Hearing protection

Hearing is a musician’s most important asset. As handbell musicians, and especially as soloists, we routinely put a loud, high-pitched instrument near our ears. We may rehearse in a room that reflects sound back at us, or in a row in front of other handbell musicians. We need to think early in our musical journey about protecting our hearing. It’s particularly important for advanced ringers, who may be exposed to more four-in-hand techniques in the high treble, and for those ringing bell trees. Bells on bell trees aren’t generally damped, so there’s an accumulation of sound right at ear level. Church ringers may need to think about protecting their hearing at Easter, where brass instruments may be combined with the bell choir, perhaps playing behind them.

There was an excellent article in the handbell guild magazine, Overtones May/June 2000, written by Michelle Tejada. Michelle is an audiologist as well as a handbell musician. My article today is based on what I learned from Michelle, from other handbell musicians, and from my own experience and research.

Hearing loss is cumulative, insidious, and irreversible. Symptoms of hearing loss include headaches, ringing or pain in your ears, or a feeling of fullness in the ears. If you notice any of these, especially after ringing, take measures to protect your hearing. Regular earplugs tend to muffle all sound, so look for something designed to allow you to hear clearly while filtering out the dangerous higher frequencies.

Etymotic universal earplugsYou can buy inexpensive musicians earplugs from Amazon and other online vendors. Etymotic makes a version with 20dB filters that other handbell musicians have had success using. They come in 2 different sizes and cost about $12/pair, including a case and a neck cord. The earplugs are easy to insert or remove, but may be uncomfortable for some people. The hole in the plug may also fill with wax and block out sound. You may want to start with these inexpensive earplugs and see if they work for you, or if you need to invest in something else. Here’s a picture of the Etymotic universal plugs.

Another brand, Earasers, is similar to the custom plugs described below. Earasers are not fitted, instead coming in sizes small, medium, or large. They cost about $40-$50/pair, and are available through the company website, Guitar Center, and Steve Weiss.

I’ve heard of four brands of custom musicians earplugs: Sensaphonics, Etymotic, Westone, and Microsonic. You can research custom fitted earplugs online, but you must buy them through an audiologist trained to work with that brand. They tend to sell a single brand. Look for someone who specializes in working with musicians. If you know which brand you want, you can go to the company website and look for names of authorized audiologists in your area. You can do online searches and ask for referrals, especially if you know someone who plays brass instruments or who plays viola in an orchestra (and sits in front of the brass section). I didn’t have any luck finding someone who works with musicians, so I chose an audiologist with an office near the Boeing manufacturing plant who specializes in hearing protection. You don’t need to choose someone convenient to your home, because you’re probably going to make only two visits: one to be fitted and another to pick up the completed earplugs. I looked for someone who routinely fits these earplugs, rather than someone who does it only occasionally.

Sensaphonics custom earplugsI chose an audiologist who works with Sensaphonics, and have been very happy with the results. In researching this article, I heard from handbell musicians who were equally happy with Etymotic. The filters all come from Etymotic, regardless of who makes the mold. Here’s a picture of the custom Sensaphonics plugs (the Etymotic plugs look similar). The three disks in front are filters.

It was easy to get a convenient appointment soon after I called. When you make the appointment, be sure to ask what is included, and what costs might be extra:

• Initial hearing test
• Taking impressions
• Finished earplugs
• Filters – one set minimum
• Second (or replacement) set of filters
• Appointment with the audiologist to pick up the finished earplugs
• Second hearing test with plugs in place

Read about your options on the manufacturer’s website so you can be prepared to make decisions. I’ll talk more about those below. Take a list of questions to the appointment, and take notes during your visit. I took some bells with me to explain what I do. The audiologist first gave me a hearing test to establish a baseline for future hearing loss. I sat in a soundproof booth wearing headphones while she triggered sounds of various frequencies and volume. Whenever I heard a sound through the headphones, I signaled to the audiologist. She graphed the results, explained them to me, and gave me a copy.

Then the audiologist took impressions for the plugs by squirting a foamy substance into my ears. It was a strange sensation but not painful. It took a few minutes for the substance to harden and be removed. I don’t recall it being messy, but you may not want to wear your best earrings, gentlemen. During the hardening, you should make whatever facial movements you’re likely to make while wearing the plugs (such as singing or talking).

To place the order, I needed to decide the earplug color, and the color and level of decibel filters. I also needed to decide on options like cables. I chose clear plugs and filters, without cables, to keep the plugs invisible to the audience. You can get them in various flesh tones, color, or glitter. The filters come in 9 dB, 15 dB, and 25 dB and are interchangeable in the earmolds. Etymotic suggests certain levels for specific instruments, but of course they don’t have handbells on the chart. I chose 15, and later bought a second set of 9 dB filters. When I wore the 15, I couldn’t hear my accompanist well enough over the bells, so I tended to wear the plugs only to practice alone, not to rehearse or perform. That meant what I heard in practice was different than what I heard in performance. I was much happier with the 9 dB, which I now wear whenever I ring. If I were primarily a choir ringer, 15 dB would be more appropriate, or even 25 if rehearsing in a very bright room. If you had a reason, you might buy different filters for each ear. You can also buy blank plugs to block out all sound. Two audiologists recommended against buying them, because it’s more comfortable just to wear soft foam earplugs when you need to block out all sound.

You may need to choose between silicone or vinyl, or the audiologist may choose for you. Mine recommended silicone, and I followed her advice. They’re fine, though they can be a little awkward to insert (they tend to stick, especially when new). Since I haven’t used the vinyl ones, I don’t know if that would make a difference. Etymotic recommends not using vinyl, which can shrink or change shape over time. Certain colors (such as glitter) may be available only in silicone. The Sensaphonics plugs have a red dot for the right ear and a blue dot for the left ear. I don’t know if that’s true of the other brands. You might ask for it. You can have the part of the earplug surrounding the filter protrude, which probably makes them easier to insert and remove. They can also be countersunk (which I chose for minimum visibility) or partially countersunk. Westone plugs have a small stem that probably makes them easier to remove. That would be worth asking about at the time you order your plugs, whatever brand you choose.

Ask the audiologist to have the lab measure the acoustic mass and send that information with the earplugs. The sound channel of a musicians earplug is supposed to have an acoustic mass of 500-750mV. This provides some assurance that you’re getting the protection you’re paying for. The audiologist may not be accustomed to asking the lab for this information, but the lab should have a meter to measure the acoustic mass, and there shouldn’t be an additional charge for it.

It took 4 weeks for the plugs to come back from the lab, and I made an appointment to pick them up at the audiologist’s office. They were hard to insert at first because they tended to stick, and it took a few weeks before I was confident they were seating correctly. They fit deep in the ear, around two bends. Be sure the audiologist trains you in how to put them in, and gives you a second hearing test with the earplugs in place. There may be a separate charge for that. Ask for a sample of lubricant and a small hardshell plastic case to store the plugs. You want the smallest case possible so you can put them in your pocket or music bag when you remove them. I put a label with my name and phone number on my earplug case.

The plugs should come with a warranty both for the filters (1 year) and for the fit of the plugs (30-90 days). Ask for this in writing. The filters can be replaced if defective, and the plugs can be remade if they don’t fit properly. Be sure to wear them during the warranty period so you know if there’s a problem. You may need to wear them for short periods on successive days, building up your tolerance as you would with contact lenses. You may want to use a commercial lubricant like Oto-ease to help insert them, especially at first. When it’s time to replace the plugs, you can reorder without having new molds made, if you’re happy with the current fit. The plugs have about a 5 year life. I’ve had my earplugs for two years and know one handbell musician who has had hers for seven years.

The plugs are easy to care for. The main thing is to keep water away from the filters. I always make sure my hands are dry before touching the earplugs. You can pop the filters out (cover the sink drain first in case you drop them) and wash the plugs with warm water and mild soap. Dawn dish detergent is recommended because it degreases the plugs. Use a cotton swab to clear out any wax. Be sure the plugs are completely dry inside and out before popping the filters back in. If the filters themselves get dirty, clean them gently with a soft dry brush, like a soft toothbrush.

The benefit of wearing any type of musicians earplugs, besides protecting your hearing, is that you can hear everything more clearly. The filters block high frequencies, but you can still hear the music and (when the music stops) words from your director or accompanist. You may not be able to hear people speaking while you ring. If you’re in a bell choir and your neighbor wants to ask you for the measure, s/he may need to use hand signs, such as waggling a finger in front of your sheet music, instead of speaking to you.

Because solo handbells are such a quiet instrument, I work hard to develop a greater dynamic range, especially forte. My accompanist has told me that I ring louder than before I wore earplugs. However, I have to look directly at her when she’s speaking, and it’s hard for me to know how loud my own voice is. I’ve heard of soloists wearing earplugs who yell at their accompanists. That may be bad manners, or it may be that they can’t hear themselves speak. Always tell your accompanist, director, or performance partners that you’ve started wearing hearing protection, and ask to be told if you’re speaking too loud or too softly. People sometimes have to ask me to speak up when I’m wearing plugs. I’m also reluctant to talk to audiences during a concert. It’s a little awkward to dig the plugs out of my ears at the end of a concert when people are coming up to the bell table to talk to me. I feel these are minor inconveniences compared to premature deafness.

The total cost for the audiologist visits, hearing test, custom plugs, and one set of filters was $200. The second set of filters cost $80, with shipping from the manufacturer. Audiologists recommend a hearing check for musicians every year to two years. It’s money well spent. The same year I got my custom earplugs, we spent several thousand dollars to buy hearing aids for my husband, and we’ll buy batteries for those for the rest of his life. I feel like I got a bargain on my purchase.

Thanks to handbell musicians Lee Barrow, Doug Jones, and Cindy Lewis for their input into this article. Thanks to audiologist Amy Stewart of Washington Audiology Services. Extra special thanks to audiologist and handbell musician Michelle Tejada.

Copyright © 2011 Nancy Kirkner, handbells.com