A systematic review pooling 67 studies and more than 28,000 musicians found that 42.6% experience tinnitus, compared with 13.2% of non-musicians. Rates of hearing loss and sound sensitivity were roughly double as well. The risk was not limited to loud genres: classical and pop musicians showed broadly similar rates.
Music is not an occupational hazard people tend to think about until something changes. Then it becomes the only thing you think about.
We work with performers, music teachers, students and hobbyists, and this research confirms what audiologists have observed for years: musicians carry a significantly higher risk of hearing problems, and most of them are carrying it without ever having had their hearing measured.
What did the research find?
The systematic review and meta-analysis, published in Otolaryngology, Head and Neck Surgery, pooled data from 67 studies across 21 countries covering more than 28,000 musicians.
Compared with non-musicians:
- 6% of musicians reported tinnitus, against 13.2% of non-musicians
- 7% had hearing loss, against 11.6%
- 3% reported hyperacusis, or sound sensitivity, against 15.3%
Among the musicians with tinnitus, 76.3% described it as occasional and 15.6% as permanent.
Worth noting how that data was collected: around 63% of the hearing loss cases rested on musicians reporting their own hearing, with only 37% confirmed by objective testing. That is a limitation of the evidence base rather than a finding about musicians, and the researchers suggested the true prevalence is likely higher than the figures show. It also points at something real: early noise damage sits in frequencies that do not affect everyday conversation, so you will not notice it.
Is it only loud genres?
No, and this is the most useful thing in the study.
It found no significant difference in tinnitus, hearing loss or hyperacusis between classical and pop or rock musicians. Pop and rock musicians showed slightly higher hearing loss, classical musicians slightly higher tinnitus and hyperacusis, but the differences were not meaningful.
So the risk is not about genre. A violinist sitting in front of the brass section, or a flautist with a piccolo to their left, is regularly exposed above the level at which Australian workplace health and safety rules require action. Orchestras, venues and music schools are workplaces, and those rules apply to them.
What appears to matter more:
- Which instrument you play, and which instruments are near you
- Where you sit within an ensemble
- Room acoustics, and how many hours you rehearse in them
- Rehearsal duration and frequency, which for most musicians outweighs performance exposure
- Whether you use hearing protection consistently, or only at the loud gigs
- Loud hobbies and other exposure outside music, which accumulates on top
Why are musicians at higher risk?
Tinnitus commonly develops after repeated noise exposure, and the musician’s working life delivers exactly that: high sound levels, sustained over years, often at close range to amplifiers, percussion, brass or stage monitors, with protection used inconsistently.
It is worth being clear that the damage is cumulative and permanent. Hearing does not recover from noise exposure the way muscles recover from a workout. A ringing in your ears after a gig that fades by morning is not a clean slate; it is a signal that you have been in a level that causes damage.
What is hyperacusis?
Hyperacusis is heightened sensitivity to everyday sound, where normal volumes feel uncomfortable or overwhelming. It frequently develops alongside tinnitus.
For most people it is unpleasant. For someone whose living depends on being in rooms full of sound, it can be career-threatening, and it is the reason it should not be ignored while it is still mild. It is also treatable, particularly early, and the instinct to avoid all sound tends to make it worse rather than better.
The culture of pushing through
In music, ringing ears after a show are normalised. Plenty of musicians assume it is simply part of the job.
Persistent tinnitus is a warning, not a badge. Left unmanaged, hearing damage can affect your playing in ways that matter professionally:
- Pitch perception becomes less reliable
- Timing and clarity suffer, particularly in ensemble settings
- Confidence drops, which shows in performance
- Mental fatigue increases, so long sessions cost more
- Anxiety about your hearing becomes its own problem
The study’s author, Professor Shaun Nguyen, noted that many musicians quietly live with ringing ears, sound sensitivity or hearing loss without ever seeking help, and called for more musician-specific risk assessment rather than generic advice.
Do musicians earplugs actually work?
Yes, and they are a completely different product from the foam plugs in a chemist.
Foam plugs cut high pitch sounds far more than low ones. That is fine on a building site, but it makes music sound muffled and dull, removing exactly the detail you need to play. This is why most musicians who try foam plugs stop using them, and then use nothing.
Musicians earplugs use an acoustic filter designed to reduce volume fairly evenly across the frequency range. Music stays balanced and detailed, just quieter, so you can still hear yourself, the room and the rest of the ensemble. They are typically available in different attenuation levels, so a classical player and a drummer are not stuck with the same amount of reduction.
Custom-moulded versions are made from impressions of your ears, which means a better seal, better comfort over a long session, and more predictable performance than a universal fit.
In-ear monitors are the other route for amplified performance, and they solve a related problem by letting you control your own mix at a lower level rather than fighting stage volume.
Who should be wearing hearing protection?
More people than currently do. Beyond professional performers:
- Music teachers, who are exposed daily in small rooms for years
- Students and conservatorium players, whose rehearsal hours are highest at the age when damage does most long-term harm
- Orchestral players, particularly anyone seated in front of brass or percussion
- DJs and sound engineers
- Weekend and pub gig musicians, who often have no protection at all
- Anyone attending loud gigs regularly, including parents taking teenagers
- Dentists, hairdressers and childcare workers. We often fit musicians earplugs, so people within these industries can continue to carry out natural conversation.
Playing less often does not mean you need less protection. Exposure accumulates.
Why a baseline test matters
Most musicians have never had their hearing measured, and the study is a reminder of why that matters: early damage is in frequencies that do not affect conversation, so self-assessment misses it.
A baseline audiogram is a fixed reference point. Repeat it every year or two, and any change shows up as a change rather than as something you eventually notice. That is what lets you act early: adjust rehearsal habits, change your monitoring setup, upgrade your protection, or manage tinnitus while it is still occasional.
Tinnitus does not mean your career is over. Most musicians who manage it well continue performing for decades. But the ones who do are, almost without exception, the ones who found out where they stood early.
Musician hearing care at Knox Audiology
We provide comprehensive baseline hearing testing with attention to the subtle high-frequency changes that matter to musicians, tinnitus assessment and management, custom musicians earplugs, and advice tailored to your instrument, your venues and how often you play.
Book a musician hearing assessment
If you notice ringing after rehearsals, sound sensitivity, difficulty hearing musical detail, or you are pushing your monitors louder than you used to, get a baseline. It is the one thing that makes everything afterwards easier.
Call 03 9800 5697 or book a hearing assessment online.
