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In addition to all of them being musicians, what do Barbra Streisand, Phil Collins, Pete Townshend and Jeff Beck have in common? All of these musicians experienced – as a result of playing the music they love – permanent hearing loss.

When musicians come to me for treatment, I feel obliged to inform them of a lamentable fact of life – playing music may damage their hearing. Noise-induced hearing loss or NIHL is caused by exposure to loud music and produces a ringing in the ears known as tinnitus; continued exposure to loud music can cause permanent hearing loss.

Not just big-name stadium rock stars are susceptible, all musicians are at risk. Players of all genres from classical, to club and small venues, even while rehearsing at home a musician can cross the threshold to overexposure resulting in NIHL. You can experience hearing loss when exposed for a prolonged period of time to any sound over 85 decibels (dB). An electric guitar played onstage generates 120dB, but a violin can produce 103dB, and thus cause almost as much hearing loss. Estimates by audiologists say that more damage is done to musicians’ hearing during the hours they practice or rehearse than in the short periods they spend performing, onstage.

Musicians can take steps to protect their hearing despite this unavoidable exposure to sound that exceeds acceptable levels, even in seemingly quiet rehearsal settings. When investing in high-quality ear protection beyond what can be had from drug-store Styrofoam ear plugs, performers can trust their hearing is protected. The first musicians earphones were invented by Etymotic Research, and other manufacturers still use their design to create specialized ear protection for musicians. Unlike the cheap Styrofoam earplugs that simply block sound, musician ear protection customized for you by your audiologist allows you to hear your normal full range of sound, just at a reduced volume ensuring your hearing is protected. Universal-fit musicians earplugs, starting at about $15 a pair, can be found at most stores that sell musical instruments. But for the musicians I see – whether they play professionally or just for fun – I recommend custom-molded musicians earplugs with Etymotic filters, because of the greater protection they provide. These will be more comfortable to wear for long periods of time, more effective at blocking undesirable levels of noise while allowing you to hear the music properly, and easier to clean and care for. They are also more expensive than the universal-fit earplugs, but when you consider that hearing damage is irreversible, the investment is more than worth it.