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I lay on the hotel bed, flat-out wasted. I'd spent the day walking around the 2001 Winter NAMM convention (the annual tradeshow for all kinds of musical gear), so my feet hurt. Far worse, I'd spent the evening with Spinal Tap, proudly known as England's loudest rock band.

I'd brought my trusty custom-fit plugs, of course, and had beamed approvingly at the ticket takers who offered foam earplugs from big bowls at the door. Nevertheless, the band lived up to its reputation, and my pocket SPL meter routinely clocked the sound at 118 dB. Even plugged, even though great fun, it was loud! By the time I crashed my ears were ringing, roaring like surf on the residue of too much noise.

Most bands don't approach Spinal Tap's dizzying decibels, but these days 100 dB or higher is normal for a small room. That's more than enough to do real damage during the typical three or four-hour club gig. If you regularly perform at these levels, you're at serious risk for hearing loss. But before the bad news about permanent loss and the good news about increasingly subtle, affordable protection it's important to understand the exquisite, yet vulnerable ear.

Anatomy Lesson

Scientists divide the human auditory system into three areas: the outer, middle, and inner ears. These components form a delicate instrument somewhat like a microphone, which transforms acoustic energy into electrical impulses that are interpreted by the brain as sound.

At the outer ear, sound is gathered and directed through the ear canal to the eardrum or tympanic membrane. The eardrum vibrates in response to the acoustic energy and transmits this vibration to a series of three tiny bones, called the ossicular chain, in the middle ear. The last bone in the chain sends the vibration into the fluid-filled inner ear, or cochlea (pronounced COKE-lee-a), which is coiled like a snail shell.

Extending the entire length of the cochlea is a small, flat structure called the basilar membrane, which is covered with more than 30,000 microscopic hair cells. Think of a fuzzy carpet on a coiled, spiral-shaped ramp. Each hair cell responds to a particular frequency, depending on its location between the base of the spiral (high frequency) and the end, or apex (low frequency). The hair cells are also connected to sensory nerve fibers.

As the incoming vibrations travel through the cochlear fluid, they stimulate different areas of the basilar membrane to vibrate, depending on which frequencies are present in the sound. The hair cells in each area generate electrical impulses in the corresponding nerve endings. The fibers of the auditory nerve then transmit these electrical signals to the brain.

In addition to frequency, the intensity or amplitude of the sound is encoded into the electrical impulses. However, when the intensity is too great for too long a period, the hair cells can be damaged. Once hair cells collapse or die, contact with the nerve fibers is broken, and the perception of a particular frequency range is reduced or lost entirely.

This noise-induced hearing loss (NIHL) is the most common occupational injury, according to government statistics. In activities such as mining, manufacturing, woodworking or jet-skiing, NIHL is a side effect that might not interfere with the primary task. But for musicians and audio professionals, it distorts and then destroys the most important tool of your trade.

Overexposure to high sound levels can also lead to tinnitus (pronounced 'TIN-i-tus' or 'ti-NIGHT-us'), a debilitating ringing, buzzing, or roaring in the ears. My day at NAMM gave me some moderate tinnitus, which fortunately went away after a couple of hours. But if I worked in that loud an environment for a long time, I could develop permanent problems.

NIHL is insidious and irreversible, but it is also preventable. Like cigarette smoking or unsafe sex, the dangers of exposure to high sound levels are real. So don't sacrifice your future musical enjoyment and livelihood, for a quick bone-buzzing blast. Be smart, and play safe. Protection is up to you.

Work Rules

Damage to the hair cells of the inner ear is proven to occur with long-term exposure to sound pressure levels of 90 dB SPL and above. The Occupational Safety and Healthy Administration (OSHA) defines "long-term" as eight hours per day for ten years. However, the higher the sound level, the more quickly the damage accumulates.

The OSHA standard cuts the safe exposure time in half for every 5 dB above 90. In other words, 95 dB is considered safe for four hours, 100 dB is safe for two hours, 105 dB is safe for one hour, 110 dB is safe for half an hour, and so on. In other countries, these guidelines are 5-10 dB lower, and studies show that at 85 dB, long-term exposure will definitely cause hearing loss in a certain percentage of those exposed.

Now, consider that rock concerts at sustained levels above 100 dB can easily last three hours or more, placing everyone's hearing at risk. Last year, in a series of articles on the blaring levels at dance clubs for the Bay Area Reporter, journalist Ed Walsh documented music as high as 115 dB at the loudest club in San Francisco. Not quite as bad as Spinal Tap, but worse than sandblasting. If this club were a factory, workers would be legally allowed in for only 15 minutes a day. Yet very few patrons or employees were observed to wear hearing protection of any kind.

Muffler Shop

NIHL does not reduce hearing response evenly across the frequency spectrum. Typically, problems are first noticed in the 3 to 4 kHz range, although losses at higher frequencies may already exist. Boosting overall levels to compensate or just pushing the high end as you lose sensitivity there is like having whiskey for breakfast to blot out a hangover. It makes matters worse in the long run, and if you're rocking the house that loud all the time, it also hurts everyone around you.

NIHL comes on slowly, so how do you know you're in trouble? You may notice temporary effects after a gig, such as ringing in your ears or the sense that everything sounds muffled, or you may notice that you hear better with one ear than the other on the phone. Most often, soft high-frequency sounds (such as the fizzing when you open a can of soda) disappear entirely.

These symptoms may come and go at first, as the hair cells in your cochlea struggle to recover from each onslaught. But with repeated exposure, things get worse. Eventually, the perception of all frequencies is permanently reduced, and additional ongoing symptoms, such as tinnitus or hyperacussis, may bring further discomfort and distress.

In addition, keep in mind that the frequency range from 3 to 5 kHz contains most spoken consonant sounds. So with the onset of NIHL, normal speech may seem mumbled. (See the sidebar, 'DIY Hearing Test,' for a simple, early-warning test that uses speech sounds on the radio.) When guitarist Pete Townsend went public with his hearing problems in 1987, he said that the saddest part was not being able to hear his children speak to him.

Prevention, protection, and early detection of hearing problems are the best hope for a long-term music career. Simple measures, such as avoiding non-musical noise, can make a big difference. Any situation in which you must shout to be heard is likely to cause damage. Alcohol consumption, cigarette smoke, and marijuana have been shown to reduce the ear's resiliency to NIHL, so cleaning up your act in those areas may benefit your hearing as well.

Take the Test

Where should you begin? Michael Santucci, president of Sensaphonics, a manufacturer of custom in-ear monitors and earplugs, explains that the cornerstone of hearing conservation is a thorough assessment by an audiologist, including an interview about your health history, musical habits, and other sources of noise exposure, such as outdoor hobbies or past military service. The audiologist will also ask about symptoms, such as ear pain, temporary decreases in hearing sensitivity, or tinnitus.

You'll then be tested to establish a pure-tone hearing profile, or audiogram, that reveals the softest level, or threshold, at which you respond to various frequencies. (OSHA regulations specify that this test is valid only if preceded by a minimum of 14 hours of 'quiet time,' so don't schedule your audiology appointment for the morning after a late, blasting gig!) If the interview or audiogram indicate that you have a problem needing medical follow-up, you'll be referred to an ear-nose-throat (ENT) physician.

It's a good idea to schedule an annual checkup even if you don't notice any symptoms. Subtle problems are best caught early, and if your hearing is normal, you'll have a baseline for future comparisons, as well as a sense of relief. Keep in mind that the typical hearing test only goes up to 8 kHz; you should shop around for an audiologist whose equipment can measure as high as 12, 16, or even 20 kHz.

Hearing Awareness and Education for Rockers (H.E.A.R.) is a San Francisco-based nonprofit organization that offers evening clinic appointments staffed by volunteer audiologists. Their site also offers a nationwide list of affiliated audiologists and doctors specializing in hearing conservation and tinnitus treatment who are likely to be sympathetic to your needs as a musician. (All audiologists on the H.E.A.R. Web site use equipment that tests above 8 kHz; those with a university affiliation may have access to research equipment that tests up to 20 kHz.) AFTER THE RAIN What if you're already dealing with significant hearing loss? First, it's important to protect the hearing you have left. In addition, talk to your audiologist about hearing aids. According to Dr. Jillian Barrett of California State University, Hayward, the new fully digital hearing aids have a wide frequency response and extensive programmability so they can be closely matched to your particular loss. Some new analog aids are also designed with the musician in mind and may be more affordable.

Unfortunately, tinnitus sufferers have fewer options; coping strategies are the main focus of tinnitus-oriented Web sites and support groups. The most common suggestion is to mask the internal roar with white noise, especially if you have trouble falling asleep. The easiest way to do this is to tune a radio between stations.

If you have significant hearing loss, do your part to educate your less-afflicted colleagues. My most memorable encounter at NAMM was with a drummer in his mid-30s who already suffers permanent, serious tinnitus. 'Get the kids to pay attention,' he urged me. 'They think they're invincible, and that hearing loss only hits grandparents. Ten years ago, I thought that too, but my ears were already damaged and I just didn't know it. Now, it's hard for me to sleep, it's hard to be any place quiet. I'm still young, and I can't enjoy music like I used to. So listen up' use your common sense and the available resources to take care of your ears. It's the only way to be sure that you'll enjoy a lifetime of listening and playing, studio gigs and concerts, and all the hotel rooms in between.

The American Speech and Hearing Association home-base for audiologists and speech pathologistsâ€”has promoted the safe use of earbud headphones as a high-priority campaign, since 2006. Read more here.

Low-tech Hearing Test Adapted from HE.A.R.'s 'Sound Check'.

On the way to your next gig or practice session, set your car radio to a talk station. Once you've parked, keep the radio on and turn the volume down to the softest level at which you can still understand the words. Turn off the car without changing the volume of the radio.

After the session, listen to the radio at the same volume setting. Can you still hear it? Can you understand the words as clearly as before, or do you have an urge to turn up the treble to make the sound more crisp?

If your perception has changed in this relatively short time, you have a form of short-term hearing loss called a temporary threshold shift. With repeated exposure to high sound pressure levels, you are at significant risk for a permanent hearing loss. See an audiologist for formal testing, and talk to your band mates about playing at safer levels.