Hearing Protection for Musicians

Musicians lose hearing and develop tinnitus far more often than other people, and the main cause is the sound of their own instruments and amplification. A 2026 systematic review and meta-analysis in Otolaryngology Head and Neck Surgery pooled 67 studies with 28,311 participants and found tinnitus in 42.6% of musicians against 13.2% of controls, and hearing loss in 25.7% against 11.6%. The damage is preventable. Filtered musician earplugs, sensible in-ear monitor levels, quieter and shorter rehearsals and a hearing test at least once a year let most players keep working for decades without giving up the sound they care about.

Key facts

• In a German study of more than 3 million insured workers, professional musicians had an adjusted hazard ratio of 3.61 for noise-induced hearing loss and 1.45 for any hearing loss compared with the general population (Schink et al., Occupational and Environmental Medicine, 2014).
• At least one in three musicians reports tinnitus or hyperacusis and about one in four has hearing loss (McCray et al., 2026).
• Brass players in two symphony orchestras were measured at 86 to 98 dB LAeq, and most musicians exceeded an eight-hour average of 85 dB (Schmidt et al., Annals of Occupational Hygiene, 2011).
• Australia's workplace exposure standard is an eight-hour average of 85 dB(A) or a peak of 140 dB(C) (Safe Work Australia code of practice).
• In a survey of German-speaking orchestras, only 9% of professional players' hours and 1% of amateurs' hours were fully protected (Hake et al., Trends in Hearing, 2024).

How common is hearing loss in musicians?

Studies keep finding the same pattern: more hearing damage, and much more tinnitus, among people who play music for a living. The 2026 meta-analysis by McCray and colleagues is the largest pooled estimate so far. Besides the tinnitus and hearing loss figures above, it found hyperacusis (sound sensitivity that makes ordinary sounds uncomfortable) in 37.3% of musicians against 15.3% of controls. The authors conclude that clinicians treating musicians "should consider routine auditory assessments and preventive counseling."

The strongest evidence on cause comes from insurance records rather than surveys. Schink and colleagues followed more than 3 million German workers aged 19 to 66 from 2004 to 2008, of whom 2,227 were professional musicians. After adjusting for age, sex and region, musicians were 3.61 times as likely to be diagnosed with noise-induced hearing loss.

An earlier systematic review by Di Stadio and colleagues (2018) of 41 studies and 4,618 professional musicians found hearing loss in 38.6%. The damage mainly affected high frequencies in the 3,000 to 6,000 Hz range, the classic notch that noise leaves on an audiogram. Tinnitus was the most common symptom, followed by hyperacusis and diplacusis, where the same note sounds at a different pitch in each ear.

Amateurs are not exempt. A 2024 survey of 370 professional and 401 amateur orchestra musicians found that two-thirds reported hearing-related problems, in both groups. Professionals had nearly four times the lifetime music exposure.

Which instruments and genres carry the most risk?

Risk depends on what you play, where you sit and what is on the stand. Measurements in symphony orchestras show that most of a player's dose comes from their own instrument and the section next to them.

Instrument group	Measured exposure	Source
Brass	86 to 98 dB LAeq during measured sessions	Schmidt et al., 2011
High strings (violin, viola)	82 to 98 dBA, with the left ear 4.6 dB louder than the right	Schmidt et al., 2011
Percussion	Peaks above 115 dBC in one study and up to 135 dB(C) in another	Schmidt et al., 2011; Rodrigues et al., 2014
Brass, woodwind, percussion and timpani	Above the 85 dB(A) upper exposure action level in rehearsal	Rodrigues et al., 2014
Other orchestral groups	Above the 80 dB(A) lower exposure action level	Rodrigues et al., 2014

The Schmidt study recorded 114 sessions covering 106 hours in two orchestras. Concerts, group rehearsals and individual practice all added to the dose, musicians reached an eight-hour average of up to 92 dB, and a majority went over 85 dB. A 2016 study of violin students found a temporary threshold shift in the left ear only after one hour of practice.

On genre, the evidence is mixed. The 2018 review found hearing loss in 63.5% of pop and rock musicians against 32.8% of classical players. The larger 2026 meta-analysis found no significant difference between classical and pop or rock musicians for hearing loss, hyperacusis or tinnitus. Either way, both amplified bands and acoustic orchestras can exceed workplace limits.

How long can you play at a given level?

Damage depends on level and time together. Australia and the US National Institute for Occupational Safety and Health (NIOSH) both use an 85 dB(A) eight-hour limit with a 3 dB exchange rate, so every 3 dB increase halves the safe time. The table below comes from the Australian code of practice for managing noise.

Average level, dB(A)	Time that equals the daily limit
85	8 hours
88	4 hours
91	2 hours
94	1 hour
97	30 minutes
100	15 minutes
103	7.5 minutes
106	3.8 minutes

For a sense of scale, the US National Institute on Deafness and Other Communication Disorders (NIDCD) puts concerts at an average of 94 to 110 dBA. At 100 dB(A), a two-hour gig uses eight times the daily allowance before any rehearsal or travel listening is counted.

The rules differ by country. US workplace law from OSHA allows 90 dBA for eight hours with a 5 dBA exchange rate, so it permits 2 hours at 100 dBA, far more than NIOSH recommends. In the UK, the Control of Noise at Work Regulations 2005 require risk assessment at 80 dB(A), hearing protection at 85 dB(A) and hearing checks for workers regularly exposed above 85 dB(A), with an exposure limit of 87 dB(A) at the ear. The Health and Safety Executive publishes Sound advice, guidance written with the music sector for concert halls, theatres, live venues and studios.

Do musician earplugs change how music sounds?

Some, but much less than foam plugs, and players adapt. Musician earplugs use a filter to cut volume fairly evenly across pitches, while foam plugs cut high frequencies more and make music sound dull. Hearing Australia says foam or silicone plugs "will reduce the sound level, but music earplugs are often a better choice."

Research backs this up:

• In a 2022 trial with pianists, players found musician earplugs more comfortable than foam plugs, and the effect on their playing shrank on the second performance and was smaller for familiar pieces.
• In a 2020 study of student musicians, most rated playing with earplugs as generally positive, and listeners could not tell recordings made with earplugs from recordings made without them.
• An Australian trial of 42 musicians fitted with custom musicians' hearing protectors found high satisfaction and fewer reports of tinnitus. The main complaint was difficulty inserting them, and most needed adjustments were spotted by the audiologist at fitting or follow-up, so the follow-up visit is worth keeping.

Earplugs clearly prevent short-term damage from loud music. In a randomized trial at an Amsterdam festival with an average level of 100 dBA, temporary hearing loss appeared in 8% of ears in the earplug group against 42% of unprotected ears, and new tinnitus in 12% against 40% of participants.

Practical tips: wear new plugs in a few rehearsals before using them on stage, wear them for the whole session rather than taking them out between songs, and choose a filter strength that matches your setting. Our guide on which earplugs to use covers the types and ratings in more detail.

Are in-ear monitors safer than wedges?

They can be, but only if you keep the level down. In-ear monitors seal the ear canal, which blocks some stage noise, so in theory you need less volume to hear yourself. A study in the Journal of Speech, Language, and Hearing Research found that musicians' minimum acceptable listening level was about 6 dB lower with in-ear monitors than with floor wedges. Their preferred level, though, was only about 0.6 dB lower, and the authors noted that counseling would likely be needed before the benefit was realized.

In practice, that means:

• Use both earpieces. Taking one out to hear the room leaves that ear open to the full stage level.
• Get custom-molded or well-sealed tips, since a good seal is what blocks stage noise.
• Ask for a lower mix with your own instrument or voice clear, rather than everything turned up.
• Use a limiter on the monitor system where your engineer can set one.
• Set the level at sound check and avoid creeping it up through the set.

What rehearsal and sound check habits reduce exposure?

Rehearsal and practice add to the dose as much as the show does. Habits that help:

• Lower the backline. Amps pointed at the back of your legs push sound into the drummer and the front row. Tilt them up toward your ears and turn them down.
• Use a sound level app or meter. Check the average level in rehearsal and compare it with the table above.
• Keep sound checks short and quiet. Repeated hits on a kick drum or snare at full level add to the dose before the show starts.
• Rest your ears. Breaks in a quiet room reduce total exposure. The World Health Organization advises limiting noise exposure in your off-hours.
• Watch the travel listening. WHO says 80 dB is safe for up to 40 hours a week, but at 90 dB the safe time falls to four hours a week.

Orchestras can manage this as an organization. The Queensland Symphony Orchestra in Brisbane introduced a hearing conservation program in 2005, and an evaluation published in 2015 found it had become part of daily operations and contributed to managing hearing risk.

How often should musicians have their hearing checked?

Get a full baseline test early in your playing life, then at least once a year, and sooner if you notice ringing that lasts, muffled hearing or pitch differences between ears. Early changes show up on an audiogram before you notice them in daily life, typically as the 3,000 to 6,000 Hz notch described in the 2018 review. WHO lists getting regular hearing check-ups among the main ways young people can protect their hearing.

In Australia, Hearing Australia offers a free 15-minute hearing check for adults aged 18 and over with no referral needed. If you are employed and regularly wear hearing protectors because of noise above the exposure standard, the Australian code of practice requires your employer to provide audiometric testing. UK employers must provide hearing checks for workers regularly exposed above 85 dB(A) under the 2005 regulations, and in the US, OSHA requires free annual hearing exams as part of a hearing conservation program.

Where can musicians find help?

• Australia: Hearing Australia explains daily sound dose and music earplugs and runs free adult hearing checks. The National Acoustic Laboratories carries out hearing research. Workplace duties are set out in the Safe Work Australia code of practice.
• United Kingdom: the HSE's Sound advice guidance for music and entertainment.
• International: the WHO Global standard for safe listening venues and events, which sets out six features for venues to protect audiences while preserving the artistic experience.

Already have ringing in your ears? See our tinnitus guide.

Frequently asked questions

Do classical musicians need hearing protection?

Yes. Orchestral brass players have been measured at 86 to 98 dB, and most orchestra musicians in one study went over an eight-hour average of 85 dB (Schmidt et al., 2011). A 2026 meta-analysis found no significant difference in hearing loss or tinnitus between classical and pop or rock musicians (McCray et al.).

Is ringing after a gig a sign of damage?

Ringing or muffled hearing after loud music is a sign your ears were overexposed. It often fades within hours or days, but NIDCD notes that loud noise can cause tinnitus, and repeated exposure at or above 85 dBA can cause permanent hearing loss.

Will earplugs make me play worse?

Most players adjust quickly. Pianists in a 2022 trial showed smaller effects on a second performance and with familiar pieces, and listeners in a 2020 study could not tell music played with earplugs from music played without them.

What is the legal noise limit for musicians at work in Australia?

The exposure standard is an eight-hour average of 85 dB(A) or a peak of 140 dB(C), and employers must keep workers' exposure within it, which covers paid musicians at a workplace (Safe Work Australia code of practice).