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Rock On…with Caution: Hearing Loss Risk in Musicians

Glantz, Gordon

doi: 10.1097/01.HJ.0000532394.98429.03
Musicians and Hearing Loss

Gordon Glantz is a freelance medical writer. Thoughts on something you read here? Write to us at HJ@wolterskluwer.com.

In 1973, Bob Seger released a song titled “Turn the Page” that attained classic status with a 1976 live version. In the lyrics, he lamented a rock musician's life on the road.

During this uneasy period of the genre, when the rules of the game were not clearly defined, long-term job-related hazards were barely considered.

“Turn the Page” referenced the effects of road hypnosis and entering 1970s truck-stop diners with shoulder-length hair. In the last verse, he referred to amplifier echoes still ringing in his head hours after a show. Those echoes—AKA tinnitus—were incurred on mercilessly long tours and left permanent battle scars. “(Seger) knew of what he spoke,” affirmed Nashville-based sideman Tom Hampton, whose credits include the Marshall Tucker Band and Robert Hazard.

Offering to gather a list of other songs with similar references, Frank Wartinger, AuD, has dedicated his career to the prevention of music-related hearing loss.

Adding that genetic disposition can be a factor in how quickly permanent hearing loss can occur, Wartinger said damage is inevitable without caution: “While it is certainly common, I want to emphasize that it shouldn't be normal, just like a hangover, sunburn, or joint injury shouldn't be normal after the excesses that caused them. Common, yes—but certainly abnormalities that should be addressed and minimized.”

Wartinger—an audiologist at the Children's Hospital of Philadelphia, the owner and founder of Earmark Hearing Conservation, a musician's clinic based in Philadelphia, and the director of communications at the National Hearing Conservation Association (NHCA)—likened those who attend concerts to casual sunbathers and those who perform nightly to those who sustain significant repeated damage to their skin.

“In that analogy, there are long-term risks to the skin from these repeated exposures,” he said. “The same is true for the ear.”

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LONG-TERM EFFECTS

As rock and roll's roots blossomed into an evergreen form of music, the evidence is clear that those “echoes from the amplifiers” have affected those who have made a living with them from the time of Woodstock to Live Aid to Farm Aid to Lollapalooza and onward.

Many icons—Genesis vocalist/drummer Phil Collins and guitar legends like Eric Clapton, Pete Townshend (The Who) and Stephen Stills (Crosby, Stills, Nash and Young)—are the most notable names to have documented hearing loss.

But they are not alone.

“Someone who says they have no problems is a liar,” asserted David Uosikkinen, the longtime drummer of The Hooters, a MTV-era band whose resume includes three Top 40 hits and two Top 40 albums in the mid-to-late 1980s and batting lead-off at 1985’s Live Aid in their hometown of Philadelphia. “This business is about power. That constant barrage of fire makes you numb to it. You don't feel yourself getting hurt. First time you hear it, it's so intense. The next time, even if it's a little bit louder, it doesn't feel as bad. You kind of start to compensate for what you don't hear, and it gets worse. It takes its toll.”

Pointing out a parallel of cancer existing before cigarettes, Hampton added, “I think you'd be hard pressed to find anyone from the Golden Age of rock and roll who hasn't been affected by occupational hearing loss. Certainly, hearing loss existed before rock and roll, but the evolution of live performance has definitely left a mark.”

While Hampton has a dominant ear and often struggles to identify the location of a voice in a room when he cannot see where it is coming from, Uosikkinen has sustained damage to the point where he wears hearing aids, which he said have improved his tinnitus and overall health.

Despite extensive international touring, it was not until Uosikkinen was around 55 years old—when his wife noted how loudly the television volume was cranked—that the now 63-year-old was officially diagnosed with significant music-related hearing loss.

Uosikkinen still plays and tours with The Hooters, as well as on other projects while teaching drums, and is not so sure it would have been possible without seeking professional help.

“I don't want anybody to feel sorry for me,” he said. “I did it by choice. I gave my ears for rock and roll. I'm not deaf. I can still play (drums) and I can still hear. But when I discovered they were making hearing aids smaller, it made life a lot easier. It's about quality of life.”

Wartinger confirmed the long-term effects of hearing damage—such as tinnitus, hyperacusis (abnormal sensitivity to loud sounds), and diplacusis (abnormal pitch perception).

“These auditory effects can diminish one's ability to communicate, connect musically with peers, and ultimately affect quality of life,” he explained. “Non-auditory effects are numerous as well, including but not limited to depression, guilt, social isolation, sleep disturbances, and other associated chronic health conditions.”

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FINE MOTOR ATHLETES

Hampton opined that the sound system used when The Beatles played their famed Shea Stadium show in 1966 might not be worthy of a modern high school auditorium.

“It's like comparing a Texas Instruments calculator to an iPhone,” he said. “So the entire industry spent a decade trying to catch up to the necessary sophistication to serve audiences that—prior to the rock and roll era—really only showed up for sporting events where all the venue needed were horns on poles scattered throughout a stadium.”

The sports analogy was not lost on Wartinger, who was quick to note that the athletes who compete at the highest levels—exposing themselves to the highest risk of injury—are constantly the recipients of upgrades in gear. Musicians are, or should be, in the same situation.

“Some speak of musicians as fine motor athletes,” he said. “Is it inevitable that a football or soccer player will get injured? Or inevitable that a racecar driver or cyclist will get in a dangerous accident? For people performing at the edge of human abilities, I suppose there is increased risk, but I would not go as far as to say there is nothing we can do to prevent the problem from occurring.”

Aside from his own quality of life improvement, Uosikkinen has embraced upgrades since music has gone the more digital route. He recalled wearing what was then a new-fangled item—in-ear monitors (IEMs)—at Live Aid, but more to hear his own bandmates across the stage above the roar of the crowd and not to protect himself. He now wears them so often, and exclusively in larger venues, that when the setup made it impossible at a recent show in the Netherlands, he had an uneasy feeling.

“Every time I hit the cymbals, it felt like I was damaging myself,” he said. It was also a sobering reminder of what he did to himself when he did not know any better, back when he was playing with bands called The Kooks and The Torpedoes, before hitting the big time with The Hooters.

“There were some guys who were smarter than I was, and they thought about protecting their ears a little bit, but I was into the rush of playing music and feeling it,” said Uosikkinen, who said putting cotton in his ears was the extent of any form of crude protection considered. “But, again, you're young and dumb, and making decisions based on what you want to feel.”

Echoing the same sentiments, Hampton said: “Musicians are a stubborn bunch, and have a history of insisting on making their own mistakes—myself included.”

A sound technician for U2 warned Uosikkinen what he was doing to himself, but he remained stubborn.

“He pointed out the fact that my monitor was making my hair blow,” he recalled. “Then I started joking about feeling the wind. I hit my bass drum, and I would feel it go through my body. If you can do that, I can only imagine what I was doing to my ears.”

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SERIOUS BUSINESS

The good news, according to Wartinger, is that upgrades continue at a rapid-fire pace. “For hearing conservation, the most significant advancement is that of in-ear monitors. They have the potential—operative word being potential—to reduce stage volumes and sound exposures of musicians, crews, and audience members alike. How they are utilized to this end is arguable, and most users require significant retraining and education to reach this goal.”

Hampton, whose gig schedule sees him anywhere from small coffee houses to large outdoor festivals, has noted a slow and steady change for the better.

“Most musicians use in-ear monitors to hear themselves onstage,” he noted. “Stage volumes have gotten lower because it's possible to control what each performer hears to a much narrower degree.

In the meantime, Wartinger does not want the music to stop. “Never stop making music,” he said. “Yes, there are risks, but with the right tools and precautions, you can reduce your risk. The key is to understand, respect, and protect your hearing as a valuable tool in the music-making process. If you're just getting into music or are a veteran musician and have hearing concerns that make you question the longevity of your career, I would revert to the original advice: Never stop making music. But also change any bad habits so you can continue making music safely.”

Uosikkinen, who gives drumming lessons, warns future generations to protect themselves in the manner outlined by Wartinger.

“It is serious business,” said Uosikkinen. “I tell my students that they should take care of their ears because they need to last you an entire lifetime. I'm grateful that technology has made it a little bit better, but I'm still concerned about young people today.

“But nobody could have told me anything about my hearing. I was thinking they were my ears, and I could do whatever I wanted.”

But the opportunity for the son of Finnish immigrants to play Live Aid, be in regular rotation during the glory days of MTV, and play as a warm-up act for Pink Floyd's Roger Waters at the Berlin Wall have created a lifetime of memories.

“Rock and roll has been good to me, man,” he added. “At Live Aid, I shook Jack Nicholson's hand before I went on stage. He said, ‘Go get ‘em, kid.’ I was hanging out with Paul McCartney and Ron Wood backstage. There were a lot of great memories. It's been a heck of a run.”

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