It was an alarm clock that caused the alarm. The kind used by tenor Roger Ohlsen emitted beeps at increasing volumes. One morning, his wife asked him to turn it off about eight beeps before he heard it. “That made me nervous,” he recalls.
A hearing test confirmed a problem. Ohlsen had 15 percent loss in his left ear that the doctor said probably stemmed from subway screeching, air horns on fire engines, and other types of everyday city noises.
Yet Ohlsen is fortunate. Although he has had to make some modifications to the way he listens and has to pay extra attention to pitch, balance, and volume, his singing and his career have not been affected. His experience, nevertheless, is a cautionary tale for singers who ignore the dangers posed by noise.
Potential Consequences
The dangers of excessive noise extend beyond hearing loss to hearing injuries, which add a noxious sensory stimulus such as ringing, pain, or pressure. In the hearing injury category are tinnitus (a ringing in the ears) and hyperacusis, a pain that stems from noise, including everyday noises that are not especially loud.
How does each of these conditions affect singers in particular? Scientist M. Charles Liberman, director of Eaton-Peabody Laboratories at the Massachusetts Eye and Ear infirmary, notes that hearing loss typically begins at high frequencies and progresses toward lower frequencies, so that “at first, the impairment will only be to change the timbre of sounds (by the loss of the harmonics at high frequencies).” Eventually, however, “the loss will begin to impair perception of the fundamental pitch frequency, and a singer will no longer be able to sing on key.”
Although many people assume that tinnitus is merely an annoyance, it can have a significant impact on one’s quality of life and it, too, affects musical abilities. As Dr. Anthony Jahn points out in “Hearing Loss and the Singer,” his January 2013 column for this magazine, “tinnitus interferes with the monitoring of sound and, if tonal, can be a major distraction during performance.”
One tinnitus sufferer is Daniel James Shigo, a teacher of singing and author in New York City who writes a blog called VoiceTalk: Historical Perspectives on the Art of Singing. In his experience, the tinnitus signal has a masking effect on the auditory system, which he combats by using high-quality hearing aids.
The second condition, hyperacusis, can destroy careers. Bryan Pollard, the president of the nonprofit Hyperacusis Research, has encountered many musicians with hyperacusis, and most of them cannot continue performing. This is not surprising, because many sufferers cannot tolerate music at any but the softest levels.
Noise to Beware
What sorts of noises can cause these conditions? Some are obvious: heavy metal concerts, roaring audiences at sport stadiums, or jackhammers. Other damaging noises are far less obvious and, for that reason, perhaps more dangerous. Take restaurants. In his 2013 column, Dr. Jahn tells us that the noise levels in many New York restaurants exceed 90 decibels. The National Institute for Occupational Safety and Health (NIOSH) recommends hearing protection when noise levels exceed 85 decibels, regardless of duration. Furthermore, some experts believe that this threshold is too high. They support a 1974 recommendation from the U.S. Environmental Protection Agency of a 70-decibel limit.
There is the well-publicized case of hearing loss encountered by Pete Townshend of the rock band The Who, but what about other kinds of music? Michael Jacobson, a professor of saxophone at Baylor University, developed hearing loss and tinnitus from continual exposure to high sound pressure levels in performances, rehearsals, and lessons. Today he warns his students to protect their ears—and he is not alone. The marching band director at Baylor now hands out hearing protection to all of the students in the band.
What about classical music musicians? Unfortunately, there have been many cases of orchestral musicians with hearing loss. Recently, the BBC reported that a viola player is suing the Royal Opera House. He claims that his hearing was damaged during rehearsals of Die Walküre, when he sat in front of the brass section. Cellist Janet Horvath, who has hyperacusis, writes about her experiences in the Atlantic in October 2015. Her pain started after a performance of Broadway favorites with the Minnesota Orchestra—and ended her career. Such cases are disturbing, but not surprising. According to a 2014 article on NBCNews.com, orchestras can reach volumes of 120 to 137 decibels—far beyond NIOSH’s 85-decibel threshold.
Even opera singing has its dangers. One mezzo believes she developed tinnitus because of blocking during dramatic scenes in Carmen, when she was very close to the tenor. In an article entitled “Losing Your Ears to Music,” published in Early Music America in 2000, author Bernard Sherman contends that “some veteran opera singers, thanks to years of being screeched at by their fellow divas at close range, have lost a good deal of hearing.”
“Prevention of tinnitus and hearing loss starts with limiting exposure to noisy environments,” Shigo observes. “Singers have an occupation hazard, do they not?”
Coping with Damage
Dr. Charles Limb, professor and chief, division of otology, neurotology, and skull base surgery at the University of California–San Francisco School of Medicine, has seen many musicians with noise-induced hearing damage. “Some have found it extremely significant and career ending—for example, deafness,” Dr. Limb says. “Others have found it to be a way to encourage new musical discoveries, such as the perception of music from a cochlear implant. But it is always a very complex, personal relationship that differs for each individual.”
The process of learning to sing with his hearing aids has been a “fascinating experience” for Shigo. “It took me a while to get used to them,” he recalls. “Now they are as much a part of me as my right arm.” Jacobson’s tinnitus is worse at night, so he often puts on background noise (TV, radio, or ambient noise generators) to mask it. Ohlsen, a Reiki master, finds that the practice helps his hearing by clarifying it.
If you have hearing loss, do not despair. Shigo stresses that it “isn’t the end of the road. You can sing, and sing very well. You can also be a very good voice teacher.”
Prevention
Of course, the best-case scenario is to avoid noise-induced hearing loss, which is entirely preventable, by taking steps to protect yourself. Some may seem obvious, but they are worth repeating for two reasons: 1) Noise-induced hearing loss rarely manifests itself immediately—in virtually all cases it accumulates over time and it’s hard to notice what you are missing and 2) Some experts believe that there are people with particularly susceptible ears who can sustain damage far below the threshold of 85 decibels.
Therefore, err on the side of caution and follow this advice:
Use earplugs. Pollard notes that musicians’ earplugs, which provide protection of up to 25 decibels, do not fully occlude the ear, so most performers can perform well with them. There are also earplugs you can use for everyday situations, such as loud subways, restaurants, exercise classes that blare music, vacuuming, grinding coffee, or mowing the lawn. The Ear Plug Superstore
(www.earplugstore.com) sells assortment packs so you can try out several brands.
Use makeshift protection when you’re caught off guard. If you find yourself in a noisy environment without earplugs, roll up tissues and stick those in your ears. If the noise is temporary (e.g., a passing siren), plug your ears with your fingers. Shigo also finds that humming or singing helps by triggering an acoustic reflex that dampens the amount of sound entering the ear. Better still, keep earplugs with you at all times.
Adjust your routines. There are lifestyle changes you can make to avoid damaging noise. Think about going out to bars or restaurants on weekday nights instead of weekends to minimize the noise of crowds and Saturday night soundtracks. Ohlsen shuns loud concerts, including amplified Broadway musicals, and avoids the noisiest subway stations and streets. Whenever possible, he takes the bus instead of the subway.
Get your hearing tested. Ohlsen suggests a test once a year. If the tests reveal any damage, you will need to take extra precautions to prevent further damage. Beyond hearing tests, familiarize yourself with the warning signs: any muffling or ringing after a loud event, any temporary tinnitus that goes away, feelings of ear fatigue or fullness, or a reaction of discomfort to a loud noise.
Choose headphones over earbuds. “Earbuds, which fit directly into the ear canal, can easily produce sound pressure levels that are damaging to the user,” says Jacobson. “The best type of headphones to use are the kind that sit on top of the ear and don’t fit into the ear canal or cover the ear completely.” If you use headphones in noisy environments (e.g., subways), choose the noise-canceling kind. The noise-cancelation feature will help you avoid overcompensating for the ambient noise by turning up the volume.
Take breaks. Dr. Jahn discusses the benefits of silence in his 2013 column: “Turn off the TV, turn off the radio, try walking in the park without your iPod,” Jahn writes. Would you sing a big role in two operas two days in a row? Ideally, no. You’d rest your voice. Treat your ears the same way.
Combating the Dangers of an Increasingly Noisy World
Ohlsen suspects that there is massive hearing loss among the general population because he encounters people yelling all the time on the street instead of talking normally. He is right: the statistics are scary. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 15 percent of Americans between the ages of 20 and 69 as well as 16 percent of teenagers have hearing loss that may be noise induced. Dr. Limb calls it a “growing epidemic.” One hyperacusis sufferer suggests that “noise is the new smoking.”
Add to these statistics a recent study that shows professional musicians are nearly four times more likely to suffer noise-induced hearing loss than non-musicians. Therefore, education is critical. “Make family, friends, and colleagues aware of the hazards of noise,” NIDCD suggests. “Often, people don’t begin paying attention to protecting their hearing until they have a problem such as tinnitus,” says Jacobson. “Unfortunately, by that time the damage has been done.”
Singers ignore the dangers at their peril. “To sing well, to sing with appropriate dynamics and in tune, your ears must work well,” says Dr. Jahn. Sure, it’s annoying to avoid noisy social activities or wear earplugs, but consider the “devastating” alternative of noise-induced hearing loss described by Dr. Limb: “Rather than using one’s ears to allow musical expression, the ears can become a source of disappointment and heartbreak.”
