A scoping review of the prevalence of musicians' hearing loss

Carl Firle ^1* Antonia Helen Richter ²

• ¹ Federal Institute for Occupational Safety and Health, Dortmund, Germany
• ² Verband deutscher Betriebs- und Werksärzte e.V., AG Bühnen und Orchester, Magdeburg, Germany

Hearing loss is the most frequently recognized occupational disease in Germany. Musicians are also affected because classical music playing can result in high to very high sound volumes. With this scoping review we aimed to retrieve the prevalence of noise-induced hearing loss in professional musicians and its characteristics. The databases Medline, Embase, Cochrane Library and Google Scholar were searched with the terms (hearing loss OR hearing impairment OR hearing difficulties OR acoustic trauma) AND (musician) ) on 2023-08-14 and 2025-01-02. Only original works and results with audiometric examination were included. Seventy-eight studies were retrieved for the descriptive analysis.The median for the number of participants was 52 (IQR 30-109). The majority of the retrieved studies included participants with a minimum of five years as practicing musicians. The proportion of men was significantly higher than that of women: medianmen portion = 69 % (IQR 53-83 %). Students were a frequent study population, i.e., data of older and retired musicians were rare or missing respectively. The lifetime prevalence of musicians' hearing loss can thus not be determined. The data analysis showed an increased risk of hearing loss > 15-20 dB in the frequency range 4000-6000 Hz in the classical genre group. Studies with normal hearing were also found in that genre. Rock, pop, jazz musicians have an increased risk for hearing loss > 20 dB in the frequencies 3000-8000 Hz. The data for military and marching band music and traditional music genre is limited. The retrieved studies indicate a higher risk of loss > 20 dB in the frequency range 4000-6000 Hz. Seventeen studies corrected audiogram results for age, two did not and 59 had no report. Data extraction yielded a prevalence of notch configuration of 20-50 % and hearing loss of 5-70 % of classical musicians. Up to 40 % of rock, pop, jazz musicians showed notch configurations and 20-60 % hearing loss.All in all, a final decision on the prevalence of musicians' hearing loss cannot be made based on the retrieved data. Prospective, longitudinal studies with reliable sample sizes and representative populations are needed. A multicenter study would be appreciated.