Sound Exposure of Healthcare Professionals Working with a University Marching Band

J Am Acad Audiol. 2018 Jan;29(1):83-89. doi: 10.3766/jaaa.17018.


Background: Music-induced hearing disorders are known to result from exposure to excessive levels of music of different genres. Marching band music, with its heavy emphasis on brass and percussion, is one type that is a likely contributor to music-induced hearing disorders, although specific data on sound pressure levels of marching bands have not been widely studied. Furthermore, if marching band music does lead to music-induced hearing disorders, the musicians may not be the only individuals at risk. Support personnel such as directors, equipment managers, and performing arts healthcare providers may also be exposed to potentially damaging sound pressures. Thus, we sought to explore to what degree healthcare providers receive sound dosages above recommended limits during their work with a marching band.

Purpose: The purpose of this study was to determine the sound exposure of healthcare professionals (specifically, athletic trainers [ATs]) who provide on-site care to a large, well-known university marching band. We hypothesized that sound pressure levels to which these individuals were exposed would exceed the National Institute for Occupational Safety and Health (NIOSH) daily percentage allowance.

Research design: Descriptive observational study.

Study sample: Eight ATs working with a well-known American university marching band volunteered to wear noise dosimeters.

Data collection and analysis: During the marching band season, ATs wore an Etymotic ER-200D dosimeter whenever working with the band at outdoor rehearsals, indoor field house rehearsals, and outdoor performances. The dosimeters recorded dose percent exposure, equivalent continuous sound levels in A-weighted decibels, and duration of exposure. For comparison, a dosimeter also was worn by an AT working in the university's performing arts medicine clinic. Participants did not alter their typical duties during any data collection sessions. Sound data were collected with the dosimeters set at the NIOSH standards of 85 dBA threshold and 3 dBA exchange rate; the NIOSH 100% daily dose is an exposure to 85 dBA over 8 h. Dose data for each session were converted to a standardized dose intensity by dividing the dose percentage by the duration of the exposure and setting the NIOSH standard as a factor of 1.0. This allowed convenient relative comparisons of dose percentages of vastly different exposure durations. Analysis of variance examined relationships of noise exposures among the venues; post hoc testing was used to assess pairwise differences.

Results: As hypothesized, ATs were exposed to high sound pressure levels and dose percentages greatly exceeding those recommended by NIOSH. Higher sound levels were recorded in performance venues compared with rehearsal venues. In addition to the band music, crowd noise and public address systems contribute to high sound levels at performances.

Conclusions: Our results suggest that healthcare providers working with marching bands are exposed to dangerous levels of sound during performances. This is especially true at venues such as football stadiums, where crowd noise and public address systems add to sound pressure. A hearing conservation program, including protection, should be required for all healthcare staff who work with marching bands. Moreover, our results should inform hearing conservation practices for marching musicians, directors, and support personnel.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Ceremonial Behavior
  • Female
  • Health Personnel
  • Hearing Loss, Noise-Induced / diagnosis*
  • Hearing Loss, Noise-Induced / epidemiology
  • Humans
  • Male
  • Music*
  • Noise / adverse effects*
  • Occupational Exposure / adverse effects*
  • Occupational Health
  • Risk Assessment
  • United States
  • Universities
  • Young Adult