Trends in Hearing Protection Use With Occupational Noise Exposure in the United States 1999 to 2016

Association between personal attenuation rating with types of earplugs and noise exposure levels in a textile factory in China

OBJECTIVE

To investigate the effects of earplug type and noise exposure level on textile workers' personal attenuation rating (PAR).

DESIGN

Initial and follow-up visits were conducted at a 17-month interval. At each visit, a baseline HPD fit test was performed using either a 3M foam or pre-molded earplug, as chosen by the workers. Workers who failed to meet targeted levels were trained and retested. Once they failed again, the other earplug was selected, and training was provided until they achieved the PAR target.

STUDY SAMPLE

192 textile workers into three noise exposure level groups (low, medium, high).

RESULTS

The median baseline PAR was 10 dB at the initial visits and 13 dB at the follow-up visits, and obtained by foam earplug users was 20 dB, which was higher than that obtained by pre-molded earplug users [12 dB (95% CI, 10-15 dB)]. The highest median baseline PAR was obtained by the high noise level group, followed by the median and low noise level groups. Training significantly increased the PAR.

CONCLUSIONS

Multiple types of earplugs need to be offered to workers to deal with individual differences in attenuation, preferences, and exposure levels. Training and stricter compliance policies can improve HPD use and fitting, contributing to better hearing health.

Cerumen impaction: Prevalence and associated factors in the United States population

Objective

To examine the prevalence of cerumen impaction in a nationally representative sample of the US population and the association of cerumen impaction with sociodemographic factors, hearing loss, and tinnitus.

Methods

The cohort included 14,230 individuals aged ≥12 years who completed otoscopy and audiometry in NHANES (2005-2016). Cerumen impaction (partial/complete) was determined by otoscopy. Hearing level was defined by speech-frequency pure-tone average (PTA). Multivariable regression analysis was performed to identify factors associated with cerumen impaction.

Results

The prevalence of any cerumen impaction was 18.6% [95% CI: 17.3%-19.9%] among individuals ≥12 years and 32.4% [29.9%-35.1%] among those ≥70 years. The prevalence of bilateral partial and complete cerumen impaction was 6.3% [5.6%-7.1%] and 1.2% [1.0%-1.9%], respectively. Any cerumen impaction was associated with male sex (OR 1.77 [1.5-2.1]), identifying as Black race (vs. Caucasian, OR: 1.78 [1.5-2.9]), lower level of education (OR: 0.84 [0.71-0.98]), and older age (OR: 1.02 [1.01-1.03]). After adjusting for sociodemographic and clinical factors, complete impaction was associated with increased PTA (right ear: β = 4.1 dB [2.4-5.8 dB], left ear: β = 1.9 dB [0.46-3.4 dB]), but not with tinnitus.

Conclusions

Cerumen impaction is highly prevalent in the US population, especially among older adults, and has disproportionate sociodemographic impacts. Complete impaction is associated with a small, statistically significant elevation in PTA, but there is no association with tinnitus. These findings emphasize the need to implement and disseminate best practices for ear hygiene and cerumen management broadly and equitably.

Level of Evidence

2B.

New Paradigm of Music Listening: Hearing Protection Perceptions and Treatment Decision-Making Among Music Venue Attendees

OBJECTIVE

Investigate the prevalence of hearing protection (HP) use and behavioral motivations and barriers among adults attending music venues.

STUDY DESIGN

Cross-sectional online survey study.

SETTING

Noise exposure levels at popular social music venues often exceed national guidelines.

METHODS

Surveys were distributed on online music communities. Respondents (n = 2352) were asked about demographics, HP use at music venues, knowledge about noise exposure impact, and perceptions of HP use. Data were characterized through descriptive statistics. Multivariable regression analysis explored differences in knowledge and perception between HP users and nonusers.

RESULTS

In this cohort (mean age 29 ± 7 years, 61% male), HP users were significantly more aware of the impact of music venues on hearing (P < .01), believed their hearing ability had decreased after attending music venues (P < 0.01), and believed HP could protect from hearing loss (P < .01) than non-HP users. HP nonusers most frequently cited never considering HP (14.45%) and apathy about it affecting music quality (12.71%). Common sources of HP information were recommended by a friend/peer. Multivariable regression analysis accounting for demographics, medical history, and attendance characteristics found belief that HP use at music venues could protect from hearing loss (β = 0.64, 95% confidence interval [CI] = [0.49-0.78]) and HP use (β = 1.73, 95% CI = [1.47-1.98]) were significantly associated with increased subjective enjoyment while wearing HP.

CONCLUSION

HP users and nonusers have significantly different perceptions of HP use and its impact. Our findings have implications for understanding motivations and barriers related to HP use and developing strategies to promote HP use at music venues.