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Issue addressed: While it is difficult to promote the use of hearing protectors in noisy workplaces and leisure settings, some nightclub attendees choose to wear earplugs when exposed to loud music. This qualitative study investigated the perceptions of clubbers about the advantages and disadvantages of earplug use in nightclubs. Such first-hand information could potentially be used to educate non-wearers about the features of different earplug types, the experience of wearing earplugs and their relative merits. Methods: Structured telephone interviews were conducted with 20 regular clubbers who wear different types of earplugs at nightclubs. Participants were asked about their experience of wearing earplugs and, in particular, what they perceive to be the advantages and disadvantages of earplugs. Results: Participants' responses revealed that cheaper foam earplugs are considered less satisfactory than more expensive earplugs, which are relatively discreet and comfortable, facilitate communication with others, create minimal music distortion and, in some cases, improve music sound quality. In terms of effectiveness, all types of earplugs were considered beneficial in reducing the after-effects of loud music and providing hearing protection. Conclusions: The perceived advantages of earplugs, which are often not recognised by non-earplug wearers, should be communicated in order to encourage the use of earplugs among clubbers.

One of the biggest barriers to effective use of hearing protection devices (HPDs) as the last line of defense against noise in the workplace is that there has never been a good way to test performance. A workshop held at the recent annual conference of the National Hearing Conservation Association showcased some innovative technologies to address this issue. Currently, one of the most widely used systems for individual fit testing of HPDs is FitCheck, developed by Michael & Associates. A different approach was demonstrated by Sonomax, which has adapted the SonoPass fit testing system to allow testing of all types of insert HPDs. The loudness balance approach developed by the House Ear Institute for Bacou-Dalloz is an innovative way to assess HPD performance. Another approach that combines HPD fit testing with exposure assessment is doseBusters.

There are four categories of ear plugs: 1. single use, which are worn once and then replaced when workers reenter a noise area; 2. multiple use, which can be used repeatedly and cleaned with soap and water; 3. banded ear plugs, which essentially are two foam ear plugs held together by a plastic or metal band; and 4. detectable earplugs, which can be used in environments where you need to be able to screen for foreign substances in the finished product. Single-use, or disposable, ear plugs are the most common type used today. They are popular because of their low cost, ease of use, and high level of comfort. A recent advance in single-use ear plugs is the use of thermoplastic elastomer foam. Multiple-use ear plugs are typically molded with a semi-rigid stem and pliable flanges, so they don't require rolling prior to insertion. They insert easily and can be quite comfortable for extended periods.

The ability to communicate in workplace noise is difficult to quantify because there are many variables, and every situation is different. Factors that influence communication include the level of the noise, temporal characteristics of the noise (how the noise varies with time), and the hearing ability of the listener. A new generation of hearing protection devices has been shown to allow better communication and superior subjective acceptance in varying background noise conditions. These HPDs are referred to as uniform attenuation devices, and they are designed to provide approximately equal attenuation across the frequency range. Execution of a Modified Rhyme Test according to ANSI S3.2-1989 indicated uniform attenuation hearing protectors provided superior speech intelligibility in a relatively high-level, low-frequency background noise for both normally hearing and moderately impaired subjects.

The current OSHA standard for occupational noise requires that hearing conservation programs be established, including exposure monitoring, audiometric testing and training. The hearing conservation program is for all employees who have exposures equal to or exceeding an eight-hour, time-weighted average (TWA) of 85 dBA. Approximately 9 million American workers are exposed to such noise levels, including about 24 percent of the total employees in the industrial, agricultural, transportation and military sectors. Since many companies choose to control exposure through personal protection devices (hearing protectors), inadequate compliance with use of the devices emerges as a major behavioral cause of NIHL. Compliance is not unidimensional. They may wear the devices but in such a way that the attenuation potential is reduced or eliminated. In addition, the devices also may be poorly maintained, improperly fitted, or inappropriate for the application. The physical and environmental demands of specific jobs or tasks may also compromise the level of protection. Research indicates that the attenuation achieved in actual work situations can be as little as one-third to one-half of the noise reduction rating (NRR) displayed on the hearing protector packaging. This is largely because manufacturer estimates are based on data from testing laboratories. NRRs refer to the theoretical effectiveness of hearing protectors when fit and worn as tested.

After a long period of dormancy, federal OSHA has picked up activity in the area of hearing loss prevention rulemaking. Activity is focused in the areas of recordkeeping and hearing conservation in construction. After being promulgated in January 2001, and delayed in July 2001, most of the hearing loss aspects of 29 CFR 1904 were made final July 1, 2002, and effective January 1, 2003. On August 5, 2002, OSHA issued an advance notice of proposed rulemaking (ANPRM) regarding hearing conservation programs for the construction industry. This mechanism is OSHA's alert that it is giving serious consideration to a new rule, and it provides an opportunity for comment and input as the rule is being developed. The construction business poses many challenges to the effective implementation of hearing conservation programs: 1. The industry is inherently noisy. 2. The stakes can be high. 3. Construction noise tends to be intermittent and impulsive - two characteristics that can compromise the effectiveness of a hearing protection program. 4. The workforce is mobile. 5. The industry is comprised, for the most part, of very small employers.

The new Auditory 4.0 model has been developed for the assessment of auditory outcomes, expressed as temporary threshold shift (TTS) and permanent threshold shift (PTS), from exposures to impulse noise for unprotected ears, including the prediction of TTS recovery. Auditory 4.0 is an empirical model, constructed from test data collected from chinchillas exposed to impulse noise in the laboratory. Injury outcomes are defined as TTS and PTS, and Auditory 4.0 provides the full range of TTS and PTS dose-response curves with the risk factor constructed from A-weighted sound exposure level. Human data from large weapons noise exposure was also used to guide the development of the recovery model. Guided by data, a 28-dBA shift was applied to the dose-response curves to account for the scaling from chinchillas to humans. Historical data from rifle noise tests were used to validate the dose-response curves. New chinchilla tests were performed to collect recovery data to construct the TTS recovery model. Auditory 4.0 is the only model known to date that provides the full TTS and PTS dose-response curves, including a TTS recovery model. The model shows good agreement with historical data.

IntroductionThe easiest way to prevent noise-induced hearing loss (NIHL) is to wear earplugs. The Republic of Korea (ROK) Ministry of National Defense (MND) is supplying earplugs to prevent NIHL, but many patients still suffer from this. We speculated that earplugs would have a high NIHL rate, depending on the rate of use of earplugs, regardless of the rate of supply. Therefore, we conducted this study to investigate the relationship between the use of earplugs and hearing loss by ROK military personnel.MethodsThe study used data from the Military Health Survey conducted in 2014–2015, which included 13 470 questionnaires completed by ROK military personnel. Hearing loss and earplug use were self-reported. Logistic regression analysis was used to assess associations between earplug use and hearing loss.ResultsThe study sample included 13 470 ROK military personnel (response rate of 71.2%) (Army, 8330 (61.8%); Navy/Marines, 2236 (16.6%); and Air Force, 2904 (21.6%)). Overall, 18.8% of Korean military personnel reported that they always wore earplugs, and 2.8% reported hearing loss. In logistic regression analysis, there were significant differences in the rates of hearing loss associated with wearing earplugs sometimes (OR=1.48, 95% CI 1.07 to 2.05) and never wearing earplugs (OR=1.53, 95% CI 1.12 to 2.10). In subgroup analysis, in Air Force, non-combat branch, forward area and long-term military service personnel increased hearing loss was associated with not wearing earplugs.ConclusionOur study confirmed that within the ROK military, there is an association between hearing loss and lack of earplug use. In the ROK MND, Army, Navy/Marines and Air Force headquarters must provide guidelines for the use of earplugs during field training to protect military personnel’s hearings and, if necessary, need to be regulated or institutionalised.