Abstract
Hearing health, a cornerstone for musical performance and appreciation, often stands at odds with the unique acoustical challenges that musicians face. Utilizing a cross-sectional design, this survey-based study presents an in-depth examination of self-rated hearing health and its contributing factors in 370 professional and 401 amateur musicians recruited from German-speaking orchestras. To probe the nuanced differences between these groups, a balanced subsample of 200 professionals and 200 amateurs was curated, matched based on age, gender, and instrument family. The findings revealed that two-thirds of respondents reported hearing-related issues, prevalent in both professional and amateur musicians and affecting music-related activities as well as social interactions. The comparative analysis indicates that professionals experienced nearly four times more lifetime music noise exposure compared to amateurs and faced more hearing challenges in social contexts, but not in musical settings. Professionals exhibited greater awareness about hearing health and were more proactive in using hearing protection devices compared to their amateur counterparts. Notably, only 9% of professional musicians' playing hours and a mere 1% of amateurs' playing hours were fully protected. However, with respect to their attitudes toward hearing aids, professional musicians exhibited a noticeable aversion. In general, an increase in music-related problems (alongside hearing difficulties in daily life) was associated with a decrease in mental health-related quality of life. This research highlights the importance of proactive hearing health measures among both professional and amateur musicians and underscores the need for targeted interventions that address musicians' specific hearing health challenges and stigmatization concerns about hearing aids.