The Show Must Go On: Understanding the effects of musicianship, noise exposure, cognition, and ageing on real-world hearing abilities

Musicians are at high risk of hearing loss and tinnitus due to regular exposure to loud music. Hearing problems may impact on performance abilities; limit employment opportunities; and impact on general wellbeing. Conventional measures of hearing loss (audiometry) do not reliably predict common hearing problems such as following a conversation in a noisy environment and tinnitus. Therefore, hearing damage might go undetected (termed ‘hidden hearing loss’), and the effects of noise exposure on musicians’ hearing may have been underestimated. Studies investigating noise-induced hidden hearing loss in musicians have produced mixed findings. This chapter provides an overview of this research area and explores how hearing may be affected by a complex interaction of factors including musicianship, noise exposure, auditory and cognitive skills, and ageing.