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Healthcare staff are typically exposed to hundreds of alarms each shift; researchers believe that the number of alarms may be more than 1000 alarms per shift. This may lead to staff becoming desensitised to the alarm, leading to a delayed or inadequate response to the alarm, known as alarm fatigue. Clinical-grade wireless smartphones are now carried by clinical staff to receive calls and notifications from a nurse call system.

Firefighter hoods must provide protection from elevated temperatures and products of combustion while simultaneously being comfortable and limiting interference with firefighting movement or completion of fireground activities. This study was to quantify the impact of hood design (traditional knit hood vs. several models of particulate-blocking hoods) on wearability measures such as range of motion, noise production and hearing threshold. Firefighters' perceptions of wearability were also collected. In a controlled laboratory environment, 24 firefighters performed movement and hearing tests. Wearing particulate-blocking hoods resulted in decreased rotational range of motion, and thicker hoods reduced hearing ability. Design, but not necessarily the number of layers, affected noise production by the hood during head movement. Practitioner summary: Particulate-blocking hoods resulted in reduced rotational range of motion relative to the traditional design and the no-hood condition. Hoods with additional layers resulted in decreased hearing ability. Noise production was increased in designs of particulate-blocking hoods with a membrane-based blocking layer independent of the number of layers.

Objective: To measure and compare the difference of personal attenuation rating (PAR) of the workers wearing foam earplugs before and after the training, and to evaluate the effect of ear protector wearing training on the noise protection. Methods: In February 2023, 94 workers exposed to noise in a machinery manufacturing factory were selected as subjects. The production noise in the workplace was measured and subjects were trained to wear earplugs. The PAR values of wearing 3M 1110 foam test earplugs were measured and recorded before and after the training by using the fit testing of hearing protection device. The differences between the actual PAR values with nominal values and the noise attenuation values in related standards were compared, and the protective effect of hearing protection device before and after training was evaluated. Results: The average age of the subjects was (36.76±11.48) years old, the average length of service was (16.34±11.64) years, and the average exposure time to noise was (15.67±11.64) years. The noise detection results of the subjects' posts were ranged from 80.1 to 94.3 dB (A). The results of subjects wore 3M 1110 foam test earplugs for fit testing showed that the binaural PAR value after training was (19.3±6.4) dB (A), which was significantly higher than that before training (11.1±7.4) dB (A) ( t =13.31, P <0.001). After training, 11 people (11.70%) could reach the corrected noise reduction value (NRR value), 26 people (27.66%) could reach the standard of single noise reduction value (SNR value) ×0.6, and 84 people (89.36%) could reach the standard of (NRR-7) /2. The under protection rate of hearing protectors after training (7.45%) was significantly lower than that before training (45.74%), and the difference of different protection levels before and after training was statistically significant (χ(2)=40.83, P <0.001) . Conclusion: It is suggested that enterprises should use the fit testing instead of nominal value estimation to evaluate the noise reduction effect of hearing protection device. Special training on the selection and use of hearing protection device should be strengthened, so as to ensure that workers wear them correctly and improve the protective effect of hearing protection device.

Objectives: This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety., Methods/design: Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2)., Setting: Intermediate care unit., Main Outcome Measures: A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0-10) and number of distractions of nurses during the medication preparation process., Results: LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2. The median [IQR] number of alarms/day/bed increased from 263 [IQR 193-320] during baseline to 394 [IQR 258-474] during period-1 (p < 0.001), then decreased to 303 [IQR 264-370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0-6.0] to 2.0 [IQR 1.0-3.0] (p < 0.001) during period-2., Conclusion: An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive., Implications for Clinical Practice: Architectural redesign seems to be effective in controlling environmental noise. Architectural redesign results in a decrease in nurses' distractions during the medication preparation process. The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Environmental and occupational noise has the potential to result in health risks. The presence of high noise levels aboard ships can cause substantial hazards that affect the well-being of those employed in the maritime industry. The study and implementation of occupational noise reduction aboard ships are of the highest priority for ensuring the well-being of marine workers, compliance with regulatory standards, protection of the environment, and improvement of overall operational efficiency and safety within the maritime sector. A scoping study was conducted to collect and summarize the existing scientific literature about approaches to preventing occupational noise in vessel operations. We searched electronic databases for papers published up to June 2024. Initially, 94 articles were identified for screening, and the present research produced 16 studies, which were finally analyzed. Resultantly, noise control may begin with elimination, substitution, engineering, administrative, and hearing protection (ear plugs or muffs). Noise control innovation would be started with engineering techniques. Hearing protection devices (HPDs) could be used to reduce noise and as an instrument of communication between sailors. More research needs to be carried out in order to find the best ways for maritime vessels to reduce noise at work and to see how well they work in lowering the risks that come with noise for workers on board.

Context: Workplace noise regulations and guidance follow the hierarchy of control model that prioritizes eliminating or reducing noise at its source., Objectives: To determine the main sources of workplace noise exposure in the Australian working population and estimate the reduction of workers exposed over the noise limit (LAeq,8h > 85 dB) if noise levels of specific tools or equipment were reduced by 10 dB., Methods: Information on the tools used and tasks performed during each participant's last working shift was collected from 4,977 workers via telephone survey. Using a predetermined database of task-based noise levels, partial noise exposures (Pa2h) were determined for each noisy activity performed by the workers and their daily noise exposure level (LAeq,8h) was estimated. Partial exposures were categorized into 15 tool/task groups and the tally, average, and sum (Pa2h) for each group were calculated. The impacts of 5 different scenarios that simulated a reduction of 10 dB in noise emissions for specific tool groups were modelled., Results: Powered tools and equipment were responsible for 59.3% of all noise exposure (Pa2h); vehicles for 10.6%; mining, refineries, and plant equipment for 5.1%; and manufacturing and food processing for 4.2%. Modelling demonstrated that a 10 dBA noise-level reduction of all powered tools and equipment would lead to a 26.4% (95% confidence interval: 22.7% to 30.3%) reduction of workers with an LAeq,8h > 85 dB. This could represent over 350,000 Australian workers no longer exposed above the workplace limit daily., Conclusions: A universal reduction of 10 dB to power tools and equipment would substantially reduce the future burden of hearing loss, tinnitus, workplace injuries, and other health effects. Initiatives to reduce the noise emissions of specific powered tool groups are warranted., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives, Purpose, or Aim: The study aimed to decrease noise levels in the ICU, anticipated to have adverse effects on both patients and staff, by implementing enhancements in acoustic design., Background: Recognizing ICU noise as a significant disruptor of sleep and a potential hindrance to patient recovery, this study was conducted at a 40-bed ICU in Fiona Stanley Hospital in Perth, Australia., Methods: A comprehensive mixed-methods approach was employed, encompassing surveys, site analysis, and acoustic measurements. Survey data highlighted the importance of patient sleep quality, emphasizing the negative impact of noise on work performance, patient connection, and job satisfaction. Room acoustics analysis revealed noise levels ranging from 60 to 90 dB(A) in the presence of patients, surpassing sleep disruption criteria., Results: Utilizing an iterative 3D design modeling process, the study simulated significant acoustic treatment upgrades. The design integrated effective acoustic treatments within patient rooms, aiming to reduce noise levels and minimize transmission to adjacent areas. Rigorous evaluation using industry-standard acoustic software highlights the design's efficacy in reducing noise transmission in particular. Additionally, cost implications were examined, comparing standard ICU construction with acoustically treated options for new construction and refurbishment projects., Conclusions: This study provides valuable insights into design-based solutions for addressing noise-related challenges in the ICU. While the focus is on improving the acoustic environment by reducing noise levels and minimizing transmission to adjacent areas. It is important to clarify that direct measurements of patient outcomes were not conducted. The potential impact of these solutions on health outcomes, particularly sleep quality, remains a crucial aspect for consideration., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Noise from firearms is well known to be harmful to human hearing. This problem has been addressed by various military units through the use of muzzle suppressors. However, as suppressor technology has advanced, shooters report hearing the mechanical action of gas-operated semi-automatic rifles (ArmaLite Rifle Model 15 style aka AR-15) as being louder than the suppressed muzzle noise. This study aims to evaluate if harmful noise is present in the shooter's ear, even when impulse noise emanating from the muzzle is suppressed. To characterize the impulse noise of the firearm action caused by the reciprocation of the bolt carrier group (BCG) and subsequent impact when it returns to battery (the forward locked position), the muzzle of a rifle was placed through a constructed plywood wall, and the noise of the action/breech was measured independently from the muzzle noise. This research finds that the impact of the BCG returning to battery (132 dBZ) has the potential to be harmful to the shooter's hearing even when the noise from the muzzle is effectively suppressed.

As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: To assess the efficacy of silicone earplugs in protecting workers exposed to noise in a typical manufacturing environment, and to provide training interventions for workers who do not achieve the anticipated noise reduction levels, as well as examining the spectral characteristics of earplug attenuation. Methods: From June to August 2022, a total of 294 noise-exposed workers in two manufacturing enterprises equipped with the same type of earplug were studied by cluster sampling method, by conducting questionnaire surveys, collecting data, fitting tests, and providing trainings, the current noise exposure levels of workers in the industry as well as the perception about the earplug were understood. Additionally, the attenuation before and after intervention in workplace were measured, the spectral characteristics of noise reduction were were described and compared. Results: The percentage of workers with Personal Attenuation Rating (PAR) of 0 is 32.7% (96/294), and the baseline pass rates are all below 60%. There were no significant differences in pass rates based on gender, age, noise exposure, education level, or cognition of earplug effectiveness. After adjusting the way that earplugs are worn or changing the type of earplugs, all workers were able to meet their noise reduction requirements. The median PAR improvement for both companies is above 10 dB. The noise attenuation of the earplug vary with frequency, with lower attenuation at 4 000 Hz and higher attenuation at 8 000 Hz, showing some deviation from the nominal values. Conclusion: The difference between the actual sound attenuation value of earplugs and the nominal value is related to the noise frequency. When using silicone earplugs, attention should be paid to the spectral composition of the noise in the workplace.

Background: Global Burden of Disease studies identify hearing loss as the third leading cause of years lived with a disability. Their estimates point to large societal and individual costs from unaddressed hearing difficulties. Workplace noise is an important modifiable risk factor; if addressed, it could significantly reduce the global burden of disease. In practice, providing hearing protection devices (HPDs) is the most common intervention to reduce noise exposure at work. However, lack of fit of HPDs, especially earplugs, can greatly limit their effectiveness. This may be the case for 40% of users. Testing the fit and providing instructions to improve noise attenuation might be effective. In the past two decades, hearing protection fit-test systems have been developed and evaluated in the field. They are called field attenuation estimation systems. They measure the noise attenuation obtained by individual workers using HPDs. If there is a lack of fit, instruction for better fit is provided, and may lead to better noise attenuation obtained by HPDs., Objectives: To assess: (1) the effects of field attenuation estimation systems and associated training on the noise attenuation obtained by HPDs compared to no instruction or to less instruction in workers exposed to noise; and (2) whether these interventions promote adherence to HPD use., Search Methods: We used CENTRAL, MEDLINE, five other databases, and two trial registers, together with reference checking, citation searching, and contact with study authors to identify studies. We imposed no language or date restrictions. The latest search date was February 2024., Selection Criteria: We included randomised controlled trials (RCTs), cluster-RCTs, controlled before-after studies (CBAs), and interrupted time-series studies (ITSs) exploring HPD fit testing in workers exposed to noise levels of more than 80 A-weighted decibels (or dBA) who use hearing protection devices. The unit 'dBA' reports on the use of a frequency-weighting filter to adjust sound measurement results to better reflect how human ears process sound. The outcome noise attenuation had to be measured either as a personal attenuation rating (PAR), PAR pass rate, or both. PAR pass rate is the percentage of workers who passed a pre-established level of sufficient attenuation from their HPDs, identified on the basis of their individual noise exposure., Data Collection and Analysis: Two review authors independently assessed study eligibility, risk of bias, and extracted data. We categorised interventions as fit testing of HPDs with instructions at different levels (no instructions, simple instructions, and extensive instructions)., Main Results: We included three RCTs (756 participants). We did not find any studies that examined whether fit testing and training contributed to hearing protector use, nor any studies that examined whether age, gender, or HPD experience influenced attenuation. We would have included any adverse effects if mentioned by the trial authors, but none reported them. None of the included studies blinded participants; two studies blinded those who delivered the intervention. Effects of fit testing of HPDs with instructions (simple or extensive) versus fit testing of HPDs without instructions Testing the fit of foam and premoulded earplugs accompanied by simple instructions probably does not improve their noise attenuation in the short term after the test (1-month follow-up: mean difference (MD) 1.62 decibels (dB), 95% confidence interval (CI) -0.93 to 4.17; 1 study, 209 participants; 4-month follow-up: MD 0.40 dB, 95% CI -2.28 to 3.08; 1 study, 197 participants; both moderate-certainty evidence). The intervention probably does not improve noise attenuation in the long term (MD 0.15 dB, 95% CI -3.44 to 3.74; 1 study, 103 participants; moderate-certainty evidence). Fit testing of premoulded earplugs with extensive instructions on the fit of the earplugs may improve their noise attenuation at the immediate retest when compared to fit testing without instructions (MD 8.34 dB, 95% CI 7.32 to 9.36; 1 study, 100 participants; low-certainty evidence). Effects of fit testing of HPDs with extensive instructions versus fit testing of HPDs with simple instructions Fit testing of foam earplugs with extensive instructions probably improves their attenuation (MD 8.62 dB, 95% CI 6.31 to 10.93; 1 study, 321 participants; moderate-certainty evidence) and also the pass rate of sufficient attenuation (risk ratio (RR) 1.75, 95% CI 1.44 to 2.11; 1 study, 321 participants; moderate-certainty evidence) when compared to fit testing with simple instructions immediately after the test. This is significant because every 3 dB decrease in noise exposure level halves the sound energy entering the ear. No RCTs reported on the long-term effectiveness of the HPD fit testing with extensive instructions., Authors' Conclusions: HPD fit testing accompanied by simple instructions probably does not improve noise attenuation from foam and premoulded earplugs. Testing the fit of foam and premoulded earplugs with extensive instructions probably improves attenuation and PAR pass rate immediately after the test. The effects of fit testing associated with training to improve attenuation may vary with types of HPDs and training methods. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence., (Copyright © 2024 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration.)

Background: There are numerous complex barriers and facilitators to continuously wearing hearing protection devices (HPDs) for noise-exposed workers. Therefore, the present study aimed to investigate the relationship between HPD wearing behavior and hearing protection knowledge and attitude, HPD wearing comfort, and work-related factors., Method: A cross-sectional study was conducted with 524 noise-exposed workers in manufacturing enterprises in Guangdong Province, China. Data were collected on hearing protection knowledge and attitudes, HPD wearing comfort and behavior, and work-related factors through a questionnaire. Using structural equation modeling (SEM), we tested the association among the study variables., Results: Among the total workers, 69.47% wore HPD continuously, and the attitudes of hearing protection (26.17 ± 2.958) and total HPD wearing comfort (60.13 ± 8.924) were satisfactory, while hearing protection knowledge (3.54 ± 1.552) was not enough. SEM revealed that hearing protection knowledge had direct effects on attitudes (β = 0.333, p < 0.01) and HPD wearing behavior (β = 0.239, p < 0.01), and the direct effect of total HPD wearing comfort on behavior was β = 0.157 (p < 0.01). The direct effect also existed between work shifts and behavior (β=-0.107, p < 0.05). Indirect relationships mainly existed between other work-related factors, hearing protection attitudes, and HPD wearing behavior through knowledge. Meanwhile, work operation had a direct and negative effect on attitudes (β=-0.146, p < 0.05), and it can also indirectly and positively affect attitudes through knowledge (β = 0.08, p < 0.05)., Conclusion: The behavior of wearing HPD was influenced by hearing protection knowledge, comfort in wearing HPD, and work-related factors. The results showed that to improve the compliance of noise-exposed workers wearing HPD continuously when exposed to noise, the HPD wearing comfort and work-related factors must be taken into consideration. In addition, we evaluated HPD wearing comfort in physical and functional dimensions, and this study initially verified the availability of the questionnaire scale of HPD wearing comfort., (© 2024. The Author(s).)

Noise is the primary cause of hearing loss during space flight. Throughout every phase of flight, particularly during launch, a significant amount of noise is generated and transferred via the vehicle's structure to the places inhabited by the crew. The results of the previous studies provide insights into space flights that may have significant effects on hearing loss. Certain precautions must be taken to ensure the habitability of the spacecraft and prevent potential hearing loss in astronauts or space flight participants.

Background: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational hazard among healthcare professionals, including medical students. Despite its detrimental effects, the awareness and utilization of hearing protection measures among medical students in Saudi Arabia remain understudied., Objective: Is to determine the level of awareness and understanding of NIHL among medical students in Saudi Arabia, as well as their knowledge and usage of hearing protection measures and to identify potential barriers and facilitators for hearing protection utilization., Methods: A mixed-methods approach was employed, involving a questionnaire survey and semi-structured interviews. The survey collected data on demographics, knowledge of NIHL, and hearing protection practices among medical students. Subsequently, a semi-structured interview was conducted to obtain in-depth insights into the students' experiences, attitudes, and beliefs regarding NIHL and the use of hearing protection., Results: The level about NIHL was 59.32%. Better access to information is associated with increased odds of awareness (odds ratio=3.07, p=0.012). Having relatives with hearing loss increases the odds of awareness (odds ratio =2.49, p=0.034). Individuals with hearing loss or impairment have higher odds of awareness (odds ratio =2.27, p=0.046). Ear Pain, temporary hearing loss, tinnitus, or ringing in the ear: These factors are not significantly associated with awareness of noise-induced hearing loss (p>0.05). Using hearing aids is strongly associated with increased odds of awareness (odds ratio =3.94, p=0.006).The quantitative analysis provided statistical information on the prevalence rates and factors influencing hearing protection usage, while the qualitative analysis uncover nuanced perspectives and experiences., Conclusion: This research will contribute to the understanding of NIHL and hearing protection practices among medical students in Saudi Arabia. Improving hearing protection awareness and practices among medical students can ultimately reduce the incidence of NIHL and promote a healthier work environment within the healthcare sector.

Objective: To investigate the occupational noise hazards in five machinery manufacturing enterprises, and to evaluate the individual noise reduction values and influencing factors of workers wearing hearing protection device (HPD) by individual fit testing. Methods: From November 2021 to January 2022, 5 machinery manufacturing enterprises in Bao'an District of Shenzhen were selected to conduct an occupational health survey to understand the noise exposure level of workers. The 3MTM E-A-RfitTM fitness test system was used to test the baseline individual sound attenuation value level (PAR) of the daily wear of the ear protecters for 485 workers in typical noise working positions. Workers whose PAR values could not meet the requirements of noise reduction at work were instructed to wear and repeated tests were conducted. PAR results of the workers before and after the intervention were collected and analyzed. Results: The noise workers who received the suitability test were mainly distributed in 24 types of work, the job noise exposure level was 80.2 dB (A) ~ 95.0 dB (A), and the job noise excess rate was 52.5% (138/263). The median baseline PAR [ M ( Q (1), Q (3)) ] for 485 workers was 6.0 (0.0, 14.0) dB. The baseline PAR of male workers, those with more than 15 years of working experience, those with more than 15 years of using ear guards, those who considered ear guards comfortable to wear, those with college degree or above, and those exposed to noise level 90 dB (A) were higher, and the difference was statistically significant ( P <0.05). A total of 275 workers (56.7%) did not pass the baseline PAR test, and there was no statistically significant difference in the intervention rate of workers in different noise groups ( P >0.05). PAR in subjects who did not pass baseline after intervention increased from 0.0 (0.0, 3.0) dB to 15.0 (12.0, 18.2) dB. Conclusion: The workplace noise hazard of machinery manufacturing enterprises is serious, and there is a great difference between the baseline PAR and the nominal value of the hearing guard worn by the noise exposed workers. The intervention measures can effectively improve the protective effect of wearing ear protectors.

Occupational noise exposure is a pervasive issue in many industries, leading to a range of health issues and sleep disturbances among workers. Additionally, there is a strong desire among these workers to prevent industrial accidents. This study, aimed at enhancing worker health and well-being, utilized a survey distributed by the Korean Confederation of Trade Unions to field workers. Data from 1285 workers were collected and analyzed using partial least squares structural equation modeling (PLS-SEM) to identify and understand the factors affecting prevention intention in noisy work environments. Our findings indicate that health problems resulting from occupational noise exposure significantly influence insomnia, perceived severity of potential accidents, perceived benefits of preventive measures, and perceived barriers. Perceived severity was significantly correlated with prevention intention, emphasizing the role of risk perception in motivating preventive behaviors. Perceived benefits were also significantly associated with prevention intention, highlighting the importance of positive outcomes in influencing workers' behaviors. Additionally, perceived barriers showed a significant relationship with prevention intention, suggesting that overcoming these barriers is crucial in promoting preventive behaviors. Demographic factors such as gender displayed a significant association with prevention intention, while age did not. This study provides valuable insights into the multifaceted factors influencing workers' intention to prevent industrial accidents in noisy environments, underlining the importance of comprehensive data collection tools in understanding these dynamics., (© 2024. The Author(s).)

Hearing protection device (HPD) fit-testing is a recommended best practice for hearing conservation programs as it yields a metric of the amount of attenuation an individual achieves with an HPD. This metric, the personal attenuation rating (PAR), provides hearing health care, safety, and occupational health personnel the data needed to select the optimal hearing protection for the occupational environment in which the HPD will be worn. Although commercial-off-the-shelf equipment allows the professional to complete HPD fit tests in the field, a standard test methodology does not exist across HPD fit-test systems. The purpose of this study was to compare the amount of attenuation obtained using the "gold standard" laboratory test (i.e., real-ear attenuation at threshold [REAT]) and three commercially available HPD fit-test systems (i.e., Benson Computer Controlled Fit Test System [CCF-200] with narrowband noise stimuli, Benson CCF-200 with pure tone stimuli, and Michael and Associates FitCheck Solo). A total of 57 adults, aged 18 to 63, were enrolled in the study and tested up to seven earplugs each across all fit-test systems. Once fitted by a trained member of the research team, earplugs remained in the ear throughout testing across test systems. Results revealed a statistically significant difference in measured group noise attenuation between the laboratory and field HPD fit-test systems ( p < .0001). The mean attenuation was statistically significantly different (Benson CCF-200 narrowband noise was +3.1 dB, Benson CCF-200 pure tone was +2.1 dB, and Michael and Associates FitCheck Solo was +2.5 dB) from the control laboratory method. However, the mean attenuation values across the three experimental HPD fit-test systems did not reach statistical significance and were within 1.0 dB of one another. These findings imply consistency across the evaluated HPD fit-test systems and agree with the control REAT test method. Therefore, the use of each is acceptable for obtaining individual PARs outside of a laboratory environment.

Objectives: Hearing loss is a major worldwide health issue affecting an estimated 1.5 billion people. Causes of hearing loss include genetics, chemicals, medications, lifestyle habits such as smoking, and noise. Noise is probably the largest contributing factor for hearing loss. Noise arises from the workplace, ambient environment, and leisure activities. The easiest noise sources to control are workplace and environmental. Workplace noise is unique in that the employer is responsible for the noise and the worker. Also, workers may be exposed to much higher levels of noise than they would accept elsewhere. Employers follow the traditional hierarchy of controls (substitution/engineering, administrative, personal protective equipment [PPE]). Substituting or engineering a lower noise level actually reduces the hazard present to the worker but demand more capital investment. Administrative and PPE controls can be effective, but enforcement and motivation are essential to reducing risk and there is still some hearing loss for a portion of the workers. The challenge is to estimate the costs more clearly for managers. A systems engineering approach can help visualize factors affecting hearing health., Material and Methods: In this study, a systems engineering causal loop diagram (CLD) was developed to aid in understanding factors and their interrelationships. The CLD was then modeled in VenSim. The model was informed from the authors' expertise in hearing health and exposure science. Also, a case study was used to test the model. The model can be used to inform decision-makers of holistic costs for noise control options, with potentially better hearing health outcomes for workers., Results: The CLD and cost model demonstrated a 4.3 year payback period for the engineered noise control in the case study., Conclusions: Systems thinking using a CLD and cost model for occupational hearing health controls can aid organizational managers in applying resources to control risk. Int J Occup Med Environ Health. 2023;36(5):672-84., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objective: To understand the current situation of noise hazard in a motor manufacturing enterprise, and to explore the protective effect of workers wearing hearing protective device and its possible influencing factors. Methods: In November 2021, a total of 179 noise workers wearing hearing protective devices in a motor manufacturing company in a city were selected as research objects. Personal attenuation rating (PAR) of workers wearing hearing protective devices was measured. Baseline PAR was analyzed for different subgroups of basic demographic information, noise exposure, and the use of hearing protective devices to evaluate the effect of the intervention. Baseline PAR was compared using nonparametric tests. Results: There were 179 workers from 35 positions in 4 types of work, and the over-standard noise rate was 51.2% (42/82), among which the noise exposure intensity of motor equipment debugging workers was the highest [94.4 dB (A) ]. Compared the baseline PAR of different characteristics, it was found that the baseline PAR of male workers, workers whose daily noise exposure time were <8 h, workers who had used the hearing protective devices for 10 to 14 years, and workers who thought the hearing protective devices were comfortable were all higher, and the differences were statistically significant ( P <0.05). Baseline PAR passing rate was 43.0% (77/179), and PAR of 102 workers who did not pass baseline test increased from 0 (0, 3) dB before intervention to 14 (12, 16) dB after intervention, with statistical significance ( P <0.05) . Conclusion: The noise hazard in this motor manufacturing enterprise is serious, and the protective effect of workers wearing hearing protective devices is not good. Gender, daily noise exposure time, years and comfort of wearing hearing protective device are the possible influencing factors of poor protective effect.

Hearing loss is a significant global health concern, affecting billions of people and leading to various physical, mental, and social consequences. This paper focuses on the risk of noise-induced hearing loss (NIHL) among specific healthcare professionals, especially ear surgeons, orthopaedic surgeons, dentists, and dental hygienists, who frequently use noisy instruments in their professions. While studies on these professionals' noise exposure levels are limited, certain conditions and factors could pose a risk to their hearing. Measures such as engineering and administrative controls, regular audiometric testing, and the use of hearing protection devices are crucial in preventing NIHL. Early detection and intervention are also vital to mitigate further damage. This paper proposes the results of a modified screening protocol, including questionnaires, audiometry, and additional diagnostic tests to identify and address potential hearing disorders. Specific healthcare professionals should remain aware of the risks, prioritize hearing protection, and undergo regular monitoring to safeguard their long-term auditory well-being.

Objectives: This study aimed to investigate whether occupational noise exposure is a risk factor for insomnia among male night-shift production workers., Methods: This study followed 623 male night-shift production workers at a tire manufacturing factory without insomnia for 4 years. Insomnia was evaluated based on the insomnia severity index at baseline and at 4-year follow-up. A score of ≥15 was defined as insomnia. The higher occupational noise exposure group was defined as those individuals exposed to 8-hour time-weighted-average noise above 80 dB (A)., Results: Participants' mean age was 46.3 ± 5.6 years. Of the 623 participants, 362 (58.1%) were in the higher occupational noise exposure group. At 4-year follow-up, insomnia occurred in 3.2% (n = 20) of the participants. In a multiple logistic regression analysis, the odds ratio of insomnia was 3.36 (95% confidence interval 1.083-10.405, P = 0.036) in the higher occupational noise exposure group when compared with the lower noise exposure group after adjusting for confounders., Conclusion: Our findings suggested that occupational noise exposure affected insomnia in male night-shift production workers. To prevent insomnia, efforts are required to reduce workplace noise exposure levels. Alternatively, moving to a less noisy work environment should be considered for workers with severe insomnia.

Experience shows the occurrence of situations when the measurements of impulse noise parameters are made with measurement equipment unsuitable for such conditions. The results of using such equipment were compared with the results of using equipment with a sufficiently large upper limit of the measurement range. The analysis was carried out on the example of noise generated during shots from a Mossberg smooth-bore shotgun and AKM rifle, as well as produced in the forge. The use of the unsuitable equipment allowed to indicate the exceeding of the exposure limit value of the peak value of the signal ( L C peak ), but this is not always possible when determining the energy properties of the signal ( L EX,8h ). While the inadequate properties of the measurement equipment will generally not prevent the conclusion that noise in a particular workplace is hazardous to hearing, the results of measurements cannot be used to select hearing protectors.

Objective: To explore the sound insulation, sound absorption and other noise reduction transformation methods in a noise workshop handover control room. Methods: In December 2021, through the occupational health investigation and on-site testing of the handover control room of a noise workshop, the causes of excessive noise were analyzed, and the transformation design scheme to reduce noise was proposed and the effect was analyzed. Results: Before the transformation, the peak frequency band noise intensity of the noise workshop handover control room was 112.8 dB (A), and the peak frequency was 1000 Hz. After noise reduction, the theoretical calculated control value was 61.0 dB (A), and the measured noise intensity was 59.8 dB (A) . Conclusion: The noise intensity of the handover control room is reduced after noise reduction, which is in line with the contact limit requirements of the control room in GBZ 1-2010 "Hygienic Standards for the Design of Industrial Enterprises", and has reference significance for noise control engineering.

Objective: To get insight into the current practice of noise reduction effect of workers as they wore hearing protectors in different domestic enterprises and the possible affected factors. Methods: From October 2020 to April 2021, using a random sampling method, 1197 workers exposed to noise in petrochemical factories, textile factories, and parts manufacturing factories were selected as the study subjects. The noise reduction effect of hearing protectors worn by workers in daily use was tested using a hearing protector suitability testing system. The personal sound attenuation level (PAR) was compared among workers in three enterprises, Targeted intervention and repetitive testing were conducted for workers who did not meet the noise reduction effect required by the enterprise, and the changes in PAR of workers before and after the intervention were compared. The comparison of baseline PARs between two or more groups was performed using the Mann Whitney test, the comparison of baseline PARs with post intervention PARs was performed using the Wilcoxon signed rank sum test, and the comparison of qualitative data between two or more groups was performed using the Chi square test. Results: The median baseline PAR for all workers was 15 dB. Men, age<30 years old, education level at or above college level, working experience of 5 to 15 years, and those who used hearing protectors for 5 to 15 years had higher PARs, with statistically significant differences ( P <0.05). The median difference in baseline PAR among workers from three enterprises was statistically significant ( H =175.06, P <0.01). The median PAR of subjects who did not pass the baseline increased from 3 dB to 21 dB after intervention ( Z =-27.92, P <0.01) . Conclusion: Some workers wearing hearing protectors do not meet the required PAR, and low PARs may be related to incorrect wearing methods and incorrect selection of hearing protectors. As a tool for testing, training, and assisting in selection, the hearing protector suitability testing system is of great significance for worker hearing protection.

The Occupational Health and Safety Act 1993 and its attending Regulations in South Africa, require employers to conduct cost analysis studies to inform decision-making related to exposure control for occupational health hazard such as noise. Cost analysis, as per South African National Standard/ISO 31000 risk assessment guideline, is an important input for the decision-making process of the risk management process. The costs of administrating a hearing conservation programme intended to minimise noise-induced hearing loss is an example of a cost analysis. This study enrolled four companies from the South African manufacturing and utilities sectors with the aim of establishing whether cost analysis is included during the noise risk assessment process; and determining administration costs of HCP administration. A HCP cost questionnaire was completed by each company's occupational hygiene professionals and risk officers. None of the companies in the study included cost analysis in their respective risk assessment processes. The overall costs, derived from the HCP cost item questionnaire, was much greater for Company A (4 290 014 Rands) than all of the other companies combined (970 685 Rands). Hearing protection device expenditures across the four companies were the greatest expense, while audiometry was the smallest expense owing to service internalisation. The HCP expenditures are incurred on periodic basis, yearly or biennial, and are internalised in companies as direct costs. Cost analysis can enhance the noise risk assessment process by providing additional input to support the decision-making process related to noise control. This challenges the occupational hygiene profession to pursue new frontiers and decision-making models in the scope of noise risk management, beyond noise measurements and hearing protection device use recommendation., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Introduction: Noise is a significant health hazard for fish harvesters. Chronic exposure to hazardous noise levels of 85 dB (A) for an 8-h work shift can have adverse health impacts, including both auditory and non-auditory health problems such as noise-induced hearing loss, stress, hypertension, sleeping disorders, and impaired cognitive performance., Methods: A review of legislation and policies governing workplace noise exposure, as well as qualitative, semi-structured interviews, were conducted to assess how fish harvesters in Newfoundland and Labrador (NL) manage onboard occupational noise exposure and perceive noise-induced health problems, as well as the barriers and challenges associated with preventing and controlling noise exposure., Results: The legal review shows no compulsory noise preventive measure at the fishing vessel design stage in Canada. Limited implementation of Occupational Health and Safety (OHS) regulations to control and prevent onboard noise by employers in Newfoundland and Labrador. Fishers reported that their workplace is noisy. Over time, fish harvesters adapted to the environment and learned to tolerate loud noise, displaying fatalistic behavior. Fish harvesters reported avoiding using hearing protection onboard due to navigation safety concerns. Fishers reported hearing loss as well as other non-auditory health problems. Inadequate noise control measures adopted by employers, a limited supply of hearing protection onboard, and a lack of regular hearing testing, training, and education were identified as the main barriers to preventing and controlling noise exposure., Conclusion: Proper implementation of NL OHS regulations and the development of hearing conservation initiatives by employers are necessary. All stakeholders, including the federal and provincial governments, WorkplaceNL, and not-for-profit fishing organizations in the province, are strongly recommended to initiate training and education campaigns to help fish harvesters understand noise exposure and adopt preventive measures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yadav, Shan, Sarkar and Moro.)

Objectives. This study aimed to determine the effect of occupational training applied to workers working in noisy parts of a glass factory on the use of ear protectors. Methods. The study was a semi-experimental pre-test and post-test design. It was carried out with 45 workers determined by purposeful sampling and working in a glass production factory who accepted to participate in the study. The data were collected with an information form and noise-related symptom chart, hearing health information questionnaire and observation. In the analysis of the study data, the number/percentage, χ 2 test, Cohen κ test and analysis of variance were used. Results. It was determined that workers pre training did not use ear protectors (100%) and there were some noise-related health complaints. There was an increase in using ear protectors (57.8%) and a decrease in their health complaints post training. It was also found that the workers' pre-training hearing health information questionnaire mean score was 11.46 ± 3.20, and post training was 13.77 ± 3.42 in the first month and 15.77 ± 2.88 in the fourth month. Conclusions. Occupational training provided to the workers increased the workers' awareness level and their rate of wearing ear protectors, and health problems caused by work-related noise started to recover.

Objective: To evaluate musicians' personal attenuation and perceptions of three types of hearing protection devices (HPDs): formable foam earplugs and both non-custom and custom versions of uniform attenuation earplugs (UAEs) marketed to musicians., Design: A mixed-methods approach was used to evaluate the HPDs. Audiometric testing obtained hearing levels at baseline and with each HPD across frequencies (125-8000 Hz) to determine personal attenuation ratings and uniformity of attenuation. Participants completed surveys over six months regarding how often they used the HPDs and their perceptions about wearing them., Study Sample: Twenty-four musicians were recruited to participate., Results: Substantial variability was observed in the attenuation achieved among participants for each HPD type, but custom UAEs provided the most consistent attenuation across frequencies. Participants' HPD preferences were influenced by multiple factors including personal instrument and specific activity. Custom UAEs were most frequently used but usage rates continually decreased over the 6-month period., Conclusions: Fit-testing is important to determine fit and sizing. Combining information on the effectiveness of HPDs with musicians' opinions about wearing them can inform recommendations for which types may be the most effective and feasible options for reducing sound exposures.

Introduction: The use of hearing protection devices (HPDs) has been an intervention of choice in many workplaces such as in the construction industry for quite some time due to impractical effects of engineering and administrative interventions. Questionnaires for assessment for HPDs use among construction workers have been developed and validated in developed countries. However, there is limited knowledge of the same, among manufacturing workers in developing countries that are assumed to have a different culture, work organizations and production processes., Methods: We conducted a stepwise methodological study to develop a questionnaire to predict the use of HPDs among noise exposed workers in manufacturing factories in Tanzania. The questionnaire included 24 items and was developed through rigorous and systematic procedures involving three steps; (i) item formulation that involved two experts, (ii) expert content review and item rating that involving eight experts with vast experience in the field, and (iii) a field pre-test that involved 30 randomly selected workers from a factory with similar characteristics as a planned study site. A modified Pender's Health Promotion Model was adopted in the questionnaire development. We analyzed the questionnaire in terms of content validity and item reliability., Results: The 24 items were categorized into seven domains i.e., perceived self-efficacy, perceived susceptibility, perceived benefits, perceived barriers, interpersonal influences, situational influences and safety climate. The score for content validity for each item was satisfactory as the content validity index ranged between 0.75 to 1.00 for clarity, relevance, and essentiality criteria. Similarly, the scores for the content validity ratio (for all items) were 0.93, 0.88 and 0.93 for clarity, relevance, and essentiality, respectively. In addition, the overall value for Cronbach's alpha was 0.92 with domain coefficients: perceived self-efficacy 0.75; perceived susceptibility 0.74; perceived benefits 0.86; perceived barriers 0.82; interpersonal influences 0.79; situational influences; 0.70; and safety climate 0.79. The mean inter-item correlation was 0.49 suggesting good internal consistency., Discussion and Conclusion: The developed and preliminary validated questionnaire can be used to predict the HPDs use among noise exposed manufacturing factory workers. Future surveys using this questionnaires warranted for further validation of the scale developed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nyarubeli, Tungu, Pallesen, Moen and Mamuya.)

This systematic literature review (SLR) aims to determine the factors influencing the use of hearing protection devices (HPDs) among industrial workers. This study was guided by the PRISMA Statement (Preferred Reporting Items for Systematic reviews and Meta-Analyses) review method, and four databases comprising Scopus, Science Direct, PubMed, Wiley Online Library, and Google Scholar were employed. A total of 196 articles were identified, and 28 studies on the factors associated with HPD use among industrial workers from 2006 to 2021 met the inclusion criteria. Resultantly, five main themes emerged from this review: sociodemographic (29%), interpersonal influences (18%), situational influences (18%), cognitive-perceptual (29%), and health-promoting behavior (6%) associated with HPD use among industrial workers. A total of 17 sub-themes were identified, including age, gender, educational level, noise level, working experience, social models, interpersonal support, social norms, safety climate, training, organizational support, perceived barrier, perceived susceptibility, perceived severity, perceived benefit, self-efficacy, and cues to action. The significant factors influencing workers to use HPDs are sociodemographic, interpersonal influences, situational influences, and health-promoting behavior. Future studies should focus on the cues to action toward human behavior influencing the use of HPDs, workers' health status, and comorbidities of hearing loss. Therefore, this systematic study gives valuable reference resources for up-and-coming researchers as well as new knowledge to expert professionals and academics in various industries.

Agricultural workers are more prone to noise-induced hearing loss than are many other workers. Hearing protection device use among agricultural workers is low, but training can increase hearing protection device use. This work proposes a system designed to automatically inform agricultural workers when they were exposed to noises that exceed the National Institute for Occupational Safety and Health (NIOSH) recommended exposure level. The smartphone-based system worn on the arm uses a noise dosimeter to measure noise exposures throughout the day to within ±2 A-weighted decibels of a Class 2 sound level meter. The device collects location and audio data, which are transferred to a server and presented to the worker on a locally hosted website. The website details noise exposure and helps the worker identify where exposure occurred and what specific tasks exceed NIOSH's recommended exposure limit, putting them at higher risk of noise-induced hearing loss. With this understanding, the worker is expected to adopt behavior changes and better hearing protection use at critical places and times. This pilot study evaluates the accuracy of the noise dosimeter and GPS relative to gold-standard instruments. The system was tested on a farm with outputs compared with gold-standard instruments. A-weighted, 1-sec averaged sound pressure levels and position data were collected while users were performing a variety of tasks indoors and outdoors. The smartphone's external noise dosimeter read within ±2 A-weighted decibels of the Class 2 reference dosimeter 59% of the time. The positioning devices had an average error of sub-4 m. While not perfectly matching gold-standard instruments, the device is capable of identifying and collecting information relative to loud noise events that promote noise-induced hearing loss.

Occupational noise exposure and hearing loss are prominent in the fire service. Firefighters are routinely exposed to hazardous levels of noise arising from the tools and equipment they use, from sirens and alarm tones to the emergency response vehicles they drive. The present study utilized the Apple Watch to continuously measure environmental noise levels for on-duty firefighters. Participants included 15 firefighters from the metropolitan South Florida area, and 25 adult non-firefighter control subjects. Firefighters were recruited from a variety of roles across two stations to ensure noise exposure profiles were appropriately representative of exposures in the fire service. All participants wore an Apple Watch for up to three separate 24 h shifts and completed a post-shift survey self-reporting on perceived exposures over the 24 h study period. Cumulative exposures were calculated for each shift and noise dose was calculated relative to the NIOSH recommended exposure limit of 85 dBA as an 8 h time-weighted average. The maximum dBA recorded on the Apple Watches was statistically significant between groups, with firefighters experiencing a median of 87.79 dBA and controls a median of 77.27 dBA. Estimated Exposure Time at 85 dBA (EET-85) values were significantly higher for firefighters when compared to controls: 3.97 h (range: 1.20-14.7 h) versus 0.42 h (range: 0.05-8.21 h). Only 2 of 16 firefighters reported the use of hearing protection devices during their shifts. Overall, our results highlight the utility of a commonly used personal device to quantify noise exposure in an occupationally at-risk group.

Objective: The aim of this study is to examine the awareness, opinions, and use of individual fit testing of hearing protection devices (HPDs) among occupational medicine practitioners., Methods: Members of the Michigan Occupational and Environmental Medicine Association completed a 21-question survey on individual fit testing of HPDs., Results: The survey response rate was 67%, 53% reported having heard of individual fit testing of HPDs, and 24% reported that their clinic/site performed the testing. Major barriers to its use were perceived time to perform (63%), cost (51%), lack of an Occupational Safety and Health Administration requirement (51%), and lack of long-term studies of its effectiveness (20%)., Conclusions: Further work to educate practitioners about the availability, implementation, and potential benefits of fit testing of HPDs is needed if use of this technology is to become more widespread., Competing Interests: Conflict of interest: None declared., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Background: Studies show that certain occupations are associated with an increased risk of hearing loss. However, many studies are cross-sectional, and the few longitudinal studies are mostly small or focus on only one occupation., Aims: We aimed to quantify the long-term hearing decline among workers in different occupations and assess whether the change differs between the occupations., Methods: The study population was 4525 adults who participated in two population-based health studies in Norway, HUNT2 1996-1998 and HUNT4 2017-2019. Linear regression models assessed the association between occupations (clerks as reference) and 20-year hearing decline (hearing thresholds at 3-6 kHz, averaged over both ears) from HUNT2 to HUNT4. Models were adjusted for age, sex, recurrent ear infections, smoking and ear pathology., Results: Among the participants (40% men), the mean age at HUNT2 was 31.2 ± 5.4 years (range 20-39) and the average 20-year hearing decline was 11.3 ± 9.8 dB. Occupations that were associated with larger hearing decline included other craft and related trades workers (3.9 dB, 95% confidence interval [CI] 0.2-7.7) and building frame and related trades workers (3.4 dB, 95% CI 1.3-5.4). Among occupations with larger hearing decline, a higher proportion of the workers reported exposure to noise., Conclusions: This large longitudinal study shows a larger long-term hearing decline among building frame workers and craft and related trades workers. Differences between occupations were modest, which may indicate successful preventive measures in Norway during the last two decades., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society of Occupational Medicine.)

Tractor cab interior noise is a risk factor that degrades operators' work performance and threatens their health; therefore, the noise must be reduced to ensure farmworkers' safety and efficiency. Cab interior noise can be classified as structure-borne noise and air-borne noise. Structure-borne noise has been extensively studied. However, although air-borne noise greatly contributes to cab interior noise, detailed frequency-domain analyses have not been performed. In this study, the components of cab interior noise were identified in the frequency domain through an order analysis, which helped improve the sound insulation of the cab and reduce the effects of air-borne noise. A test was performed while driving a tractor on a chassis dynamometer in a semi-anechoic chamber for reproducible measurement and evaluation. The A-weighted sound pressure was transformed by a fast Fourier transform algorithm, and its order was tracked by the engine speed signal. In addition, a direct path was identified by acoustic images using a sound camera. The contributions of major noise sources were identified through an order analysis. We proved that air-borne noise significantly contributes to the interior noise of tractor cabs and that improvement of the cab sound insulation is an effective noise-reduction technique., (© 2022. The Author(s).)

Objective: To assess the risk of noise-induced hearing loss in workers from a petrochemical plant. Methods: In October 2020, 488 male workers exposed to noise in a petrochemical plant in Guangdong Province were selected by cluster sampling. Acoustics-Estimation of Noise-Induced Hearing Loss (ISO 1999: 2013) was used to assess the risk of noise-induced hearing loss of workers, and individual fit testing was used to evaluate the sound attenuation obtained by the workers. The risk assessment results and fitness test results of workers with different hearing levels were compared. Results: The average noise exposure equivalent sound level of the workers in the petrochemical plant was 86.7 dB (A) . The median of PARs (personal attenuation ratings) was 16 (4, 23) dB. There were statistically significant differences in age and service years among workers with different hearing results ( P <0.05) , but no statistically significant differences in noise intensity and PARs ( P >0.05) . According to risk assessment results of ISO 1999: 2013, the current risk of high-frequency hearing loss in 488 workers were negligible risk and acceptable risk. The risk of noise-induced deafness weredivided into three levels: negligible risk in 452 workers (92.7%) , medium risk in 27 workers (5.5%) and high risk in 9 workers (1.8%) . The risk of high-frequency hearing loss in next 5 to 15 years for workers with noise exposure level of >94 to 97 dB and >97 dB or above would be medium risk or above. The risk of noise-induced deafness in next 5 to 15 years for workers exposed to noise withlevel of 91 to 94 dB would be medium risk or above. Conclusion: The risk of noise-induced hearing loss in workers from the petrochemical plant is high in next 5 to 15 years, and noise prevention and control measures need to be strengthened. ISO1999: 2013 assessment method may underestimate the risk of hearing loss among workers.

Background: Occupational noise is one of the most common and prevalent occupational hazards worldwide and may induce adverse auditory and/or non-auditory health effects. However, the relationship between occupational noise exposure and hypertension is controversial and has long been debated., Methods: Based on large sample cross-sectional data from all registered occupational health examination units from 2021 to 2022 ( N = 101,605), this study aimed to analyze the prevalence of hearing loss and hypertension and to explore the influencing factors of hypertension of workers in Wuhan. Descriptive statistics, univariate analyses and multivariate analyses were used. Forest plot and nomograms were constructed for the visualization of predictive results. The ROC curve, AUC, C-index and calibration curves were used to assess the predictive accuracy and validity. DCA was performed to evaluate the net benefit that workers could receive., Results: Higher rate of high-frequency hearing loss (25.3%), speech frequency hearing loss (8.8%), ECG abnormalities (31.9%) and hypertension (21.0%) were found in workers exposed to occupational noise in Wuhan. Occupational noise exposure (OR = 1.09, 95% CI: 1.01-1.18, p = 0.04), growth of age (OR: 1.07, 95% CI: 1.07-1.07, p < 0.001), overweight (OR: 1.82, 95% CI: 1.73-1.92, p < 0.001), obesity (OR: 3.62, 95% CI: 3.42-3.83, p < 0.001), hyperglycemia (OR: 1.84, 95% CI: 1.73-1.96, p < 0.001), hypercholesterolemia (OR = 1.34; 95% CI 1.22-1.48; p < 0.001), ECG abnormalities (OR = 1.11; 95% CI 1.07-1.15; p < 0.001) and family history of hypertension (OR = 1.69; 95% CI 1.58-1.81; p < 0.001) were risk factors of hypertension for workers. Male workers had a relatively higher hypertension risk than female workers (OR = 1.61; 95% CI 1.54-1.69; p < 0.001). Ear protective measures could not reduce the risk of hypertension in workers. Our nomogram has good predictive accuracy and validity. A dynamic nomogram to predict the workers' risk of hypertension was established publicly available online., Conclusion: Occupational noise exposure may elevate workers' hypertension risk. More effective and relevant prevention measures should be taken. Our nomogram may help identify high-risk workers and facilitate timely interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Chen, Chen, Yin, Fu, He, Pan, Yi and Tan.)

Although a causal relationship exists between military occupational noise exposure and hearing loss, researchers have struggled to identify and/or characterize specific operational noise exposures that produce measurable changes in hearing function shortly following an exposure. Growing evidence suggests that current standards for noise-exposure limits are not good predictors of true hearing damage. In this study, the aim was to capture the dose-response relationship during military rifle training exercises for noise exposure and hearing threshold. To capture exposure, a wearable system capable of measuring impulse noise simultaneously on-body and in-ear, behind hearing protection was used. To characterize hearing threshold changes, portable audiometry was employed within 2 h before and after exposure. The median 8-h time-weighted, protected, free-field equivalent in-ear exposure was 87.5 dBA at one site and 80.7 dBA at a second site. A significant dose-response correlation between in-ear noise exposure and postexposure hearing threshold changes across our population ( R = 0.40 , p = 0.0281) was observed. The results demonstrate an approach for establishing damage risk criteria (DRC) for in-ear, protected measurements based on hearing threshold changes. While an in-ear DRC does not currently exist, it may be critical for predicting the risk of injury for noise environments where protection is mandatory and fit status can vary.

The orthopedic environment exposes surgeons and staff to infection, surgical smoke, and high levels of noise. It is helpful to understand how exposure increases the risk for adverse health consequences. Protective equipment, safety protocols, and instrument modification can reduce exposure to hazards. When modifications to practice are made, they must be evaluated to ensure they do not introduce new hazards or impede the use of instruments. Despite evidence of risk, protective measures are seldom employed in orthopedic practice. Wider implementation of protection for clinicians may not occur unless the same hazards are shown to impact patient outcomes., (Copyright © 2022 Elsevier Inc. All rights reserved.)

National and international regulatory and consensus standards setting bodies have previously proposed derating hearing protector ratings to provide a better match between ratings determined in a laboratory and the real-world measurements of attenuation for workers. The National Institute for Occupational Safety and Health has proposed a derating scheme that depends upon the type of protector. This paper examines four real-world studies where personal attenuation ratings (PARs) were measured at least twice, before and after an intervention in earplug fitting techniques. Results from these studies indicate that individualized earplug fitting training dramatically improves a worker's achieved PAR value. Additionally, derating schemes fail to accurately predict the majority of achieved PARs. Because hearing protector fit testing systems are now readily available for use in the workplace, personal attenuation ratings provide a better estimate of worker noise exposures and are able to identify those persons who need additional instruction in fitting hearing protection devices.

The use of hearing protection devices is one possible way of reducing the negative impact of noise on hearing. However, it is important to keep in mind that only properly used hearing protection devices provide adequate hearing protection. The aim of this article is to describe a newly developed tester to verify the correct placement of earplugs in the ear canal. This tester was developed using easily accessible and low-cost components. It implements the real-ear attenuation at threshold (REAT) method by which the sound attenuation of hearing protection devices is determined. The headphones with a greater low-frequency attenuation value were selected for use in the tester. The results of the sound attenuation measurement performed with the use of the tester did not differ by more than 5 dB compared to the measurements performed with the use of the Norsonic NOR838 system dedicated to this purpose. The developed tester is considered to be a device that will obtain reliable sound attenuation values. Thus, it can also be used as a device with which the correct placement of earplugs in the ear canal can be assessed.

Objective: To investigate the current situation of occupational exposure to noise among noise workers in an automobile manufacturing enterprise in Tianjin, understand the impact of noise on workers＇ nervous system and hearing, and assess the risk of hearing loss among noise workers. Methods: In May 2021, 3516 workers in an automobile manufacturing enterprise were investigated by using a self-made questionnaire＂Noise Workers Questionnaire＂ and cluster sampling method. The occupational noise hygiene survey and occupational hazards detection were carried out in their workplaces. They were divided into noise exposure group and non-noise exposure group according to whether they were exposed to noise or not. The general characteristics, hearing and nervous system symptoms of the two groups of workers were compared, and the risk of hearing loss was assessed. Results: There were 758 workers in the noise exposure group, aged (26±5) years old, with a working age of 3.0 (2.0, 6.0) years exposed to noise. 2758 workers in the non-noise exposure group, aged (25±6) years old, with a working age of 2.0 (1.0, 4.0) years. There were statistically significant differences in the distribution of workers＇education level, working age and memory loss between the two groups (χ(2)=37.98, 38.70, 5.20, P <0.05). The workers in the noise exposure group showed a decreasing trend of insomnia, dreaminess, sweating and fatigue with the increase of working age (χ(2trend)=6.16, 7.99, P <0.05). The risk classification of binaural high-frequency hearing loss for workers in all noise positions until the age of 50 and 60 was negligible, the risk of occupational noise deafness was low for workers in stamping and welding noise positions until the age of 60. Conclusion: The occupational noise exposed to automobile manufacturing workers may cause certain harm to their nervous and auditory systems. Noise protection measures should be taken to reduce the risk of hearing loss and occupational noise deafness.

Offering hearing protection devices (HPDs) to workers exposed to hazardous noise is a noise control strategy often used to prevent noise-induced hearing loss (NIHL). However, HPDs are used incorrectly and inconsistently, which explains their limited efficiency. Numerous models based on social cognition theories identify the significant factors associated with inconsistent HPD use and aim to improve HPD training programs and to increase HPD use. However, these models do not detail (dis)comfort aspects originating from complex interactions between characteristics of the triad "environment/person/HPD" while these aspects are known to largely influence HPD (mis)use. This paper proposes a holistic model explaining HPD (mis)use, based on the integration of a comfort model adapted to HPDs into an existing behavioral model already developed for HPDs. The model also takes into account the temporal dimension, which makes it possible to capture the scope of change in HPD-related health behaviors. This holistic description of HPD use could be used as a tool for stakeholders involved in HPD use to effectively prevent NIHL among workers.

Compliance with noise regulations in the past three decades has significantly reduced workplace noise exposures, particularly in the loudest industries and occupations. However, the overall effectiveness of hearing conservation programs in preventing occupational noise-induced hearing loss remains uncertain and unquantified, while the incidence and cost of occupational hearing loss remain inexplicably high. This review/commentary critically explores this paradox by examining why the billions of annual audiograms conducted worldwide have not been aggregately utilized or applied to predict early NIHL in groups of workers or to measure the efficacy of exposure controls. Principal contributory reasons include regulation of noise as a safety standard rather than as a health standard, the inherent complexity of audiometric data, and the lack of a standardized method of interpretation for audiograms. The unsuccessful history of efforts to develop and adopt methods and tools to analyze aggregate audiometric data is described. Consequently, the Standard Threshold Shift-a regulatorily defined, lagging indicator of individual, irreversible hearing loss that is not an effective preventive metric-remains the de facto standard of care. A population-based Best Practices approach is proposed to leverage the raw audiometric data already available and turn it into actionable data for effective secondary prevention to strategically manage and reduce occupational hearing loss risk. This approach entails statistical methods and information management tools necessary to transform audiometry from a compliance-driven, individual screening test with limited preventive capability into a medical surveillance process directly linked to aggregate corrective and prevention actions., (© 2022 Wiley Periodicals LLC.)

Hearing protection device (HPD) fit-testing is considered "best practice" for hearing conservation programs in the military. Yet many hearing conservation personnel do not have access to dedicated fit-test equipment. In this study, estimates of personal attenuation rating (PAR) obtained with a boothless audiometer are compared to those obtained with a field-microphone in a real ear (F-MIRE) system. Results suggest that boothless audiometers can be used to make accurate PAR estimates. The ability to perform HPD fit-testing with multipurpose boothless audiometers has the potential to greatly expand the accessibility of earplug verification and ultimately to improve the effectiveness of hearing conservation programs.

Background: Occupational noise-induced hearing loss (NIHL) is the second most common medical disability for military veterans and accounts for 24% of all hearing loss in the United States. Hearing loss negatively affects health and billions of dollars are spent annually for direct and indirect medical costs and lost work productivity. Proper hearing protection device (HPD) fit can prevent NIHL. Quantitative fit-testing systems to determine personal attenuation rates (PARs) are available, but not widely utilized. Without quantitative testing, validating appropriate fit and attenuation to a permissible exposure level to prevent NIHL is difficult., Methods: A quality improvement project measured 100 employees enrolled in a hearing conservation program (HCP) to determine if they obtained a target PAR after inserting the HPDs in their "usual" fashion. Those who did not obtain target PAR ( n = 27) received an evidence-based intervention that demonstrated proper HPD fit by a skilled trainer followed by a repeat attempt by the participant to replicate the feel of the demonstrated HPD placement. PAR was subsequently measured to assess for appropriate noise attenuation., Findings: Seventy-one percent achieved target PAR (≥ 20 decibels) at baseline testing. After the intervention, 91 of 100 participants had achieved target PAR, a 20% improvement., Conclusions/implications for Practice: Findings suggest this evidence-based intervention was an effective strategy for improving HPD fit for employees enrolled in HCPs. This intervention may prevent occupational hearing loss and decrease the health and socioeconomic impacts of NIHL.

Purpose: Noise-induced hearing loss (NIHL) has been found in rural children, potentially due to occupational and recreational noise exposure without consistent use of hearing protection devices (HPDs). However, questions remain regarding the specifics of rural adolescents' noise exposure and use of hearing protection around different types of noise. As such, the purpose of the current study was to provide preliminary results on rural adolescents' noise exposure and use of hearing protection for gunfire, heavy machinery, power tools, all-terrain vehicles (ATVs), and music., Method: A questionnaire was administered to 197 students (seventh to 12th grade) from rural schools in West Texas. Questions were related to noise exposure and use of HPDs for specific categories of noise. Testing was performed at the schools, with an investigator recording each student's responses., Results: Approximately 18%-44% of adolescents reported exposure 12 or more times a year to gunfire, heavy machinery, power tools, and ATVs. Only 1%-18% of the adolescents reported never being exposed to such noise sources. Almost half of rural adolescents never used hearing protection around gunfire, and 77%-91% reported never wearing hearing protection when exposed to heavy machinery, power tools, and ATVs., Conclusions: The current study revealed that rural adolescents are exposed to noise sources that could damage their hearing. However, the majority of rural adolescents do not consistently wear hearing protection. Additional research is now needed to extend these findings by assessing rural adolescents' duration of exposure to different noise sources, in addition to investigating prevention of NIHL in this population. Supplemental Material https://doi.org/10.23641/asha.17139335.

At a major hazard facility, cases of occupational noise-induced hearing loss have occurred despite the use of hearing protection devices. Preliminary measurements of personal attenuation ratings (PAR) suggested that earplugs may not achieve the attenuation implied by their Australian SLC80 Class designation in field-use conditions. We examined the relationship between PAR and the SLC80 classification for earplugs, as a good understanding of the attenuation provided by earplugs under normal field-use conditions, rather than in laboratory settings, is vital to their effective use as a control measure for noise exposure. A cross-sectional study was performed with 65 volunteers. Participants were recruited from Operations and Maintenance Technicians at the major hazard facility. The participants had their PARs checked with different earplug types using the 3 M™ E-A-Rfit™ system. We examined the PARs measured and also assigned a 'pass' or 'fail' rating depending on whether the earplug achieved 22 dB attenuation. 22 dB attenuation for 80% of users is the minimum to meet the definition for Australian SLC80 Class 4 hearing protection. None of the earplug types achieved 22 dB attenuation for 80% of users when tested in field-use conditions. There were statistically significant differences in the frequency of achieving a 'Pass', and in PAR, depending on earplug type. Roll-down foam earplugs may provide superior attenuation compared to pre-moulded earplugs. Earplugs are unlikely to achieve the attenuation found in laboratory conditions during field-use. Personalised selection of hearing protection devices based on fit-testing results should be encouraged., (© 2021. Australasian College of Physical Scientists and Engineers in Medicine.)