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Investigating the health of musicians

Since 2011, the Norwegian Musicians’ Health Project has investigated the psychosocial work environment, sleep, mental health and use of healthcare services among Norwegian musicians. The project was the result of a collaboration between the Norwegian Musicians’ Union (MFO, now Creo), Performing Arts Health Norway, Nord University and the Norwegian University of Science and Technology (NTNU). The data collection and initial project were funded by the Norwegian Extra Foundation through Mental Health Norway.

Here is a systematic overview of the results of the articles that has been published internationally from this project.

If you want to know more about the project, contact associate professor Jonas Rennemo Vaag by e-mail: jonas.vaag@nord.no.

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Tinnitus, Anxiety, Depression and Substance Abuse in Rock Musicians a Norwegian Survey

Authors: Carl Christian Lein Stormer, Tore Sorlie, Niels Christian Stenklev

Objective: Rock musicians are known to have an increased prevalence of hearing loss and tinnitus. The aims of the present study were to examine the distribution of anxiety and depression symptoms among rock musicians with or without tinnitus and how these mental health indicators and internal locus of control influenced upon their tinnitus symptom concerns and the degree to which the tinnitus affected their lives.

Design: The study was a questionnairebased cross-sectional survey of subjects selected from a cohort of rock musicians. We recruited 111 active musicians from the Oslo region, and a control group of 40 non-musicians from the student population at the University of Tromso.

Results: Among the rock musicians 19.8% reported permanent tinnitus vs. 0% among the controls. Musicians more often reported anxiety symptoms than controls (35.1% vs. 17.5%), however this prevalence was not different in musicians with and without tinnitus. Tinnitus-affected musicians reported depressive symptoms, significantly more than controls (13.6% vs. 5%). Rock musicians consumed more alcohol than controls, but alcohol consumption was unrelated to severity of tinnitus. Drug abuse was not more prevalent in rock musicians than in controls. Duration of tinnitus, internal locus of control, sleep disturbance and anxiety were significant predictors of how affected and how concerned musicians were about their tinnitus.

Conclusion: Rock musicians are at risk for the development of chronic tinnitus, and they have an increased prevalence of anxiety. There is an association between chronic tinnitus and depressive symptoms in rock musicians, but our results are ambiguous. Although rock musicians have a chronic exposure to noise, noise-induced hearing loss is not the sole causative agent for the development of tinnitus.

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A cross-sectional study of psychosocial work environment and stress in the Danish symphony orchestras

Authors: Gitte Juel Holst, Helene M. Paarup, Jesper Bælum

Purpose: To investigate psychosocial work environment and stress in Danish symphony orchestra musicians.

Methods: This was a cross-sectional questionnaire survey of psychosocial work factors and stress symptoms among 441 musicians in six Danish symphony orchestras. The response rate was 78% (n = 342). The questions were from COPSOQ (Copenhagen Psychosocial Questionnaire). Mean values of 19 COPSOQ-scales were compared by gender and instrument group. The results for the musicians were compared with results for the general Danish work force (COPSOQ database).

Results: Female musicians reported higher work demands and higher stress symptoms than their male colleagues. Between instrument groups, 2nd violinists seemed to be of particular risk compared with the other instrumental groups in aspects of work pace, work organization, and content, whereas 1st violinists perceived higher emotional stress compared with 2nd violinists. The musicians’ experience of increased work demands as well as deteriorated, work organization and job content, interpersonal relations and leadership, and work-individual interface was significantly associated with increasing stress symptoms. Compared to the general workforce independently of gender, Danish symphony orchestra musicians reported higher emotional demands, lower influence, lower social support, lower sense of community, and lower job satisfaction. However, the musicians reported a higher commitment to the workplace.

Conclusions: The Wndings indicate a more demanding psychosocial work environment exposure among symphony orchestra musicians than among Danish workers in general. Critical results are the relatively high work demands, low influence, and low social support, females being of higher risk than males.

Keywords: Psychosocial work environment exposure, Stress symptoms, Symphony orchestra musicians

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Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: a cross-sectional study

Authors: Helene M Paarup, Jesper Bælum, Jonas W Holm, Claus Manniche and Niels Wedderkopp

Background: Musculoskeletal symptoms are common in the neck, back, and upper limbs amongst musicians. Playing-related musculoskeletal disorders have been found to range from 32% to 87% with a tendency for female musicians to have more problems than males. Studies of musculoskeletal problems in instrumentalists have generally involved pre-professional musicians or populations comprising musicians of different levels. The objective of this study was therefore to investigate the prevalence, duration and consequences of musculoskeletal symptoms in professional symphony orchestra musicians.

Methods: A cross-sectional questionnaire study. The study population comprised of 441 musicians from six Danish symphony orchestras; 342 (78%) completed the questionnaire.

Results: During the last year 97% of the women and 83% of the men experienced symptoms in at least one of nine anatomic regions (neck, upper and lower back, shoulders, elbows, and hands and wrists). 86% of the women and 67% of the men experienced symptoms for more than seven days, while 63% of the women and 49% of the men had symptoms for more than 30 days. Woodwind players had a lower risk for musculoskeletal symptoms and a lower risk for the consequences. Among consequences were changed way of playing, reported by 73% of the musicians, difficulty in daily activities at home, reported by 55%, and difficulty in sleeping, reported by 49%. Their health behaviour included taking paracetamol as the most used analgesic, while physiotherapists and general practitioners were reported as the most consulted health care professionals concerning musculoskeletal problems. Results regarding symptoms in six anatomic regions were compared to results for a sample of the general Danish workforce. Symptoms were more frequent in musicians and lasted longer than in the general workforce. This applied to both genders.

Conclusions: Within the last year most symphony orchestra musicians experienced musculoskeletal symptoms in the neck, back or upper extremities. The symptoms impacted on their level of function in and outside work and were reflected in their health behaviour. Generally women had a higher risk than men and woodwind players a lower risk than other instrumentalists. Finally, symptoms were more frequent and lasted longer in the musicians than in the general workforce.

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Tinnitus Severity Is Related to the Sound Exposure of Symphony Orchestra Musicians Independently of Hearing Impairment

Authors: Jesper Hvass Schmidt, Helene M. Paarup and Jesper Bælum

Objectives: Tinnitus can be debilitating and with great impact of musicians professional and private life. The objectives of the study were therefore to: (1) describe the epidemiology of tinnitus including its severity in classical orchestra musicians, (2) investigate the association between tinnitus severity in classical musicians and their cumulative lifetime sound exposure, and (3) the association between tinnitus and hearing thresholds.

Design: The study population included all musicians from five Danish symphony orchestras. Answers regarding their perception of tinnitus were received from 325 musicians, and 212 musicians were also tested with audiometry. Any tinnitus and severe tinnitus were two definitions of tinnitus used as outcomes and analyzed in relation to an estimation of the cumulative lifetime sound exposure from sound measurements and previously validated questionnaires and the average hearing threshold of 3, 4, and 6 kHz.

Results: Thirty-five percentage of all musicians (31% female and 38% of male musicians) reported having experienced at least one episode of tinnitus lasting for more than 5 minutes during their life. Severe tinnitus with a severe impact on daily life was reported by 19% of the musicians (18% of female and 21% of male musicians). The severity of tinnitus was associated with increased lifetime sound exposure but not to poorer high frequency hearing thresholds when the lifetime sound exposure was considered. The odds ratio for an increase in one unit of tinnitus severity was 1.25 (95% CI, 1.12–1.40) for every 1 dB increase in lifetime sound exposure.

Conclusion: Musicians frequently report tinnitus. Any tinnitus and severe tinnitus are significantly associated with the cumulative lifetime sound exposure, which was shown to be the most important factor not only for the prevalence but also for the severity of tinnitus—even in musicians without hearing loss. High-frequency hearing thresholds and tinnitus severity were correlated only if the cumulative lifetime sound exposure was excluded from the analyses.

Key words: Tinnitus, Musicians, Hearing loss, Music, Noise induced.

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