Symptoms of respiratory illness in wind players and their relationship to instrument hygiene

Playing a wind instrument has been proposed as a potential trigger of respiratory illness if harmful microorganisms residing in the instrument are repeatedly inhaled. Case reports suggest that respiratory symptoms may improve when affected individuals avoid playing their instruments and engage in appropriate hygiene measures. In this epidemiological study, an online questionnaire assessed the twelve-month prevalence of self-reported respiratory symptoms and diseases in wind players and non-wind controls recruited from German orchestras and other professional music institutions. Associations were examined between symptoms/diseases, instrument contact, hygiene behaviours, and hygiene-specific education and attitudes. Data were analysed using frequentist inferential statistics and Bayesian mixed-effects models, with Evidence Ratios (ER) ≥ 19 interpreted as strong evidence. Wind (n = 245; 117 woodwind, 128 brass) and non-wind controls (string, n = 43) did not differ in instrument contact time or smoking habits. We observed strong evidence that asthma (ER = 47.58) and diagnosed respiratory disease (ER = 22.10) were reported more frequently by wind players compared to non-wind, but no differences were seen for other symptoms such as coughing or shortness of breath. In terms of hygiene, most wind players (woodwind 86%, brass 94%) reported never disinfecting their instrument, and the frequency of both cleaning and drying were inconsistent. Contrary to our predictions, more frequent disinfection predicted a higher likelihood of reporting respiratory symptoms (ER = 432.24), possibly reflecting reactionary behaviour following symptom onset. Hygiene-specific education was inconsistent, with most wind players (85%) reporting having received no instruction about disinfection. Those who received hygiene education were more likely to consider hygiene as an essential part of their musical activity (all ER > 19). Findings may help to clarify potential relationships between wind instrument playing and respiratory health, although interpretations are drawn cautiously due to the inherent limitations of self-reported data and cross-sectional designs. As respiratory illness can potentially have severe consequences, stronger integration of evidence-based hygiene practices into wind pedagogy is warranted.