those in traditional music, also appear to be at risk, but fewer studies have focused on these groups.

How Much Hearing Loss Are We Talking About?

• Classical Musicians: 5–70% showed signs of hearing loss, with 20–50% displaying notch configurations (a distinct pattern of frequency loss associated with noise exposure).
• Rock, Pop, and Jazz Musicians: 20–60% exhibited hearing loss, with up to 40% showing notch configurations.
• Military and Marching Band Musicians: A significant portion had hearing loss, though data remains sparse.
• Traditional Music Performers: Studies suggest an increased risk, but again, more research is needed.

The wide range in hearing loss prevalence highlights inconsistencies in study methodologies, sample sizes, and reporting. Most studies focused on younger musicians, leaving little information on long-term hearing health in retired professionals. Additionally, the majority of study participants were male, making it difficult to assess gender differences in risk.

Why Don’t Musicians Use Hearing Protection?

The challenge of protecting musicians’ hearing lies in the nature of their work. Traditional hearing protection devices, like foam earplugs or industrial earmuffs, can distort the frequencies essential for musical performance. Some musicians opt for specialized high-fidelity earplugs that reduce overall volume while preserving sound clarity, but adoption remains low. Other interventions, such as sound baffles or positioning adjustments within orchestras, can sometimes backfire by reflecting sound waves in unexpected ways.

Even administrative measures, such as reducing the volume of rehearsals or restructuring setlists, are difficult to implement. After all, how do you tell a symphony orchestra to play quieter or ask a rock band to turn down their amps when volume is integral to their music?

What’s Next?

Despite strong indications that musicians are at risk, gaps in the research prevent a definitive understanding of the full scope of music-induced hearing loss. Most studies focus on active musicians with at least five years of experience, but data on long-term hearing outcomes or retired musicians is scarce. Future research should address:

• Longitudinal Studies: Tracking musicians over decades would provide a clearer picture of how hearing loss develops over time.
• Better Representation: More studies should include women and older musicians to understand how risk factors vary.
• Protective Strategies: Research into musician-friendly hearing protection and sound management techniques is essential.

Join the Conversation

How should the music industry balance hearing protection with artistic performance? Should concert venues or orchestras do more to protect their musicians? If you’re a musician, have you experienced any hearing difficulties? Share your thoughts in the comments or join the discussion on social media!

Hearing is essential for creating and enjoying music. If we want to keep the music playing, we need to start listening—to the risks, the research, and the solutions.

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For an additional account, check out 2020’s Sound of Metal starring Riz Ahmed