717 - Behind the Music: A Scoping Review Linking Chronic Sound Exposure to Mild Traumatic Brain Injury-like Symptoms in Touring Road Crew Workers

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

ER

Emory L. Reyes, DO

Resident Physician
University of Arkansas for Medical Sciences
Pomona, California, United States

Co-Author(s)

AN

Angela Nguyen, BS

Medical Student
Touro University Nevada College of Osteopathic Medicine
Henderson, Nevada, United States
DK

David Kim, MA

Medical Student
Pacific Northwest University
Seattle, Washington, United States
JK

Justin Kim, BA

Medical Student
Lewis Katz School of Medicine at Temple University
Philadelphia, Pennsylvania, United States
JL

Jason J. Liu, BS

Medical Student
Renaissance School of Medicine at Stony Brook University
Centereach, New York, United States

Corresponding Author(s)

NT

Niña Carmela R. Tamayo, DO, MS, MPH

Founder/Physiatrist
Prime Directives PM&R, LLC
Lakewood, Ohio, United States

Submitter(s)

ER

Emory Reyes, DO

University of Arkansas for Medical Sciences
Pomona, California, United States

Objectives: To evaluate current evidence linking long-term occupational sound exposure to concussion/ mild traumatic brain injury (mTBI)–like symptoms and highlight the need to study this relationship in road crew workers (“roadies”—audio engineers, lighting technicians, managers, stagehands who travel with performing artists), an underserved population. Currently, no studies directly examine the touring community whose strenuous working and living conditions increase risk for chronic mTBI sequelae. Therefore, proxy populations with similar patterns of chronic, blast-like sound exposure must be used to understand potential risks.

Design: A scoping review using PRISMA guidelines was conducted using MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, and WHO Guidelines. Search concepts included “auditory and vestibular disorders (tinnitus, deafness, vertigo, auditory threshold, hyperacusis)”, “brain injury (mTBI, blast injury, chronic brain injury)”, “time/exposure duration (long-term, chronic, prolonged exposure)”, “occupations at risk (military, veterans, law enforcement, construction workers, miners, industrial workers, emergency responders, transportation workers, seafarers, musicians)”, “sound/noise exposure (vibration, decibels, blasts, explosions, music-related exposure, concerts)”. Articles were limited to the human studies in the English language between 1946-2025.

Results: Of 645 articles identified, 87 full-text articles were assessed for eligibility and 61 studies met inclusion criteria. Across studies, clear connections established chronic sound exposure to long-term auditory dysfunction, with studies exploring potential links to neurocognitive sequelae such as decreased concentration and attention. Studies also reported psychiatric comorbidities, including increased risk for depression and anxiety. No studies directly addressed road crew workers.

Conclusions: Chronic blast-like sound exposure can lead to mTBI symptoms, notably hearing loss, cognitive dysfunction, tinnitus, and psychiatric disorders in high-noise industries. This review highlights a gap in performing arts and brain injury literature as “roadie” populations face intense working conditions that predispose to health disparities addressable by rehabilitation practitioners. Insights from proxy populations emphasize the urgent need for targeted research to guide occupational safety, prevention, and management for this critical workforce.