Occupational Noise Exposure and Ear Health Knowledge in Piano Technicians

Background: Piano technicians (PTs) are professional ear users whose work depends on highly refined auditory perception for tuning, voicing, and regulating the piano while exposing them to potentially hazardous sound from tuning itself and from associated wood- and metalworking tasks. Occupational sound exposure and ear-health knowledge in this group have not been systematically characterized. Methods: In a cross-sectional observational study, we quantified A-weighted equivalent continuous (L _eq ) and 8-h normalized (L _{EX, 8 h} ) sound levels using calibrated personal noise dosimetry during piano tuning, complemented by reference workshop measurements. In addition, PTs completed the Professional Ear User Questionnaire (PEU-Q) to assess ear health knowledge and attitudes. Results: A total of 102 tuning sessions were recorded in 12 PTs (mean duration: 74 min, standard deviation (SD): 22). Mean tuning L _eq was 76.4 dB(A) (SD: 3.2), with 17.7% of sessions ≥80 dB(A) and 1.0% ≥85 dB(A). Upright tuning was 2.4 dB louder than grand tuning ( P  = 0.02); room size had no significant effect. Workshop tasks reached L _eq values up to 93 dB(A), yet cumulative L _{EX, 2000 h} per activity grouping remained ≤81 dB(A). Among 51 PEU-Q respondents, ear-health knowledge showed marked gaps; despite 71% reporting concern about future hearing loss and widespread use of hearing protection, 35% had never undergone a formal hearing examination. Conclusion: Sound exposure in PTs is moderate on average but carries a non-negligible upper tail, particularly for upright piano tuning and workshop tasks. Combined with notable gaps in ear-health awareness and access to formal hearing care, these findings support targeted education, individualized noise-risk assessment, and dedicated ear-health pathways for this professional ear user group.