Occupational Health and the Performing Arts: An Introduction.

OBJECTIVE: Workplace hazards in the performing arts cause injuries, disabilities, and deaths every year. Occupational health professionals are familiar with most of these hazards and are particularly qualified to contribute to efforts to reduce them. This article reviews current health issues in the performing arts and highlights opportunities for occupational health contributions. METHODS: Recognized experts in performing arts medicine were consulted and articles illustrating performing arts health issues were reviewed. Literature sources included medical databases, unindexed art-health publications, and popular press articles. RESULTS: Resources discussing hazards and health issues in theater, dance, voice, and instrumental musicians were located and reviewed. CONCLUSIONS: Treatment providers have a history of involvement with segments of the performing arts. The occupational health approach to workplace health issues can effectively complement these efforts. Sources of further information on performing arts health concerns are available.

Benefits of music training are widespread and lifelong: a bibliographic review of their non-musical effects.

Recent publications indicate that musical training has effects on non-musical activities, some of which are lifelong. This study reviews recent publications collected from the Performing Arts Medicine Association bibliography. Music training, whether instrumental or vocal, produces beneficial and long-lasting changes in brain anatomy and function. Anatomic changes occur in brain areas devoted to hearing, speech, hand movements, and coordination between both sides of the brain. Functional benefits include improved sound processing and motor skills, especially in the upper extremities. Training benefits extend beyond music skills, resulting in higher IQs and school grades, greater specialized sensory and auditory memory/recall, better language memory and processing, heightened bilateral hand motor functioning, and improved integration and synchronization of sensory and motor functions. These changes last long after music training ends and can minimize or prevent age-related loss of brain cells and some mental functions. Early institution of music training and prolonged duration of training both appear to contribute to these positive changes.

Performing arts medicine-a bibliographic retrospective of the early literature: an historical examination of bibliographic references pre-1975.

Performing arts medicine (PAM) emerged as a medical specialty around 1985. Prior to this time, relatively few publications addressed the identification and concerns of musicians' and dancers' medical problems. To determine what number and types of publications occurred prior to the actual beginnings of PAM as a discipline, and to determine how these original topics compared with present-day publications, a retrospective review of the current bibliographic database of the Performing Arts Medicine Association (PAMA) was undertaken. Out of a total of 12,600 entries to date, 489 references were found published from 1798 through 1974, which represent only 3.9% of the current database listings. One-sixth of the references were originally written in a language other than English. Journal articles were by far the most numerous type of publication. Topics with the highest number of entries included the neurobiology of music (n=77), dental/orofacial matters (71), and biographical accounts of composers or musicians and their illnesses (59). Other frequently published topics included hearing loss, physiology of playing instruments, and instrumental technique and teaching. Early topics with multiple publications included composers' biographies, dystonias, and surgery to improve finger independence for playing piano. Subjects whose publications occurred principally in the last two decades of this review included dermatological disorders, hearing loss, and ballet physiology, teaching, and technique. Those which remain popular to the present day include hearing loss, performance anxiety, focal dystonia, and dental/orofacial problems.

Bassoonists' medical problems-current state of knowledge.

Specific musical instruments can be a source of physical problems to their players. Based on reviews of the literature and personal experience, this paper summarizes current knowledge of problems affecting musicians who play instruments in the bassoon family (including the bassoon, contrabassoon, and several other instruments). Prevalence rates are higher in reports of surveys (ranging up to 86%), compared to clinical reports of patients seen and treated. Significant risk factors include young age, small body size, female gender, and use of large instruments. Problems unique to bassoonists are rare; most physical difficulties also are seen in general musculoskeletal clinical practices and in musicians playing all types of instruments. The left upper extremity is more commonly affected by overuse-related conditions in bassoonists. Non-playing-related problems are equally important for consideration (such as degenerative disorders and acute trauma), since they also affect practice and performance. Little experimental data exist to validate current and widely-held principles of treatment, rehabilitation, and prevention.

How and why musicians are different from nonmusicians: a bibliographic review.

Musicians differ from nonmusicians in many ways; their many special skills reflect the fact that their brains are built differently and function differently. This review of 172 references from PAMA's bibliographic database reveals that most differences occur in the neurobiological realm, in contrast to those of gross anatomy and physiology. Gross changes occur in both cerebral and cerebellar hemispheres and in both gray and white matter. Neurophysiologic differences, measured by sophisticated imaging and electrophysiological techniques, are revealed in sound processing in general, as well as in multiple parameters of music perception, processing, and performance. Most of the neurological differences, both structural and functional, seem to be related to the early age of onset, intense degree, and prolonged duration of musical training and affect multiple, widespread areas of the brain. Training-related differences extend beyond the musical realm to speech, special senses, and general mental parameters and are seen in both instrumental and vocal musicians. A small percentage of reviewed papers demonstrated no appreciable differences between musicians and nonmusicians in a few parameters.

Wolfgang Amadeus Mozart--controversies regarding his illnesses and death: a bibliographic review.

More has been written about Mozart's illnesses and death than for any other composer. An exploration of PAMA's Bibliography of Performing Arts Medicine provides the data for this review. The bibliography contained 136 entries that pertained to Wolfgang Amadeus Mozart. Of these, 81 were available to the author, either in printed or electronic copy. In order to provide a clearer historical perspective on this topic, this review assembles information pertaining to illnesses and other medical problems that occurred during Mozart's life as well as those purportedly contributing to his death.