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Preventing Hearing Injury in the Music Industry

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Preventing Hearing Injury in the Music Industry PREVENTING HEARING INJURY IN THE MUSIC INDUSTRY SIOBHAN MCGINNITY ORCID 0000-0003-4598-2397 Submitted in total fulfilment of the requirements of the degree of Doctor of Philosophy April 2019 Department of Audiology and Speech Pathology The University of Melbourne i © 2019 HEARing CRC Ltd ALL RIGHTS RESERVED ii iii ABSTRACT Sound levels in the live music industry have been demonstrated to reach levels capable of causing harm to the auditory system. The body of work presented here aimed to explore ways in which hearing injury can be prevented in the Australian music industry. To do so, multiple stakeholders were engaged, including venue owners, live-music sound engineers, audiologists and manufacturers of hearing protectors for musicians. Four discrete, mixed-methodology studies were conducted to address the topic. Study 1 aimed to investigate the clinical provision of musicians’ hearing protectors (MHPs) by audiologists and manufacturers of MHPs in Australia. Method. Audiologists and manufacturers were asked to complete one of two surveys, investigating the delivery of clinical care for musicians, and recommended processes relating to the manufacture of earplugs. Results. Inconsistencies in the clinical procedures were noted in both the practice of audiological care for musicians, and the recommendations made by manufacturers of MHPs. Study 2 aimed to investigate whether the use of, and satisfaction with, MHPs is influenced by the specific treatment delivered to musicians by audiologists. Method. Musicians rated their satisfaction with the services as delivered across the four treatment conditions. Results. No statistically significant differences across conditions were observed, however, certain aspects of care were perceived positively by musicians, such as the provision of a hearing test. iv Study 3 aimed to assess the hearing of live music sound engineers and their risk of hearing injury. Method. Participants completed a questionnaire on their hearing health as well as a hearing assessment. Results. Ninety-six percent of sound engineers reported having experienced at least one symptom of hearing injury during or after a work shift in music. Use of hearing protection was low, however, individuals who frequently wore hearing protection had significantly better hearing, particularly in the extended high frequencies. Study 4 aimed to investigate if the use of sound level management software can assist in reducing exposure levels in indoor live music venues. Method. Use of a commercial sound level management system in six indoor live-music venues of Melbourne was trialled. Results. Overall, there was no reduction in mean sound level (LAeq,T), however the number of nights on which extreme volume levels were recorded was reduced. Subjective questionnaires indicated that one-fifth of patrons would prefer lower sound levels than experienced. Overall, the results indicate there is a significant risk of hearing injury to individuals working within and attending live music venues in Australia. Findings indicated that there is a need for greater hearing awareness across all stakeholders. Audiologists would benefit from the development of best-practice guidelines for the care of musicians’ ears, while more broadly, the inclusion of EHF hearing thresholds would benefit in early detection and monitoring of noise-induced hearing loss. Greater research focus and hearing v conservation training is needed for both LMSEs and staff in live-music venues, who would benefit from the implementation of strategies to manage venue sound levels in a way that takes into account the sound level preferences of patrons, while minimising the risk of hearing injury for all. vi DECLARATION I hereby certify that: i) this thesis comprises only my original work towards the degree of Doctor of Philosophy, except where indicated in the preface; ii) due acknowledgement has been made in the text to all other material used; iii) the thesis is fewer than 100,000 words in length, exclusive of tables, maps, bibliographies and appendices. April 2019 _______________________ Siobhan McGinnity vii PREFACE This thesis is comprised of my own, original work, and contains no material previously published or written by another person, except where due reference has been made in text. The undertaking of this research was inspired by my experience working as both musician and audiologist, and personal endeavour to help people hear music for life. The PhD candidate, Siobhan McGinnity, was responsible for the development, preparation and execution of the dissertation. Critical revision and interpretation of the data was supported by supervisors Professor Robert Cowan, Dr Elizabeth Beach and Dr Johannes Mulder, who assisted with the quality of all written publications. Additional support was obtained from Dr Caitlin Barr and Mr Dominic Power for the critical revision of the publication resulting in Chapter 4. Statistical support was kindly obtained by Sandy Errey of the Statistical Consulting Centre at the University of Melbourne where required. The status for each of the results chapters is outlined below: Chapter 3 Published by the International Journal of Audiology, February 2018: McGinnity, S., Beach, E. F., Mulder, J., & Cowan, R. (2018). Caring for musicians’ ears: Insights from audiologists and manufacturers reveal need for evidence-based guidelines. Int J Aud, 57(sup1), S12–S19. Chapter 4 Accepted for publication to the International Journal of Audiology, April 2019: McGinnity, S., Beach, E.F., Cowan, R., Mulder, J., Power, D., & Barr, C. (In Press). Exploring person-centred care in the practice of audiology for musicians. In J Aud. viii Chapter 5 Submitted for publication to Archives of Environmental and Occupational Health, September 2018: McGinnity, S., Beach, E.F., Cowan, R., & Mulder, J. The hearing health of live-music sound engineers. Chapter 6 Accepted for publication in the Journal of the Audio Engineering Society, April 2019: McGinnity, S., Mulder, J., Beach, E. F., & Cowan, R. (In press). Management of sound levels in live music venues. J Audio Eng Soc. Funding for this thesis was provided by the HEARing CRC, established under the Australian Government’s Cooperative Research Centres (CRC) Program. The CRC Program supports industry-led collaborations between industry, researchers and the community. ix ACKNOWLEDGEMENTS This thesis was supported by so many individuals in my life to whom I am incredibly grateful. First and foremost, I would like to thank my supervisors for their guidance, patience and knowledge. Liz, you were the most omnipresent and calming force, and I thank you sincerely for always being at the ready to answer my questions, no matter how small. I wouldn’t have made it through without you. I also believe the thesis would’ve veered far off track if it wasn’t for the grounding force that is Jos Mulder. Jos, your industry knowledge and insight was invaluable to this body of work, thank you for always reminding me of true purpose if I was ever lost in the numbers. And Bob, though I joke that your reply speed to emails can sometimes more closely resemble times of internet dial-up, when you did, your feedback was always spot on. More importantly, you were an empathetic boss and if I needed mountains moved, you moved them, thank you. I’d also like to thank my beautiful family for seeing me through the inevitable ups and downs of undertaking a doctorate. For sending me boxes of food when it was needed, celebrating my milestones and listening to me on the phone any time I felt it was impossible. You kept me going at all stages, thank you. And my friends, who brought the laughter, joy and distractions that made everything easier. Every night of wine, cheese and tea was appreciated, especially when coupled with RuPaul. I cannot thank you all enough for sharing this journey with me and being my cheer squad right through to the end. Finally, I’d like to thank my best friend and partner, Richard Bradbeer. As fate would have it, the week I submit, I also get to marry you. How two such enormous life x events collided, I’ll never know. Though some may say I created it, we both know it wasn’t the intention. You have kept me calm through all the storms, and I truly believe that any relationship that starts at the beginning of a PhD and somehow not only stays alive, but thrives, can make it through anything. Thank you for every meal you made me after a long day, for every time you cleaned knowing I wouldn’t get time, and all the little things that added up to a weight off my shoulders. I can’t wait to spend a lifetime with you, repaying you for all your incidental acts of kindness. With love and gratitude. xi xii TABLE OF CONTENTS ABSTRACT…………………………………………………………………………….iv DECLARATION………………………………………………………………………..vi PREFACE ....................................................................................................................... vii ACKNOWLEDGMENTS ............................................................................................. viii LIST OF TABLES AND FIGURES ............................................................................. xxi ACRONYMS .............................................................................................................. xxiii CHAPTER 1 INTRODUCTION .......................................................................................................... 1 1.1 OVERVIEW ........................................................................................................... 1 1.2 ANATOMY OF AUDITION ....................................................................................
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