Research suggests that educations programs can be beneficial to musicians as well as working with hearing care professionals to help address the specific issues that musicians face. [2]
In 2018, a musician named Chris Goldscheider won a case against Royal Opera House for damaging his hearing in a rehearsal of Wagners thunderous opera Die Walkure. Workplace standards
In the United States, the Occupational Safety and Health Administration (OSHA) describes standards for occupational noise exposure in articles 1910.95 and 1926.52. OSHA states that an employer must implement hearing conservation programs for employees if the noise level of the workplace is equal to or above 85 dB(A) for an averaged eight-hour time period. OSHA also states that "exposure to impulsive or impact noise should not exceed 140 dB peak sound pressure level". The National Institute for Occupational Safety and Health (NIOSH) recommends that all worker exposures to noise should be controlled below a level equivalent to 85 dBA for eight hours to minimize occupational noise induced hearing loss. NIOSH also recommends a 3 dBA exchange rate so that every increase by 3 dBA doubles the amount of the noise and halves the recommended amount of exposure time. The United States Department of Defense (DoD) instruction 605512 has some differences from OSHA 1910.95 standard, for example, OSHA 1910.95 uses a 5 dB exchange rate and DoD instruction 605512 uses a 3 dB exchange rate.
Both sides of the body tend to be equally affected. The tremor is called an action tremor, becoming noticeable in the arms when they are being used. Patients often report that alcohol helps lessen the symptoms. Primary medical treatments for ET are usually beta-blockers. For patients who fail to respond sufficiently to medication, deep brain stimulation and thalamotomy can be highly effective.A "flapping tremor," or asterixis, is characterized by irregular flapping-hand movement, which appears most often with outstretched arms and wrist extension. Individuals with this condition resemble birds flapping their wings. Volitional hyperkinesia
Volitional hyperkinesia refers to any type of involuntary movement described above that interrupts an intended voluntary muscular movement. These movements tend to be jolts that present suddenly during an otherwise smoothly coordinated action of skeletal muscle. Pathophysiology
The causes of the majority of the above hyperkinetic movements can be traced to improper modulation of the basal ganglia by the subthalamic nucleus. In many cases, the excitatory output of the subthalamic nucleus is reduced, leading to a reduced inhibitory outflow of the basal ganglia. Without the normal restraining influence of the basal ganglia, upper motor neurons of the circuit tend to become more readily activated by inappropriate signals, resulting in the characteristic abnormal movements.There are two pathways involving basal ganglia-thalamocortical circuitry, both of which originate in the neostriatum. The direct pathway projects to the internal globus pallidus (GPi) and to the substantia nigra pars reticulata (SNr).