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PubMed2005

Ethnic differences in predictors of hearing protection behavior between Black and White workers.

The purpose of the study is to determine whether there are ethnic differences in predictors of hearing protection behavior between Black and White workers. The Predictors of Use of Hearing Protection Model (PUHPM) derived from Pender's Health Promotion Model (Pender, 1987) was used as a conceptual model. A total of 2,119 (297 Blacks, 1,822 Whites) were included in the analysis. Internal consistency of instrument items was assessed using theta reliability estimates. Significant predictors of the use of hearing protective devices (HPDs) for Black and White workers and differences in predictors between the two groups were examined using multiple regression with interaction terms. Ethnic differences in scale or individual item scores were assessed using chi-square and t-test analyses. Different factors influenced hearing protection behavior among Black and White workers. The model was much less predictive of Blacks' hearing protection behavior than Whites' (R2 = .12 vs. .36). Since the PUHPM was not as effective in predicting hearing protection behavior for Blacks as for Whites, future studies are needed to expand the PUHPM through qualitative study and to develop culturally appropriate models to identify factors that better predict hearing protection behavior as a basis for developing effective interventions.

Adult↗
PubMedDate not supplied

Effectiveness of a tailored intervention to increase factory workers' use of hearing protection.

BACKGROUND: In the United States it is estimated that more than 30 million workers are exposed to harmful levels of noise on the job. When engineering or administrative controls cannot be used to reduce noise, workers should always use hearing protection devices (HPDs) when exposed to loud noise to prevent noise-induced hearing loss (NIHL). Previous research has shown that workers do not always use HPDs when required; therefore, it is essential that workers assume personal responsibility for preventing NIHL by increasing their use of HPDs. OBJECTIVES: This study tested the effectiveness of an individually tailored multimedia intervention to increase use of HPDs by factory workers. METHODS: A randomized controlled design was used to compare the effects of a tailored intervention (n= 446) with two other interventions (a nontailored predictor-based intervention (n= 447) and a control intervention (n= 432)) on workers' self-reported use of HPDs 6 to 18 months following the intervention. RESULTS: Only those workers receiving the tailored intervention significantly increased their use of HPDs from pretest to posttest. However, this increase significantly differed from the nontailored group but not from the control group. CONCLUSIONS: Individually-tailored interventions offer promise for changing behavior. In light of the similarity between the results for the tailored intervention and the control intervention groups, further research is needed to understand barriers to HPD use and how to maximize the benefits of individually tailored interventions in this setting.

Adult↗
PubMedDate not supplied

Testing decisional balance and self-efficacy applied to workers' use of hearing protection.

BACKGROUND: The continued prevalence of low rates of hearing protection device (HPD) use by workers exposed to hazardous noise requires ongoing efforts to investigate ways to increase HPD use. OBJECTIVE: The aim of this study was to investigate the utility of the Transtheoretical Model (TTM) for research with factory workers' use of HPDs, specifically focusing on the model suppositions related to the constructs of decisional balance and self-efficacy. METHODS: Using secondary analysis, pretest measures were obtained through a randomized controlled clinical trial of an intervention to increase use of HPDs. The sample included in the analyses were factory workers (N = 1,245) exposed to hazardous noise in a Midwestern automotive manufacturing plant. Using analysis of variance (ANOVA), the TTM constructs pros, cons, and self-efficacy of HPD use were examined across stages. RESULTS: Using ANOVA, significant variance was found across stages of HPD use. Pros, cons, and self-efficacy significantly differed by stage of HPD use in predicted patterns: pros, F(4, 1240) = 46.29, p < .001; cons, F(4, 1240) = 17.14, p < .001; and self-efficacy F(4, 1240) = 7.32, p < .001. The crossover effect of pros and cons occurred in the preparation stage, as expected. CONCLUSIONS: Support was found for the presence of conceptually distinct stages of HPD use and the TTM predictions for decisional balance and self-efficacy across stages. Performance of the TTM constructs within current research on HPD use presents opportunities for increased tailoring of training for factory workers on use of HPDs.

Analysis of Variance↗
PubMed1997

Gender differences in blue collar workers' use of hearing protection.

In this study, the Health Promotion Model (HPM) was used as the basis for a structural equation model of male and female blue collar workers' self-reported use of hearing protection devices (HPDs). Overall use did not differ by gender; in addition, self-efficacy and barriers to use of HPDs were the two best predictors of this behavior for both men and women. Despite the similarities in HPD use and the most important predictors of that use between men and women, the predictive models differed by gender in several ways. Significant predictors of use among men also included age and value of use of HPDs. For women, ethnic status and plant site were additional significant predictors of use. Because the influences of plant site and gender on self-reported use of HPDs could not be separated in this study, further research should address worksite culture and assess differences by gender. Knowledge of these differences will aid development of more effective interventions and may increase the use of hearing protection.

Adult↗
PubMed2004

Sound attenuation of the indoor/outdoor range E-A-R plug.

The sound attenuation provided by the AOSafety Indoor/Outdoor Range E-A-R Plug was examined. This device, currently used in military operations in several countries, is comprised of two plugs that provide conventional ("indoor" plug) and level-dependent sound reduction (the "outdoor" plug), respectively. The effects of the user's gender and repeated fittings were explored. Eight men and eight women were tested on two separate occasions. Unoccluded and protected hearing thresholds were measured for each of nine one-third octave noise bands centered at 0.125 to 8 kHz. Attenuation was calculated as the difference between these two measures. The indoor plug provided 21 to 40 dB of sound reduction across the frequencies tested, closely matching the manufacturer's specification. The outdoor plug provided 5 to 22 dB of conventional attenuation, suggesting that it might serve as a safe means of conventional and level-dependant attenuation in hearing-impaired users. No differences were found in relation to gender or repeated fittings.

Adult↗
PubMed1989

[The effect of occlusion. Part I. The mechanism].

To clarify the mechanism of the occlusion effect the following experiments were performed on 18 healthy and 4 patients with conductive impairment: 1) measurement of the improvement in bone conduction threshold after the ears were covered with occluding devices of different volumes (earphones and calibrated spherical glass enclosures), 2) measurements of sound pressure level (SPL) changes in the meatus under the same conditions. The increase of SPL under covers was found, which was parallel to the improvement of bone conduction threshold in covered ears. Both phenomena were closely related to the volume of the enclosures: the larger the volume the smaller the change in SPL and in the threshold shift was found. In ears with a conductive loss--only the SPL was increased without any change in the bone conduction threshold. It was concluded that the occlusion effect is caused by the resonance phenomena in close meatus: the increased SPL induces the bone conducted threshold shift via the normal conductive apparatus (bone-air conduction). That explains the lack of threshold changes in conductive lesions. In the open meatus acoustic energy radiated by the bony walls becomes dissipated.

Auditory Threshold↗
PubMed1990

Outer ear canal shape and its relation to the effectiveness of sound attenuating earplugs.

This investigation was undertaken to explore the relationship between the level of sound attenuation achieved by the wearing of hearing protectors, and the shape of the external ear canal. Bilateral molds of the outer portion of the external ear canal were made in 93 males and females with normal hearing, who had participated in a previous study on the effect of gender on sound attenuation, measured for a variety of insert type devices. The ear canal molds were analyzed in terms of tortuosity, caliber, and degree of funneling. The results showed that individuals with straight canals achieved significantly higher attenuation scores than those with twisted canals. With regard to caliber, the more important of the two parameters reviewed was the cross-sectional area of the canal measured at the cartilaginous-bony junction (IA). The relationship between IA and attenuation depended on both gender and the type of earplug tested. Funneling, measured by the ratio of concheomeatal and cartilaginous-bony cross-sectional areas, had the opposite effect of that for IA. These findings underscore the need for more controlled prescription and fitting procedures for the insert type of hearing protectors commonly used in the industrial setting.

Ear Canal↗
PubMed2006

Noise exposures aboard catcher/processor fishing vessels.

BACKGROUND: Commercial fishing workers have extended work shifts and potential for 24 hr exposures to high noise. However, exposures in this industry have not been adequately characterized. METHODS: Noise exposures aboard two catcher/processors (C/P) were assessed using dosimetry, sound-level mapping, and self-reported activities and hearing protection device (HPD) use. These data were combined to estimate work shift, non-work, and 24 hr overall exposure levels using several metrics. The length of time during which HPDs were worn was also used to calculate the effective protection received by crew members. RESULTS: Nearly all workers had work shift and 24 hr noise levels that exceeded the relevant limits. After HPD use was accounted for, half of the 24 hr exposures remained above relevant limits. Non-work-shift noise contributed nothing to 24 hr exposure levels. HPDs reduced the average exposure by about 10 dBA, but not all workers wore them consistently. CONCLUSIONS: The primary risk of hearing loss aboard the monitored vessels comes from work shift noise. Smaller vessels or vessels with different layouts may present more risk of hearing damage from non-work periods. Additional efforts are needed to increase use of HPDs or implement noise controls.

Cross-Sectional Studies↗
PubMed2006

Dysfunctional thinking patterns and immigration status as predictors of hearing protection device usage.

BACKGROUND: There is limited research on the role of dysfunctional/irrational thinking processes and immigration status on hearing protection device (HPD) usage. PURPOSE: The aim of the study is to investigate the effects of low frustration tolerance (LFT) and immigration status on HPD usage among employees exposed to hazardous industrial noise. METHODS: A total of 117 Israeli-borns and 80 new immigrants from former Soviet Union completed a questionnaire. The association between HPD usage and barriers to action, self-efficacy, and LFT (accounting for age, years of exposure, and immigration status) were assessed using ordered logistic regression models. RESULTS: LFT was associated negatively (adjusted odds ratio [OR]=.25, 95%; confidence interval [CI]=.15-.41) with HPD usage. Self-efficacy was a modifier (adjusted OR=1.47, 95%; CI=1.34-1.63): the higher the self-efficacy for a given LFT level, the higher the extent of HPD usage. Immigration status was not a significant predictor. CONCLUSIONS: HPD usage is associated with both rational and irrational motivations. The role of LFT in hearing protection should be further investigated.

Adult↗
PubMedDate not supplied

Construction noise: exposure, effects, and the potential for remediation; a review and analysis.

More than one-half million construction workers are exposed to potentially hazardous levels of noise, yet federal and state Occupational Safety and Health Administration (OSHA) programs provide little incentive to protect them against noise-induced hearing loss. Construction noise regulations lack the specificity of general industry noise regulations. In addition, problems that characterize the construction industry, such as worker mobility and the large proportion of small businesses, make implementing hearing conservation measures more difficult. The apparent severity of exposure depends greatly on the measurement method, with the 3-dB exchange rate almost always showing higher average exposure levels than the 5-dB (OSHA) rule. Construction workers demonstrate hearing threshold levels that generally conform to those expected in manufacturing. The prevalence of hearing protection device (HPD) use among U.S. construction workers is very poor, partly because of perceived difficulties in hearing and understanding speech communication and warning signals. In addition, masking by noise of necessary communication and warning signals is of particular concern in construction, where recent research demonstrated the association between fatalities and the failure to hear reverse alarms. Judicial use of HPDs is of the utmost importance, along with avoiding overattenuation, selecting HPDs with uniform attenuation, and using noise-attenuating communication systems when possible. A successful hearing conservation program in British Columbia can serve as a model for the United States, with a long-standing positive safety culture, a high percentage of HPD use, improvement in average hearing threshold levels over the last decade, and a centralized record-keeping procedure, which helps solve the problem of worker mobility. However, controlling construction noise at the source is the most reliable way to protect worker hearing. U.S. manufacturers and contractors should benefit from the activities of the European Community, where noise control and product labeling in construction has been carried out for more than 20 years.

Ear Protective Devices↗
PubMed1990

Hearing conservation programs (HCPs): the effectiveness of one company's HCP in a 12-hr work shift environment.

An existing hearing conservation program (HCP), originally designed when an 8-hr work shift schedule was in effect, was evaluated at a plant site where a 12-hr work shift schedule is now utilized. The study included the following phases: a noise analysis of the work environment, HCP evaluation through the use of audiometric data base analysis (ADBA), applying ADBA procedures and a comparison of the shift in hearing threshold levels (HTLs) for the 8-hr and 12-hr work shifts, and an evaluation of the hearing protection devices (HPDs) being used at the facility over the 12-hr work shift by measuring temporary threshold shift (TTS). The mean measured employee time-weighted average (TWA) in the process area where the TTS study was conducted was 92 dBA. It was found that the existing HCP is at best marginal. The most likely causes of this less-than-desirable rating are inadequate audiometric testing procedures and inadequate HPD utilization. Furthermore, it was concluded that, at this time, the introduction of the 12-hr work shift has had no impact on the level of effectiveness of the HCP. In evaluating the three HPDs in use at the facility (3-M foam earplug, E-A-R foam earplug, and Bilsom Soft earplug), it was found that they all offered effective protection from noise at all audiometric test frequencies (0.5 to 6 kHz) except 0.5 kHz. All three HPDs exhibited TTS at 0.5 kHz with the TTS measured significant at the p less than 0.05 level for the E-A-R and 3-M wearer groups.

Audiometry↗
PubMed1984

An evaluation of the effectiveness of three hearing protection devices at an industrial facility with a TWA of 107 dB.

Three hearing protection devices [Siebe Norton Com-fit earplug, Flents Silenta model 080 earmuff, and E-A-R foam earplug] were compared for their effectiveness in preventing both daily temporary threshold shifts (TTS) and threshold variability between sequential annual audiograms for workers in an industrial environment with a TWA of 107 dB. Com-fit wearers showed significant TTS at 500-4000 Hz from the beginning to the end of the workday. Silenta wearers displayed significant TTS at 500 Hz and nonsignificant improvement at 6000 Hz. E-A-R wearers showed significant TTS at 1000-2000 Hz and nonsignificant improvement at 3000-6000 Hz. Statistical analysis indicated that the protection provided by the E-A-R plug was significantly better than that of the Com-fit plug at 500-4000 Hz, and significantly better than the protection of the Silenta muff at 500, 3000, and 4000 Hz. Employees' last four annual audiograms prior to the start of the TTS study were evaluated to compare the wearer groups' mean values of the %BWs statistic (sequential percent better or worse). Previous research indicates that the %BWs statistic for a properly protected population with past audiometric test experience will be less than 30%. The E-A-R group showed an acceptable %BWs value (26%), but the Silenta wearers (45%) and Com-fit wearers (53%) showed excess threshold variability in threshold measurements from year to year.

Adult↗
PubMed2005

The effectiveness of hearing protection among construction workers.

Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control efforts in the construction industry.

Cohort Studies↗
PubMed2002

Hearing protectors acceptability in noisy environments.

OBJECTIVES: Although hearing protectors must be used as a temporary solution, their choice should take into account several aspects, such as ergonomic features, associated with this device. The present study aims to analyse the relationship between the acoustical attenuation efficiency and other aspects related to the comfort afforded by hearing protectors and, consequently, their acceptability when used in industrial noisy environments. METHODS: An evaluation of comfort was performed using a questionnaire, completed by 20 workers. Several scales related to the subjective feeling of comfort were used to quantify the comfort index of a given protector. Simultaneously, the time of usage of each protector was self-recorded by each subject. To test the relationship between the comfort index and the time during which protectors were used, a two-way analysis of variance (two-way ANOVA) was applied. RESULTS AND CONCLUSIONS: The results obtained seem to demonstrate that there are significant differences between catalogued and effective attenuation. Protectors with less catalogued attenuation, but with higher acceptability, i.e. which were more comfortable, tended to be more efficient than protectors with a higher catalogued attenuation, but which were less comfortable. Finally, it must be emphasized that high efficiency can only be achieved through the attainment of an adequate balance between the range of parameters likely to determine its usage.

Adult↗
PubMed2000

Four earplugs in search of a rating system.

OBJECTIVE: The performance of four insert earplugs was evaluated by determining the Noise Reduction Rating (NRR) and the Subject-Fit Noise Reduction Rating [NRR(SF)]. The NRR and NRR(SF) were calculated from real-ear attenuation at threshold (REAT) data collected using the experimenter-fit protocol described in the now-rescinded ANSI S3.19-1974 (American National Standards Institute, 1974) and the subject-fit protocol of the recently revised ANSI S12.6-1997 (American National Standards Institute, 1997) standards for REAT measurement. DESIGN: A comparison of the experimenter-fit and subject-fit REAT performance was conducted using four pools of subjects, one pool per protector. Each device was tested with at least 20 subjects, the minimum size necessary to estimate the NRR(SF) for an earplug. The REAT was measured with third-octave narrowband noise stimuli for center frequencies at 0.125, 0.25,0.5, 1, 2, 3.15, 4, 6.3, and 8 kHz. The REAT means and standard deviations were compared with the manufacturer data. RESULTS: This study showed that the NRR(SF) is typically lower than the NRR and that the NRR(SF) is not well-predicted by the NRR derating schemes recommended by the National Institute for Occupational Safety and Health and required by the Occupational Safety and Health Administration. CONCLUSION: The difference between the present NRR on hearing protector labels and the NRR(SF) is sufficiently large and unpredictable enough to render the application of derating schemes meaningless even though these schemes attempt to account for the difference between the laboratory and real-world outcomes. The only way to provide a protector noise rating that is predictive of a real-world outcome is to retest the protector according to the subject-fit method of ANSI S12.6-1997 (American National Standards Institute, 1997).

Auditory Threshold↗
PubMedDate not supplied

Applying the health promotion model to development of a worksite intervention.

INTRODUCTION: Consistent use of hearing protection devices (HPDs) decreases noise-induced hearing loss, however, many workers do not use them consistently. Past research has supported the need to use a conceptual framework to understand behaviors and guide intervention programs; however, few reports have specified a process to translate a conceptual model into an intervention. PURPOSE: The strongest predictors from the Health Promotion Model were used to design a training program to increase HPD use among construction workers. SUBJECTS/SETTING: Carpenters (n = 118), operating engineers (n = 109), and plumber/pipefitters (n = 129) in the Midwest were recruited to participate in the study. DESIGN: Written questionnaires including scales measuring the components of the Health Promotion Model were completed in classroom settings at worker trade group meetings. MEASURES: All items from scales predicting HPD use were reviewed to determine the basis for the content of a program to promote the use of HPDs. Three selection criteria were developed: (1) correlation with use of hearing protection (at least .20), (2) amenability to change, and (3) room for improvement (mean score not at ceiling). RESULTS: Linear regression and Pearson's correlation were used to assess the components of the model as predictors of HPD use. Five predictors had statistically significant regression coefficients: perceived noise exposure, self-efficacy, value of use, barriers to use, and modeling of use of hearing protection. Using items meeting the selection criteria, a 20-minute videotape with written handouts was developed as the core of an intervention. A clearly defined practice session was also incorporated in the training intervention. CONCLUSION: Determining salient factors for worker populations and specific protective equipment prior to designing an intervention is essential. These predictors provided the basis for a training program that addressed the specific needs of construction workers. Results of tests of the effectiveness of the program will be available in the near future.

Adult↗
PubMed2004

Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults.

Over 11 million individuals exhibit some degree of permanent noise induced hearing loss (NIHL). Despite such data, there remains a paucity of empirical evidence on the knowledge of noise exposure and hearing protection devices (HPDs) for young adults, particularly those of diverse racial/ethnic backgrounds. This lack of research is unfortunate, as prior research suggests that the incidence of NIHL can be reduced through educational programs, such as hearing conservation programs (HCPs). Moreover, research also indicates that such educational programs are more beneficial when developed for specific age and/or ethnic/racial groups. The primary aim of this investigation was to determine the knowledge base of 200 college-aged young adults aged 18-29, concerning the auditory mechanism, NIHL, and the use of HPDs. The second aim of this study was to identify race and ethnicity differences or similarities in knowledge of these areas among African-American and caucasian young adults. Overall, in many instances, a majority of the young adults in our study demonstrated a high degree of knowledge concerning factors associated with exposure to excessive noise and the risk of hearing loss. Yet, the results also revealed significant racial/ethnic differences in knowledge, behaviors, and attitudes about the use of HPDs. Recent estimates suggest that more than 11 million individuals in the United States exhibit some degree of NIHL. Moreover, 40 million individuals work in environments that contain potentially harmful noise levels, and over 50 million Americans routinely use firearms--a common cause of noise-induced hearing impairment. A specific hallmark manifestation of NIHL is a permanent decrease in hearing sensitivity from 3,000-6,000 Hz, with a characteristic notch at 4,000 Hz. Additional effects of exposure to high noise levels include physiological changes in heart rate and blood pressure, decrease in work productivity, and an interference with communication that results from the masking of speech. With these considerations in mind, the purpose of this study was to investigate the knowledge, behaviors, and attitudes of a young-adult population in the United States concerning the factors that contribute to NIHL and the use of hearing protection. Additionally, this study was interested in whether there were racial/ethnic differences or similarities in knowledge of hearing loss and the use of HPDs among African-American and caucasian young adults.

Adolescent↗
PubMed1976

External auditory canal stenosis.

Stenosis of the external auditory canal may occur from a variety of causes. The numerous surgical techniques illustrate that repair may be difficult. The problems were resolved in two cases with the use of a silicone-rubber insert that is made at the time of the surgical procedure and is used throughout the postoperative period.

Adult↗