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Earplugs can reduce the risk of hearing loss and tinnitus. However, earplug use during noisy recreational activities is uncommon, and methods for increasing uptake and regular use have had limited efficacy. The aim of the present study was to examine barriers and enablers of ever-performers (e.g., people who have used earplugs) and never-performers (e.g., people who have not used earplugs) to identify targets to inform the content of interventions to increase uptake and regular use of earplugs in recreational settings. The Capabilities, Opportunities, and Motivations model of Behaviour (COM-B) informed the outline for 20 semi-structured telephone interviews (ever-performers, N = 8, age range = 20–45 years; never-performers, N = 12; age range = 20–50 years). Thematic analysis was used to identify barriers and enablers to earplug use, which were mapped onto the Theoretical Domains Framework (TDF). Six key domains of the TDF were identified. Ever-performers described being more exposed to ‘social influences’ (e.g., facilitators such as friends/peers) and were more positive than never-performers concerning ‘beliefs about consequences’ (e.g., earplug protection outweighs any negative effects on listening/communication). Involvement of ‘emotion’ (e.g., fear of losing ability to listen to music) and ‘reinforcement’ tactics (e.g., creating habits/routines) were discussed by ever-performers, but were not mentioned by never-performers. Both groups reported lack of ‘environmental context and resources’ (e.g., prompts and cues), and their own ‘memory, attention, and decision processes’ (e.g., deciding when to use earplugs) as barriers to earplug use. The present research identifies the variables that would need to change in order to increase earplug uptake and use in recreational settings among ever-performers and never-performers. Further work is required to translate these findings into testable interventions by selecting appropriate intervention functions (e.g., modelling), policy categories (e.g., communication/marketing), behaviour change techniques (e.g., demonstration of behaviour), and mode of delivery (e.g., face-to-face).

Background Hearing loss and tinnitus are global concerns that can be reduced through hearing protection behaviors (e.g., earplug use). Little is known about the effectiveness of interventions to increase hearing protection use in recreational domains. For the first time we review systematically the effectiveness of such interventions. Methods Systematic searches of nine databases, as well as grey literature and hand-searching, were conducted. Any study design was included if it assessed quantitatively a purposeful attempt to increase hearing protection in recreational settings. Studies were excluded if they assessed noise exposure from occupational sources and headphones/earphones, as these have been reviewed elsewhere. PROSPERO protocol: CRD42018098573. Results Eight studies were retrieved following the screening of 1908 articles. Two pretest-posttest studies detected a small to medium effect ( d  ≥ 0·3 ≤ 0·5), one a small effect ( d  ~ =0·2) and two no real effect. Three posttest experimental studies detected small to medium effects ( d  ≥ 0·3 ≤ 0·5). Studies were rated as “poor quality” and 17 out of a possible 93 behavior change techniques were coded, with the majority targeting the intervention function ‘education’. Conclusions Hearing loss and tinnitus due to recreational noise exposure are major public health concerns yet very few studies have examined preventive interventions. The present systematic review sets the agenda for the future development and testing of evidence-based interventions designed to prevent future hearing loss and tinnitus caused by noise in recreational settings, by recommending systematic approaches to intervention design, and implementation of intervention functions beyond education, such as incentivization, enablement and modeling.

Interventions to increase hearing protection behaviours within noisy recreational settings are limited by the lack of an underpinning evidence base. The aim of the present study was to identify targets for interventions in a population exposed to recreational noise, including those who had used hearing protection (ever-performers) versus those who had not (never-performers). A cross-sectional survey was administered to 185 UK adults who had been involved in noisy recreational activities. Participants had an average age of 36.79 years; the majority were women (68.1%), from a white ethnic background (87.6%), and with non-manual occupations (75.7%). Using Chi-square, MANOVA and ANOVA, we looked for differences in sociodemographic variables and variables from the capabilities, opportunities and motivations model of behaviour change (COM-B) between ever- and never-performers. Ever-performers were more likely to be younger (p < 0.050), men (p < 0.050), and in a manual occupation (p < 0.050) compared to never-performers. Although the two groups felt capable and reported similar opportunities to use hearing protection, never-performers lacked automatic motivation (p < 0.001) and reflective motivation (p < 0.001) compared to ever-performers. For the first time, the present study identifies potential groups at whom hearing protection interventions might be targeted and what those interventions may contain. Further work is required to develop interventions targeted at older people, women and those in non-manual occupations. Lack of motivation is a key concern, and further work that uses specific theoretical frameworks, such as the PRIME (Plans, Responses, Impulses, Motives, and Evaluations) theory of motivation, may shed light on the kinds of interventions that are needed to boost hearing protection use effectively.

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

Firefighters are exposed to extensive hazardous noise while on the job, both during routine tasks at the station and when responding to calls. However, little is known about firefighters’ occupational noise hazards. This study employed mixed methods, including focus groups, a survey, and audiometric testing, to identify sources of noise in the firefighters’ work environment, determine hearing protective strategies, discern firefighters’ perceptions of occupational noise exposure and impacts to their health, and quantify the prevalence of hearing loss among South Florida firefighters. A total of 6 senior officers served in an expert panel, 12 participated in focus groups, 300 completed the survey, and 214 received audiometric tests. Most firefighters were unaware of the risk and their departments’ policies, and did not participate in hearing protection practices and avoided using hearing protection devices, which they believed impede team communication and situational awareness. Nearly 30% of participating firefighters showed mild to profound hearing loss, a prevalence that is considerably worse than expected by normal aging alone. Educating firefighters about noise-induced hearing loss early in their careers may have significant health implications for their future. These findings provide insights for developing technologies and programs to mitigate the effects of noise exposure in the firefighting population.

Background: Occupational noise-induced hearing loss (ONIHL) remains one of the most prevalent occupational diseases globally and in South Africa. Despite awareness and regulatory frameworks, consistent use of hearing protection devices (HPDs) is suboptimal in high-noise industries. Aim: To investigate patterns of HPD use and the factors influencing compliance among workers in an aluminium manufacturing company exposed to noise levels exceeding 85 dB(A). Methods: A cross-sectional survey was conducted with 115 workers, including 68.7% males and 31.3% females. Chi-square tests assessed associations between categorical variables, and logistic regression identified significant predictors of consistent HPD use. Results: Although 94.8% of workers were aware of the risks of hazardous noise, only 51.3% reported always using HPDs. Gender, education level, type of HPD, type and duration of noise exposure, and perceived susceptibility to hearing loss were significantly associated with consistent HPD use. Logistic regression revealed that gender, type of HPD, type of noise exposure, and perceived susceptibility significantly predicted consistent use. Conclusions: Despite high awareness and access to HPDs, consistent use remains moderate and is influenced by demographic, perceptual, device-related, and workplace factors. Findings highlight the need for targeted interventions, training, and workplace strategies to improve HPD compliance and prevent ONIHL.

A survey was administered to 385 noise-exposed workers from an auto parts factory and 1268 non-noise-exposed health department employees in China. Individual 8 h A-weighted equivalent sound levels (LAeq,8h), earplug personal attenuation ratings (PARs), and pure-tone audiometric tests were performed. The average LAeq,8h of noise-exposed workers was 87 dB (A) with a mean PAR of 7 dB. The prevalence of high-frequency hearing loss was 65% for noise-exposed workers and 33% for the non-noise-exposed employees. The use of earplugs had no observable effect on the prevalence of high-frequency hearing loss of the study participants (OR 0.964, 95% CI 0.925–1.005, p = 0.085). No significant relationship between the effectiveness offered by earplug use and high-frequency hearing thresholds at 3, 4, and 6 kHz was found (t = −1.54, p = 0.125). The mandatory requirement of earplug use without individualized training on how to wear HPDs correctly had no detectable effect on the prevention of hearing loss at the auto parts factory. The hearing conservation program at the surveyed factory was not effective. Periodic hearing tests, earplug fit testing, expanding the offer of different types of hearing protection, and employee education about the importance of protecting their hearing were recommended to the occupational health and safety program.

Noise-induced hearing loss (NIHL) is a common occupational hazard and a major cause of deafness among airport workers. However, few studies have been conducted to investigate the various risk factors related to hearing loss. Purpose: the purpose of this study was to measure the prevalence and risk factors of NIHL among Muscat International Airport airside workers. Method: Their daily noise exposure level at the airport was measured, and the time-weighted average (TWA) was calculated for each airside department. A cross-sectional study design involving 312 workers from the eight departments of the airport was chosen and the prevalence of NIHL among workers was assessed. The study participants then completed a self-administered questionnaire that covered their socio-demographic characteristics, occupational exposure history and the health-related risk factors of NIHL. Results: The TWA recorded for the workers was above the accepted limit in some departments, namely, cabin appearance, ramp, line maintenance and hangar. The prevalence of NIHL among participants was 21.79% (n = 68). Of these 68 participants with NIHL, 22.30% were exposed to job-related high noise levels. NIHL was common among participants aged 40 or above (57.35%, n = 39) and high school degree holders (29.60%, n = 29), as well as those who were exposed to higher noise levels (84.89%, n = 191) or who did not wear their hearing protection devices (HPDs) regularly (53.65%, n = 125). Conclusion: around a quarter of our study participants who were exposed to high noise levels suffer from NIHL.

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

Combat soldiers are currently faced with using a hearing-protection device (HPD) at the cost of adequately detecting critical signals impacting mission success. The current study tested the performance of the Perforated-Concave-Earplug (pCEP), a proof-of-concept passive HPD consisting of a concave bowl-like rigid structure attached to a commercial roll-down earplug, designed to improve sound localization with minimal compromising of noise attenuation. Primarily intended for combat/military training settings, our aim was an evaluation of localization of relevant sound sources (single/multiple gunfire, continuous noise, spoken word) compared to 3M™-Combat-Arms™4.1 earplugs in open-mode and 3M™-E-A-R™-Classic™ earplugs. Ninety normal-hearing participants, aged 20–35 years, were asked to localize stimuli delivered from monitors evenly distributed around them in no-HPD and with-HPD conditions. The results showed (1) localization abilities worsened using HPDs; (2) the spoken word was localized less accurately than other stimuli; (3) mean root mean square errors (RMSEs) were largest for stimuli emanating from rear monitors; and (4) localization abilities corresponded to HPD attenuation levels (largest attenuation and mean RMSE: 3M™-E-A-R™-Classic™; smallest attenuation and mean RMSE: 3M™-Combat-Arms™4.1; pCEP was mid-range on both). These findings suggest that the pCEP may benefit in military settings by providing improved sound localization relative to 3M™ E-A-R™-Classic™ and higher attenuation relative to 3M™-Combat Arms™-4.1, recommending its use in noisy environments.