In their own words: interviews with musicians reveal the advantages and disadvantages of wearing earplugs

BACKGROUND: Musicians are at risk of hearing loss from sound exposure, and earplugs form part of many musicians' hearing conservation practices. Although musicians typically report a range of difficulties when wearing earplugs, there are many who have managed to successfully incorporate earplugs into their practice of music. OBJECTIVE: The study aim was to provide a detailed account of earplug usage from the perspective of the musician, including motivating factors, practical strategies, and attitudes. METHODS: In-depth interviews with 23 musicians were transcribed and content analysis was performed. Responses were coded and classified into three main themes: advantages, disadvantages, and usage patterns and strategies, together with an overlapping fourth theme, youth perspectives. RESULTS: Several positive aspects of wearing earplugs were identified, including long-term hearing protection and reduced levels of fatigue and pain. Musicians reported that earplugs present few problems for communication, improve sound clarity in ensembles, are discreet, and are easy to handle. However, earplugs also present challenges, including an overall dullness of sound, reduced immediacy, and an impaired ability to judge balance and intonation due to the occlusion effect, all of which influence usage habits and patterns. CONCLUSION: The experiences of the younger musicians and long-term users of earplugs indicate that practice, persistence, and a flexible approach are required for successful earplug usage. In time, there may be greater acceptance of earplugs, particularly amongst a new generation of musicians, some of whom regard the earplugs as a performance enhancement tool as well as a protective device.