for the right amount of protection. Fit-testing raises several key follow-up
Are workers using appropriate hearing
Based on the metrics from several companies using earplug fit-testing, a significant number of workers initially choose
the wrong earplug, and those who choose
the right earplug may be using it incorrectly.2 Use markers such as stickers on
hard hats or badges to identify the appropriate earplug for each employee and
maintain an inventory of each product.
Are workers using hearing protection
when it is needed?
The walk-through audit is the traditional
metric for determining whether workers
are using earplugs consistently. But visual checks may not be enough. The best
way to determine whether workers are
really protected by their hearing protection is through in-ear monitoring. As
mentioned above, in-ear monitoring reports the dose of hazardous noise for the
individual and notifies the worker of
overexposures as they occur, which helps
workers learn when hearing protection is
needed. In-ear monitoring records the
overall dose for the work shift and transmits single-day overexposures to a supervisor or safety manager for preventive
Are workers using personal protective
equipment (PPE) effectively?
In a study of nearly 100 workers, three
out of four were able to estimate the
correct range of protection (within 7–8
dB) that they achieved from earplugs
after a short fit-test training session.
(Results of this study will be presented
at AIHce 2011.) By asking workers to
estimate the amount of protection they
expect to receive and verifying the
amount via fit-testing, you can make a
game out of prevention—a game that
helps motivate workers to use hearing
protection and makes them part of the
How consistent is the protection provided by an earplug?
Repeated fit-testing can document the
variability of fit that workers achieve with
a given earplug. In-ear monitoring can
also be used to check consistency of use.
Figure 3. Distribution of protected exposure levels (PrEL) for 147 workers before (light bars)
and after (dark bars) one-on-one training.
Which earplugs are needed to provide
“appropriate selection” of hearing
Knowing which level of protection
earplugs provide for your workers helps
ensure that you keep the proper selection
in stock. After earplug fit-testing has
been completed on all workers, you’ll be
able to manage earplug inventory.
Remember that some workers need
more than one hearing protector—for example, one for their highest noise exposures and one for lower exposures. A
logistics-related metric can be used to
measure the availability of the right mix
Are workers trained in hearing loss
The traditional metric involves counting
the number of people in a group training
room or auditing training records. A
metric focused more on prevention could
involve the use of in-ear monitoring to
help workers recognize when they need
hearing protection and whether their
protection is working. Some companies
use in-ear dosimeters to train new em-
ployees: once workers demonstrate the
ability to use hearing protection effec-
tively by achieving 50 percent dose or
less for a few weeks or a few months,
they can use similar hearing protection
without in-ear monitoring. Selection of
the earplug that will not be constantly
monitored can be based on fit-testing.
Even periodic retests can be completed
to confirm appropriate protection. Meas-
uring the desired behavior is certainly a
better metric than just checking atten-
dance at training sessions.
Metrics are often used to submit a required report. But proactive metrics can
show the value of hearing loss prevention activities, which can help justify resources and prioritize what you need to
work on to make a real difference in your
hearing loss prevention program.
1. NIOSH: “Preventing Occupational
Hearing Loss—A Practical Guide.”
[Online] Available at www.cdc.gov/
2. Witt, Brad: “Putting the Personal
Back into PPE: Hearing Protector
Effectiveness.” Occupational Health
and Safety, June 76( 6), 90-4: 2007
[Online] Available at www.ohsonline.
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