Is classical music less damaging to your ear than industrial noise?

Introduction
Sound levels in classical orchestras during rehearsal and performance are about 85-95 dB(A). Despite this studies on occupational hearing loss in this group has been have been conflicting. In the present study we have investigated the hearing status as well as the individual life time exposure of classical symphony orchestra musicians and testing the hypothesis that occupational sound exposure in a symphony orchestra musicians poses a different risk of hearing loss than equal level industrial noise.

Methods
From the audiometry of 223 musicians from five symphony orchestras mean hearing threshold of the frequencies 3, 4 and 6 kHz corrected for age and gender (ISO 7029) was used as outcome. Sound exposure for selected musicians was measured in two orchestras and a mapping sound exposure for left and right ear separately was made by a regression model with instrument, location, work played, concert vs. rehearsal vs. individual practice, and orchestra as parameters. Annual and life time exposure during practice, rehearsal, and concerts was taken from questionnaires.

Results
Audiometry showed at the mean of 3, 4 and 6 kHz a 0.8 to 7.2 dB mean poorer hearing than expected for age at both ears of trumpet players, and at the left ear of 1st violinists, timpani players and percussionists. 1st violinists had on average 5.6 dB poorer hearing on their left ear compared to the right ear. Most musicians had better hearing for age than expected but musicians had additionally a noise induced hearing loss which was related to increasing exposure.

Discussion
Classical musicians are at risk of developing a significant hearing loss. The dose-response relation between hearing loss and exposure when performing classical music does not differ from that of industrial noise.