Attending music festivals? Mumbai doctors say you need to protect your ears!

It has been a busy year for music lovers who enjoy attending concerts. While it started off with the much-anticipated series of Coldplay concerts, it was followed by performances by Cigarettes After Sex, Ed Sheeran, and then Green Day, Glass Animals, Shawn Mendes, Louis Tomlinson and Aurora among others at Lollapalooza. It did not end there because Guns N Roses completely brought out their best to a packed Mahalaxmi Racecourse. With a packed schedule across five months, Indian music concert attendees had already witnessed Maroon 5 and Dua Lipa before that, showcasing how many concerts have happened in less than a year in India. 

Every year, World Music Day is observed on June 21. For India, which is at the peak of this concert culture, music is now an experience. Interestingly, the music festival season was traditionally thought to be between September and May, but the last few years have shown how international artists are visiting India all throughout the year to perform some of their greatest hits. The whole experience sounds like a lot of fun but what many may not realise it how attending many of these concerts can affect your ears. Yes, your ears. Especially if you stand close or next to the speakers. 

With the ongoing music concert boom in India, mid-day spoke to Dr Jarvis Pereira, ENT expert at Holy Family Hospital in Bandra and Dr. Amol Patil, senior consultant, ENT, Nanavati Max Super Speciality Hospital in Vile Parle to know how listening to loud music at concerts affects your ears. They not only highlight why the ears need to be protected while enjoying the performance but also highlight how you can do it.

Are people at risk of hearing issues after attending music festivals with loud music?
Patil: People are definitely at the risk of hearing issues after attending music festivals. The loud noise exposure leads to hearing loss — sometimes sudden, most often long-term loss.

Pereira: Yes, listening to loud music at music festivals can impair hearing temporarily or sometimes even permanently. It depends on the duration of exposure to loud music and the proximity of the individual to the loudspeaker. Prolonged exposure can definitely cause tinnitus or noise-induced hearing loss (NIHL). The risk increases with higher decibel levels, longer exposure and close proximity to the loudspeaker.

How does loud music at festivals harm the ears?
Patil: Sudden nerve-related hearing loss common after loud noise exposure affects the inner ear of people.

Pereira: Loud music generates sound waves that can overstimulate and damage the hair cells in the cochlea (inner ear). These cells are responsible for converting sound vibrations into electrical signals for the brain. Once damaged, they cannot regenerate, leading to hearing loss or persistent ringing (tinnitus).

What is the ideal amount of decibels to listen to music at festivals? Where can people ideally stand?
Patil: Ideally, sound lesser than 70 decibel is relatively safe. It is advisable to stay away from loudspeakers.

Pereira: The ideal scenarios are:
1. Ideal decibels: Safe listening levels are around 70-85 dB. Exposure to levels above 100 dB (common at festivals) for more than 15 minutes can be harmful.  
2. Ideal placement: Stand 10-20 meters away from speakers for reduced exposure. Avoid standing directly in front of the speakers or subwoofers.

What are the short-term and long-term effects of listening to loud music at festivals?
Patil: Sudden hearing loss is a medical emergency leading to significant loss, the reason being sudden exposure to high decibel sounds. Repeated exposure can also lead to long term hearing loss over many years.

Pereira: There are both short-term and long-term effects on listening to loud music at festivals:
The short-term effects include:
1. Temporary hearing loss or muffled hearing.  
2. Ringing in the ears (temporary tinnitus).  
3. Ear discomfort or pain.  

The long-term effects include:
1. Permanent hearing loss.  
2. Chronic tinnitus.  
3. Sensory overload and ear fatigue.  
The effects worsen with repeated exposure over time.

What conditions can people suffer from due to loud music?
Patil: Apart from sudden or long-term hearing loss, people can suffer from ringing sound (tinnitus) in the ear, which can be quiet disturbing, few people experience dizziness as well.

Pereira: A myriad of auditory and general conditions may be seen due to loud music.
Some auditory conditions include:
1. Temporary Threshold Shift (TTS) or a temporary reduction in hearing ability due to acoustic nerve fatigue can occur.
2. Repeated exposure to loud music for long time can lead to Noise-Induced Hearing Loss (NIHL) which is basically permanent reduction in hearing capacity most commonly starting with higher frequencies.
3. Tinnitus or persistent ringing/buzzing in the ears is a very common symptom seen in people exposed to loud music.
4. Hyperacusis or increased sensitivity to everyday sounds is possible 
5. Earwax can be pushed deeper inside the auditory canal leading to blockage and possibly even ear canal infections

Some other conditions include:
1. Headaches and migraines can be triggered by loud music
2. Sleep disturbances can occur due to disruption in sleep patterns, causing insomnia, daytime somnolence and fatigue
3. A constant feeling of tiredness, stress and mental exhaustion are also possible due to prolonged exposure to loud music.

Which age groups are most vulnerable to hearing issues at music festivals?
Patil: Anybody can be affected by hearing issues, but the impact is more as age advances as natural weakening of hearing due to ageing adds.

Pereira: These are some of the vulnerable age groups:
1. Teens and young adults: They often attend festivals and may not take preventive measures.  
2. Elderly individuals: Pre-existing hearing issues make them more susceptible to further damage.  
3. Children: Their developing auditory systems are particularly sensitive to loud sounds.

What can festival organisers do to prevent hearing issues?
Patil: Sound decibels should be kept at acceptable level and continuous exposure should be avoided.

Pereira: Some of the steps that festival organisers can take to prevent hearing issues are:
1. Lower sound levels: Monitor and cap music at safe decibel levels.  
2. Speaker placement: Position speakers to distribute sound evenly without concentrating it in one area.  
3. Quiet zones: Create designated quiet areas for attendees.  
4. Awareness campaigns: Educate attendees about safe listening practices.  
5. Provide ear protection: Offer or sell earplugs at entry points.

How can municipal authorities help at music festivals?
Patil: Pamphlets and advertisements of music festival should carry a statutory warning of ill effects; same thing can put up at the entrance of the festival.

Pereira: Municipal authorities can help in many different ways in Mumbai. They could start with:
1. Regulate sound levels: Enforce decibel limits for festivals.  
2. Inspection: Conduct sound checks to ensure compliance.  
3. Public awareness: Run campaigns on hearing health.  
4. Support services: Provide medical booths with audiologists or earplugs.

What are the common misconceptions about listening to loud music at festivals?
Patil: Young people should be made aware that ill-effects of loud sound exposure can happen after 15 to 20 years as well.

Pereira: Some of the common misconceptions about listening to loud music at festivals are:
1. “It’s safe because it’s outdoors”: Noise levels can still be harmful even in open spaces.  
2. “Temporary ringing will go away”: Repeated exposure can make tinnitus permanent.  
3. “Earplugs ruin the experience”: High-fidelity earplugs maintain sound quality while reducing harmful noise levels.

What are some of the easy tips to protect ears at music festivals?
Patil: Some of the easy ways to protect ears include using ear plugs to dampen sounds, avoiding continuous exposure to sounds, don’t attend festival on regular basis, give body time to heal, and stay away from loudspeakers.

Pereira: Some of the easy tips to follow while attending music festivals are:
1. Wear earplugs: Use noise-reducing earplugs designed for concerts.  
2. Keep distance: Stand away from speakers and sound sources.  
3. Take breaks: Give your ears rest by stepping into quieter areas.  
4. Monitor exposure time: Limit time spent in high-decibel zones.  
5. Use apps: Sound-level apps can help monitor harmful noise exposure.  
6. Hydrate: Staying hydrated helps reduce ear pressure.  
7. Post-festival care: If you experience ringing or discomfort, consult an audiologist. 

The importance of using ear plugs 
While the advice is necessary, Dr Pereira, who is not only a health expert but also a musician, serving as the lead guitarist and vocalist of his own band, The Doctor J Collective, is in the thick of all things music, and often encounters cases of hearing loss. He shares, “Many musicians in my circle are aware that I’m an “ear doctor,” so they consult me for their hearing-related issues. One case that stands out is a drummer who experienced constant exposure to loud sounds during performances. Over time, he began developing tinnitus—persistent ringing in the ears and a hearing test revealed some degree of hearing loss. While he wore in-ear monitors during performances, the prolonged exposure to high decibel levels still caused damage.”

Such cases, he says, are unfortunately common in the music industry. “Tinnitus and temporary or permanent hearing loss are often seen in individuals exposed to excessive noise,” he says, continuing, “In some instances, hearing loss can improve gradually, depending on the duration and intensity of the exposure. Recovery might take anywhere from a few days to a week, but not everyone is that fortunate.” 

Being a frequent concert attendee, Tanishka D’lyma has been one to make a gradual shift to take care of her ears. The Mumbaikar, who loves attending gigs first bought ear plugs for her husband. “Loud noises are really uncomfortable for him, and I wanted to attend gigs,” she chuckles, but it did not take long for her to make the switch herself. “Soon, I bought them for myself too because I realised that I listen to music really loud and that could possibly be damaging. I`m not 20 anymore and I need to take care of my body,” adds D’lyma, who made the conscious decision to wear them last year, after being frequently exposed to loud music at gigs and festivals and being prompted by advertisements online. 

The more she read about they protect the eardrums the more she was convinced and even advises her friends about it. “Protect your ears! Wear earplugs or something more expensive like loop. I think anything is fine. Even earbuds for Rs 100 from local shops will work,” shares the Mumbaikar.

It did not take long for her friend Divya Ramesh, a Pune-based marketing professional to follow suit. “I started wearing earbuds in the last one year, especially in closed venues where it can get very loud. Interestingly, when I started wearing it for club gigs, it was less overpowering and made me less exhausted. I can also hear a lot of musical nuances with the earbuds in that I would otherwise miss in the wall of sound,” she concludes.

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