Hearing protection fit-testing

Hearing protector fit-testing, also known as field attenuation estimation system (FAES), measures the degree of noise attenuation when using the hearing protection device by a particular worker in the enterprise. Such measurements are necessary because noise attenuation is very variable among workers, and it can be close to zero for a significant proportion of them.[2] Individual anatomical differences and varying ability to correctly apply HPD do not allow predicting noise attenuation in workers based on laboratory measurements with satisfactory accuracy.[3] This is typically carried out using one of the available fit-testing hardware and software systems.[4] The effectiveness is typically measured as a personal attenuation rating (PAR) which is subtracted from the known noise exposure to estimate the total noise exposure a single person has when wearing the tested hearing protection device (HPD).[5][6] The Occupational Safety and Health Administration, National Hearing Conservation Association and National Institute for Occupational Safety and Health recommend it for all workers used HPD as a best practice,[7] and describes existing testing methods and how to incorporate them in hearing conservation programs.[8]

Fit testing (MIRE)[1]

Hearing protection devices such as earplugs or earmuffs must be worn correctly for the wearer to be protected from noise.[9] Correct use of hearing protection includes:

  • Choosing the most appropriate hearing protection device, both with appropriate level of attenuation and appropriate fit for the individual.[10] Ideally, the device should limit the sound intensity that reaches the ear to levels below 85 dBA. If the attenuation does not limit the noise levels to that level, other alternatives should be sought. If the attenuation is greater than that, it can also interfere with the HPD use.[11]
  • Wearing or inserting the hearing protection device correctly so it seals the wearer's ear canal, using the "roll-pull-hold" method for foam earplugs, and ensuring earmuffs create an unbroken seal around each ear.[12]

Fit-testing hearing protection can facilitate an appropriate choice of hearing protection, and allow for the professional administering the fit-test to train users on proper techniques for wear.[5][13][14][15][16][17]

Alberta Government changed the requirements of the laws. Employers are required to fit test HPD of each employee from March 31, 2023.[18] A similar trend has emerged in the European Union & USA.[19][20]

Personal attenuation rating (PAR)

Similar to a noise reduction rating (NRR) required on hearing protection devices in the United States, a personal attenuation rating (PAR) is obtained from an attenuation measurement at one or more than one frequency. However, the PAR is regarded as more accurate than the NRR because it is calculated per individual and per hearing protection device, while NRR is a generalized estimate of potential sound reduction based on the protection provided to a small population of people. Therefore, PAR gives the evaluator an estimate of the total noise exposure an individual is receiving when wearing hearing protection.

Fit-testing methods

Although all fit-testing systems assess hearing protection devices to give a resulting personal attenuation rating, there are a few different types of technology that have been developed, with real-ear attenuation at threshold (REAT) as the established standard under ANSI/ASA S12.6. It is important to note that the outcome measure generated by each system varies from a simple pass/fail to a quantitative personal attenuation rating (PAR) and can be interpreted differently to determine the effectiveness of hearing protection or calculate total noise exposure.[21]

The different methods[22] used to measure the attenuation provided by HPDs are as follows:

Real-ear attenuation at threshold (REAT)
NIOSH mobile laboratory for REAT measuring (sound thresholds & real attenuation of earplugs)[23]

REAT is the most commonly used type of fit-testing technology used in commercial systems, and is considered the "gold standard" for fit-testing. REAT technology measures the difference in auditory (hearing) thresholds without hearing protection (unoccluded) and with hearing protection (occluded). Most REAT systems use a subjective measure to determine auditory thresholds much like a hearing test where the subject indicates when sound is heard at various frequencies. For earmuffs this must be tested in an acoustic chamber, however for earplugs, headphones can be used, making the test easier for commercial use.[21] For noncritical screening, REAT can be performed using a web browser and simple audio devices.[24]

Microphone-in-real-ear (MIRE)
Earplugs with probes for MIRE measurements.

Also referred to as F-MIRE (field microphone in real ear). This method measures attenuation by placing a small microphone inside the ear canal while hearing protection is worn. Sound pressure levels (SPL) are measured inside and outside of the ear simultaneously and used to calculate a PAR.[25]

Loudness balance

This method first has the subject listen to tones with headphones and "match" loudness between both ears until tones sound equally loud on both sides. Then an earplug is placed in one ear while the baseline procedure is repeated to match loudness in both ears, then the procedure is repeated a third time so both ears are tested individually with earplugs. This calculates a personal attenuation rating based on the loudness of the sound delivered to the unprotected ear when it matches the protected ear.[25]

Use of Fit-testing as a training tool

There has been evidence that including fit-testing as a part of employee training for correct hearing protection device use increases user ability for proper insertion on follow-up.[13][26][17][27]

See also

References
  1. Kah Heng Lee; Geza Benke; Dean Mckenzie (2022). "The efficacy of earplugs at a major hazard facility". Physical and Engineering Sciences in Medicine. Springler. 45 (1): 107–114. doi:10.1007/s13246-021-01087-y. ISSN 2662-4729. PMID 35023076. S2CID 221812245. Retrieved 2022-08-10.
  2. Gong, Wei (2021). "Evaluating the effectiveness of earplugs in preventing noise-Induced hearing loss in an auto parts factory in China". International Journal of Environmental Research and Public Health. 18 (3): 7190. doi:10.3390/ijerph18137190. PMC 8297223. PMID 34281127.
  3. Berger, Elliott H.; Voix, Jérémie (2018). "Chapter 11: Hearing Protection Devices". In D.K. Meinke; E.H. Berger; R. Neitzel; D.P. Driscoll; K. Bright (eds.). The Noise Manual (6th ed.). Falls Church, Virginia: American Industrial Hygiene Association. pp. 255–308. Retrieved 10 August 2022.
  4. Voix, Jérémie; Smith, Pegeen; Berger, Elliott H. (2018). "Chapter 12: Field Fit-Testing and Attenuation-Estimation Procedures". In D.K. Meinke; E.H. Berger; R. Neitzel; D.P. Driscoll; K. Bright (eds.). The Noise Manual (6th ed.). Falls Church, Virginia: American Industrial Hygiene Association. pp. 309–329. Retrieved 10 August 2022.
  5. Witt B (October 2007). "Fit testing of hearing protectors". Occupational Health & Safety. 76 (10): 118, 120–2. PMID 17972707. Retrieved 2018-12-28.
  6. Trompette N, Kusy A, Ducourneau J (2015-04-01). "Suitability of commercial systems for earplug individual fit testing". Applied Acoustics. 90: 88–94. doi:10.1016/j.apacoust.2014.11.010.
  7. OSHA (July 6, 2022). "OSHA Technical Manual (OTM) Section III: Chapter 5. Noise". www.osha.gov. US Occupational Safety and Health Administration. Retrieved 18 January 2023. ... has recommended HPD fit-testing as a best practice and valuable training tool that can help in training the worker to achieve an optimal fit
  8. NHCA/OSHA/NIOSH Alliance (2008). "Hearing Protection-Emerging Trends: Individual Fit Testing". NHCA Alliance Best Practice Bulletin: 3. Retrieved 18 January 2023. PDF
  9. Ntlhakana L, Kanji A, Khoza-Shangase K (2015). "The use of hearing protection devices in South Africa: exploring the current status in a gold and a non-ferrous mine". Occupational Health Southern Africa. 21: 10–15.
  10. Murphy WJ, Themann CL, Kardous CA, Byrne DC (2018-10-24). "Three Tips for Choosing the Right Hearing Protector". NIOSH Science Blog. Retrieved 2018-12-28.
  11. Svensson EB, Morata TC, Nylén P, Krieg EF, Johnson AC (2004-11-11). "Beliefs and attitudes among Swedish workers regarding the risk of hearing loss". International Journal of Audiology. 43 (10): 585–93. doi:10.1080/14992020400050075. PMID 15724523. S2CID 1071009.
  12. "Are your ears really protected? Find out with NIOSH's QuickFitWeb". NIOSH Science Blog. 2008-05-12. Retrieved 2018-12-28.
  13. Murphy WJ, Themann CL, Murata TK (November 2016). "Hearing protector fit testing with off-shore oil-rig inspectors in Louisiana and Texas". International Journal of Audiology. 55 (11): 688–98. doi:10.1080/14992027.2016.1204470. PMC 5333758. PMID 27414471.
  14. Hager LD (2011). "Fit-testing hearing protectors: an idea whose time has come". Noise & Health. 13 (51): 147–51. doi:10.4103/1463-1741.77217. PMID 21368440.
  15. Schulz TY (2011). "Individual fit-testing of earplugs: a review of uses". Noise & Health. 13 (51): 152–62. doi:10.4103/1463-1741.77216. PMID 21368441.
  16. Smith PS, Monaco BA, Lusk SL (December 2014). "Attitudes toward use of hearing protection devices and effects of an intervention on fit-testing results". Workplace Health & Safety. 62 (12): 491–9. doi:10.3928/21650799-20140902-01. PMID 25207586. S2CID 45642267.
  17. Gong W, Liu X, Liu Y, Li L (May 2019). "Evaluating the effect of training along with fit testing on foam earplug users in four factories in China". International Journal of Audiology. 58 (5): 269–277. doi:10.1080/14992027.2018.1563307. PMID 30880506. S2CID 81978766.
  18. "Change highlights: Noise exposure – Part 16 in the OHS Code". ohs-pubstore.labour.alberta.ca/. Alberta (Canada): Government of Alberta. December 2022. p. 3. Retrieved 11 February 2023. A new requirement has been added for employers to ensure workers are fit tested for the hearing protection devices they use and wear. ... This change is intended to prevent noise induced hearing loss. The effectiveness of hearing protection is greatly reduced if the equipment does not fit correctly or is not inserted or worn correctly.
  19. Technical Committee CEN/TC 159 “Hearing protectors” (17 November 2021). EN 17479-2021. Hearing protectors - Guidance on selection of individual fit testing methods. Brussels: European Committee for Standardization. p. 46. ISBN 978-0-539-04746-2. link
  20. Accredited Standards Committee S12, Noise (2018). ANSI/ASA S12.71-2018. Performance Criteria for Systems that Estimate the Attenuation of Passive Hearing Protectors for Individual Users. Melville, New York: Acoustical Society of America. p. 54. Retrieved 25 October 2023.
  21. Kelechava B (2016-11-21). "ANSI/ASA S12.6-2016 – Real-Ear Attenuation of Hearing Protectors". American National Standards Institute. Retrieved 2019-02-20.
  22. John R. Franks, William J. Murphy, Dave A. Harris, Jennifer L. Johnson & Peter B. Shaw (2003). "Alternative Field Methods for Measuring Hearing Protector Performance" (PDF). American Industrial Hygiene Association Journal. Akron, Ohio: Taylor & Francis. 64 (4): 501–509. doi:10.1080/15428110308984846. ISSN 0002-8894. PMID 12908866. Retrieved 16 February 2023.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  23. Kwitowski, August J.; Carilli, Angela M.; Randolph, Robert F. (September 2010). "MultiFit4: An Improved System for Insert-Type". Spectrum. National Hearing Conservation Association. 27 (2): 17–25. Retrieved 6 January 2023.
  24. Randolph, Robert F. (December 2008). QuickFit Earplug Test Device (Technology News 534). Pittsburgh: DHHS (NIOSH) Publication No. 2009–112. p. 2. Retrieved 6 January 2023. + online test tool
  25. Hager LD (June 2006). "Fit testing ear plugs". Occupational Health & Safety. 75 (6): 38, 40, 42 passim. PMID 16805277. Retrieved 2019-02-19.
  26. Assunção CH, Trabanco JC, Gomes RF, Moreira RR, Samelli AG (August 2019). "Longitudinal evaluation of a hearing protector fit training program". La Medicina del Lavoro. 110 (4): 304–311. doi:10.23749/mdl.v110i4.8214. PMC 7809996. PMID 31475692.
  27. Sayler, Stephanie K.; Rabinowitz, Peter M.; Cantley, Linda F.; Galusha, Deron; Neitzel, Richard L. (2018-01-26). "Costs and effectiveness of hearing conservation programs at 14 US metal manufacturing facilities". International Journal of Audiology. 57 (sup1): S3–S11. doi:10.1080/14992027.2017.1410237. ISSN 1499-2027. PMC 6188788. PMID 29216778.
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