Occupational health of musicians: A crucial yet invisible issue

Marc Perrenoud 
University of Lausanne 

Occupational health problems affect all musicians. However, those whom I have called “musicos1” or “ordinary musicians”, the musicians who stand on the lower levels of the professional pyramid and mostly practice “contemporary popular music”, are the most numerous, the most precarious and the most exposed to these problems. 

This brief text2 aims to provide an ethnographic insight into the occupational health of ordinary musicians. It brings to light the realities on the ground as I have observed them in France for almost ten years. Indeed, musical practice has long been both an object of study and a profession for me, since between 1996 and 2005 I played the double bass or electric bass nearly six hundred times in public with musicians of all ages (16 to 60 years old) in very varied contexts (from banquet animation to international festivals) and very diverse musical genres (from pop songs to free-jazz). 

This very long-term ethnography is part of a research approach in the sociology of artistic work which of course takes health issues into account. In this CMB guide, the various problems linked to musicians’ occupational health are, and quite rightly so, mainly from a medico-psychological perspective. But we know that the causes of the occurrence of health problems as well as the obstacles to their resolution are highly multi- factorial and therefore include very important social and cultural elements. I suggest to also consider the health of musicians through a socio-anthropological questioning by linking health issues with the identities at work and the professional careers of musicians, with their uses, their values and their mental framework. To do this, I will begin by looking at the “ways of making” music for musicologists before looking more broadly at their professional culture and lifestyles. Some of the problems encountered are common to all musicians (and sometimes beyond), but we must bear in mind that the “musicos” population is particularly vulnerable. 

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1. Musical practice and health risks 

A good part of popular music is largely based on the intention and the sometimes outrageous intensity of commitment, including physically, to playing. In fact, from the first jazz bands to death metal players, there is never question of taking care and saving energy. On the contrary, the search for the limit, for excess, even in pain, is both the mark of a set of subversive values and the expression of a creative singularity as a way of producing sound material. 

Thus, among the health problems most obviously related to musical practice, ear problems and musculoskeletal disorders are probably that ones that come the most spontaneously to mind. Ear care is taken into account more and more and even if it was quite rare in the 1990’s, the use of ear plugs is becoming a standard. The other issue, MSDs, are still a threat to all musicians. One can think in particular of “classical” musicians who practice on their instrument several hours a day and do a lot of work to make their movements as “perfect” as possible, inscribing academic positions in their bodies to the point where these become “natural”. For many musicians who are conservatory graduates, the work of adapting to the instrument does not lead to a “good” position from a medical or ergonomic point of view (although no activity requiring such assiduity under the strain of the body could be considered as without consequences for the body), but for each instrument there is nevertheless a position considered to be good or even the best, or it may be because it is considered as such that it allows the musician to be at ease. This incorporation of the right way of doing things would widely contradict a musical culture and practice based on an anti-academism claimed by a large part of musicians practicing popular music. Louis Armstrong’s cheeks permanently swollen, Thelonious Monk’s fingers stretched out on the keyboard and weighed down with big rings, Jimi Hendrix’s thumb wrapped around the neck of his guitar, Flea or Rob Trujillo’s bass carried at knee level, all these positions are incongruous with regard to the reasoned and reasonable uses of musical practice, but are inseparable from the aesthetic material produced by these artists. It is indeed in this long filiation that a good part of the musicos are situated, if not in opposition, at least out of step with an academic culture of the “right position” on the instrument. 

Secondly, referring to the health problems of ordinary musicians, one might also spontaneously think of the damage caused by handling material. Here again, the musicos who play on small stages, music bars and village festivals are the most exposed since they often use heavy and bulky equipment necessary for the practice of amplified music, but having no roadies or technicians, they find themselves having to handle, transport and install everything themselves. Before the musical performance, they load their vehicle (or the band’s truck) with a drum kit (the bass drum is the largest object but the heaviest is usually the bag of cymbal feet), with a bass or a guitar and an amplifier that can easily exceed 30kg, the singers are not spared since the microphone will have to be connected to a sound system, therefore a mixing desk, an amp, speakers… Once at the venue, they unload the equipment, install everything in the room (sometimes a cellar accessible only by a small staircase), then they have to do the sound-check and set everything up themselves. After the performance, it’s usually one or two in the morning, they’ve just played sometimes for up to three or four hours (five hours in a dancing orchestra), and they have to dismantle and transport everything themselves again, at the risk of their knuckles. 

However, these problems are relatively well identified and recognized by musicians. If they do not find a lasting solution on their own by adapting their posture or equipment, they know that their musical practice, and therefore the practice of their profession, is threatened. This is the whole paradox of their condition: how can they maintain a sustainable professional activity involving a permanent endangerment? Solutions do not always exist. A drummer in his sixties who had just passed his first occupational medicine examination explained to me when he was putting his drums together that he had been advised not to carry heavy objects: “I asked the doctor: will you buy me a roadie?”… 

2. Occupational culture and lifestyles 

Beyond the particular modalities of the body’s involvement in musical practice, ordinary musicians live in a general context of precariousness and instability, referring to uncertain life courses that we know are likely to degrade health. These life courses are associated with customs and, in fact, a very particular occupational culture that includes the consumption of harmful substances and nocturnal work. 

Tobacco consumption is probably not much higher among musicians than in the general population, and the ban on smoking in public places might even contribute to reducing the consumption of musicians, many of whom spend several evenings a week in bars, clubs and restaurants that hire them for entertainment work. On the other hand, it can be said that in some respects various forms of addiction are part of the romantic mythology of the profession (and perhaps of the professional culture of artists and creators in general). While cocaine was rarely present (at least visibly) on my fieldwork in the early 2000s, cannabis was extremely common. Of course, its use can also be considered widespread in the general population, but among the musicians I met in my survey almost one in two was a regular smoker, although “heavy smokers” using cannabis all day long were rare. 

More frequent and probably more problematic in relation to the health of these musicians is the use of alcohol. No statistical survey exists to date to corroborate this statement, which comes from a decade of empirical study, so one should remain cautious, but while I have met many musicians who did not smoke (neither cigarettes nor “joints”), I have almost never seen one who did not drink. It is not necessarily large quantities, which may be the case quite regularly, especially in a context of exclusive male sociability, but it is “normal” to drink several glasses of alcohol (beer in general) every night of performance, especially in bars, clubs, pubs and restaurants which are the most frequent work spaces for musicians. 

Yet this consumption of alcohol and drugs is again an important element in music production. Once again, when in an expressionist gesture and attitude, one tries to give a fragility, a crack, one tries to feel and to make feel emotions, a sensitivity, these risky behaviours give access to a ” feverish ” music making which, as we have seen, can be highly valued in these circles. At the same time, as these behaviours can be lived by the musician and felt by the audience as the mark of an “authenticity ” all the less questionable as the deviation is (more) spectacular… 

Concerning the way of life of the musicos, I would like to pinpoint one last element, so obvious that it is rarely evoked by the musicians when talking about the reasons of the strain and laboriousness of their work: the professional engagements are generally executed at night. This night work is not systematic since they don’t play every single night, but it is frequent enough to impose a shifted rhythm. Even if this reality is integrated into the urban landscape by the musicians, as by all the actors of the city “night life”, it is nevertheless a source of fatigue, stress and potentially an immediate danger when it comes to driving home after a gig, between two and four o’clock in the morning and after having worked for hours on end: driving to the venue, setting up the stage and instruments, doing sound-check, playing for at least two or three hours with a short 15-minute break, dismantling the material and heading straight back home. This scenario is very frequent for musicians anchored in “local” careers whose every other gig may be in a small town or village a few hours away from home. 

What comes to surface here is a fundamental element for characterizing musicians: musical careers, regardless of the instrument or musical genre, can take place within a more or less “local” or “cosmopolitan” sphere of influence. Depending on the case, very different life paths and lifestyles will emerge, marked by the classical phenomena of cumulative advantage or disadvantage. 

A “cosmopolitan” career is mostly played out in concert halls or places expressly intended for the performing arts, where musicians are properly remunerated, have access to working conditions on and off stage that involve the intervention of various intermediate actors (technicians, handlers, managers), who are there to absorb much of the fatigue and stress associated with peripheral activities (from handling equipment to negotiating contracts and other administrative tasks), allowing musicians to concentrate on artistic tasks and helping them to develop a positive self-image. 

Conversely, the “local” careers that include most musicians who “just do the job”, as the expression goes, encompass all the tasks (technical and administrative) related to the musical activity. These careers are mainly played out in music bars, dance parties, or even anonymous entertainment. Musicians are poorly paid, and the infrastructures and support staff are non-existent. As a musician, you are at the same time your own agent, technician and driver and you try to multiply the “gigs” within a perimeter of about 200km around your home. A gig farther away would oblige the employer to house the musicians, thus implementing a different economic model, that of cosmopolitan careers where one travels far and for a long time. This second major type of career, the least spectacular one, often ignored by quantitative surveys on the music profession (in particular because a large part of the work is undeclared) is probably the most tiring, the most painful and the most problematic in terms of health problems as musicians suffer from poor working and employment conditions. Moreover, these musicians are condemned to a social and symbolic inscription that best reflects the figure of the craftsman, but economically often that of the blue-collar worker or small employee, in a situation of an auxiliary service provider reflecting a degraded image. Moreover, it is very difficult for musicians who have seen their careers become locally rooted to remain in the professional business, and many of them gradually fall back around the age of 40 to practicing multiactivity (teaching, technical and administrative jobs next to music) or even polyactivity (non-musical employment), having become literally exhausted by the race for wages in a very difficult context of work and employment. 

3. Prevention and supervision: essential, albeit paradoxical, approaches 

We have seen here that the very concrete ways of doing things, as well as the values and lifestyles of many musicians, are, as it were, substantially linked to risk-taking and endangerment, not just symbolic. It is understandable that concrete ways of making music, professional culture and lifestyles are inseparable. They are all part of a “habitus” which, precisely because it is based on a set of values, ways of doing things, saying and thinking against academism, against authority and against “good manners” (of playing, speaking, etc.), is intrinsically opposed to any institutionalization, or even any rationalization that would objectify the ineffable, demystify musical production by dismantling the forces that underlie the “social magic of creation”, and normalize the actions of the instrumentalist as well as his work and his entire career. This is once again the major challenge and paradox of the professionalization of contemporary music. 

The same applies, for example, to learning in music schools: how can anti-academic music be academicized? Can there be a conservatory medal for punk guitar? The same applies to economic and social issues: how can we get musicians to admit and respect the ban on illegal work as they can only self-build and think of themselves as musicians if they play as often as possible in public, including in bars, pubs and clubs that cannot afford to declare them? 

However, the stakes are considerable, whether it is a question of the pedagogical transmission of these musical practices or, even more so, of employment issues, not to mention the health problems to which this guide is devoted. The discourse and measures aimed at supervising these practices, particularly through prevention, seem all the more essential as the population is not very sensitive to them. This is indeed the challenge taken up by this musician’s health guide, and let us hope that it will find the deserved echo in the professional world. 


  1. It was a familiar term in France in the 1980’s – 1990’s. []
  2. This text was originally published in French as the preamble to the occupational health guide Les guides Santé au travail du CMB. La musique et le chant, 2009: http://www.cmb-sante.fr/guides/musique/appli.htm []

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