If you have seen the Oscar-winning film Sound of Metal, you will have gained a harsh insight into the impact that the music industry can have with regards to hearing loss. Below we explore some of the data behind it, and what it might mean for the future.
The impact of noise exposure on hearing is a prevalent topic within occupational health, and according to the World Health Organisation (WHO) ‘noise exposure contributes to 22% of workplace related health issues.’1
The truth is, the root cause of noise-induced hearing loss (NIHL) is just as much down to recreational noise exposure as it is to high levels of noise in the workplace, if not more-so. Already in 2015, the WHO identified entertainment venues as a future cause of noise-induced hearing loss, and research found that ‘more than 40 million adult Americans between the ages of 20 and 69 are affected by non-occupational NIHL.’2
The Noise Directive 2003710/EC requires employers to perform an up-to-date risk assessment regarding noise exposure in the workplace. The following limits are imposed based on daily and weekly exposure:
||Daily exposure level LEX,8h
||Peak sound pressure level LC,peak
|Lower exposure action level
|Upper exposure action level
|Exposure limit value
Table 1. Exposure action values and exposure limit values defined in the EU-Directive 2003/10/EC
For UK organisations, suitable hearing protection is required to be made available when the daily or weekly noise exposure is above 80 dB(A), or a peak pressure of 135 dB(C) is measurable.3 However, as music is created for enjoyment and entertainment, HSE has different guidelines for professionals working in this sector.
How much is the music industry responsible for hearing problems
"Research has found that a majority of staff (70%) in music venues are exposed to noise levels above the daily recommended limit. Worryingly, 70% reported that they never used hearing protection, and only 15% reported using hearing protection regularly."4
Several studies have proven that exposure to high sound levels for those within the music and entertainment industry has led to an increased chance of them suffering from a hearing disorder. In fact, according to the Hearing Health Foundation, professional musicians are 'four times as likely to develop noise-induced hearing loss as the general public.'5
Exposure to loud music can start from a young age too. In primary and secondary school classes, marching band rehearsals can reach sound levels of 91-97 dB(A)6, while in orchestra music, flue pipes and piccolo players alone reach levels of 95 dB(A). A rock band can easily reach 125 dB(A), while the noise floor in a discotheque can reach 115 dB(A).7/8
Why hearing protection is a challenge for the music industry
Even with all of this, the music industry is not considered hazardous when it comes to noise-induced hearing loss risks. Why? Because the sound level is considered to be a necessary part of the performance.
The challenge for professionals such as musicians, technical staff, and performers, is that the noise they are exposed to isn’t a choice, which is different to the general public who might enjoy listening to music and can choose ‘if’ and ‘when’ to play it loud.
Despite this, professionals often won’t accept wearing hearing protectors, as they feel it will hamper their ability to perform or enjoy the performance. They depend heavily on their hearing ability to perform at their absolute best, but the reality is, if they don’t start taking precautionary steps to protect their hearing, this could have a detrimental effect on their ability to perform in the long-run.
This highlights a need for more specific protection compared to the conventional solutions used by workers in other industries. Unfortunately, conventional solutions such as earplugs aren’t enough for professionals within the music industry and are actually more likely to have a negative effect by applying the wrong attenuation and having an increased occlusion effect.
The film mentioned at the beginning of this article, Sound of Metal, also leans towards the philosophy that deafness is not something to fix,9 however, as audiologists with over 85 years of experience, we believe there are some preventative steps that can be taken as well as potential solutions to help with NIHL.
Preventative steps for noise-induced hearing loss (NIHL)
Those responsible for music environments have a statutory duty to the people using, performing, studying, and working in these environments (The Control of Noise at Work Regulations 2005). Where there is any potential risk to health, an effective hearing conservation program should be implemented which includes several simultaneous actions:
- Risk assessment
- Proactive intervention with control measures, known as risk management, and;
- Feedback on efficacy of control processes through health surveillance and audit.
In addition, by educating people from a young age about the potential risks to their hearing from working in the music and entertainment industry, they can choose to protect themselves accordingly.10
As well as this, adopting protective behaviours can benefit long-term hearing health overall. It’s recommended by The Hearing Conservation to do the following:
- Avoid or limit exposure to excessively loud sounds
- Turn down music volume where possible. A lot of high noise exposure comes from wearing headphones, so it’s recommended to download a hearing safeguarding app which will help monitor this for you
- Keep a distance from the source of loud sounds if you can
- Use hearing protection devices as much as possible. Upgrade your ear buds to good quality ‘over-ear’ headphones which will reduce background noise
- When feasible consider wearing active noise cancelling headphones
- If attending live music events take hearing protection with you and use it when the support act is on to give your ears a break
- Test your hearing regularly with a licensed audiologist or other qualified professional. This can help to identify any hearing issues and/or balance function early on, so that any necessary action can be taken.
Occupational health training
Amplivox is a member of the Hearing Conservation Association, and we understand that NIHL is one of the main reasons for occupational audiometry.
For occupational health practitioners who deal with adults who have experienced hearing loss issues, we offer several occupational health competency and refresher courses within audiometry. These courses are accredited by the Faculty of Occupational Medicine (FOM), a UK professional and educational body which supports good practice.
The courses all offer some learning and insight around NIHL. They combine both theoretical and practical sessions, providing delegates with a broad understanding of the ‘why’ along with how to apply their learnings in practice.
We work hard to make our courses interactive, enhancing the learning experience and improving knowledge retention. They are designed to be informative and educational, whilst also being practical and enjoyable.
For more information on any of our occupational health training courses please visit our webapge, contact our customer support team on +44 (0)1865 880 846, or email.
1World Health Organiziation (2018). Addressing the rising prevalence of hearing loss. ISBN 978-92-4-155026-0
2Centre for Disease Control and Prevention (2017). Too Loud! For Too Long! Loud noises damage hearing
3Pouryaghoub G, Ramin R, Pourhosein S (2017). Noise-Induced hearing loss among professional musicians. J Occup Health. 2017 Jan 20; 59(1): 33–37
4Hearing Conservation Association. Hearing conservation in music and entertainment. Accessible at:
5National Institute for Occupational Safety and Health (2015). Reducing the risk of hearing disorders among musicians, By Chucri Kardous, Christa Themann, Thais Morata, Jennifer Reynolds, Sue Afanuh; 2015. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2015-184.
6Babisch, W. (2000). Schallpegel in Diskotheken und bei Musikveranstaltungen (in German), Umweltbundesamt – WaBoLu-Veröffentlichung, Berlin
7Serra, M.R, Biassoni, E.C., Ortiz Skarp, A.H., Serra, M., Joekes, S. (2007). Sound immission during leisure activities and auditory behavior. Applied Acoustics 68 (2007), pp. 403-420
8Brockt, G. (2008). Music - Safe and Sound. Hearing Conservation for Professionals in Music and Entertainment. Wirtschaftsverlag NW Verlag für neue Wissenschaft GmbH, Bremerhaven
9Audiology Worldnews. (2021). Interview with Sound of Metal director Darius Marder: “This film doesn’t have an opinion about cochlear implants. Accessible at:
10Centers for Disease Control and Prevention. Hearing loss in children. Preventing Noise-Induced Hearing Loss. Accessible at: