The goal of this document is to provide recommendations and strategies for best practices in a comprehensive hearing loss prevention plan for musicians and others that work in the music industry. This document does not address music exposures for those who are not involved in the music industry (i.e., concert goers, venue employees, etc.). Evidence-based recommendations are drawn from a review of the literature in peer-reviewed and non-peer- reviewed journals where possible. In the absence of scientific data, consensus practice was considered in making recommendations. Additional research that would facilitate the further development of evidence-based guidelines is recommended in the document when appropriate.

This document was prepared by the American Academy of Audiology Task Force for the audiological services and prevention of hearing disorders in musicians and music industry personnel. The task force members were selected based upon their clinical and scientific expertise in the prevention of music-induced hearing disorders.

Key Points

This clinical consensus document provides evidence-based recommendations for how to verify the safe use of in-ear monitors, how to verify appropriate attenuation and frequency response of earplugs, and how to deliver comprehensive hearing loss prevention services and counseling to musicians; it is not intended to endorse the selection of specific hearing loss prevention-related products. 

Musicians and other performing artists rely on their hearing for their livelihood. Hearing loss and other auditory disorders can compromise their performance skills. Audiologists working with performing artists must strive to provide best practices, including verification of hearing protection devices and careful education and counseling on in-ear monitors (IEMs) if used. There are multiple areas in which new research data are urgently needed to improve hearing-health care for this at-risk population. Updated guidance should be sought as new data emerge. 

Evidence-based and consensus guidelines were used in recommending the following audiological procedures targeting musicians and music-industry personnel: 

  • Case history 
  • Audiometric evaluation 
  • Consultation and education 
  • Ear impressions
  • Fitting, verification, and orientation of devices 
  • Counseling regarding gear for the music industry, including custom and noncustom musicians’ earplugs; custom and noncustom IEMs; active attenuation; IEM options; IEM best practices; IEM safety considerations. 
  • Sound-level measurements
  • Follow-up hearing tests and support

Get Involved

Whether serving on a clinical document development panel or participating as peer reviewers, volunteers have regular chances to deepen their engagement with the Academy and make important contributions benefiting the field of audiology. If you are interested in clinical document development, please volunteer to express interest and submit a CV to the Academy’s guidelines staff by email.

To view the list of guidelines and strategic documents in development and to learn more about the Academy’s clinical document development process, visit the Academy’s Practice Resources website. Information from interested members is accepted on an ongoing basis, and members will be contacted as clinical document volunteer openings occur.

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