Professional musicians are almost four times as likely to develop noise-induced hearing loss and 57% more likely to develop tinnitus than the general public. These are the findings of a new study published in Occupational & Environmental Medicine.

Previous studies have shown that noise-induced hearing loss occurs in up to 58% of classical and 49% of rock and pop musicians.

There are a large number of variables that influence this kind of hearing loss, including number of years exposure to high sound levels, the position of players in an orchestra on stage, distance from loud speakers and instruments played.

But there are other intrinsic contributing factors that are less well known, and many studies examining hearing loss in musicians have been inconclusive.

The new study is a large epidemiological study that uses data from insurance claims to assess the risk of musicians contracting hearing disorders. It also investigates to what extent professional musicians have a higher incidence of hearing problems, compared with the general public.

'Professional musicians' identified through health insurance records

For the purpose of the study, a "professional musician" was defined "as an insurant who had had at least one insurance period in the study period from January 1st, 2004, through December 31st, 2008, coded as 'musician.'"

Using data from three statutory health insurance providers - which contained the details of seven million German citizens - the researchers identified 2,227 professional musicians.

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The authors recommend that professional musicians - whether they play classical or rock music - should use ear protection when playing live.

During the study period, there were 238 cases of hearing loss among these musicians and 284,000 cases of hearing loss registered on the database overall.

Adjusting the findings for sex and population density - the musicians were mostly found to live in cities - professional musicians were still more likely to have noise-induced hearing loss than the general public.

The musicians were 57% more likely to having tinnitus - incessant ringing in the ears - and almost four times as likely to have some level of deafness.

Some previous research has shown that long-term exposure to industrial noise is linked to hearing loss, but that long-term exposure to music actually has the opposite effect and increases hearing sensitivity.

The authors of the new study say their results contradict these findings:

"Our data suggest that in professional musicians, the risks of music induced hearing loss outweigh the potential benefits for hearing ability, as reported by [other researchers]. Given the number of professional musicians and the severity of the outcome, leading to occupational disability and severe loss of quality of life, hearing loss in [this group] is of high public health importance."

The authors recommend that professional musicians - whether they play classical or rock music - should use ear protection when playing live, and that sound shields should also be installed between different sections of an orchestra.

A 2010 study published by the BMJ found that personal music devices - such as mp3 players - put young people at risk of hearing loss, as they can generate levels of sound in the ear in excess of 120 decibels. The authors behind that study explained that, at that volume, the sound level is similar in intensity to a jet engine.