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Tinnitus Severity Is Related to the Sound Exposure of Symphony Orchestra Musicians Independently of Hearing Impairment

Schmidt, Jesper Hvass1,2; Paarup, Helene M.3; Bælum, Jesper2,4

doi: 10.1097/AUD.0000000000000594
Research Article: PDF Only

Objectives: Tinnitus can be debilitating and with great impact of musicians professional and private life. The objectives of the study were therefore to: (1) describe the epidemiology of tinnitus including its severity in classical orchestra musicians, (2) investigate the association between tinnitus severity in classical musicians and their cumulative lifetime sound exposure, and (3) the association between tinnitus and hearing thresholds.

Design: The study population included all musicians from five Danish symphony orchestras. Answers regarding their perception of tinnitus were received from 325 musicians, and 212 musicians were also tested with audiometry. Any tinnitus and severe tinnitus were two definitions of tinnitus used as outcomes and analyzed in relation to an estimation of the cumulative lifetime sound exposure from sound measurements and previously validated questionnaires and the average hearing threshold of 3, 4, and 6 kHz.

Results: Thirty-five percentage of all musicians (31% female and 38% of male musicians) reported having experienced at least one episode of tinnitus lasting for more than 5 minutes during their life. Severe tinnitus with a severe impact on daily life was reported by 19% of the musicians (18% of female and 21% of male musicians). The severity of tinnitus was associated with increased lifetime sound exposure but not to poorer high frequency hearing thresholds when the lifetime sound exposure was considered. The odds ratio for an increase in one unit of tinnitus severity was 1.25 (95% CI, 1.12–1.40) for every 1 dB increase in lifetime sound exposure.

Conclusion: Musicians frequently report tinnitus. Any tinnitus and severe tinnitus are significantly associated with the cumulative lifetime sound exposure, which was shown to be the most important factor not only for the prevalence but also for the severity of tinnitus—even in musicians without hearing loss. High-frequency hearing thresholds and tinnitus severity were correlated only if the cumulative lifetime sound exposure was excluded from the analyses.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Odense C, Denmark;

2Institute of Clinical Research, University of Southern Denmark, Odense M, Denmark;

3Department of Clinical Immunology, Odense University Hospital, Odense, Denmark; and

4Department of Occupational and Environmental Medicine, Odense University Hospital, DK-5000 Odense C, Denmark.

ACKNOWLEDGMENTS: The present study was approved by the regional ethical committee, and informed consent was given by all test subjects.

Supported by Danish Working Environment Research Fund no. 20070014504, Ear Nose and Throat specialist Hans Skouby’s and Hustru Emma Skouby’s Foundation, Oto-rhino-laryngologist L. Mahler’s and N.R. Blegvads foundation for young oto-rhino-laryngologists, Region of Southern Denmark 12/7740.

The authors declare no other conflict of interest.

Address for correspondence: Jesper Hvass Schmidt, Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Kløvervænget 19, Indgang 85, 3.sal, 5000 Odense C, Denmark. E-mail:

Received August 5, 2016; accepted March 21, 2018.

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