Is the audiologic status of professional musicians a reflection of the noise exposure in classical orchestral music?

The sound in classical orchestral music is louder than noise emissions allowed by national rules in industry. We wanted to assess the audiologic status of professional musicians at different ages of their careers and to look for a coherence of declined hearing ability and the sound emissions in order to substantiate advices for hearing protection and occupational medicine in musicians. Data from questionnaires (anamnestic data on sound exposure in profession and leisure times, use of hearing protection, self-evaluation of hearing function and hearing deficits), audiometric data and amplitudes of OAE were evaluated from 109 professional musicians aged 30-69 years from three major German orchestras and from 110 students of an academy of music (aged 11-19 years). Sound emissions of the whole orchestra and of single instruments/instrument groups were measured at the orchestra stages and pits during rehearsals and performances. None of the musicians was engaged in noisy hobbies and only a few used hearing protectors regularly. More than 50% of the musicians had a hearing loss of 15 dB(A) and more. Highest losses were found among the strings and the brass players. DPOAE amplitudes coincidently declined with the duration of performing music in the orchestras. Professional musicians aged older than 60 years had a significantly greater hearing loss at 4 and 6 kHz than those aged 30-39 years. Among the strings in one orchestra a dominant hearing deficit in the left ears was observed. Musicians need the same health care for their hearing as workers in noisy industry. A better education on the hearing hazards (use of hearing protectors) as well as sound protection in the rehearsal rooms is necessary. Hearing loss in professional musicians should be accepted as an occupational disease.