1. Determining Protected Exposures for Noise-Exposed Workers Theresa Y
Determining Protected Exposures for Noise-Exposed Workers Theresa Y. Schulz, PhD. Lt. Col. USAF (ret.)

2. Agenda
Background
NRR
Fit-testing studies
Fitting HPDs
Motivation

3. Background
Noise-induced hearing loss is the most common permanent and preventable occupational injury in the world.
The extent of the problem is shown in this statistic: The World Health Organization reported a few years ago that noise-induced hearing loss is the most common permanent and preventable occupational injury in the world.
World Health Organization

4. Worker’s Compensation
Background
Worker’s Compensation
In many countries, excessive noise is the biggest compensable occupational hazard. Cost of NIHL to developed countries ranges from 0.2 to 2% of its GDP. NIHL is on the rise globally. (Source: WHO)
In many countries, excessive noise is the biggest compensable occupational hazard. Cost of NIHL to developed countries ranges from 0.2 to 2% of its GDP. NIHL is on the rise globally. (Source: WHO)

5. United States Statistics
Background
United States Statistics
Most common occupational injury in the United States. 22 million US workers are exposed to hazardous noise at work on a daily basis. Approx. 8 million Americans suffer from NIHL. (Source: NIOSH, 2009)
Most common occupational injury in the United States. 30 million US workers are exposed to hazardous noise at work on a daily basis. Approx. 10 million Americans suffer from NIHL. (Source: NIOSH)

6. Background
In the United States, 76% of noise-exposed workers need no more than 10 dB of protection. 90% need no more than 15 dB of protection.
The vast majority of workers in the U.S. need no more than 10 dB of real protection, and 90% need no more than 15 dB of protection, according to NIOSH data.

7. Noise Reduction Rating (NRR)

8. Noise Reduction Rating

9. Noise Reduction Rating
Noise Level = 100 dB
Noise Reduction Rating = dB
How much noise is reaching the ear of the worker ?
Confusion about the proper application of a hearing protector’s rated attenuation has led to many to assume that most workers obtain protection at a level that equals noise minus NRR. But the amount of noise reaching the eardrum of a particular worker is completely unknown.
That is completely unknown …
(55 – 104 dB)

10. 0 dB 0 dB 33 dB How much protection? EAR #1 EAR #2 EAR #3
Just having an earplug in the ear is no guarantee of protection. In the photos shown here, a safety supervisor inspecting worker compliance may assume that the middle ear is protected. Actually, that worker is receiving 0 dB of protection, due to a poor fit.
How much protection?

11. Good Fit vs Bad Fit Frequency in Hz Attenuation in dB Max Poor Fit
-10
125
250
500
1000
2000
3150
4000
6300
8000
Frequency in Hz 90 80 70 60 50 40 30 20 10
Attenuation in dB
Max Poor Fit
NRR = 0dB
Max Good Fit
NRR = 33dB
<space> to show two fittings of the same earplug in the same worker’s ear on the same day. In both cases, the earplug was visibly in the ear far enough to satisfy a cursory compliance check. But the difference – a good insertion versus a poor insertion – is enough to cause a 30+ dB improvement in attenuation when the earplug is deeply inserted and achieves a good seal in the ear. The worker may be lulled into a false sense of protection when, even with a poor fit, he detects a slight muffling of high-frequency sounds – some of the “edge” is taken off shrill noise. But because the poor fit has seriously compromised low-frequency attenuation, the effective overall protection is 0 dB!

13. Noise Reduction Rating
A laboratory estimate of the amount of attenuation achievable by 98% of users when properly fit
A population-based rating ― some users will get more attenuation, some will get less
The NRR is only a population estimate,
not a predictor of individual attenuation.
The Noise Reduction Rating is a laboratory estimate of the amount of attenuation achievable by 98% of users when properly fit. It is a population-based rating … some users will get more attenuation, some will get less.

14. Noise Reduction Rating
NVLAP-Accredited Labs
San Diego, CA
Indianapolis, IN
State College, PA
There are currently three acoustic laboratories accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for testing hearing protectors against the EPA-required standard (ANSI S ).

15. Noise Reduction Rating – Determining an NRR
10 human subjects tested in a reverberant room
Tested with ears open/occluded at nine frequencies
Each subject tested 3x
NRR calculated to be population average
Hearing protectors are tested in a laboratory sound room which is intended to simulate a typical noisy setting in industry. Subjects are tested with ears open (no hearing protectors) and occluded (with hearing protectors), and the difference between those measurements is the noise reduction of the HPD. The attenuation measurements for all subjects are then input into a formula (the measurements are logarithmically added, two standard deviations are subtracted to account for variability, and 3 dB is subtracted to account for the different noise spectrums in industry). The result is the Noise Reduction Rating (NRR).
A test subject in the Howard Leight Acoustical Lab, San Diego, CA, accredited by the National Voluntary Laboratory Accreditation Program (NVLAP)

16. Noise Reduction Rating – in the real world
Real-World Attenuation ≠ NRR
192 users of a flanged reusable earplug ~ 27 NRR 50
NRR = 27 Multiple-Use Earplug 40 30 20
Attenuation in dB
There is quite a bit of variability in the attenuation obtained by users in the real world. This may be due to intentional factors (not inserting the HPD far enough in order to make it less intrusive, or more comfortable) or unintentional factors (improper sizing of HPD, poor seal around earmuffs, etc.). This scattergram shows the results of one study, indicating a wide variety of real-world attenuations for 192 workers wearing an earplug with a laboratory NRR of 27 dB. (<Space> to show retraining benefit.) Researchers in this study then took the workers with the lowest attenuation, and refit/retrained them in using the HPD properly. This resulted in an average 14 dB improvement in measured attenuation. The moral of the story? The effectiveness of an HPD relies heavily upon proper training and fitting by the wearer. 10
-10
From Kevin Michael, PhD and Cindy Bloyer “Hearing Protector Attenuation Measurement on the End-User”

17. Noise Reduction Rating
De-Rating Methods
OSHA
NRR ÷ 2
(feasibility of engineering controls)
NIOSH
Earmuffs
NRR – 25%
Formable Earplugs
NRR – 50%
All Other Earplugs
NRR – 70%
CSA
Class
A up to 100
B up to 95
C up to 90
Fit Test
The mistrust of NRRs has led to the promulgation of several de-rating schemes. But once again, none of these does anything to predict the individual protection to be expected from a particular user.

18. Noise Reduction Rating
The EPA recently made an announcement about a proposed change to the Noise Reduction Rating [NRR]
This is the first change in hearing protector regulation in nearly 30 years
At the beginning of August 2009, the EPA recently made an announcement about a proposed change to the Noise Reduction Rating [NRR]. This is the first change in hearing protector regulation in nearly 30 years

19. Noise Reduction Rating
Three New Labels
LABEL
DESCRIPTION
Conventional HPD
Perform lab test with 20 subjects who fit the protector after brief training
Estimates the range of protection achieved by 20% and 80% of users
Active Noise Reduction [ANR]
Uses a Microphone-in-Real-Ear [MIRE] method to estimate protection
Measured with ANR turned OFF and ON to show the additional attenuation from the ANR
Level Dependent/ Impulse Noise Reduction
Testing will occur over a range of impulse noise levels. Multiple tests to determine lower and upper ranges of impulse noise reduction
Will include two ranges to identify attenuation for passive and active modes
This slide covers the three new proposed labels, and the different types of HPDs will be tested.

20. Noise Reduction Rating
The New System: A Range
Represents a range of expected protection
Uses a new ANSI-standard (S ) lab testing to generate the attenuation ratings
New NRR will provide an indication of how much attenuation minimally-trained users [the lower number] versus highly-motivated trained users [the higher number] can be expected to achieve
For some hearing protectors, the spread of this range may be quite significant
The EPA has proposed changing the Noise Reduction Rating [NRR] from a fixed number to a range of attenuation. Represents a range of expected protection. This new NRR uses a new ANSI-standard lab testing to generate the attenuation ratings. The new NRR will provide an indication of how much attenuation minimally-trained users [the lower number] versus highly-motivated trained users [the higher number] can be expected to achieve. For some hearing protectors, the spread of this range may be quite significant.

21. Noise Reduction Rating
Current vs. Proposed NRR
Current NRR
Proposed NRR
Rating
A single-number estimate of protection
A high/low range of estimated protection
Description of Rating
Estimates the 98th percentile of protection obtained by users when properly fitted
Estimates the 80th and 20th percentile of protection obtained by users
Test Protocol
ANSI S [Experimenter Fit]
10 subjects for earplugs and earmuffs, HPDs fit by experimenter
ANSI S Method A [Supervised Subject-Fit]
20 subjects [for earplugs] or 10 subjects [for earmuffs], HPDs fit by subject after brief training
This slide demonstrates the differences between the current and proposed NRR.

22. Noise Reduction Rating
Current vs. Proposed NRR
Current NRR
Proposed NRR
Application
Intended for use with dBC noise measurements Requires a 7 dB correction for use with dBA noise measurements.
Can be applied directly to dBA noise measurements
De-Rating
Various de-rating schemes promulgated by various organizations [including OSHA]
Designed to be used with no required de-rating
Retesting
Currently, no retesting of HPDs required
Periodic retesting of HPDs required every 5 years

23. Noise Reduction Rating
80th %
Minimally-trained
20th %
Proficient Users
The EPA has announced its intention to modify the EPA label, changing the single number rating to a two-number range. The low point on that range would represent the 80th percentile (the level that most minimally-trained users could achieve), and the high point of that range would represent the 20th percentile of protected workers (the level the some proficient users could achieve).
Current NRR Label Mock-up of New Label

24. Noise Reduction Rating
How to Apply the New Label
Two-number range displays the estimated protection achievable by minimally-trained users [80%] versus proficient users [20%].
A wider range indicates greater variability in the fit of that HPD. Smaller ranges indicate more consistency of fit. For example, earmuffs will usually have a tighter fitting range than earplugs, and may have a smaller NRR range.
80%
20%
The new label will display a range of attenuation for each HPD.
Two-number range displays the estimated protection achievable by minimally-trained users [80%] versus proficient users [20%].
A wider range indicates greater variability in the fit of that HPD. Smaller ranges indicate more consistency of fit. For example, earmuffs will usually have a tighter fitting range than earplugs, and may have a smaller NRR range.

25. Noise Reduction Rating
Will OSHA 29 CFR change?
OSHA has not announced any proposed changes to the Occupational Noise Standard
OSHA will presumably respond to the revised NRR label by issuing a field directive or technical memorandum, informing its compliance officers how to deal with the new two-number NRR range
OSHA has not announced any proposed changes to the Occupational Noise Standard. OSHA will presumably respond to the revised NRR label by issuing a field directive or technical memorandum, informing its compliance officers how to deal with the new two-number NRR range.

26. Noise Reduction Rating
Will the new rating methods favor earplugs or earmuffs?
While a well-fit foam earplug generally has greater attenuation than most earmuffs, earmuffs are inherently easier to fit for most users
There is less variability in the fit of earmuffs
Overall range of attenuation for earmuffs will usually be tighter and often higher, than earplugs
Workers should be offered a choice of earplugs, bands and earmuffs that meet the requirements of the work environment
While a well-fit foam earplug generally has greater attenuation than most earmuffs, earmuffs are inherently easier to fit for most users. There is less variability in the fit of earmuffs. Overall range of attenuation for earmuffs will usually be tighter and often higher, than earplugs. Workers should be offered a choice of earplugs, bands and earmuffs that meet the requirements of the work environment.

27. Noise Reduction Rating
Earplug Fit Testing
Provides an accurate, real-world picture of hearing protector effectiveness.
Identify if hearing protection users are:
Receiving optimal protection
Require additional training
Need to try a different earplug style
Use VeriPRO fit testing to train how to properly fit HPDs, select appropriate HPDs and document adequate protection.
Use QuietDose in-ear dosimetery to document the noise dose employee is exposed to during their work shift.

28. As a problem solver: Derating Schemes One-on-One Training
Earplug Fit-testing
As a problem solver:
Derating Schemes
One-on-One Training
HPD Selection
NRR Change
Use VeriPRO fit testing to train how to properly fit HPDs, select appropriate HPDs and document adequate protection.
Use QuietDose in-ear dosimetery to document the noise dose employee is exposed to during their work shift.

29. Attenuation at Threshold (R.E.A.T.) Loudness Balance
Field Verification – Fit-Testing
Real-Ear
Attenuation at Threshold
(R.E.A.T.)
Loudness Balance
(Real-Ear Attenuation Above Threshold)
At the 2006 NHCA conference, we hosted a workshop to review the four common methods of measuring attenuation of an earplug in the field. These methods are as follows:
- Real Ear Attenuation at Thresholds (REAT), as used in FitCheck by Dr. Kevin Michael
- Real-Ear Attenuation Above Threshold (REA-AT), as used in VeriPRO
- F-MIRE, as used by Sonomax / AEARO
- In-Ear Dosimetry, as used in DoseBuster by Dr. Kevin Michael
Microphone in Real-Ear
(M.I.R.E.)
In-Ear Dosimetry

30. Ear plug fit-testing methods
Audiometric
FitCheck
EARfit
VeriPRO
REAT
MIRE
REAAT
Sound booth
Very Quiet Room
Quiet Room
Anywhere
PAR
Derived PAR
Any earplug
Selected modified earplugs
Special training required
Anyone can perform

31. www.hearingconservation.org www.howardleight.com
Reducing Costs + Claims
OSHA Alliance: Best Practice Bulletin
Additional Information
What does OSHA feel about fit testing systems for hearing protection? In an OSHA Alliance Best Practices Bulletin (see link), seven benefits of fit-testing systems are offered, and the concept is endorsed as a best practice for Hearing Conservation Programs.

32. Earplug fit-testing as a Problem Solver
Reducing Costs + Claims
Training tool for noise-exposed workers
Train-the-trainer tool
Follow-up on significant threshold shifts in hearing
Documentation of HPD adequacy
Assessment of overall HCP effectiveness
Match HPD to worker’s specific noise level
Selection of appropriate HPDs for new hires
Benefits per Best Practices Bulletin (OSHA Alliance)
There are several instances where QuietDose can improve a Hearing Conservation Program. It can be used with:
Employees with Documented Noise-Induced Hearing Loss or Standard Threshold Shift [STS]
Employees At-Risk for NIHL
Employee Training + Sampling
Dual-Protection/Extreme Noise Exposure
Engineering Controls

33. Review of some fit-testing studies

34. Noise Reduction Rating – in the real world
Real-World Attenuation ≠ NRR
Real user attenuation <0 to 38 dB
192 users of a flanged reusable earplug ~ 27 NRR 50
NRR = 27 Multiple-Use Earplug 40 30
Retraining and refitting resulted in an average
14 dB improvement for this group
Attenuation in dB 20
There is quite a bit of variability in the attenuation obtained by users in the real world. This may be due to intentional factors (not inserting the HPD far enough in order to make it less intrusive, or more comfortable) or unintentional factors (improper sizing of HPD, poor seal around earmuffs, etc.). This scattergram shows the results of one study, indicating a wide variety of real-world attenuations for 192 workers wearing an earplug with a laboratory NRR of 27 dB. (<Space> to show retraining benefit.) Researchers in this study then took the workers with the lowest attenuation, and refit/retrained them in using the HPD properly. This resulted in an average 14 dB improvement in measured attenuation. The moral of the story? The effectiveness of an HPD relies heavily upon proper training and fitting by the wearer. 10
-10
From Kevin Michael, PhD and Cindy Bloyer “Hearing Protector Attenuation Measurement on the End-User”

35. Fit-testing Studies Published NRR
Taken from a study of 101 workers at eight different companies, this scattergram shows how far away each worker was from the published NRR of the respective earplug they were using. About 1/3 of the workers had measured attenuation that were higher than the published NRR. About 1/3 were within the range about 5 dB below the published NRR. And about 1/3 of the workers had attenuation that was more than 5 dB below the published NRR. The bottom left photo shows the variety of earplugs that were tested in this study.
This scattergram shows the danger in using de-rating policies like the oft-misapplied 50% de-rating by OSHA. If we were to summarily just assume that all earplugs only achieve 50% of the published NRR in the field, then clearly 2/3 of the workers are seriously overprotected, since they are achieving much higher protection than 50%.

36. Personal Factors Program Factors Fit-testing Studies Gender Age
Years in Noise
Ear Canal Size
Familiarity
Model of Earplug
Program Factors
# Group Trainings
# Personal Trainings
What is the best predictor of a worker achieving good attenuation from an earplug? We looked at the following personal and program factors, and concluded there was only one strong factor that correlated with good protection: that factor was individual training. Workers who receive individual training in how to use their hearing protectors are more likely to achieve a high personal attenuation. All other factors just followed a random distribution.

37. REDUCING COSTS / CLAIMS
Fit-testing Studies
REDUCING COSTS / CLAIMS
Published NRR
A second important factor in achieving good attenuation in the field is the option of trying a second hearing protector. If a worker obtains low attenuation with one type of earplug, will he obtain low attenuation with all types of earplugs? Our study showed the answer is definitely NO. Workers who tried a second pair of earplugs often had major leaps in attenuation, bringing them closer to the published attenuation.
Trying a second earplug often improves attenuation

38. Self-Efficacy Pilot Study
“How well can users predict their attenuation after a short fit-testing training session?”

39. Pilot Study
Pilot study
Subjects
Subjects: 17 construction workers with varied HPD experience levels
Equipment: VeriPRO earplug fit-test system
HPD: Volunteers
Process: 2-4 Quick Check fits where employee sees feedback of exact PAR

41. Data show improved PARs!
Pilot Study
Results
Data show improved PARs!
Initial RE=19 LE=22
Final RE=29 LE=27
Average improvement 7.5 dB

42. Pre- and Post-Test Pre and Post-Test
Pilot Study
Pre and Post-Test
Pre- and Post-Test
How would you rate your ability to fit your earplugs?
Don’t know how I do OK Expert

43. Initial Ability Post-Test Ability Pre and Post-Test Pilot Study Expert
I do OK
Pretty good
Expert
Not good
Pretty good
I do OK
Expert
Don't know
how
Not good
I do OK
Pretty good
Expert Fitter

44. “How much noise do you think your earplugs block?”
Pre and Post-Test
Pilot Study
Self-Efficacy
“How much noise do you think your earplugs block?”
76% (13 of 17) judged attenuation as HIGHER post-test

45. 64% (11 of 17) rated their ability HIGHER post-test
Pre and Post-Test
Pilot Study
Post-Test
Are you better able to assess the effectiveness of your earplugs after VeriPRO fit-testing?
No Maybe No change Improved Yes
64% (11 of 17) rated their ability HIGHER post-test

46. Pilot Study
Pre and Post-Test
“How well can users predict their attenuation after a short fit-testing training session?"

47. (Each subject estimated atten. for each ear)
Pre and Post-Test
Pilot Study 2 4 6 8 10 12 14 16 18 20
Within 5 dB
category
+/- 7.5 dB
(one Category off)
+/ dB
(2 categories off)
(Each subject estimated atten. for each ear)
Number of Ears
Ability to Predict Noise Reduction

49. Risk Management

50. Indicators for Hearing Loss:
Risk Management
Indicators for Hearing Loss:
Standard Threshold Shift
Temporary Threshold Shift
Recordable Hearing Loss
Dosimetry
Labeled NRR (derated?)
In-ear Dosimetry
Personal Attenuation Level (PAR)

51. Lagging Indicators vs. Leading Indicators
Risk Management
Lagging Indicators vs. Leading Indicators

52. Indicators for Hearing Loss:
Risk Management
Indicators for Hearing Loss:
Standard Threshold Shift
Temporary Threshold Shift
Recordable Hearing Loss
Dosimetry
Labeled NRR (derated?)
In-ear Dosimetry
Personal Attenuation Level (PAR)

53. Fit Testing In-Ear Dosimetry
Risk Management
Reducing Costs + Claims
Risk Management
Fit Testing
In-Ear Dosimetry
There are now two methods that allow users to measure the fit and exposure protection in the workplace”
Fit Testing (using a system like VeriPRO)
In-ear Dosimetry (using a system like QuietDose)

54. In-ear dosimetry measures/records worker’s actual noise dose, with and without protection
Provides real-time monitoring and alerts when worker approaches/exceeds safe limits
Only metric with direct potential to measure and prevent further progression of occupational hearing loss
In-ear dosimetry records and monitors a worker’s actual noise dose, both with or without hearing protection.

55. In-ear dosimetry as a Problem Solver
Risk Management
In-ear dosimetry as a Problem Solver
Reducing Costs + Claims
Employees with Documented Noise-Induced Hearing Loss or Standard Threshold Shift [STS]
Employees At-Risk for NIHL
Employee Training + Sampling
Dual-Protection/Extreme Noise Exposure
Engineering Controls
There are several instances where QuietDose can improve a Hearing Conservation Program. It can be used with:
Employees with Documented Noise-Induced Hearing Loss or Standard Threshold Shift [STS]
Employees At-Risk for NIHL
Employee Training + Sampling
Dual-Protection/Extreme Noise Exposure
Engineering Controls

56. Risk Management
The typical sequence of measurements from in-ear dosimetry on an individual worker may look something like this. Initially, measured noise doses are quite high (over 100%). As the worker receives feedback about the overexposures, the daily noise doses work their way downward, until nearly all noise doses are below 50%.

57. Research > Alcoa Intalco Works
Risk Management
Reducing Costs + Claims
Research > Alcoa Intalco Works
Mean Hearing Threshold (2k, 3k, 4kHz): – 2007 (N = 46)
Employees using continuous in-ear dosimetry starting in 2005
Case Study: ALCOA Intalco (presented by Dr. Kevin Michael et.al. at AIHA 2007, used with permission)

58. Preventive Action After NIHL
Risk Management
Reducing Costs + Claims
Preventive Action After NIHL
In practice, an OSHA-recordable STS is not a preventive action
It is documentation of a hearing loss after the fact.
How soon will an employee suffering NIHL be re-fit / re-trained ?
“Best case scenario” per Hearing Conservation Amendment
In-ear dosimetry “worst case” scenario …
1 Day
Months
• Audiometric test • Retest • Notification
By itself, OSHA’s Standard Threshold Shift is not a preventive measure. It documents hearing loss after the fact, and simply resets the clock for retesting without verifying whether preventive measures were successful. The annual audiogram is a “lagging indicator” of whether a Hearing Conservation Program is successful. In-ear dosimetry, however, gives users immediate feebback, allowing them to immediately adjust their protection level until they reach sufficient levels. In-ear dosimetry thus becomes a “leading indicator.”

59. Roll-Down Foam Earplugs
Fitting Tips
Roll-Down Foam Earplugs
2. Pull Back pinna by reaching over head with free hand, gently pull top of ear up and out
1. Roll entire earplug into a crease-free cylinder
3. Insert earplug well into ear canal and hold until it fully expands
For earplugs, effective protection is dependent upon a deep insertions. With foam earplugs, this is accomplished by following these three steps:
- Roll down the foam earplug to a small crease-free cylinder
- Straighten out the bend in the ear canal by reaching over the head with the free hand, and pulling the ear up and out.
- Insert the earplug well into the ear canal and hold it in place a few seconds while the foam fully expands

60. Earplug Fitting

61. Fitting Tips

62. Multiple-Use Earplugs
Fitting Tips
Multiple-Use Earplugs
1. Reach While holding the stem, reach hand overhead and gently pull top of ear up and back.
2. Insert Insert earplug so all flanges are well inside the ear canal.
3. Fit If properly fitted, only the stem of the earplugs should be visible to someone looking at you from the front.
Steps for proper insertion of no-roll foam earplugs.
Steps for proper insertion of multiple-use earplugs.
(see Howard Leight fitting poster, available free of charge)

63. Visual + Acoustical Checks
Fitting Tips
Visual + Acoustical Checks
2. Acoustical Check Cup hands over ears and release. Earplugs should block enough noise so that covering your ears with hands should not result in a significant noise difference.
Visual Check The earplug should sit well inside the ear canal and not stick out.
There are two ways to determine if the earplug is in far enough to provide adequate protection:
1) Visual Check. When viewed directly from the front, the end of a properly-fit earplug should not be visible.
2) Acoustic Check. Cup your hands tightly and place them over your ears, then release. When earplugs are properly fit and doing their job, there should be no noticeable change in the noise level. If the earplugs are not inserted far enough, there will be a noticeable change in the noise when hands are cupped over the ear.

64. Training + Motivation

65. Personalize Hearing Loss
Training + Motivation
Personalize Hearing Loss
Show, Don’t Tell
Provide copy of annual audiogram to worker
Use personal examples to demonstrate consequences of hearing loss
Ask questions:
What is your favorite sound?
What sound would you miss the most if you couldn’t hear?
What sounds connect you to people and your environment?
We can motivate employees to wear their hearing protection if we can prove to them that they are not invincible nor invulnerable to noise-induced hearing loss. This can be accomplished by giving workers a copy of their audiometric test, or by clearly showing workers the noise hazardous noise levels at their worksite.
Getting workers to think about what their hearing means to them can help to personalize their motivation to prevent noise-induced hearing loss.

66. Demonstrate Future Risk
Training + Motivation
Demonstrate Future Risk
Training Materials
atl.grc.nasa.gov/HearingConservation/Resources/index.html
It is human nature to weigh our risks in terms of “here and now.” But with noise-induced hearing loss, we must show the worker the future risk. This can be accomplished by means of audio demonstrations, or simulated hearing losses, so that the worker has a clear understanding of his future risk, and the need for adequate protection today. The links listed on this slide offer great training and educational resources, including audio demonstrations, that can be used in your HC training program.

67. Send Clear Message On + Off Job
Training + Motivation
Send Clear Message On + Off Job
HC Part of Everyday Life
Include recreational hearing conservation in annual training
Provide extra HPDs for home use
Promote Hearing Conservation at company/family events
Many employers encourage their workers to use the company-provided hearing protectors off-the-job. After all, any noise-induced hearing loss (whether on- or off-the-job) will cause hearing loss which will be detected in the company-sponsored audiometric testing program. Proper use of hearing protectors both on and off the job will prevent noise-induced hearing loss.
Emphasize that Hearing Conservation should be a part of everyday life, at both work and home.
Include recreational HC training in your annual training. Many employers encourage their workers to use the company-provided hearing protectors off-the-job. After all, any noise-induced hearing loss (whether on- or off-the-job) will cause hearing loss which will be detected in the company-sponsored audiometric testing program. Proper use of hearing protectors both on and off the job will prevent noise-induced hearing loss.

68. Remove Barriers to HPD Use
Training + Motivation
Remove Barriers to HPD Use
Make HPDs Available
Highlight “where to find HPDs” in annual training
Make sure HPDs are well-stocked and accessible
Include group of workers in selection process for increased acceptance
Offer wide variety to match comfort, job requirements
Compliance in wearing hearing protection will be greatest when we remove the barriers or excuses that employees may raise as objections. Is an adequate supply of hearing protectors available? Is there a reasonable selection of comfortable protectors for workers? Does the amount of attenuation match the noise level?
Make HPDs Available
Highlight “where to find HPDs” in annual training
Make sure HPDs are well-stocked and accessible
Include group of workers in selection process for increased acceptance
Offer wide variety to match comfort, job requirements

69. Hearing Loss Due To Noise Exposure Is … Painless Permanent Progressive
Training + Motivation
Hearing Loss Due To
Noise Exposure Is …
Painless
Permanent
Progressive
… and very Preventable!