Health and Safety for Musicians

Students of the School of Music

The California State University, Fullerton School of Music wishes to thank the Butler University School of Music and the California State University, Fresno Department of Music for providing information and resources that have been incorporated into the contents of this page



The California State University, Fullerton Department of Music, as required by the National Association of Schools of Music, is obligated to inform students and faculty of health and safety issues, hazards, and procedures inherent in practice, performance, teaching, and listening in general and as applicable to their specific specializations. This includes, but is not limited to, information regarding hearing, vocal and musculoskeletal health, injury prevention, and the use, proper handling, and operation of potentially dangerous materials, equipment, and technology. The School of Music has developed policies, protocols, and operational procedures to guard against injury and illness in the study and practice of music, as well as to raise the awareness among our students and faculty of the connections between musicians' health, the suitability and safety of equipment and technology, and the acoustic and other health-related conditions in the University's practice, rehearsal, and performance facilities.

It is important to note that health and safety depends largely on personal decisions made by informed individuals. CSUF has health and safety responsibilities, but fulfillment of these responsibilities cannot and will not ensure any individual's health and safety. Too many factors beyond the University's control are involved. Each individual is personally responsible for avoiding risk and preventing injuries to themselves before, during, and after study or employment at CSUF. The policies, protocols, and operational procedures developed by the School do not alter or cancel any individual's personal responsibility, or in any way shift personal responsibility for the results of any individual's personal decisions or actions in any instance or over time to the University.

Performance Injuries

Anyone who practices, rehearses or performs instrumental or vocal music has the potential to suffer injury related to that activity. Instrumental musicians are at risk for repetitive motion injuries. Sizable percentages of them develop physical problems related to playing their instruments; and if they are also computer users, their risks are compounded. Instrumental injuries often include carpal tunnel syndrome, tendonitis, and bursitis. Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain, disability, and the end of careers.

What Instrumentalists Should Do

The Department of Music wishes to thank the Associated Board of the Royal Schools of Music and the Canadian Network for Health in the Arts for the following information:

1. Evaluate your technique. Reduce force, keep joints in the middle of their range of motion, use large muscle groups when possible, and avoid fixed, tense positions.

2. Always warm up. As an athlete would not begin a vigorous physical activity without warming up, a musician must warm up carefully before practice or performance.

3. Take breaks to stretch and relax. Take short breaks every few minutes and longer breaks each hour. Two or more shorter rehearsals each day are more productive than marathon single sessions. Even in performance, find those opportunities to relax a hand, arm, or embouchure to restore circulation.

4. Pace yourself. No pain, no gain is a potentially catastrophic philosophy for a musician. Know when enough is enough, and learn to say 'no' to certain performances or lengths of performing that might result in injury.

5. Check out your instrument. Does your instrument place undue stress on your body? Is your instrument set up optimally for you to relieve pressure on hands, joints, etc.? Is there a strap, carrier, or stand available to relieve the stress?

6. Evaluate other activities. Pains and injuries affecting your music making could be caused by other activities in your daily life. Computer use is notorious for causing afflictions including carpal tunnel syndrome and tendinitis.

7. Pay attention to your body. Pain is the mechanism by which your body tells you that something is wrong. Listen to your body; if it hurts, stop what you are doing.

8. Get medical attention. Do not delay in seeing a doctor. A physician may prescribe a minor adjustment or, in worst-case scenarios, stipulate not performing for a period of time. As drastic as this may sound, a few months of rest is better than suffering a permanent, career ending injury. Likewise, the demands placed on singers' voices are immense. Hardly a month goes by where a top singer is not forced to interrupt a tour, take a break, or undergo a medical procedure due to problems with their voice. Medical professionals are making the case that the demands put on one's voice when singing one to three hours is as intense as those made on an Olympic marathon runner's body. Additional factors such as nutrition, smoking, drug use, noisy environments, and proper voice training (or the lack of it) all play a role in a singer's ability to perform at her/his best.

What Singers Should Do

The School of Music wishes to thank The Singer's Resource, the Texas Voice Center, Houston, and the University of Michigan Vocal Health Center for the following information:

1. Maintain good general health. Get adequate rest to minimize fatigue. If you do become ill, avoid "talking over your laryngitis." See your physician and rest your voice.

2. Exercise regularly.

3. Eat a balanced diet; include vegetables, fruit and whole grains, and avoid caffeinated drinks (coffee, tea, and soft drinks) and alcohol. Avoid spicy, acidic, and dairy foods if you are sensitive to them.

4. Maintain body hydration; drink two quarts of water daily.

5. Avoid dry, artificial interior climates. A humidifier at night might compensate for the dryness.

6. Limit the use of your voice. High-ceilinged restaurants, noisy parties, cars and planes are especially damaging to the voice. If necessary, use amplification for vocal projection.

7. Avoid throat clearing and voiced coughing.

8. Don't  yell, and avoid hard vocal attacks on initial vowel words.

9. Adjust the speaking pitch level of your voice. Use the pitch level in the same range where you say, "Umm-hmm?"

10. Speak in phrases rather than in paragraphs. Breathe slightly before each phrase.

11. Reduce demands on your voice – don't do all the talking!

12. Learn to breathe silently to activate your breath support muscles and reduce neck tension.

13. Take full advantage of the two free elements of vocal fold healing: water and air.

14. Vocal athletes must treat their musculoskeletal system as do other types of athletes; therefore, vocal warm-ups should always be used prior to singing. Vocal cool-downs are also essential to keep the singing voice healthy.

15. Singers who engage is physical training that includes weight lifting or bursts of high intensity (like kick boxing) should always exhale when they lift or during a burst of force. Holding your breath and/or "grunting" can damage the vocal folds.

16. Singers should also be very aware that medications can have an adverse effect on the voice. View a list of common medications and the potential side effects from the National Center for Voice and SpeechOpens in new window .

What All CSUF Musicians Should Do

1. Stay informed. Awareness is the key. Like many health-related issues, prevention is much easier and less expensive than cures. Take time to read available information concerning injuries associated with your art.

2. Musicians might find the following books helpful (copies of these and many other print resources are on display in the Performance Science Centre Lab): 

Conable, Barbara. What Every Musician Needs to Know About the Body (GIA Publications,2000) 
Klickstein, Gerald. The Musician's Way: A Guide to Practice, Performance, and Wellness (Oxford, 2009) 
Norris, Richard N. The Musician's Survival Manual (International Conference of Symphony and Opera Musicians, 1993) 

3. Make one appointment each semester in the Performance Science Centre Lab (PSCL) in CPAC 261 to be evaluated for excessive muscular tension buildup as you play, sing, or conduct. Review the results with your applied music instructor. The PSCL has software and peripherals for monitoring with graphs, video recording, and audio recording your technical approach. ProFormaVision uses surface electromyography (sEMG) to take readings of microvolts produced in the primary muscle groups used in performing, backed up with real time video recording from two cameras, and audio recording. VoceVista is designed to give real time spectrum analysis and electroglottograph for singers. The PSCL is manned 6 hours per week (please see the door for drop-in office hours) and additional times can easily be arranged by contacting the Assistant Director or one of the Directors of the lab.

Other links:

Associated Board of the Royal Schools of Music (ABRSM)Opens in new window , the world's leading authority on musical assessment, actively supporting and encouraging music learning for all.

Performing Arts Medicine Association (PAMA)Opens in new window , an organization comprised of dedicated medical professionals, artists educators, and administrators with the common goal of improving the health care of the performing artist.

Texas Voice CenterOpens in new window , founded in 1989 for the diagnosis, treatment, and prevention of voice disorders.

National Center for Voice and Speech (NCVS)Opens in new window , conducts research, educates vocologists, and disseminates information about voice and speech.

Vocal Health Center, University of Michigan Health SystemOpens in new window , recognized locally, regionally and nationally as a leading institution for the treatment and prevention of voice disorders. At the heart of the Center is a professional team comprised of experts from the University of Michigan Health System and UM School of Music, encompassing the fields of Laryngology, Speech Pathology, and Vocal Arts

School-Owned Instruments

The School of Music maintains a collection of musical instruments for checkout and use by members of the music faculty and students enrolled in our courses and performing ensembles. As with other items we use in the course of our daily lives, musical instruments must be cared for properly and cleaned regularly (please read the cleaning guidelines below) . Each instrument in the Department's collection receives a thorough inspection at the conclusion of the academic year. Every year, thousands of dollars are spent to clean, adjust, and return instruments to full playing condition. 

Instrument Hygiene

Antiseptic Cleanliness

More and more our society is pushing for products that are anti-fungal, anti-bacterial and anti-viral. Some even go the next step further aiming to achieve sterile. However, our bodies by design are not meant to live in a sterile environment. As kids we played in the dirt, ate bugs and countless other things and became stronger because of it. Keep in mind that total sterility is a fleeting moment. Once a sterile instrument has been handled or exposed to room air it is no longer considered to be sterile. It will however remain antiseptically clean until used. Most viruses cannot live on hard surfaces for a prolonged period of time. Some die simply with exposure to air. However, certain groups are quite hardy. Therefore, musicians must be concerned with instrument hygiene. Users of school owned and rented musical equipment might be more susceptible to infections from instruments that are not cleaned and maintained properly. If the cleaning process is thorough, however, musical instruments will be antiseptically clean. Just as with the utensils you eat with, soap and water can clean off anything harmful. Antibacterial soaps will kill certain germs but all soaps will carry away the germs that stick to dirt and oils while they clean. No germs/ no threat.

Infectious Disease Risks

Sharing musical instruments is a widespread, accepted practice in the profession. However, recent discussion in the profession has included concern regarding shared musical instruments and infectious disease, especially HIV. The Centers for Disease Control (CDC), has confirmed that there is no risk of transmission of HIV (the virus that causes AIDS), or Hepatitis B (HBV) through shared musical instruments. The reasons for this are that these diseases are passed via a blood-to-blood, sexual fluid or mucous membrane contact. There has been no case of saliva transmission of HIV (the virus that causes AIDS), or Hepatitis B (HBV).

While the possibility of transmission of the above bacteria and viruses is not a real consideration, it is apparent that there should be a protocol with regard to shared musical instruments. Sharing of instruments is routine in music schools, where students practice and perform on borrowed instruments throughout the year. In our discussion with our consultants, certain basic considerations and recommendations for standard operating procedures regarding shared instruments were recommended as follows:

1. All musicians or students should have their own instrument if possible.

2. All musicians or students should have their own mouthpiece if possible.

3. All students and faculty sharing reed instruments MUST have their own individual reeds. Reeds should NEVER be shared.

4. If instruments must be shared in class, alcohol wipes or Sterisol germicide solution (both available from the Department of Music) should be available for use between different people. When renting or using a School-owned musical instrument, each user must understand that regular cleaning of these musical instruments is required in order to practice proper hygiene.



The mouthpiece (flute headjoint), English Horn and bassoon bocal, and saxophone neck crook) are essential parts of wind instruments. As the only parts of these instruments placed either in or close to the musician's mouth, research has concluded that these parts (and reeds) harbor the greatest quantities of bacteria. Adhering to the following procedures will ensure that these instrumental parts will remain antiseptically clean for the healthy and safe use of our students and faculty.


Cleaning the Flute Head Joint

1. Using a cotton swab saturated with denatured, isopropyl alcohol, carefully clean around the embouchure hole.

2. Alcohol wipes can be used on the flute's lip plate to kill germs if the flute shared by several players.

3. Using a soft, lint-free silk cloth inserted into the cleaning rod, clean the inside of the headjoint.


Cleaning Bocals

Bocals should be cleaned every month with a bocal brush, mild soap solution, and running water. English Horn bocals can be cleaned with a pipe cleaner, mild soap solution, and running water. Be careful not to scratch the inside of the bocal with the exposed wire ends of the pipe cleaner.


Cleaning Hard Rubber (Ebony) Mouthpieces 

1. Mouthpieces should be swabbed after each playing and cleaned weekly.

2. Select a small (to use less liquid) container that will accommodate the mouthpiece and place the mouthpiece tip down in the container.

3. Fill the container to where the ligature would begin with a solution of half water and half white vinegar (50% water and 50% hydrogen peroxide works too). Protect clarinet  mouthpiece corked tenons from moisture.

4. After a short time, use an appropriately sized mouthpiece brush to remove any calcium deposits or other residue from inside and outside surfaces. This step may need to be repeated if the mouthpiece is excessively dirty.

5. Rinse the mouthpiece thoroughly and then saturate with Sterisol germicide solution. Place on paper towel and wait one minute.

6. Wipe dry with paper towel.

7. Note: Metal saxophone mouthpieces clean up well with hot water, mild dish soap (not dishwasher detergent), and a mouthpiece brush. Sterisol germicide solution is also safe for metal mouthpieces.


Cleaning Saxophone Necks (Crooks)

1. Swabs and pad-savers are available to clean the inside of the saxophone neck. However, most saxophonists use a flexible bottlebrush and toothbrush to accomplish the same results.

2. If the instrument is played daily, the saxophone neck should be cleaned weekly (and swabbed out each day after playing).

3. Use the bottlebrush and mild, soapy water to clean the inside of the neck.

4. Rinse under running water.

5. Sterisol germicide solution may be used on the inside of the neck at this time, if desired (not necessary). Place on paper towel for one minute.

6. Rinse again under running water, dry, and place in the case.

7. If using pad-savers, do not leave the pad-saver inside the neck when packed away.


Cleaning Brass Mouthpieces

1. Mouthpieces should be cleaned monthly

2. Using a cloth soaked in warm, soapy water, clean the outside of the mouthpiece.

3. Use a mouthpiece brush and warm, soapy water to clean the inside.

4. Rinse the mouthpiece and dry thoroughly.

5. Sterisol germicide solution may be used on the mouthpiece at this time. Place on paper towel for one minute.

6. Wipe dry with paper towel.


Other Instruments

String, percussion, and keyboard instruments present few hygienic issues that cannot be solved simply by the musician washing their hands before and after use.

Safety and Wellness links:

CSUF Student Wellness
Opens in new window
CSUF Student Safety Guidelines for FacultyOpens in new window

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Last Published 4/18/22

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