A Systematic Literature Review of the Factors Influencing Hearing Protection Device Usage among Industrial Workers

The Prevalence, Knowledge, Attitude, and Practice of Occupational Hearing Loss Among Industrial Workers in Saudi Arabia

PURPOSE

Occupational noise poses a persistent hazard to hearing, while lack of awareness and inadequate hearing protection device (HPD) training heighten the risk of noise-induced hearing loss (NIHL). Few studies have investigated the effects of NIHL and HPD use in Saudi Arabia, with only one in Jeddah. Therefore, this study aimed to estimate the prevalence of occupational NIHL and assess workers' knowledge, attitudes, and practices (KAP) regarding HPDs in Jeddah, Saudi Arabia.

METHOD

This cross-sectional study included 200 industrial workers aged 18-55 years who were exposed to noise. Data were analyzed using descriptive and inferential statistics, including correlations and chi-squared tests. A 32-item questionnaire assessed the KAP regarding occupational NIHL and HPD usage. Hearing screening was conducted using pure-tone audiometry at 0.5, 1, 2, 3, 4, 6, and 8 kHz. Participants who failed screening underwent a comprehensive audiological evaluation.

RESULTS

The analysis revealed that 39.5% of the participants failed hearing screening. Regarding participants' knowledge, 82% believed that noise could affect hearing, 64.5% believed that NIHL could be prevented, and only 35% knew that it was permanent. In terms of HPD usage, 49% always wore them and 34% wore them sometimes. The main reason for not using HPDs was the difficulty communicating with others while wearing them (40%).

CONCLUSIONS

Findings revealed that the prevalence of occupational NIHL was higher than the global prevalence. Thus, hearing conservation programs and enhanced awareness of the permanent nature of NIHL can encourage HPD utilization, which is crucial for preventing diminished productivity, income, and overall quality of life.

A scoping review of the prevalence of musicians' hearing loss

Introduction

Hearing loss is the most commonly recognized occupational disease in Germany. Musicians are also affected, as playing classical music can expose them to high or very high sound volumes. With this scoping review, we aimed to assess the prevalence of noise-induced hearing loss among professional musicians and evaluate its characteristics.

Methods

The databases such as MEDLINE, Embase, Cochrane Library, and Google Scholar were searched using the terms (hearing loss OR hearing impairment OR hearing difficulties OR acoustic trauma) AND (musician) on 14 August 2023 and 2 January 2025. Only original studies with audiometric examination results were included.

Results

A total of 79 studies were retrieved for descriptive analysis. The median number of participants was 52 (IQR 30-109). The majority of the retrieved studies included participants with at least 5 years of experience as practicing musicians. The proportion of men was significantly higher than that of women, with the medianmen portion of 69% (IQR 53-83%). Students were a common study population, indicating that the data on older and retired musicians were either rare or missing. As a result, the lifetime prevalence of hearing loss in musicians could not be determined. The data analysis showed an increased risk of hearing loss >15-20 dB in the frequency range of 4,000-6,000 Hz among participants in the classical genre group. Studies with participants having normal hearing were also found within that genre. Rock, pop, and jazz musicians had an increased risk of hearing loss >20 dB in the frequency range of 3,000-8,000 Hz. The data for military and marching band music and traditional music genres were limited. The retrieved studies indicated a higher risk of hearing loss >20 dB in the frequency range of 4,000-6,000 Hz. A total of 17 studies adjusted the audiogram results for age, 2 did not, and 59 had no report. Data extraction yielded a prevalence of notch configurations in 20-50% of the classical musicians, with hearing loss affecting 5-70% of them. Up to 40% of rock, pop, and jazz musicians showed notch configurations, with 20-60% experiencing hearing loss.

Conclusion

Overall, a definitive assessment of the prevalence of musicians' hearing loss cannot be drawn from the available data. Prospective, longitudinal studies with reliable sample sizes and representative populations are essential. A multicenter study would also be valuable.

Effectiveness of workplace health promotion programs for industrial workers: a systematic review

BACKGROUND

Workplace health promotion is essential for individual and organisational well-being and disease prevention, also in industrial workers. As the transfer of the evidence on the effectiveness of such programs into practice is limited due to scattered effects, the need for a consolidation of the available studies is given. The purpose of this systematic review was to synthesise the evidence on the effectiveness of workplace health promotion programs for industrial workers.

METHODS

An electronic literature search was conducted in PubMed, Cochrane Library, Web of Science™, Scopus, and EBSCOHost until July 26th 2023. Studies investigated industrial workers who performed manual labour for at least 20 h per week were included. They had to receive a workplace health promotion intervention under any control condition. Outcomes were workplace health interventions' safety and corresponding health-related outcomes. The revised Cochrane risk-of-bias assessed the risk of bias (Rob 2) tool for randomised control trials (RCT) and cluster RCT. Quality assessment was performed using a modified Downs and Black Checklist.

RESULTS

Of the 25,555 studies initially identified, 39 were included. Generally, the mean quality of the studies was moderate, with most studies judged with a high overall risk of bias. Twenty-seven studies employed a behavioural approach, while one study adopted an organisational one. Ten studies utilised a multicomponent approach, and one intervention improved safety outcomes. The analysis of the results indicated an overall positive but heterogeneous effect across the different approaches.

CONCLUSIONS

The studies included in this review provide evidence that workplace health promotion can be effective. However, the overall findings are inconclusive due to the high risk of bias. Therefore, the results should be interpreted cautiously. Despite the considerable amount of research conducted in this field, additional well-designed studies are needed to fully confirm the effectiveness and determine the most promising types of interventions for improving and maintaining industrial health.

Effect of Occupational Noise on Employee Health: A Longitudinal Study

OBJECTIVE

This study investigated the long-term health risks associated with occupational noise exposure. By using 9 years of health examination data from a major manufacturing company in Taiwan, this study compared the health indices of employees in noise-intensive and non-noise-intensive work environments.

METHODS

A retrospective analysis of 6278 health examination reports spanning 9 years was conducted to compare 20 health indices among 166 employees evenly distributed between noise-intensive and non-noise-intensive workgroups. These employees were carefully matched for sex, age, and work experience. Linear regression models were used to assess the temporal impact of noise exposure on each health index by incorporating a unique range ratio to quantify index fluctuations attributable to noise.

RESULTS

Employees exposed to occupational noise had an increase in platelet count of 16.594 K/µL, with an annual increment of 1.228 K/µL. Moreover, employees in noisy environments exhibited a significant increase in blood urea nitrogen level by 0.438 mg/dL, with an annual increase of 0.171 mg/dL. Additionally, their carcinoembryonic antigen level was significantly increased by 0.187 ng/mL on average, with the annual increase being 0.034 ng/mL. Moreover, increases in systolic blood pressure (2.015 mmHg), heart rate (4.620 beats/min), and white blood cell count (0.536 K/µL) and a decrease in red blood cell count (0.107 M/µL) were discovered to be solely attributable to noise exposure.

CONCLUSIONS

Prolonged exposure to high occupational noise levels significantly increases the risk of cardiovascular, renal, and colorectal diseases. This longitudinal study underscores the detrimental health consequences of prolonged noise exposure in occupational settings.

Advancing noise management in aviation: Strategic approaches for preventing noise-induced hearing loss

As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector.

Strategies of Hearing Preservation With Military Personnel: A Scoping Review

PURPOSE

The purpose of this study was to map the strategies used in hearing health education with military personnel during the Hearing Preservation Program (HPP).

METHOD

This study is a scoping review, with electronic searches conducted in online databases and gray literature: Latin American and Caribbean Literature in Health Sciences, PubMed/Medline, Scopus, Web of Science, ASHAWire, Google Scholar, and ProQuest Dissertation & Theses. Only studies describing, analyzing, or evaluating the application of the HPP to active duty or training military personnel were included.

RESULTS

A total of 3,478 references were retrieved, and 12 studies met the inclusion criteria. The strategies were classified into five categories: focus group aimed at exploring knowledge and perceptions regarding hearing health (five studies), training on the proper fitting of hearing protection devices (four studies), the utilization of audiovisual materials (seven studies), questionnaires administrated before and after educational intervention (five studies), and feedback survey concerning the implemented hearing health education (three studies).

CONCLUSION

There are five strategies that aimed at assessing knowledge and attitudes, improving hearing health education, facilitating information access, and evaluating the applied actions.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25219589.

The influencing factors of hearing protection device usage among noise-exposed workers in Guangdong Province: a structural equation modeling-based survey

BACKGROUND

There are numerous complex barriers and facilitators to continuously wearing hearing protection devices (HPDs) for noise-exposed workers. Therefore, the present study aimed to investigate the relationship between HPD wearing behavior and hearing protection knowledge and attitude, HPD wearing comfort, and work-related factors.

METHOD

A cross-sectional study was conducted with 524 noise-exposed workers in manufacturing enterprises in Guangdong Province, China. Data were collected on hearing protection knowledge and attitudes, HPD wearing comfort and behavior, and work-related factors through a questionnaire. Using structural equation modeling (SEM), we tested the association among the study variables.

RESULTS

Among the total workers, 69.47% wore HPD continuously, and the attitudes of hearing protection (26.17 ± 2.958) and total HPD wearing comfort (60.13 ± 8.924) were satisfactory, while hearing protection knowledge (3.54 ± 1.552) was not enough. SEM revealed that hearing protection knowledge had direct effects on attitudes (β = 0.333, p < 0.01) and HPD wearing behavior (β = 0.239, p < 0.01), and the direct effect of total HPD wearing comfort on behavior was β = 0.157 (p < 0.01). The direct effect also existed between work shifts and behavior (β=-0.107, p < 0.05). Indirect relationships mainly existed between other work-related factors, hearing protection attitudes, and HPD wearing behavior through knowledge. Meanwhile, work operation had a direct and negative effect on attitudes (β=-0.146, p < 0.05), and it can also indirectly and positively affect attitudes through knowledge (β = 0.08, p < 0.05).

CONCLUSION

The behavior of wearing HPD was influenced by hearing protection knowledge, comfort in wearing HPD, and work-related factors. The results showed that to improve the compliance of noise-exposed workers wearing HPD continuously when exposed to noise, the HPD wearing comfort and work-related factors must be taken into consideration. In addition, we evaluated HPD wearing comfort in physical and functional dimensions, and this study initially verified the availability of the questionnaire scale of HPD wearing comfort.

Auditory Changes in Occupational Health Associated With Metabolic Diseases in Adult Workers

INTRODUCTION

The most common hearing losses in the population are associated with genetic conditions, use of ototoxic substances or medications, infectious diseases, metabolic diseases and chronic ear diseases and the association of exposure to occupational risks or the natural aging process.

OBJECTIVE

Verify the association between hearing loss in workers and metabolic diseases.

METHOD

Retrospective cross-sectional study with analysis of secondary data of subjects exposed to occupational noise and undergoing drug treatment for metabolic disease, attended in two occupational health clinics (C1 and C2) from January 2020 to December 2022, considering the data of reference examinations from the year 2005.

RESULTS

Of the n = 97 subjects evaluated, 73.20% were male, exposed to occupational noise (64.90%), with medication use for treating cardiovascular diseases (89.70%). The most recurrent auditory complaint was tinnitus (28.90%), n = 53 subjects presented sensorineural hearing loss with a statistical association between the decline of hearing loss and medications used for metabolic and hormonal regulation.

CONCLUSION

Here was a higher frequency in the use of medications for treating cardiovascular diseases with a risk of triggering or worsening hearing loss in these subjects and greater impairment and decline of hearing thresholds were observed in the results of C2.