Noise and the conservation of hearing.

This study was designed to test the hypothesis that partial hearing conservation is attainable after cochlear implantation with a long perimodiolar electrode. Surgical strategies for hearing conservation during cochlear implantation are described. Prospective, single-subject, repeated-measures design. Academic tertiary care center. Twenty-eight severely to profoundly hearing-impaired adult cochlear implant recipients who had some measurable hearing preoperatively. Cochlear implantation using Nucleus Freedom Contour Advance electrode. Preimplant and postimplant pure-tone thresholds and speech recognition scores were obtained to determine the incidence and degree of conserved hearing at a mean interval of 9 (+/-3.9) months. Thirty-two percent of subjects experienced complete conservation of hearing (0- to 10-dB loss), and 57% experienced partial conservation of hearing (>11 dB) after implantation. However, open-set speech recognition was partially conserved in only one subject. Cochlear implant performance was not better in patients with conservation of residual hearing. Conservation of pure-tone hearing was possible in 89% of implanted patients; however, residual speech perception was not conserved with this long perimodiolar electrode. A ceiling effect tends to inflate the prevalence of hearing conservation in implantation studies of severely to profoundly hearing-impaired patients.

: Due to the lack of an efficient and economical way to obtain essential data from medical records, naval hearing conservation management personnel lack the capability for assessing the adequacy of their programs. A model Hearing Conservation Management Information System (HECMIS) developed for the Navy Environmental Health Center (NEHC), Norfolk should alleviate this problem. The HECMIS, currently undergoing further operational modeling at NEHC, now contains some 19,000 DD-2215 forms and 12.400 DD-2216 forms. It will be used initially by hearing conservation staff at NEHC as a management tool and to disseminate to field activities the information considered necessary for the efficient operation of their hearing conservation programs. When implemented, the HECMIS, in conjunction with microprocessor-controlled group audiometers soon to be acquired for use in Navy hearing conservation programs, will provide reliable hearing data and a means by which Navy hearing conservation management personnel can derive the critical information necessary to determine the adequacy and efficiency of their hearing conservation programs. Originator supplied keywords include: Hearing conservation; Occupational medicine; Hearing testing; Reference and monitoring audiograms; Hearing conservation data base; Management information systems; Microprocessor-controlled audiometers.

You have accessThe ASHA LeaderASHA News1 May 2007Conference Focuses on Hearing Conservation: “Passion to Preserve” Theme Ranges From Research to Practice Sharon Beamer Sharon Beamer Google Scholar More articles by this author https://doi.org/10.1044/leader.AN4.12062007.5 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Nearly 300 national and international professionals dedicated to the mission of hearing conservation attended the 32nd Annual Conference of the National Hearing Conservation Association Conference (NHCA), held Feb. 15–17 in Savannah, Georgia. The theme, “Passion to Preserve,” included diverse topics ranging from the practical to current research. Workshops, platform sessions, and forums addressed contemporary issues in hearing conservation. An all-day seminar on the basics of hearing loss prevention offered presentations from six experts in the field, who discussed the important elements of a hearing loss prevention program. Presenters included Timothy Swisher of Hearing Safety, Pittsburgh; Cindy Bloyer of Examinetics, Inc., Overland Park, Kansas; Col. Nancy Vause, U.S. Army Center for Health Promotion and Preventive Medicine-Pacific; Ltc. Lynette B. Ardolf, PhD, USA Aeromedical Research Lab, Ft. Rutger, Alabama. Dennis Driscoll, an engineer with Associates in Acoustics, Inc., Evergreen, Colorado, offered a separate session on noise-exposure data for work shifts that extend beyond eight hours. Driscoll’s presentation helped clarify the confusion that can arise when determining employee time-weighted average (TWA) noise exposure for employees on an extended work shift. Charles Ross, dean of the College of Arts and Science, Longwood University (Farmville, Virginia), presented his work on the “Use of Acoustic Phenomena to Make Strategic and Tactical Decisions During the Civil War.” Ross was guest speaker at the conference luncheon. Several awards and honors were bestowed on individuals who represent commitment, dedication and excellence in hearing conservation. The recipient of the Outstanding Hearing Conservationists Award was G. Richard Price, a consultant for auditory hazard analysis and guest researcher for the U.S. Army Research Laboratory, Aberdeen Proving Grounds, Maryland; James Lankford, professor emeritus at Northern Illinois University, received the Michael Beall Treadgill Award. Lankford also received the honor of delivering the 2007 Gasaway Lecture. The NHCA Scholarship Foundation honored six students pursuing degrees in a discipline related to hearing conservation with the 2007 Student Travel Awards. Four of the recipients—Elizabeth Baum, Cory Portnuff, Benson Davis, and Darrin Worthington—are pursuing AuD degrees. Stephanie Griffin is a master’s degree candidate in industrial hygiene and Khaled Alali is obtaining a PhD in human factors engineering and ergonomics. These awards may be used to help defray the cost of attending the NHCA conference. The 2008 conference will be held Feb. 21–23 in Portland, Oregon. More information is available at www.hearingconservation.org. ASHA, an affiliate member, exhibited at the convention along with more than a dozen affiliates and sponsors. Author Notes associate director of audiology professional practices, can be contacted at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 12Issue 6May 2007 Get Permissions Add to your Mendeley library History Published in print: May 1, 2007 Metrics Current downloads: 109 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2007 American Speech-Language-Hearing AssociationLoading ...

You have accessThe ASHA LeaderFeature1 Oct 2010Teens at Risk: Audiologists Respond Marat Moore Marat Moore Google Scholar More articles by this author https://doi.org/10.1044/leader.FTR1.15122010.8 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Audiologists are weighing in on the research on teen hearing loss published two months ago in the Journal of the American Medical Association (JAMA) and its implications for the profession. The study, described in Part 1 of this series (The ASHA Leader, Sept. 21), showed a 31% overall rise in the prevalence of hearing loss in teens aged 12 to 19 from 1988–1994 to 2005–2006. Most of the hearing loss was slight, between 15 and 25 dB—but the prevalence of mild and worse (25 dB or greater) hearing loss increased 77%. The study also found that unilateral hearing loss was more common than bilateral (for reasons unknown), and that individuals reporting an income below the national poverty level in the 2005–2006 survey cycle had a significant risk of hearing loss. The study’s Aug. 18 publication triggered a media blast—ASHA media efforts alone reached a broadcast and online audience of nearly 45 million people. This media exposure pushed noise-induced hearing loss—and audiologists—into the national spotlight and sparked discussions on how to protect the hearing of young Americans. Audiologists are taking that conversation further, exploring with colleagues and ASHA their ideas for strategies to educate people of all ages about the impact of hazardous noise on hearing health and quality of life. The ASHA Leader interviewed six audiologists in a variety of settings—private practice, academia, occupational audiology, and educational audiology—for their perspectives on the impact of potentially accelerated hearing loss in the rising generation, and for their ideas for next steps audiologists can take to continue to play a visible role in addressing the problem of noise-induced hearing loss. The interviews follow on pages 8–10. What’s their bottom line? These professionals say: The time is ripe for audiologists to make connections in school systems and offer themselves as a resource. Parents need to understand the risk factors and have their child’s hearing screened if the child is in a high-risk group. The cultural dimension in an individual’s exposure to dangerous levels of sound must be considered. Educational audiologists are few in number, and need the support of all audiologists in a unified campaign. School-based speech-language pathologists could help link science teachers and administrators with audiologists in educational outreach to middle schools and high schools. Our goal should be the eradication of noise-induced hearing loss in our children’s lifetime. Audiologists are front and center in this national discussion. In Part 3 of this series, the Leader will profile programs such as ASHA’s “Listen to Your Buds” and others—including “Dangerous Decibels”—and provide a full list of resources to those members committed to making a difference on the issue of noise-induced hearing loss. Brian Fligor, ScD, CCC-A Director of Diagnostic Audiology, Children’s Hospital Boston Instructor in Otology and Laryngology, Harvard Medical School We know that hearing loss is related primarily to two factors—age and noise. Given that the recent JAMA study evaluated teenagers, age-related hearing loss is factored out. So it’s likely from noise—from many sources. It’s not all about headphones. But with 90% of teens using portable listening devices (PLDs), it would not be unreasonable to expect an acceleration of age-related changes in hearing due to what these one in five teens have been doing to their hearing health during their first two decades. What if their lifestyle choices cause them to have hearing more like 30- or 40-year-olds than like teenagers? Their “ear age” may have greatly outpaced their chronological age. That could mean that at age 30 or 40, they may have the hearing of a 50- or 60-year-old. They may need hearing aids at much younger ages. This study also could affect our thinking about the standard of “audiometric zero,” which is based upon screened 18-year-olds who supposedly have pristine hearing. We use that measure to determine our expectations for age-related hearing loss. This study says that one in five teens tested didn’t have pristine hearing—that’s a huge number. The JAMA study was unable to show any causal link for hearing loss, with the exception of children with a lower socioeconomic status. That factor is something we know to have a very robust effect, but it’s hard to explain why your hearing is worse if you are poor. I was concerned about the paper’s inability to show cause and effect related to the use of firearms, which was not shown to be a significant predictor of hearing loss in this study. That finding makes me wonder if the questions they asked were not sensitive enough to show cause, because use of firearms is the leading cause of recreational noise-induced hearing loss (NIHL). Here’s the good thing—because this research appeared in JAMA, hearing health is in the public’s mind. Awareness is a great thing, but it’s important that it not be overblown. The amount of hearing loss is not outrageous. Most of the hearing loss is slight. As a first step, parents need to ensure that teens see an audiologist to establish a baseline hearing level. Audiologists can then recommend a hearing loss prevention program if, for example, a child is playing percussion in a marching band. My message to parents is simple—respect your child’s hearing. People need to take responsibility for hearing health for themselves and their children, but it’s up to us to give them educational tools for making better hearing health decisions. Audiologists also should consult with industry to help develop technical tools that help consumers use their devices more responsibly. Audiologists are uniquely suited to help children and teens get preventive hearing care, not so different from preventive dental care. Musicians, teens who use PLDs heavily, or any at-risk individuals need an audiologist like everyone else needs a dentist. The public awareness brought about by the JAMA research offers us a great opportunity—audiologists could partner with science teachers and speech-language pathologists in the schools, and they could contact their administrators about bringing in an audiologist. We could participate in science fairs in middle school and high school, and we could do in-service training for biology and physics teachers. The time is ripe for audiologists to make connections in the school system and offer ourselves as a resource. Our participation also may encourage some students to have an interest in audiology at a time when there is a critical need to promote careers in audiology and hearing science. Mary McDaniel, AuD, CCC-A Occupational Audiologist Pacific Hearing Conservation Seattle, Wash. For decades we have known the effects of noise on hearing and that noise-induced hearing loss often is preventable. To think that noise-induced hearing loss is primarily an occupational hazard is a misconception. We live and play in a noisy world, and noise damage knows no age boundaries. It is tragic that hearing loss prevention isn’t part of every child’s school curriculum. We must teach our children at an early age about how to prevent noise-induced hearing loss. This effort also can be accomplished through a media campaign that would serve to educate parents and the public. Young people often underestimate the impact of noise and hearing loss on their lives. Even a slight loss can affect an individual’s ability to discriminate sounds, perhaps missing the punch line of a joke or the details of a school assignment. Hearing loss will affect both their social and academic lives, and will be with them throughout their lifespan. The most important strategy that could be implemented through both the media and the nation’s schools is a program of education and motivation about the potential hazard of noise in our lives. There’s absolutely no reason that a school-based SLP could not assist in this process, unless it might be because of a bulging caseload! We also could enlist parents or teachers’ aides to spread the word. One of the most significant things about this research is the attention that it brings to noise-induced hearing loss. This current research illuminates a problem that will affect our society for years to come. Our goal should be to eradicate noise-induced hearing loss in our children’s lifetimes. Janice Trent, AuD, CCC-A Private-practice Audiologist Hearing Health Care Services LLC Bowie, Md. The JAMA research dovetailed with the findings of a report by the Kaiser Family Foundation published in January that looked at the use of all media by children 8 to 18 years old. They found that kids were engaged with entertainment media an average of 7.5 hours a day—using earbuds with all types of media including laptops, television, video games, and personal listening devices like iPods and MP3 players. It’s a bombardment of the auditory system. And classrooms are another source of noise. After doing a radio talk show interview on the impact of the JAMA research, I received an e-mail from a teacher who said he wished we had addressed school cafeteria noise. It was a stressor for him and he wondered about the impact of high noise levels on digestion. We need to make a bigger statement about protecting hearing health—and not just to kids in the schools. The question for adults is, have we been too tolerant of noise? If adults are not modeling hearing conservation, why should we expect our children to protect their ears? We also need to consider the cultural dimension in the audiological context. I’m African American and a preacher’s wife. One of the things I have found is that in many evangelical churches the music is too loud. I have done breakfast workshops with area ministers talking about noise levels, the impact on their congregants, and strategies to change the listening environment. I’m not trying to curtail the spirit, but a 150-voice choir does not need an amplifier set at maximum volume. After another radio talk show interview, a blogger wrote to ask, can you do something about the volume of music at bar mitzvahs? I was reminded that loud music has infiltrated our lives in many different areas. As audiologists, we are the professionals to address publicly the issue of sociocusis in our communities and its impact on the auditory system. We need to talk aggressively about prevention—and not just screening, but a full diagnostic evaluation. Most insurance will pay for that, similar to a complete vision evaluation. We need to start looking more broadly at all environments: classrooms, the workplace, recreational activities, transportation, and the home environment. I applaud the JAMA study, but we also need to let the public know that researchers in our discipline have done great research on these issues. So many people do not understand noise-induced hearing loss or its risk factors. We have to educate the public about the impact of noise. Audiologists are the go-to people on noise-induced hearing loss—we’re out there on the front lines making the diagnoses and encouraging prevention, and with the recent rise in public awareness, it’s time to ramp up our efforts on these issues and try to make a real difference. Dennis Hampton, PhD, CCC-A Private-practice Audiologist Westchester Audiology Center White Plains, N.Y. The JAMA article confirms that hearing loss appears to be on the increase and a significant cause of the increase appears to be hearing loss we inflict on ourselves. Our ears don’t care whether the toxic noise levels are from the factory floor or motorcycle noise, Beethoven or rap. Is the use of personal headsets by teens a cause? Years ago, that question was answered when Maurice Miller, an audiologist from New York, studied the output levels of the Sony Walkman portable tape player (Hearing Loss Magazine, 2006). He found that users of personal headsets often set the Walkman at levels that could damage hearing. Today, it’s MP3 players, plus rock concerts and all the other sources of noise around young adults. We no longer have to debate whether personal headphones (and loud music) causes hearing loss. Our job is to spread that message to other health care providers, educators, and to teens and young adults. This also is an opportunity to reinforce our belief that hearing screening, which takes place in the primary school setting in most states, should be a part of a person’s health examination throughout the lifespan. Unfortunately, only about 10% of physicians actually screen for hearing loss. The publication of this research is an opportunity, then, for us to prevent hearing loss by increasing public awareness, educating health care providers and the public, and encouraging regular hearing screenings. In my practice, we mail newsletters to our patients and local physicians, and we will review this research in an upcoming article, written for physicians, that will address the role of the family physician in screening for and preventing patients’ hearing loss. School-based speech-language pathologists and educational audiologists could have an important role in bringing this research to the attention of science teachers--and school nurses and health teachers. Hearing loss prevention could be incorporated into the science and health curricula. Local SLPs might also recruit a local audiologist as the hearing expert to talk to students in science and health classes. And why not invite an audiologist to be the commencement speaker at graduation! Graduates, go out into the world--but protect your hearing! John Ribera, PhD, CCC-A Director of Audiology Department of Communicative Disorders and Deaf Education Utah State University Logan, Utah With the development of portable devices that deliver favorite tunes, there is nothing to dampen the sound between the transducers of these devices (earphones that fit in the concha) and the eardrum. If there is high ambient noise, the tendency is to mask the unwanted sounds by raising the volume even higher. If we fail to turn the tide, adolescents and young adults will begin to experience hearing loss much earlier in life, a condition that is crucial because their academic performance can be adversely affected. Hearing loss also can affect daily activities, social interactions, career progression, and quality of life. We must do more to educate and motivate our youth to think about exposure to dangerous levels of noise. This effort needs to be a multifaceted approach that targets not just youth, but also parents, teachers, and administrators, and other groups that reach young people to help create a new culture and way of thinking about hearing conservation. In Europe there is pressure to require manufacturers of personal listening devices to cap volume levels. This approach might be one to consider in this country. I suggest that young listeners use the 60/60 rule—no higher than 60% of maximum volume for no more than 60 minutes. Classroom presentations on youth hearing health and noise-induced hearing loss can help bring about change. Where there are no educational audiologists, speech-language pathologists could help bring other audiologists to the schools to spread the word. Also, young people usually have heroes in sports and entertainment. The more stars and celebrities who are willing to speak on behalf of hearing conservation, the better. I think ASHA and other organizations have stepped up to the plate by developing materials and websites like “Listen to Your Buds” geared to youthful listeners. Audiologists and speech-language pathologists should always be vocal advocates for hearing conservation and educating the public about the importance of preserving the ability to communicate. Tena McNamara, AuD, CCC-A President-elect, Educational Audiology Association Assistant Professor, Eastern Illinois University When we were growing up, when the stereos went up, the windows went down. Now the sound is going directly into the ears of young people. I work at a special-education co-op and on a college campus, and I see college kids working out in the gym with earbuds on and the levels set at high intensities—which is likely to be a dangerous combination because blood flow increases to the limbs and away from the ears. Some of the oxygen to the cochlea may be depleted, making hair cells more susceptible to noise-induced hearing loss. We need a strong education campaign. It’s hard for educational audiologists—we’re spread so thin. Sometimes we have one professional for every 20,000 to 30,000 students. All audiologists should be involved. We need a team effort led by audiologists with school-based speech-language pathologists, teachers, and administrators. An initial step would be to gather materials and resources to use for in-service training with school districts. We could then implement hearing conservation programs, and put posters and other materials around the schools with the message: Turn it down! Kids are surrounded by electronics, and they don’t realize the consequences to their health. Hearing loss is permanent, and at present there is no cure. Hearing decreases with age, so if you’re starting out with a slight or mild loss at 20, you don’t have the best prognosis. Hearing conservation has been with us for years. We’re really good at promoting it one-on-one, but now we need to step up and expand our efforts and do it in a unified way. This is not just an issue with teenagers. ASHA has the “Listen to Your Buds” campaign that reaches out to young children. We also need to heighten public awareness among adults. We need a public campaign that reaches all age groups. Media Alert for Audiologists Audiologists wishing to connect with media representatives to spread the message about the importance of hearing conservation can contact ASHA’s public relations unit by e-mailing [email protected]. Author Notes Marat Moore, managing editor of The ASHA Leader can be reached at [email protected]. Additional Resources FiguresSourcesRelatedDetails Volume 15Issue 12October 2010 Get Permissions Add to your Mendeley library History Published in print: Oct 1, 2010 Metrics Downloaded 171 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2010 American Speech-Language-Hearing AssociationLoading ...

Noise-induced hearing loss and tinnitus are two of the most prevalent service-connected disabilities of United States military veterans. Educational materials meant for hearing conservation program-eligible Airmen were evaluated from active-duty, continental United States (CONUS) Air Force bases for compliance with US Air Force (USAF), Department of Defense (DoD), and Occupational Safety and Health Administration (OSHA) regulations. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), while readability was assessed with Flesch-Kincaid Grade Level (FKGL). Educational materials were received from 44 of 61 (72%) active-duty, CONUS bases, with 27 bases sending one item and 17 bases sending multiple items, for a total of 67 educational materials, which were evaluated by three evaluators. Educational materials were categorized into one of four types: (A) supervisor’s guide to hearing conservation (n = 21); (B) new worker hearing conservation training (n = 20); (C) two-page hearing conservation program training pamphlet (n = 14); and (D) other (n = 12). Overall mean compliance was 84% (CI: 63,100) (USAF), 83% (CI: 62,100) (DoD), and 88% (CI: 67,100) (OSHA), respectively. Overall mean understandability was 75% (CI: 63,87) and actionability was 89% (67,100). There was good agreement between the three evaluators for each of the criteria (87-90%). Overall mean readability was grade level 10.68 ± 1.68 on the FKGL scale. For educational materials, 65 of the 67 (97%) were above the recommended 6th-grade reading level, and 62 of the 67 (93%) educational materials were above the average American 8th-grade reading level. This study established compliance, understandability, actionability, and readability scores for educational materials that military service members receive upon entry into the hearing conservation program, gathered from active-duty, CONUS Air Force bases. Using the determined scores, recommendations, such as providing active feedback and condensing information, were given to improve future hearing conservation educational materials.

It was 1976, hearing conservation and earplug technology had just been advanced by the introduction of the first slow-recovery roll-down foam earplug four years ago, and Elliott Berger had just entered the workforce. Over the next 41 years, Elliott would be a key player in many other advancements in hearing conservation. This paper will briefly summarize his career and contributions to hearing conservation, including research and development of new hearing protectors, standardization of many aspects of hearing conservation, and education of hearing conservation practitioners. Along the way, Elliott documented his work in numerous journal articles, book chapters, and presentations. Several of Elliott's colleagues, collaborators, and friends are here today to fill in more of the details of his career and work to advance hearing conservation.

Hearing conservation—A shipyard challenge

Hearing conservation and noise exposure management for professional orchestras is a difficult issue resistant to standard control measures as used in other industries with excessive noise problems. Although there has been a great deal of research into this area in terms of the audiological status of musicians and their exposure to noise, there are relatively few industry-specific strategies that can be adopted by an orchestra looking to address these issues. Australia does not have a uniform approach to hearing conservation management in its orchestras; however, each orchestra actively grapples with the challenges of balancing legal, practical, and artistic concerns. This study systematically investigated hearing conservation practices, noise exposure management, and audiological screening protocols in eight professional orchestras. The research involved personal interviews with staff at each orchestra, including inspection of venues and facilities. While all these orchestras were aware of the risks and were actively taking significant steps to reduce noise exposure, a range of approaches, with varying degrees of effectiveness and understanding of the issue, were found across the sector. There was limited evidence of educational programs for either the musicians at risk of excessive noise exposure or the staff responsible for devising and implementing control measures. In addition, the reported use of adequate personal hearing protection by musicians was poor. As Australia has recently introduced a national approach to workplace health and safety, a similar approach to noise and audiological management across the country's orchestral sector is proposed, drawn from existing research and practice. This will enable both consistent procedures and meaningful dialogue between the orchestras on the topics of hearing conservation, audiological monitoring, and educational practices.

Orchestral musicians are an at-risk population for noise-induced hearing loss. Following strategic approaches to mitigate exposure, many must use earplugs to safeguard their hearing, although reported usage rates are poor. Australia has progressive hearing conservation programs within many of its orchestras, yet little is known of earplug usage rates, abilities with earplugs or self-perceived hearing loss in this population. To help direct and inform future approaches to hearing conservation in Australia's orchestras a questionnaire assessing hearing conservation behaviors and the prevalence of self-perceived hearing loss was distributed. A total of 580 musicians across eight professional orchestras were surveyed, with 367 completed surveys (63%) returned. Eighty percent of respondents reported a risk of hearing damage in the orchestra, 64% used earplugs of some type at least some of the time and 83% found this use difficult/impossible. Forty-three percent reported a hearing loss, including 54% in pit orchestras and 46% of those ≤50 years of age. Brass players were least likely to use earplugs, most likely to report usage difficulties and most likely of those ≤50 years of age to report a hearing loss. While earplug usage rates in Australia are encouraging and may be linked to hearing conservation measures in the orchestras, the widespread difficulty reported with the use of these earplugs, the prevalence of self-reported hearing loss and the continued vulnerability of those most at-risk indicate improvements in both earplug design and further education for musicians are required to progress hearing conservation options for this population.

The English term “boilermaker's deafness” was often used during the 1700 and 1800s. It referred to high-frequency sensori-neural hearing loss found in workers exposed to high levels of noise intensity. Second-level noise control relates to hearing conservation programmes (HCPs) and hearing protection (as well as hearing protection devices, known as HPDs). First-level noise control involves using modern engineering to quieten machines. Effective secondlevel noise control (hearing conservation) is required in the presence of noise. This article focuses on HPD trends, personal hearing protection and personal hearing conservation. Statistics gathered over the years have indicated that HCPs were and still are inadequate, and the assumption that workers are well-protected is a dangerous one. Despite all the HCP models and HPD types, noise-induced hearing loss (NIHL) compensation statistics are still incredibly high. The multidimensionality of the problem necessitates a more personal and individualised approach to hearing conservation. This article reports on a study of HPD and HCP trends based on a questionnaire survey conducted with 55 specialist safety, health and environmental (SHE) managers in industry. The article describes a new paradigm of personal (custom-made) hearing conservation based on individual risk profiles, personal hearing protection, and higher HPD/HCP standards to prevent further spread of the irreversible and incurable NIHL pandemic. Keywords: hearing conservation, hearing protection, noise control, noice-induced hearing loss, personal protection equipmentAfrican Safety Promotion Vol. 6 (2) 2008: pp. 42-62

This narrative review critically examines the state of occupational noise regulation and hearing conservation in African low-and middle-income countries (LMICs), a region where the burden of noise-induced hearing loss (NIHL) is escalating due to rapid industrialization and systemic weaknesses in regulatory design and implementation. Using structured searches in PubMed, Scopus, and Web of Science, peer-reviewed literature published between 2000 and April 2025 was systematically identified and screened. Twelve eligible studies focusing on regulatory and policy aspects of occupational hearing conservation in African LMICs were included. An inductive thematic analysis revealed four core themes: The existence and variability of occupational noise regulations across countries, persistent implementation and enforcement challenges, limited and fragmented characteristics of hearing conservation programs (HCPs), and critical gaps in policy frameworks. The findings indicate that while several African LMICs have adopted regulations addressing occupational noise exposure, there is significant inconsistency in scope, content, and application. Weak enforcement mechanisms, inadequate training and monitoring systems, low health literacy among workers, and lack of integration with broader public health strategies hinder effective prevention of NIHL. High-risk industries such as mining, manufacturing, and construction remain disproportionately affected. Emerging evidence from innovative interventions and the underutilized role of audiologists highlights opportunities for integrated, contextually tailored HCPs. This review highlights the need for strengthened, context-sensitive, and enforceable regulatory frameworks that are aligned with international standards but tailored to local realities. It provides essential insights for policymakers, occupational health professionals, audiologists, and other stakeholders seeking to reduce the burden of NIHL and advance hearing conservation in Africa. By consolidating findings and offering implementation-focused recommendations, this review contributes to shaping more responsive and sustainable occupational health policy across the region.

HighlightsNoise-measuring applications (apps) and in-person classroom presentation were identified as the most preferred approaches by the college agriculture students.Multiple features of noise apps and in-person intervention were identified as beneficial.A subset of participants reported that a combination of approaches could influence hearing protection use.Abstract. Noise-induced hearing loss is a major public health challenge for agricultural communities. However, there is limited hearing conservation research addressing the issue, especially for youth and young adults. The purpose of this study was to investigate the perceptions and practices of Indiana undergraduate students who lived or worked on a farm. The students were asked to rank the most common and current hearing conservation educational approaches, including in-person classroom presentation, mailers, and technology-based approaches, i.e., computer-based training, interactive websites, static websites, and smartphone noise-measuring applications (apps). A total of 91 undergraduate students enrolled in agriculture classes at four Indiana higher educational institutions participated in the study. They completed a sociodemographic and farm activity survey, followed by a 30-minute in-person presentation on hearing health conservation. After the presentation, each participant completed a questionnaire that included items about their perceptions of the feasibility, sustainability, rankings, and preferences of the various educational approaches discussed in the presentation. Participants ranked the noise-measuring app and in-person classroom presentation as their most preferred educational approaches for hearing conservation (39% and 28%, respectively). They identified multiple features of these two intervention approaches as beneficial. Sixty-four percent of participants indicated that a combination of approaches could influence hearing protection use and should include in-person classroom presentation and one of the technology-based approaches (noise-measuring apps, 37.3%). These findings are expected to assist health interventionists and program designers in developing future hearing protection education programs for farm youth, who may otherwise lack access to resources for preventing premature hearing loss due to loud noise exposure. Keywords: Agricultural workers, Hearing conservation, Hearing protection, Undergraduate college students, Youth education.

An educational hearing conservation (HCP) program was designed and presented to 45 normal hearing third- and fourth-grade children enrolled in regular education programs. Questionnaires assessing knowledge of hearing, noise-induced hearing loss, and hearing conservation practices were administered prior to and following a HCP which consisted of a lecture, film, hearing screening demonstration, question and answer and discovery learning periods, and distribution of earplugs and a handout. Most children reported that they did not participate in noisy activities; however, of those who did participate an average of only 5.5% (2.5) reported use of ear protection. Knowledge about noise and noise-induced hearing loss increased an average of 23% following the HCP and 91.1% reported that they "learned something" from the HCP. Post-HCP responses revealed that 96.7% of the children intended to use ear protection when engaged in the depicted noisy activities. Although students indicated their intentions to pursue hearing conservation practices, follow-up studies are needed to determine whether hearing conservation programs are effective in establishing positive, long-term hearing health habits. School hearing conservation programs must be comprehensive in scope, including educational programming aimed at prevention and reduction of the prevalence of hearing loss, as well as identification and management of hearing loss.

BackgroundMany youth and young adults experience high noise exposure compounded by lack of access to hearing health education. Although the need for hearing health education programs is evident, the efficacy of these programs for youth is unclear. We evaluated the literature for efficacy of various hearing conservation programs aimed at youth and young adults, and analyzed their strengths and limitations.MethodsStudies reporting results of hearing conservation or hearing loss prevention programs with youth or young adults, using randomized controlled trials, quasi-experimental designs, experimental design, or qualitative research, and published in peer-reviewed journals in English between 2001 and 2018 were included. Studies were found through searches of selected literature databases (i.e., PubMed, Google Scholar, NIOSH Toxline, and Scopus). Identified publications were assessed for relevance, and data were extracted from the studies deemed relevant.ResultsA total of 10 studies were included. Very little evidence of efficacy of hearing conservation educational programs was found in these studies. Several methodological limitations including lack of rigorous study designs, inadequate power, and application of inappropriate statistical analysis were noted. Some use of technology in programs (e.g., smartphone apps, mobile phone text messages, and computers) was observed, but conclusions as to the effectiveness of these tools were limited by the small number of studies and small sample sizes.ConclusionsThe number of studies of educational hearing conservation programs for youth and young adults was low. The efficacy of the program was not reported in most studies, and it is difficult to draw public health conclusions from these studies due to their multiple methodological limitations. While use of technology in hearing conservation educational programs offers promise, its effectiveness has not been studied.

NIOSH recommends that hearing loss prevention programs (HLPPs) be implemented for all workers whose unprotected 8-h TWA exposures equal or exceed 85 dB and that the programs include at least the following components: (1) initial and annual audits of procedures, (2) noise exposure assessment, (3) engineering and administrative control of noise exposures, (4) audiometric surveillance and evaluation, (5) use of hearing protectors (for exposures >85 dB, regardless of duration), (6) education and motivation, (7) recordkeeping, and (8) program evaluation. All components except program evaluation and routine in-hour audits are generally discussed in the Occupational Safety and Health Administration (OSHA) Hearing Conservation Amendment (HCA). This paper presents research approaches for systematically evaluating OSHA-mandated hearing conservation programs. The intent of such research is to (a) develop methods for evaluating hearing conservation programs that can be used across several industrial sectors and (b) identify ways in which ‘‘hearing conservation’’ can effectively become ‘‘hearing prevention’’ programs. General approaches are presented for each program element and data collection issues are discussed with specific examples of how various methods can been used for program evaluation. The goal of such research strategies is to identify the best predictors of program effectiveness.