We are excited to have you join us for an amazing educational line up, check out the agenda below for the 2025 Conference. Please note that this agenda is subject to change.
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Exposures to noise – that is, unwanted or harmful sound – have long been linked in workplace and (community!) settings to a host of adverse health effects, including noise-induced hearing loss (surprise, amirite?), cardiovascular disease (including hypertension and ischemic heart disease), and injuries. Yet millions of Americans remain unaware of the dangers of noise and occupational and environmental policies continually under-recognize noise as an important pollutant. On this auspicious 49th NHCA conference, what do we *really* know about noise exposures in American workplaces and communities, and how much harm those exposures are causing? This talk will provide an overview of trends and patterns in workplace and community noise in the US, discuss estimates of health risks associated with noise, and address health disparities and occupational and environmental justice issues. It will also highlight gaps in our understanding, opportunities for research that will help us better understand the impacts of noise, and potential paths forward for reducing noise in America.
The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The examination component of NHANES typically includes a hearing threshold evaluation. Large datasets such as NHANES provide essential information on hearing in various populations as well as an opportunity to examine methodological aspects of audiometry. However, conventional audiometers provide limited stimulus, calibration, test protocol, and data options for researchers. An audiometric system designed to overcome these limitations built on commercially available hardware will be discussed in this presentation. The current system includes automated, semi-automated, and manual threshold-finding procedures; in-situ and fully automated calibration; full control of stimulus and test protocol parameters; comprehensive time and presentation histories; and continuous comparison of stimulus presentation levels against both ambient noise limits and presentation level for boothless applications. The system was developed in 2011 for NIOSH-sponsored projects and has been used in NHANES since 2017. Technical challenges, methodological issues, and performance metrics of the system will be presented. Examples of scientific findings which the system made possible will be discussed. Tools like this have the potential to help transform hearing testing in the future.
Gaps in the public health prevention of hearing loss likely exist in the US, but these have not been wholistically characterized previously. Using data on personal environmental noise exposure and hearing-related surveys from >100,000 participants consented and enrolled in the Apple Hearing Study from 2019-2022, we used multilevel regression and poststratification models to estimate the population at risk of noise-induced hearing loss (primary prevention), the prevalence of poor/fair hearing ability and diagnosed hearing loss (secondary prevention), and the use of hearing aid/cochlear implants (tertiary prevention). Modeling estimates suggest that 88 million US adults (95% confidence interval: 81-95) are consistently exposed to noise levels high enough to cause hearing loss. Around 67 million (62-72) perceive a poor/fair ability to hear, of which only roughly half have been diagnosed with a hearing loss (36 million [32-40]). Nearly 16.5 million (16-17) of those diagnosed with a hearing loss are estimated to not be using hearing aids or cochlear implants. Regulation of noise (e.g., work- and transportation-related), audiological testing, especially of younger adults, and expanded access to hearing assistive devices are needed to reduce the considerable gaps in hearing-related public health.
Objective: This study aimed to determine the effect of noise exposure history on the rate of pure-tone threshold change per year. Methods: Participants were 1,347 adults (mean age 63.4 [SD 14.3], follow-up time 5.1 [SD 5.7] years, 57.3% female, 17.6% racial Minority) from a longitudinal cohort study. Noise exposure history, determined via self-report and military history, was categorized as no/little, some, or high exposure. Outcome measures were audiometric thresholds (0.25-8.0 kHz) and pure-tone average (PTA [0.5, 1.0, 2.0, 4.0 kHz]), averaged bilaterally. Linear mixed regression models were used to estimate the effect of age (per +1 year) on the rate of threshold and PTA change. Results: Participants with more noise exposure had poorer baseline thresholds at most frequencies 1.0-8.0 kHz and PTA. Those with high noise exposure (vs no/little) showed higher rates of threshold change per year at 1.0 and 2.0 kHz. Those with some and high noise exposure showed lower rates of change per year at 3.0-8.0 kHz and 4.0-8.0 kHz, respectively, where hearing loss had already occurred. Conclusions: Noise exposure was associated with poorer baseline hearing, and higher rates of annual decline at some mid frequencies. Noise exposure can have immediate and potentially long-term negative impacts on hearing.
In 2009, damage to the synapses connecting the inner hair cells to the auditory nerve fibers was identified as one of the earliest noise-induced pathologies in the cochlea. Since then, there has been tremendous interest in the identification of damage-risk relationships in rodent models. In addition, there have been many efforts to translate these findings from rodent models to humans. Whereas studies in rodents and non-human primates have been rigorously controlled using a single exposure to calibrated noise, studies in humans have attempted to estimate the cumulative effects of lifetime exposure and seek associations between exposure estimates and functional measurements, and identify biomarkers for specific damage, such as cochlear synaptopathy. This session will review the current understanding of noise-induced cochlear synaptopathy in rodents, non-human primates, and humans, and provide an overview of key questions in the application of these data to workers with chronic exposure to noise in the workplace. An overview of new studies assessing chronic noise exposure in non-human primates will be provided. In addition, this session will provide practical take home messages you can share with patients who have questions about noise-induced hearing deficits beyond the audiogram.
Background: The purpose of this study was to estimate the prevalence of hearing difficulty and workplace exposures to ototoxic chemicals and noise within U.S. industries and occupations.
Methods: National Health Interview Survey data from 2023 were examined, including 17,726 workers. Weighted prevalence and adjusted prevalence ratios of self-reported hearing difficulty and self-reported workplace exposures to ototoxic chemicals, noise and a combination of these exposures were estimated by industry, occupation and demographic. Workplace exposure to secondhand smoke was examined combined with other ototoxic chemicals, but also separately.
Results: Eleven percent of workers reported hearing difficulty. Within the past year, 13% were exposed to ototoxic chemicals and 5% were exposed to secondhand smoke. Twenty-eight percent of workers had a history of occupational noise exposure, with 16% exposed within the past year. Seven percent were exposed to both noise and ototoxic chemicals.
Conclusions: Hearing hazards in the workplace are common. This study was the first to report the prevalence of ototoxic chemical exposure among U.S. workers. This exposure cannot be overlooked when protecting worker hearing. Both noise and ototoxic chemical exposures can be reduced using the hierarchy of controls. Workers with both exposures should receive special attention in hearing conservation programs.
Hearing Protector Fit Testing (HPFT) is quickly gaining acceptance as a critical element of a successful hearing conservation program. NHCA encourages the continued adoption of this practice and recognizes the need for research in this area. To support these goals, NHCA founded the Task Force on Hearing Protection Fit Testing (HPFTTF).
The first task of HPFTTF was to draft an evidence-based Position Statement on HPFT, representing current recommendations and best practices. The Position Statement recognizes HPFT as a powerful tool for preventing noise-induced hearing loss, with potential to shape the practice of hearing loss prevention. Some of the topics covered in the Position Paper are Measurement Methods and Systems, Resulting Data and Statistics, Benefits and Challenges, and Incorporating HPFT into a Hearing Conservation Program (HCP). The document also discusses practical considerations such as how to choose a system, who to test and when to test them, how to interpret and apply results, and special situations.
NHCA recommends the use of HPFT as part of a comprehensive HCP and encourages continued research to further define best practice policy, explore use cases, and evaluate the long-term impact of HPFT.
In 2024, the National Hearing Conservation Association established a task force to draft a position statement on the use of equivalent rectangular bands (ERBs) in audiometric testing. The Occupational Safety and Health Administration does not require testing at 8000 Hz as part of audiometric monitoring for noise-exposed workers. Although inclusion of 8000 Hz is recommended as a best practice, many workplace hearing conservation programs do not test this frequency. One reason is that pure tone thresholds at 8000 Hz can be unreliable due to the short wavelength of the tone and the potential for standing waves in the ear canal. However, epidemiologic surveys have shown that females are more likely to have a maximum audiometric “notch” at 6000 Hz than males, who typically show a maximum “notch” at 4000 Hz. Without testing 8000 Hz, early noise-induced hearing changes may be missed in women. Recent research has shown that the use of ERBs as audiometric stimuli results in thresholds that have equal or greater reliability than pure tone thresholds, even at 8000 Hz. This presentation will provide an update from the NHCA Task Force on the feasibility and effectiveness of using ERBs in place of pure tones for occupational audiometric monitoring.
The primary sense of many marine mammals is hearing. To some degree, nearly all marine mammals rely on hearing for foraging, predator avoidance, and navigation. Anthropogenic noise in the world’s oceans has steadily increased since the industrial revolution. Anthropogenic ocean noise sources (e.g., sonar, seismic surveys, shipping) range in frequencies from tens of Hz to more than hundreds of kHz, can project at levels exceeding 235 dB re 1 µPa, and can be impulsive or continuous. Impacts to marine mammals resulting from noise exposure are like humans, mainly masking, temporary or permanent threshold shift (TTS and PTS, respectively), and behavioral disturbance or annoyance. In some extreme cases, whales have stranded and died after intense noise exposure. Extensive research over the last three decades has sought to determine the thresholds of received sound associated with the onset of TTS. The use of auditory evoked potential methods has also been used to measure audiograms in stranded or wild-caught species, since most marine mammals are not kept under human care. Collectively, these data for the basis of auditory weighting functions that are used to assess potential impacts to marine mammals as defined by the Marine Mammal Protection Act.
The development of professional-level musicianship requires playing and listening to music many hours per day over many years, but extended exposure to loud music (>85 dB) can lead to hearing loss. Because limiting exposure to music or controlling acoustic environments is not always feasible for student musicians, it is important to understand the likelihood of using personal hearing protection. The purpose of this study was to evaluate the impact of social, attitudinal, and emotional input on retention and acceptance of information on hearing preservation by college music students. Two types of instruction were evaluated: the standard written information on hearing preservation disseminated by NASM, and a multimedia video containing the same information, but presented via video interviews of socially relevant role models. Participants comprised 66 music majors enrolled in a large Midwestern university and were randomly assigned to each group. Data were collected and analyzed to understand if there were differences in knowledge scores, satisfaction scores, and intention to use hearing protection between the two groups. Knowledge scores between the two interventions were not significantly different but the video group had significantly higher scores regarding their intention to use hearing protection, suggesting the importance of including role models in interventions.
This project was funded in part by an NHCA Scholarship Foundation Student Research Award
Sound quality is cited as a major barrier to musicians wearing musicians hearing protection devices (MHPD). Level and flatness of attenuation demonstrated significant yet weak correlations with sound quality. This study builds on previous research by using custom-fit products (to remove differences in comfort), recruiting musicians as well as untrained listeners, and adding music perception tests to the test battery.
Both musicians and untrained listener groups are asked to rate the sound quality of music and complete music perception tests while listening to music through custom-fit passive MHPDs (cMHPDs) and electronic uniform-fit MHPD (eMHPDs). Three attenuation filters are used for the cMHPD (9, 15, and 25 dB attenuations) and three attenuation settings were used for the eMHPD (9 and 15 dB, and an off setting).
Data collection is ongoing. Data will be analyzed to test hypotheses related to changes in perceived sound quality and performance on music perception tests with increasing attenuation.
The results of this study will contribute to the understanding of barriers to the use of MHPD by musicians and music appreciators. Data from the music perception tests will reveal whether increasing attenuation compromises performance. Taken together, these findings will help guide education on MHPD use by musicians.
From homeowners cutting grass on the front lawn to large construction companies building skyscrapers, power tools are essential. Unfortunately, power tools can generate hazardous exposures that can cause hearing damage. For those looking to protect their hearing, buying quieter equipment can reduce total noise exposures and prevent hearing loss; however, noise may not be a major purchasing factor for many people. NIOSH researchers aiming to promote the Buy Quiet initiative wanted to better understand the factors motivating power tool purchases and how noise is viewed in comparison to factors like cost and durability. Three questions were included on a recent Porter Novelli FallStyles Survey. Porter Novelli Styles is an online, nationally-representative market research survey. The questions explored factors which influence consumer power tool purchasing decisions. Over 3500 respondents provided data on whether they consider noise and to what degree. This presentation will explore the process of using Porter Novelli ConsumerStyles surveys and the useful insight they provided regarding attitudes toward noise.
A review of current policy issues and trends in interstate practice by audiologists, including ongoing changes to state telepractice laws and an update on the implementation of the audiology and SLP interstate compact (ASLP-IC).
The megatrend on improving sustainability is touching personal protective equipment through standards and regulations relevant to product design, packaging selection and manufacturer claims about product life cycles and their environmental impact. Recent revisions in a European hearing protection standard, anticipated regulations concerning sustainability claims, and increased consumer interest in general sustainability factors, spurred the effort to create a Product Category Rule for hearing protector devices. This project followed on the heels of the first publication of a PCR for respiratory protective devices. A PCR sets the rules for creating a Life Cycle Assessment (LCA) and provide the requirements and guidelines for developing an EPD (Environmental Product Declaration) for a specific product category. Using a standardized approach globally, establishes a consistent and transparent process for conducting the LCA and ensure that functionally similar products are assessed in the same ways. This presentation explains the work undertaken to create the first PCR for hearing protector devices. It describes how the PCR is used to help calculate legitimate LCA’s, which provide the data and foundation for Environmental Product Declarations (EPDs). Benefits of the PCR include the potential to improve authenticity and transparency for consumers when comparing environmental impact of like products.
This project was funded in part by an NHCA Scholarship Foundation Student Research Award
Hazardous noise exposure is an important health concern in many workplaces and is one of the most common work-related injuries in the United States. Dental professionals are frequently exposed to high levels of occupational noise in their daily work environment. This noise is generated by various dental handpieces such as drills, suctions, and ultrasonic scalers. Prolonged exposure to such noise levels is known to have adverse effects on hearing health. Despite the prevalence of occupational noise in dentistry, there is a paucity of comprehensive research specifically addressing the noise intensity of dental handpieces and examining the prevalence of hearing loss and tinnitus in dental professionals. First, noise levels were measured from different dental handpieces and evacuation systems in a typical clinic setting. To evaluate the prevalence of hearing loss and tinnitus, data were collected from 60 dental professionals including participant demographics and audiometric thresholds. Results showed that 15-25% of males and 13-18% of females had hearing loss that exceeded 95 th percentile limits based on the International Organization for Standardization (ISO) normative age-distributions. Tinnitus was reported in 40% of the participants. This study is the first to offer a comprehensive characterization of auditory thresholds in dental professionals with comparisons to the ISO normative age-distributions for males and females.
Firefighters encounter a multitude of toxic substances in their line of duty, significantly impacting their health. NIOSH has investigated many of the exposures and health effects that are prevalent among firefighters. Ototoxic agents (carbon monoxide, hydrogen cyanide, volatile organic compounds, and metals) are some of the hazards firefighters face. Despite the risk of hearing effects, hearing testing is not consistently offered to firefighters, and when available, it is limited to pure-tone audiometry. Cases of ototoxicity may or may not include poorer hearing thresholds, but often lead to difficulties in discriminating sounds such as speech, particularly in adverse listening conditions. Unfortunately, no standardized methods are in place for monitoring hearing in individuals exposed to hazardous chemicals at work. To address this gap, the International Ototoxicity Management Group is finalizing expert consensus resources designed for occupational health and safety programs. The proposed strategies include early identification through self-report questionnaires, expanded hearing testing and vestibular screening, criteria for referral and management of cases. Continuous efforts are needed to improve protective measures and reduce these hazardous exposures firefighters face. Listen as one firefighter joins us to share his story.
The World Health Organization (WHO) Make listening safe initiative aims to realize a world where people of all ages can enjoy all types of recreational listening without risk to their hearing. Over 3 billion people worldwide regularly engage in video gameplay and esports and may be exposed prolonged and high-intensity audio, demonstrating the need to prioritize safe listening among game players. This presentation will provide an overview of the WHO Make listening safe initiative, with a focus on efforts related to safe listening among video game and/or esports players. In addition to providing an overview on the WHO Make listening safe initiative, this presentation will focus on three primary topics. First, the speaker will present an overview of the current evidence base, including details from a systematic review and global surveys, related to the risk of unsafe listening among video game players. Second, the speaker will discuss the creation of evidence-based standards, developed in collaboration with various stakeholders, aiming to promote safe listening among video game players. Third, the speaker will present ways in which the WHO aims to raise global awareness on safe listening.
A Hybrid Model of Presenting Dangerous Decibels to Multiple Classrooms Simultaneously Valerie Pavlovich Ruff, AuD, Sharon Sandridge, Ph.D. Descriptives of cohort one participants in the Apple Hearing Study Lauren M. Smith, MS, MPH, COHC Evaluating the Necessity of Follow-Up Test Two in DoD Hearing Conservation Protocol John Foster, Lt Col, AuD, MSPH, Jennifer Sweny, AuD Hearing Loss and Physical Activity in Aging Farmers Jan Moore, Ph.D. Investigation of Spatial Memory and Learning Skills in Rats with Unilateral Mild-Moderate Congenital Hearing Loss: A Preliminary Behavioral Study FATMA NUR KOMUR, MSc., OZLEM TUGCE CILINGIR KAYA, Ph.D., AYCA CIPRUT, Ph.D., AYSE NUR YAVUZ, Ph.D., ALI CEMAL YUMUSAKHUYLU, Ph.D. Mapping occupational noise research topics Krystin Carlson, PhD Exploration of Prevalence, Progression, and Prevention of Hearing Loss in Osteogenesis Imperfecta Types III and IV by COL1A1 and COL1A2 mutations. Julie Christensen, M.S. Sound exposure and hearing protection: A survey of electronic dance music attendees Hannah Miller, BA Speech Intelligibility and Phonemic Errors in Veterans with Sensorineural Hearing Loss Madison Aivaz, B.S., Sridhar Krishnamurti, Ph.D, Kathleen McDevitt, Undergraduate Student The Role of Music Educators in Hearing Loss Prevention Blake Voss, B.S. Influence of reference transducer location on hearing protector attenuation metrics for impulse noise William J. Murphy, Ph.D. Using data science tools to elucidate information from a complex occupational exposure database. -- Christopher Wendt, MPH Evaluation and Comparison of Hearing Protector Training Methods William J. Murphy, Ph.D.
