Hear the Music: Effects of Cardiovascular Fitness on Hearing Sensitivity and Otoacoustic Emissions Among Musicians and Nonmusicians

1
Hear the Music Effects of Cardiovascular
Fitness on Hearing Sensitivity and Otoacoustic
Emissions Among Musicians and Nonmusicians

• Maribeth DiSalvo, Tricia Deatharidge, Timothy
  Phoenix, K. M. Hutchinson and Helaine Alessio
• Miami University, Oxford, Ohio

2
Abstract

• Deafness or hearing impairment resulting from
  prolonged exposure to loud noise is most
  frequently associated with industrial workplaces,
  airports etc. Studies have shown that up to 52
  of classical musicians and up to 30 of rock or
  pop musicians suffer from music-induced hearing
  loss (MIHL). Recent studies, however, have
  revisited some prior ways of thinking about
  sensory changes due to noise, and have uncovered
  variables other than time and duration of
  exposure, that play a significant role in hearing
  changes. In this study, cardiovascular (CV)
  health and hearing acuity were measured in 30
  musicians and 35 nonmusicians, aged 19-24 years.
  Pure tone hearing results showed that the high CV
  fitness had better hearing than low CV subjects.
  Otoacoustic emissions demonstrated similar
  patterns. The fitness-hearing relation appears
  to be specifically related to CV fitness among
  both groups.

3
Introduction

• It can result from the booming drums or the
  blaring guitar amplifiers of a hard-rock group.
  But it can also result from the violin or the
  piccolo flute of a symphony orchestra. For a
  musician whose livelihood depends on rehearsing
  and playing music 4-8 hours a day, the danger of
  a hearing impairment is always present.
• It is hardly surprising that music can cause
  damage while on the job. The sound pressure of a
  large concert orchestra may reach 112 dB of
  amplified rock bands even up to 130 dB, far more
  than that accepted in an industrial environment.
  Reasons for reduced hearing acuity over time
  include compromised blood circulation through the
  inner ear. Variations in cochlea blood flow may
  affect the availability of oxygen and glucose,
  which is more rapidly metabolized during sound
  stimulation. If a person has a compromised
  circulation it is possible that blood flow
  through the cochlea may also be reduced.

4
Introduction cont.

• There is also evidence that chronic exercise
  may have a protective role in hearing
  conservation. Researchers reported improved pure
  tone and temporary threshold shifts in healthy
  but low-average fit young adults who improved
  their VO2 peak following eight weeks of
  twice-weekly aerobic exercise performed at 70 of
  maximum oxygen consumption. On the other hand,
  older adults (gt50 years) who were healthy but
  low-average fitness, did not improve either
  hearing acuity nor VO2 peak following eight weeks
  of twice-weekly aerobic exercise performed at 70
  of maximum oxygen consumption.
• The purpose of this study was to determine if
  hearing acuity among a group of musicians and
  nonmusicians was influenced by cardiovascular
  health in subjects aged 18-26 years. Repeated
  exposure to high levels of sound can cause
  hearing loss, particularly in the higher
  frequency ranges. Therefore hearing thresholds
  were measured up to 16 kHz.

5
Methods

• Subjects were 65 volunteers, 29 females and 36
  males (mean age 22 years) with 30 musicians and
  35 nonmusicians. No one reported smoking. None
  reported a history of any significant noise
  exposure, other than their music performances.
  All subjects were found to determine normal
  hearing sensitivity (thresholds 25 dB HL or above
  from 1000 to 6000 Hz).
• Baseline pure tone frequency thresholds were
  determined on a GSI 33 audiometer using insert
  earphones. Closed dynamic HAD 200 Audiometric
  Headphones, were used to test extended high
  frequency (EHF) hearing levels.
• Distortion Product Otoacoustic Emissions (OAE)
  were measured using a Madsen Celeste OAE
  instrument from 2000 to 4000 Hz at a f1/f2 ratio
  of 1.22 and levels of 65/55.

6
Methods cont.

• VO2 peak was determined using a submaximum
  graded exercise test on a Monark Bicycle
  ergometer or using a questionnaire designed to
  estimate VO2 max. Heart rate and blood pressure
  were measured during the graded exercise tests.
  No test had to be terminated due to subjects
  report of angina, or any other abnormal exercise
  response.
• Analysis of variance (ANOVA) was used to
  compare pure tone hearing levels and OAEs between
  and within the two groups. Pure tone hearing
  levels are reported at three frequencies 2 , 3,
  and 4 kHz and at extended high frequencies
  between 10 to16kHz. Post-hoc analysis using
  contrast-comparison tests compared hearing levels
  among the high and low fitness category groups at
  three frequencies to determine whether hearing
  was significantly different on a group by group
  comparison for each test period. The significant
  probability level was plt .05.

7
Descriptive Variables of Two Subject Groups
Age (Mean) Smoking Years of Exposure Tinnitus ( present)
Musician 21.1 18 11 70
Non-Musician 22.2 15 0 52
8
Results

• No significant difference in the mean DPOAE and
  high frequency pure-tone levels between and
  within musicians and non-musicians
• No significant difference between VO2 levels of
  musicians and non-musicians
• Significance at .05 alpha level within musicians
  group concerning signal to noise ratio

9
Discussion

• Marked trend in EHF thresholds of musicians
  compared to nonmusicians
• As frequency increased, greater differences in
  thresholds were found between groups in favor of
  the musicians
• Both groups within normative data ranges
• No statistically significant differences in
  thresholds between different musicians

10
Discussion

• Predicted VO2 maximal values were not
  significantly different between the two groups.
• DPOAE amplitudes across the frequencies were not
  statistically significant.
• Signal to noise significance noted as a trend due
  to small sample size
• Results possibly due to effects of everyday
  exposure to leisure noise within the control
  group.

11
Summary

• Reasons for this cardiovascular health-hearing
  association are unclear, but it has been
  speculated that relative to persons with low
  VO2max, circulation of blood in persons with
  above average VO2max, may be enhanced.
  Circulation of the blood may be improved by less
  resistance to blood flow, higher oxygenation of
  blood, or greater sensitivity and ability of
  tissues to receive blood.

12
References

• Ahmed, H.O., Dennis, J.H., Badran, O., Ismail,
  M., Ballal, S.G., Ashoor, A., Jerwood, D.
  (2001). High-frequency (10-18kHz) hearing
  thresholds reliability, and effects of age and
  occupational noise exposure. Occup Med, 51, 4,
  245-258.
• Chasin, Marshall (1996). Musicians and the
  prevention of hearing loss. San Diego Singular
  Publishing.
• Hall, J.W. Santucci, M. (1995). Protecting the
  professional ear conservation strategies and
  devices. The Hearing Journal, 48, 3, 37-45.
• Harrell, R.W. (2001). Pure tone evaluation. In
  J.Katz (Ed.), Handbook of Clinical Audiology,
  (pp. 71-87). Baltimore, MD Lippincott, Williams
  Wilkins.
• Henderson, D., McFadden, S.L., Liu, C.C., Hight,
  N., Zheng, X.Y. (1999). Role of antioxidants
  in protection from impulse noise. In Henderson,
  D., Salvi, R., Quaranta, A., McFadden, S.,
  Burkard, R., (Eds), Ototoxicity Basic Science
  and Clinical Application (pp. 368-380). New
  York New York Academy of Sciences.
• Hutchinson, K.M., Alessio, H.M., Hoppes, S.,
  Gruner, A., Sanker, A., Ambrose, J. Rudge, S.J.
  (2000). Effects of cardiovascular fitness and
  muscle strength on hearing sensitivity. Journal
  of Strength and Conditioning Research, 14, 3,
  302-309.
• Manson, J., Alessio, H., Cristell, M.,
  Hutchinson, K.M. (1994). Does cardiovascular
  health mediate hearing ability? Medicine and
  Science in Sports and Exercise, 26, 7, 866-871.
• Stelmachowicz, P.G., Beauchaine, A.K., Kalberer,
  A. Jesteadt, W. (1989). Normative thresholds
  in the 8-to-20kHz range as a function of age. J.
  Acoust. Soc. Am., 86, 4, 1384-1391.