Ask an Audiologist: Protecting Musicians’ & Audio Engineers’ Greatest Asset
You only get one set of ears to last you through your whole lifetime, so when your income depends on keeping them in good shape, protection is key.
One of the most crucial components in the process of taking care of your ears—arguably your most important professional asset—is to have an Audiologist as part of your health care team.
To begin my two-part investigation into hearing protection, I decided to go ask an audiologist, Dr. Julie Glick of Musicians Hearing Solutions in Manhattan, to help start my research. What follows below is a transcript from our conversation during a specialized exam.
Dr. Julie Glick of Musicians Hearing Solutions.
Prior to my visit with Dr. Glick, I was apprehensive about getting my ears tested. I’m a complete baby about them, and I can’t stand getting them syringed or cleaned, so I was a bit nervous to say the least.
The two of us chatted briefly when I first arrived, and she explained what we would need to accomplish during our visit.
I quickly learned that in order to properly test my hearing and fit my ears for the custom molds I would be trying out for my big hearing protection roundup (coming next week) we would first need to clean them out.
This is a process I usually need Xanax for, as most general practitioners’ offices will have a nurse syringe your ears to clear out the waxy blockages that can compromise your hearing sensitivity. This is an experience that can feel a bit like having your ear canal water-boarded.
But Dr. Glick made me feel at ease—at least as at ease as I could be—and it was over and done with quickly and painlessly, with as little squirming as I could muster.
Instead of syringing my ears, Dr. Glick used what seemed to be a magic wand. It was almost like a small lightsaber with a miniature scooper at one end, where a bright beam of light shot out.
It was unlike past experiences in which nurses have dug around a bit in my ear, making it feel like some one was trying to touch my brains with a stick, leaving me gritting my teeth thinking, “Don’t flinch, don’t flinch!” Dr. Glick did this in one quick motion. No digging, no terror. (She also assured me that I would be happier after and hear better. She was right!)
She then fitted me for the molds and administered the hearing tests. These tests are crucial in establishing what kind of hearing protection you need, and what to do to make sure that your ears remain healthy.
Fortunately for me, it turns out my hearing is even on both ears, and that I’m able to hear the full range of frequencies from 20 Hz – 20,000 Hz. This meant then that I was good to go to review the range of plugs that will be featured in part two of this article.
Surprisingly enough, both of these attributes are apparently much more rare than most audio workers imagine, and many of us will have to compensate for the idiosyncrasies that come from our genetics, our environment, and the aural abuse some of us expose ourselves to after many years working in loud studios and venues.
Read on, as I “Ask an Audiologist” about hearing protection, and best practices for keeping ears that work in the music industry:
How is a visit with you different from a standard visit with a primary care physician in terms of the type of exams you do, and the type of hearing care you provide?
If you went to a primary care physician’s office with a hearing problem, they’d likely send you out to an audiologist, or an ear, nose, and throat physician.
Some primary care doctors may have a very basic hearing test available at their office. [But] you wouldn’t get what would be considered a “diagnostic” hearing test from a primary care doctor.
My tests, [including] the diagnostic hearing test that I administer at my office, actually differ from a regular audiologist as well. I test hearing from 250 Hz – 20,000 Hz, whereas a standard diagnostic test focuses on the speech range of 250 Hz – 8,000Hz.
I test up to 20kHz, because I work with so many musicians and sound engineers who are kind of appalled that a regular hearing test stops at 8kHz.
The benefit to testing the entire frequency range is that it can be really revealing. For example, if some one comes in and says their hearing is better in one ear over the other, and [a standard test is] showing that it’s even through 8kHz, sometimes it shows a difference from 9KHz through 20kHz.
So you don’t have to look at some one and say, “Sorry that’s your perception but its not reality,” when in fact testing the whole range will [confirm what they’re hearing]. It can also show a sort of noise-induced notch, that maybe doesn’t reveal itself until the hearing gets better at 9kHz.
Audio engineers who are mixing, want to know how their hearing is past 8kHz. So, its just more detailed. Another good reason to have a hearing test is that it shows more than just show your hearing thresholds—it shows us the health of your auditory system.
A hearing test can reveal if there’s pathology—For example, if the three small bones behind your ear drum aren’t moving properly, or it can show—if hearing is worse in one ear which coupled with other scores—[the possibility of an] acoustic tumor.
The test will also show if your hearing has been affected by noise. The frequencies that are affected by noise are in a narrow range, typically from 3-6kHz, and it takes a certain configuration on the test.
If you are wondering how your hearing is, or care about your hearing health, you should visit an audiologist.
What are some of the first signs of hearing loss?
Sometimes people describe a clarity issue, a feeling of having cotton in [their] ear, or a feeling of straining to hear—asking people to repeat [what they are saying].
Even if your hearing is normal, it can be difficult to hear in a noisy environment, but more so with any kind of hearing loss. So if you feel you are having more difficulty than others, or on the phone you hear better on one ear over the other, that could be a sign too.
If you put your head down on a pillow and you’re hearing better out of one ear over the other, that can also be indicative of asymmetry in your hearing. But generally its just in asking people to repeat, straining, clarity, volume, more than other people, maybe having the television higher, things like that.
What is the most dangerous risk to musicians’ and audio engineers’ hearing? Is it more of a long hours of exposure or is it loudness or both?
For anybody—no matter if you’re a musician or sound engineer—it’s all about the overall loudness level, and how long you are exposed to it.
There are two scales we use in determining safe levels of exposure: The OSHA scale and the NIOSH scale. I go by the NIOSH scale because its more conservative. NIOSH states that 85dB is safe for 8 hours, and every time you increase that level by 3dB, you cut your safe listening time in half.
A comparison of the NIOSH and OSHA hearing guidelines.
Clients come here every day stating, “My environment is loud.” Whether its rehearsing, performing, or bar tendering; my response is always the same: What is loud? Loudness is a perception. The scale is what will tell us exactly what’s safe.
Of course your own body is going to tell you too, if you have ringing in your ears, depressed hearing after exposure, it’s too loud. But if you are consistently rehearsing some where, you want to do sound level checks. Like so many things, it is important to be proactive. If you have control, then turn it down. If you can’t turn it down, then wear ear plugs.
The other step is to have a hearing test. If you don’t have a hearing test, we don’t know what your hearing is, and noise induced hearing loss is sneaky. So people don’t tend to notice it when it is mild, but you will when it is severe, but by then it’s too late.
So it gradually gets worse over time?
Right, it can. Ultimately, at the end of the day, everyone’s advice is to monitor your loudness levels and wear hearing protection in loud environments. But, on top of it, especially if you are showing a noise-induced notch, you want to have an annual test.
If everything is normal, maybe you can go every couple of years, or if you feel like something changed. It’s all about loudness level and exposure time. It doesn’t matter the frequency you are being exposed to.
What is the best way to care for your ears? I know you said hearing exams and protection, are there any other things that people should be doing to protect their hearing or care for their ears?
Well, wearing earplugs. The gold standard [is] custom earplugs, because they are going to be more comfortable and they retain sound quality better.
Flanged “ETY Plugs” from Etymotic are an affordable, over-the counter hearing protection solution.
At the very leastm you can get a nice over-the-counter plug. I happen to like these ETY plugs, they’re $15. I prefer these over the foam earplugs. With these you just screw them in, and they tend to stay in place better.
The reason why foam plugs don’t sound good is because our ear canals have a resonant peak at around 2,500 Hz. Your ear naturally gives you boost of about 10-15 dB there. So, you put a foam plug in, of course its going to soften sound, but it’s also going to muffle it because you are dampening that peak.
The high frequencies contain a lot of the important consonants in speech and also give our words meaning. I always use this example: If you see the letters T B L you can probable take a guess the word is T-A-B-L-E. But, if you have only the A E it could be so many other words.
If say, your environment is 100 dB, at the peak its 110-115 dB. So if you are there long enough, and its loud enough, what happens is the tiny hair cells in the cochlea, the sensory organ of your hearing, are all frequency coded. So the hair cells following following that peak at 2,500 Hz are affected by the noise, and then the hearing will get better following the notch created by the noise.
That’s why we can say that a noise-induced notch is typically from 3-6kHz. Whereas, as we get older, high frequencies are affected first. So just like when you get older, and you can’t see clearly, that clarity of vision is lost and so is clarity of hearing.
On top of noise affecting the high frequencies, as you get older, the high frequencies are the most affected as well. It is inevitable and unfortunately no one’s immune to it.
I had also read somewhere that your perception of pitch shifts.
If you have hearing loss in the high frequencies your perception is going to change. Words may seem muffled, so your perception is going to be that you can hear, but cannot understand. A lot of people, when they have high frequency hearing loss, and you put hearing aids on them for the first time, will say “Oh! It sounded really dull without that.”
That’s very telling.
Yes! So, its like if you wear contacts or glasses and you put them on and everything gets sharper and clearer.
So to sum it up, what can the audiologist exams that you provide teach us about our hearing and its health?
I think a lot of people, because hearing is invisible, let it fall by the wayside until it affects their lives. The test can show noise-induced loss, it can reveal a number of pathologies that you may not even know you have.
It can show that the three little bones behind your middle ear aren’t moving properly, it can show if there is fluid behind your ear, [which can be quite painful.]
It can show an acoustic tumor. If your hearing test reveals more of a high frequency hearing loss in one ear more than the other, with reduced word understanding, coupled with a few other things, it can be indicative of a tumor.
They’re rare, but I’ve seen them in my career. A red flag can be when I hear people say, “Well I hear better in this ear than the other, “ You definitely need to get a hearing test. Maybe its just wax blocking the ear, and that can cause a perception of a loss, but, if that’s the case, it’s really quick fix!
And how frequently should this exam be administered?
It depends. If you are around loud noise a lot, you probably want to have an annual test. Optometrists recommend vision tests annually too.
That said, if your hearing’s normal, you’re not in a lot of loud noise, maybe bi-annual, or if you feel like something’s changed. Always have your hearing checked and if something has changed you should get an exam. If you have been diagnosed with hearing loss you will definitely want to have an annual test.
If some one isn’t ready to commit to custom molds because of cost, what’s the next best thing? Or do you have any recommendations of what would be next best?
[As mentioned], I like the ETY plugs, made by Etymotic Research. [Etymotic] makes the filter for the custom plugs [that I recommend]. These [over-the-counter plugs] are $15.00 and typically fit well and sound better than foam plugs.
The custom plugs sound even better because the filters re-create the peak in you’re the peak in your canal and then reduce sound. There’s a choice of either a 9 dB reduction, 15 dB, or 25 dB reduction and you can have more than one set of filters for different environments. But the 15 dB versions are going to have the most even reduction.
I make my recommendations on the filter depending on what you are using them for. For example, a vocalist isn’t going to want to take down too much because then they can’t monitor their voice. So maybe the 9dB is more appropriate, whereas maybe a drummer wants a little bit more.
And again, then, it all depends on how often you are playing, and how loud it is. If we can look at your hearing test results, that’s even better. And its not necessarily style of music, but loudness, because anything can be too loud. Walking down the street, the pneumatic hammers are too loud.
Yeah I guess timpani in an orchestra can be just as loud!
Yes, exactly. And the only way to know is to get a sound level meter—[models for under] $50 and can be purchased online.
There are some phone apps, but do you feel those are accurate?
There’s one app called logSPL that seems pretty accurate. But again, the best way to measure is with an actual sound level meter otherwise it’s a guessing game because loudness is a perception.
Dr. Julie Glick treats musicians, producers and audio engineers at Musicians Hearing Solultions. She provides diagnostic audiologist’s exams and performs custom mold fittings for professional-grade in-ear monitors and hearing protection products.
Kallie Marie is a producer, composer and educator who lives in New York.
Stay tuned next week for part two, a comprehensive review and roundup of the many types of hearing protection on the market.
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