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Background Recreational noise—specifically loud music experienced at music venues—has been recognized as a hazard for hearing damage and associated pathologies such as tinnitus. In Europe and other countries around the world, there is a range of regulatory and legislative approaches to managing the sound levels and minimizing the risk of hearing damage for those attending music venues. It is important to have an understanding of these different approaches to inform the development of future regulations and legislation. Methods In December 2018, an online search of legislative instruments was conducted, and we identified 18 items that were aimed at protecting the hearing of people attending entertainment venues. Results Twelve documents were from European jurisdictions and the remainder were from cities or states of North and South America. The regulatory measures included in the documents ranged from sound level limitations, real-time sound exposure monitoring, mandatory supply of protective devices, requirements for signage and warnings, loudspeaker placement restrictions and the provision of ‘quiet spaces’. Conclusions European countries are well advanced in terms of providing legislation and other regulatory documents aimed at protecting people at entertainment venues when compared with the rest of the world. Future research is required to assess the effectiveness of these regulatory measures in reducing the risk associated with sound exposure at music venues.

Most studies of hearing loss prevention in the music industry focus on the risk of hearing injury to musicians. However, live-music sound engineers (LMSE) may also be at risk of hearing injury due to their work-related sound exposure. We studied 27 LMSE, all of whom underwent otologic examination, including audiometry, distortion product otoacoustic emissions, speech discrimination and uncomfortable loudness levels, and completed a questionnaire investigating their history of sound exposure and use of hearing protectors. Hearing thresholds were significantly poorer than normative data across several frequencies, and a substantial proportion reported constant tinnitus (30%) and reduced sound tolerance (41%). Use of hearing protection was relatively low, with many reporting interference with their job when using it. Our results suggest that LMSE are at risk of hearing injury due to their work-related sound exposure.

Objective: To reduce the risk of hearing injury, musicians are often recommended custom-made musicians’ hearing protectors (MHP). Studies report benefits of use however, many still report challenges leading to relatively low uptake and inconsistent usage. Person-centred approaches to health have been shown to improve patient outcomes, and these principles may be translatable to musicians’ hearing care. The aim was to investigate if use of, and satisfaction with, MHP is influenced by the treatment delivered to musicians by audiologists. Design: Participants were randomly allocated to one of four conditions that varied in extent of person-centred care. Study sample: Forty-two musicians with an interest in purchasing MHP were recruited. Results: Satisfaction with MHP was high overall and users reported a reduction in incidence of tinnitus. Participants reported few issues related to sound quality, however insertion difficulty was the main problem reported. Only one musician self-identified the need for alterations to their MHP. Conclusions: Adoption of person-centred approaches to MHP was not found to increase likelihood of use, however, satisfaction was high across all conditions. Most often, the need for MHP alterations were clinician-identified during fitting appointments or follow-up contact, underscoring the importance of including these components when providing audiological services to musicians.

In 2015, the World Health Organization (WHO) convened a group of researchers and industry experts to tackle the risk of noise-induced hearing loss from loud music exposure because of personal listening devices and entertainment venues...

Excessive sound levels at events where amplified music is a central element pose a risk to hearing. Whereas noise exposure in the workplace has been recognized as a hazard for over a century, the potential harm resulting from recreational sound exposure has only become apparent in recent years. In occupational settings where sound levels are high, employers are required to implement risk-mitigation strategies to reduce sound exposure and protect employees in accordance with the hierarchy of controls. In principle, this same risk management approach can be applied to entertainment venues. In this paper we discuss how the measures stipulated in various policies and regulations aimed at protecting the hearing of audience members at entertainment venues fit within the hierarchy of controls. We compare the relative likely effectiveness of each of the measures and outline how the particular characteristics of entertainment venues impact on the practical application of these measures.