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Updated: Jul 7, 2026

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Preferred and minimum acceptable listening levels for musicians while using floor and in-ear monitors
Jeremy Federman1, Todd Ricketts
1Vanderbilt University Medical Center, Department of Hearing and Speech Sciences, Medical Center East, South Tower, 1215-21st Avenue South, Room 8310, Nashville, TN 37232, USA. jeremy.federman@vanderbilt.edu
Purpose:
This study examined the impact that changing on-stage music and crowd noise levels during musical performance had on preferred listening levels (PLLs) and minimum acceptable listening levels (MALLs) across both floor and in-ear monitors.
Method:
Participants for this study were 23- to 48-year-old musicians, with and without hearing loss, who had 10 years of musical training or comparable professional experience. For this study, PLLs and MALLs were established for the musician's own voice, whereas the levels of other onstage musical signals were systematically varied. PLLs for in-ear monitors were found at significantly lower levels than for floor monitors (approximately 0.6 dB).
Results:
PLLs for in-ear monitors were found at significantly lower levels than for floor monitors (approximately 0.6 dB). However, despite large spectral differences, PLLs across the 2 monitor types were small enough that the same recommended exposure time would be advocated based on National Institute for Occupational Safety and Health and Occupational Safety and Health Administration recommendations. MALL data also indicated significantly lower levels (approximately 6.0 dB) when musicians were using in-ear monitors in comparison to floor monitors.
Conclusion:
The much larger difference suggests that musicians' risk of noise exposure may be reduced by the use of in-ear monitors. However, given the similar PLL results and known monitor output levels, proper counseling would likely be required before this potential advantage would be realized.
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