Symphony orchestra musicians' use of hearing protection and attenuation of custom-made hearing protectors as measured with two different real-ear attenuation at threshold methods.
Level 4 - case-series / case-control
Cross-sectional survey and observational acoustic measurement study
PubMed 21368443 · doi:10.4103/1463-1741.77210
What was done
The authors surveyed 15 symphony orchestra musicians regarding usage rates, comfort, and perceptual difficulties with custom-molded ER-15 earplugs. Real-ear attenuation at threshold (REAT) was measured in a sound field across 0.125 to 8 kHz. An additional 10 subjects were tested using sweeping signals in Békésy audiometry with ER-9 and ER-15 earplugs to evaluate whether continuous frequency sweeps provide more detailed attenuation profiles than fixed-frequency REAT.
What was found
Earplug use among musicians was low. Reported reasons included discomfort and impaired perception of timbre, dynamics, and the playing of oneself and colleagues. Mean sound-field REAT was 13.7 dB, but individual attenuation varied by up to 15 dB across frequencies (0.125–8 kHz). Békésy audiometry attenuation was closer to nominal ratings below 1 kHz, whereas sound-field REAT showed more uniform attenuation between 1 and 6 kHz. No significant association was found between earplug attenuation properties and frequency of use.
Why it matters
This study shows that achieving target acoustic attenuation does not guarantee compliance in classical musicians, as perceptual distortion of dynamics and timbre remains the primary barrier to regular hearing protection use.
Limits
The sample size was very small (15 musicians for the main survey/REAT and 10 additional subjects for audiometry testing). Behavioral and perceptual data relied entirely on self-reported questionnaires without objective monitoring of wear time or sound exposure levels.
Cited by
- supports Musicians' earplugs typically provide approximately 14 decibels of acoustic attenuation.