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NIOSH Hearing Loss Research Program Review NIOSH Publications on Noise and Hearing The National Academies - Advisors to the Nation on Science, Engineering, and Medicine

What does the HLR Program Do?

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Research Goal 1

Research Goal 2

Research Goal 3

Research Goal 4

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R&D Portfolio - Research Goal 1: Contribute to the Development, Implementation, and Evaluation of Effective Hearing Loss Prevention Programs

In both theory and practice, protecting workers from noise exposure is difficult. One reason for this difficulty is that there are many aspects to protection. In “Preventing Occupational Hearing Loss - A Practical Guide,”[1] the HLR program addressed the seven components of an effective hearing loss prevention program (HLPP) that were first defined in the NIOSH 1973 Criteria Document. These seven areas are: noise exposure monitoring, engineering and administrative controls of noise, audiometric evaluations of workers’ hearing, HPDs, training, record keeping, and evaluation of results.1 However, there is a need for intervention effectiveness research designed to validate best practices for each program element. There is also a need to promote the adoption of evidence-based best practices by employers and employees.

Virtually every strategy for preventing hearing loss requires significant human effort. Engineering controls must be developed, implemented, and maintained. Administrative controls have to be designed and then adopted by workers to whom they may be unfamiliar. HPDs must be provided and worn correctly. When these human efforts fall short, workers can receive hazardous noise exposures.

The HLR program conducts three streams of research designed to improve HLPPs. The first HLR program focus is on developing criteria for recommended standards (e.g. ANSI and ISO standards, standards of practice for hearing loss prevention professionals, and recommendations to regulatory agencies). The HLR program reviews and analyzes the relevant scientific literature on occupational hearing loss and its prevention for these bodies and other groups.

Second, the HLR program investigates hearing conservation program approaches, methods, and materials to develop and field-test best practices. The HLR program is currently doing this with the Ford Motor Company and with groups in the construction industry. Beginning in 2006, the HLR program will also be working with the DOD in U.S. Navy shipyards. In these studies, baseline and validation data is gathered by examining records, conducting focus groups and interviews with managers and employees, observing procedures such as annual monitoring audiometry and hearing loss prevention (HLP) training, and conducting noise surveys and dosimetry. We may also participate in the development and analysis of new audiometric databases. HLR staff and research partners use these data to validate successful program elements, to design improvements for deficient elements, and to evaluate the overall effectiveness of HLPPs. Management and labor representatives participate in this research, increasing its face validity.

The third HLR program focus applies principles from social psychology, persuasion science, social marketing, and health communication to create training and information programs that -meet the needs of intended audiences and improve the motivation of employers and employees to protect hearing. The HLR program is doing this research in high-risk sectors such as construction and mining. This research improves our understanding of what makes HLPP training effective. Investigations are conducted using a training laboratory or by participatory field research.

The HLR program transfers lessons learned from training research, as well as novel methods and materials to the workplace by disseminating them to:

In 2004, the HLR program realigned its training research to be consistent with the Research Goals of the CDC Life Stages initiative. The initiative acknowledges that training and information needs can be optimized by recognizing differences in learning styles and information needs across age groups. Thus, the methods and materials used to inform, train and motivate various groups of HLPP stakeholders will differ. We are currently investigating these differences among young workers (high school students and apprentices), adult workers (journeymen) and mature workers (older workers who already may have substantial levels of occupational and/or age-related hearing loss).


[1] NIOSH [1996]. Preventing Occupational Hearing Loss—A Practical Guide. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 96-110. (Revision of NIOSH [1990] A Practical Guide to Effective Hearing Conservation Programs in The Workplace [DHHS (NIOSH) 91-152]).

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