Participating core and specialty programs: Occupational Health Equity, Small Business Assistance, Safe●Skilled●Ready, and Surveillance

Employers, workers, equipment manufacturers, non-governmental organizations, and suppliers use NIOSH information to reduce hearing loss in building services workers and in services sector small business enterprises.

NOTE: Goals in bold in the table below are priorities for extramural research.

  Health Outcome Research Focus Worker Population* Research Type
A Hearing loss Overexposure to noise (intermittent use of loud equipment) Building services workers, arts and entertainment subsector, small businesses InterventionTranslation
B Hearing loss Lack of awareness of noise as a hazard and how to protect hearing Building services workers, arts and entertainment subsector, small businesses Translation
C Hearing loss Characterizing noise exposures and prevalence of hearing loss Building services workers, arts and entertainment subsector, small businesses Basic/etiologic

Surveillance research

* See definitions of worker populations

Activity Goal 2.7.1 (Basic/Etiologic Research): Conduct basic/etiologic research to better characterize noise exposures among building services and arts and entertainment workers in the services sector.

Activity Goal 2.7.2 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions to reduce noise exposure among building services and arts and entertainment workers in the services sector.

Activity Goal 2.7.3 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective hearing protection interventions among building services and arts and entertainment workers in the services sector.

Activity Goal 2.7.4 (Surveillance Research): Conduct surveillance research to better characterize hearing loss prevalence among building services and arts and entertainment workers in the services sector.


In the U.S., occupational hearing loss is one of the most common work-related illnesses. Twenty-four percent of the hearing difficulty among U.S. workers is attributable to occupational exposures [Tak and Calvert 2008; Themann et al. 2013]. Within the services sector, there are very large groups of workers with hazardous noise exposure. For instance, 45% are exposed in repair and maintenance (approximately 900,000 exposed workers); within arts, entertainment, and recreation 22% of workers are exposed (approximately 550,000 exposed workers); and approximately 13% are exposed within public administration (approximately 650,000 exposed workers) [Tak et al. 2009]. Twenty percent of noise-exposed services workers have a material hearing impairment in one or both ears (overall) [Masterson et al. 2015]. However, among some industry sub-sectors, 23-36% have impairment [Masterson et al. 2013]. Services workers lose 2.6 healthy years, each year, for every 1,000 noise-exposed workers [CDC 2016]. These lost healthy years are shared among the 13% of noise-exposed services workers with hearing impairment in both ears (about 130 workers out of each 1,000 workers). Over a 30-year working lifetime, about 78 healthy years are lost by 130 workers [CDC 2016].


Effective interventions to prevent noise induced hearing loss in the services sector are multi-faceted. First, field studies are needed to evaluate feasibility and effectiveness of noise control solutions, as workplace noise is best controlled at the source. In particular, research is needed to promote and develop “Buy Quiet” approaches that address supply and demand for equipment often used in Services, in addition to developing databases of noise levels for tools and equipment [Beamer et al. 2016]. Second, best practices for hearing conservation programs in Services are needed that include effective use of hearing protectors, hearing protector fit-testing, and effective worker training on the dangers of noise exposure and preventing hearing loss [Byrne et al. 2017; Murphy et al. 2011]. Services sector workers are often from vulnerable populations which puts them at higher risk to occupational hazards, noise exposure among them. Moreover, services sector employers are often small business employers which often have fewer resources to devote to issues like occupational noise exposure.

Educational materials and guidelines for workers and employers are needed to inform them about steps that can be taken to reduce noise exposures and to protect their hearing, such as the proper way to insert foam ear plugs, “Buy Quiet” programs, ways to reduce vibration of equipment to possibly reduce noise, and use of administrative controls. Furthermore, educational materials should be tailored to specific Services audiences, taking into account barriers to implementing best practices. Contingent workers and their employers are an especially important audience as these workers are particularly vulnerable to workplace hazards and that there is sometimes a lack of clarity about who is responsible for their hearing protection programs.

Basic/etiologic and surveillance research are needed to better characterize noise exposures and hearing loss prevalence, especially among building services and arts and entertainment workers in the service sector. Additionally workplace noise exposures for targeted services sector tasks should be studied to characterize the noise dose, use/non-use of hearing protection, and assessment of hearing conservation programs.

Beamer B, McCleery T, Hayden, C [2016]. Buy quiet initiative in the USA. Article. Acoust Aust 44(1): 51-44.

Byrne DC, Murphy WJ, Krieg EF, Ghent RM, Michael KL, Stefanson EW, Ahroon WA [2017]. Inter-laboratory comparison of three earplug fit-test systems. J Occup Environ Hyg 14(4):294-305.

CDC [2016]. Hearing impairment among noise-exposed workers — United States, 2003–2012. MMWR 65(15):389-394.

Masterson EA, Deddens JA, Themann CL, Bertke S, Calvert GM [2015]. Trends in worker hearing loss by industry sector, 1981-2010. Am J Ind Med 58(4):392-401.

Masterson EA, Tak S, Themann CL, Wall DK, Groenewold MR, Deddens JA, Calvert GM [2013]. Prevalence of hearing loss in the United States by industry. Article. Am J Ind Med 56(6):670-681.

Murphy WJ, Stephenson MR, Byrne DC, Witt B and Duran J [2011]. Effects of training on hearing protector attenuation. Noise Health 13(51):132-141.

Tak S, Calvert GM [2008]. Hearing difficulty attributable to employment by industry and occupation: an analysis of the National Health Interview Survey–United States, 1997 to 2003. J Occup Environ Med 50(1):46-56.

Tak S, Davis RR, Calvert GM [2009]. Exposure to hazardous workplace noise and use of hearing protection devices among US workers — NHANES, 1999-2004. Am J Ind Med 52(5):358-371.

Themann CL, Suter AH, Stephenson MR [2013]. National research agenda for the prevention of occupational hearing loss – part 1. Seminars in Hearing 34(3):145-207.

Page last reviewed: April 24, 2018