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Original article
Incidence and relative risk of hearing disorders in professional musicians
  1. Tania Schink1,
  2. Gunter Kreutz2,
  3. Veronika Busch3,
  4. Iris Pigeot4,5,
  5. Wolfgang Ahrens5,6
  1. 1Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  2. 2Department of Music, School of Linguistics and Cultural Studies, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
  3. 3Department of Musicology and Music Education, Faculty of Cultural Studies (FB 9), University of Bremen, Bremen, Germany
  4. 4Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  5. 5Institute of Statistics, Faculty of Mathematics and Computer Science (FB 3), University of Bremen, Bremen, Germany
  6. 6Department of Epidemiologic Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  1. Correspondence to Dr Wolfgang Ahrens, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department of Epidemiologic Methods and Etiologic Research, Achterstraße 30, Bremen 28359, Germany; ahrens{at}


Background Hearing disorders have been associated with occupational exposure to music. Musicians may benefit from non-amplified and low-intensity music, but may also have high risks of music-induced hearing loss.

Aims To compare the incidence of hearing loss (HL) and its subentities in professional musicians with that in the general population.

Methods We performed a historical cohort study among insurants between 19 and 66 years who were employed subject to social insurance contributions. The study was conducted with data from three German statutory health insurance providers covering the years 2004–2008 with about 7 million insurants. Incidence rates with 95% CIs of HL and the subentities noise-induced hearing loss (NIHL), conductive HL, sensorineural HL, conductive and sensorineural HL, as well as tinnitus were estimated stratified by age, sex and federal state. A Cox regression analysis was conducted to estimate adjusted HRs and two-sided 95% CIs for HL and its subentities.

Results More than 3 million insurants were eligible, of whom 2227 were identified as professional musicians (0.07%). During the 4-year observation period, 283 697cases of HL were seen, 238 of them among professional musicians (0.08%), leading to an unadjusted incidence rate ratio of 1.27. The adjusted hazard ratio of musicians was 1.45 (95% CI 1.28 to 1.65) for HL and 3.61 (95% CI 1.81 to 7.20) for NIHL.

Conclusions Professional musicians have a high risk of contracting hearing disorders. Use of already available prevention measures should reduce the incidence of HL in professional musicians.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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