Enhancing and Sustaining Noise Attenuation From Hearing Protection Devices: a Mixed Methods Review of Fit Testing and Instruction Approaches.

Details

• Alternative Title:
  Journal of Occupational and Environmental Hygiene, 2026, v. 23, no. 5: Enhancing and Sustaining Noise Attenuation From Hearing Protection Devices: a Mixed Methods Review of Fit Testing and Instruction Approaches.
• Journal Article:
  Journal of Occupational and Environmental Hygiene
• Personal Author:
  Gong, Wei ; Morata, Thais C ; Samelli, Alessandra G
• Description:
  Extensive training has been shown to improve the effectiveness of hearing protection devices (HPDs) in reducing noise exposure for workers. This study aimed to (1) assess the evidence for short- and long-term effectiveness of HPD fit testing paired with extensive instructions and (2) identify the type and frequency of refresher instruction associated with maintaining its effectiveness. A literature search was completed on February 5, 2025. The inclusion criteria focused on uncontrolled before-and-after (UBA) studies that reported personal attenuation ratings (PARs) provided by HPDs in the field. A total of 23 UBA studies involving 5,575 workers were included, meta-analyses were performed when multiple comparable studies were located. For earplugs, retesting immediately after extensive training increased the mean PAR by 12.88 dB (13 studies) compared with the pre-intervention PARs without instructions. The improvement decreased to 8.84 dB (2 studies) within 6 months and further reduced to 4.46 dB (2 studies) at 12 months. For earmuffs, only one study reported increase in PARs of 5, 2, and 3 dB for immediate, short-term, and long-term assessment, respectively. Introducing extensive refresher training within a 6-month interval increased the mean PAR from earplugs by 1.53 dB (2 studies) compared with the post-intervention PAR retested immediately after extensive training, with a further increase of 3.45 dB (1 study) following annual extensive instruction. Simple refresher instructions within a 6-month interval maintained the PAR values (1 study). However, without any refresher training, the PAR decreased by 2.64 dB (2 studies) within 6 months and 3.09 dB (2 studies) over 6 months or longer. Refresher training may increase the probability that workers receive efficient protection from their HPDs. However, more high-quality studies could help inform the optimal type and frequency of refresher training.
• Content Notes:
  Author manuscript
• Subjects:
  • Ear Protective Devices
  • Humans
  • Noise, Occupational
  • Hearing Loss, Noise-Induced
  • Occupational Exposure
• Keywords:
  • Earmuff
  • earplug
  • hearing conservation program
  • hearing loss prevention
  • personal attenuation ratings (PARs)
  • training
• Source:
  Journal of Occupational and Environmental Hygiene, 2026, v. 23, no. 5
• DOI:
  https://doi.org/10.1080/15459624.2025.2602758
• ISSN:
  1545-9624 ; 1545-9632
• Pubmed ID:
  41592213
• Pubmed Central ID:
  PMC12927255
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  319-333 (18 pdf pages)
• Volume:
  23
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/260821/cdc_260821_DS1.pdf
• File Type:
  [PDF - 507.96 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:bd07754d656d5a4424e1093c10eb7f5057ddbf63c1a019a24c6a274977128dcc5b44edfffac880d2adc3ecab26c5ade91dabfbd46f2cc49259f2e02c12baf474