Its Time to Prioritize Hearing Protection Nationwide

Amidst rising cases of noise-induced hearing loss and regulatory oversights, this feature underscores the imperative to reinforce hearing conservation efforts for millions of U.S. workers.

• By Dan Glucksman
• Oct 11, 2023

Is protecting hearing as high a priority in the workplace as it should be? After all, hearing is an important primary sense that connects us to each other and the environment around us. Hearing allows us to communicate critical information and helps keep us safe on the job.

Yet, the numbers show that more work is needed to improve hearing conservation for millions of workers, especially as new (and noisy) construction sites blossom nationwide, thanks to a big increase in federal infrastructure spending. 

While regulatory requirements obligate employers to protect workers, these regulations in the U.S. have not kept pace with science and the known risk to hearing health from over-exposure to hazardous noise and ototoxic chemicals. Regulatory agencies and employers can prioritize workers’ hearing by adopting more protective measures.

The Occupational Safety and Health Administration (OSHA) did launch a Regional Emphasis Program for Noise Induced Hearing Loss in 2022, which moved into the enforcement phase beginning May 17, 2022. But this emphasis program only targeted Colorado, Montana, North Dakota and South Dakota, focusing on manufacturing industries with high rates of occupational hearing loss.

OSHA citations for hearing conservation are very low; however, noise-induced hearing loss (NIHL) is a common occupational illness. In spite of long-standing regulatory requirements, non-use of hearing protection is high.

Research reported by the National Institute for Occupational Safety and Health (NIOSH) shows that “28 percent of noise-exposed Manufacturing workers report not wearing hearing protection,” despite the reality that about “46 percent of all workers in Manufacturing have been exposed to hazardous noise.” The numbers are even higher in Construction, where NIOSH reports that about 51 percent of all workers have been exposed to hazardous noise, and 52 percent of noise-exposed Construction workers report not wearing hearing protection.

A strong federal nationwide effort on hearing loss — similar to last year’s heat stress campaign — would move employers to take preventive action.

What might a big federal initiative look like?

• It could take the form of a formal Request for Information (RFI) on workplace hearing conservation programs.
• It could include an education effort aimed at infrastructure projects getting federal funding.
• It could put employers on notice that noise is a serious health hazard that demands urgent action.
• It could utilize creative public service announcements.

Information Is Plentiful

There’s no shortage of information available for employers and workers who want to learn more — and do more — about hearing protection, including OSHA’s own webpage on workplace noise standards. The challenge is converting information to inspiration and action.

OSHA itself has a useful online primer about occupational noise exposure, as well as guidance on using leading indicators. My organization, the International Safety Equipment Association (ISEA), has long maintained a hearing-protection page on our website. Additionally, The New York Times published an excellent June 9, 2023, article about what noise does to the human body, “Noise Could Take Years Off Your Life. Here’s How.”

NIOSH, the National Hearing Conservation Association (NHCA), and the Council for Accreditation in Occupational Hearing Conservation (CAOHC), have partnered to recognize companies that go above and beyond in their workplace hearing conservation efforts. The Safe-in-Sound Awards™ “honor excellent hearing loss prevention (HLP) practices in the work environment,” according to the partnership’s website, safeinsound.us.

Other resources employers can use to promote best practices in hearing loss prevention include annual observance periods, such as National Protect Your Hearing Month (October) and World Hearing Day (March 3). Plus, The Hearing Journal featured an excellent article on Total Hearing Health.

Scope of the Problem

NIOSH notes that all industries have hearing risks, with 22 million U.S. workers exposed to hazardous noise levels at work each year and 30 million exposed to ototoxic or hearing-hazardous chemicals.

The Center for Construction Research and Training (CPWR) explains that, although OSHA set the permissible exposure limit (PEL) for construction noise to 90 A-weighted decibels (dBA) over an eight-hour period, “NIHL often results from extended exposure to sound levels at or above 85 dBA, and can even occur at lower exposure levels.”

CPWR reports that hearing loss varies by occupation but increases with age.

• Using NIOSH data, CPWR determined “that construction workers have the highest prevalence of hearing loss of any industry except for mining. Among construction workers tested between 2003 and 2012, 16.3 percent had hearing impairment compared to 12.9 percent among all industries. It is estimated that hearing loss leads to more than three disability-adjusted life years per 1,000 construction workers, the second highest among all industries.”
• “Among construction workers ages 18-25 years surveyed by NIOSH, only less than 2 percent had hearing impairment. However, among those ages 56-65 years, nearly half (48.6 percent) had some hearing impairment.”
• Moreover, says CPWR: “Findings from the Building Trades National Medical Screening Program (BTMed), which examined construction workers with an average of more than 20 years of occupational exposure, show that over 58 percent of construction workers examined between 1996 and 2015 had material hearing impairment (1998 NIOSH definition); among welders, it was 77 percent.”

According to the U.S. Department of Veterans Affairs, which has conducted long-term research on hearing loss, “[h]earing problems—including tinnitus, which is a perceived ringing or other type of noise in the ears—are by far the most prevalent service-connected disability among American Veterans.”

Exposure Levels

While most federal agencies mandate a PEL of 90 dBA averaged over an eight-hour work shift using a 5-decibel exchange rate, a lower limit of 85 dBA averaged over an eight-hour work shift using a 3-decibel exchange rate is specified by nearly all other jurisdictions around the globe.

For example, NIOSH and the U.S. Department of Defense use this lower limit and exchange rate (see Recommended Exposure Limit).

“Studies show that enforcing mandatory hearing protector use at 85 dBA TWA and louder can significantly reduce the percentage of excess risk for acquiring noise-induced hearing loss” says Laurie Wells, AuD, Lead Regulatory Affairs Specialist at 3M, and chair of ISEA’s Hearing Protection Product Group.

Wells says sustained exposure to dBA levels at 90 dBA and greater can harm your hearing over time. Employers and workers really need to make sure they’re not only well-trained on hearing protection and that they are using hearing protection conscientiously, but also that the hearing protectors are the right type to suit the task and work environment. “Once you lose your hearing, it’s gone” adds Wells.

Preventing hearing loss is obviously important, but noise also has some surprising effects on human health that people should remember, as the New York Times article referenced above points out.

Stress, chronic fatigue, high blood pressure, and even digestive disorders are among those effects. Tinnitus is as well, and it’s been connected to sleep problems, brain function, anxiety, depression, fatigue, irritability, and more.

Thus, hearing needs to be understood in a larger context — both for worker health and workplace safety reasons. For example, NIOSH includes “total hearing health” as an element of its Total Worker Health (TWH) Program, which takes a holistic approach to worker well-being.

NIOSH “recommends an integrated approach to address the hearing health of workers. An integrated approach is a comprehensive consideration of risk factors intended to protect workers from work-related injury and illness and help them advance their overall health and well-being, on and off the job. The approach includes addressing exposures at work, environmental factors, and personal factors.”

Proper Hearing Protection

For workers and employers who prioritize protecting hearing, basic awareness of the need for hearing protection is common. What’s less common is knowing how to select and use hearing protection appropriately. There are many types of hearing protectors with different features for a variety of noise exposures and work environments.

It takes training and skill to fit hearing protectors in a manner that achieves the amount of noise reduction needed for the task. NIOSH shows a three-step process in this simple how-to guide: roll, pull, and hold. That middle step — pulling the top of the ear up and back with the opposite hand — is often skipped, which may compromise the noise reduction needed.

“We now have the capability of fit testing hearing protectors on each worker. This is similar to the concept of respiratory fit testing, and it provides an opportunity to train workers to develop the skill needed to achieve the attenuation they need,” Wells notes.

For complex noise environments and to improve communication in noise, electronic hearing protectors feature a variety of technologies to help improve speech understanding while reducing background noise. These are often integrated into communication headsets or even in-ear products.

There are several ISEA member companies offering hearing-protection PPE. These companies are more than simply a source of PPE, however. These companies not only provide PPE but also contribute insights and innovations to the OH&S community.

“We encourage every employer to utilize the knowledge available from manufacturers, distributors and trained occupational health and safety professionals and even arrange for on-site noise-assessment consultations,” Wells says. “ISEA member companies care about protecting the hearing of workers exposed to hazardous noise and are committed to being part of the solution.”

This article originally appeared in the October 2023 issue of Occupational Health & Safety.