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Hearing conservation program

hearing conservation program, hearing conservation program template
Hearing conservation programs are designed to prevent noise induced hearing loss A written hearing conservation program is required by the Occupational Safety and Health Administration OSHA "whenever employee noise exposures equal or exceed an 8-hour time-weighted average sound level TWA of 85 decibels measured on the A scale slow response or, equivalently, a dose of fifty percent"1 This 8-hour time-weighted average is known as an exposure action value While the Mine Safety and Health Administration MSHA also requires a hearing conservation program, MSHA does not require a written hearing conservation program MSHA's hearing conservation program requirement can be found in 30 CFR § 62150,2 and requires has almost the same exact requirements as the OSHA hearing conservation program requirements Therefore, only the OSHA standard 29 CFR 191095 will be discussed in detail

Contents

  • 1 Program requirements
  • 2 Sound survey
  • 3 Engineering and administrative controls
  • 4 Hearing protection device
    • 41 Earplugs
    • 42 Earmuffs
  • 5 Noise reduction ratings
  • 6 Audiometric testing program
  • 7 Employee training and education
    • 71 Motivating Employees to Follow a Hearing Conservation Program
  • 8 Record keeping
  • 9 Program evaluation
  • 10 Hearing conservation for children
    • 101 Overview
    • 102 Creation of Programs
    • 103 Examples of Programs & Campaigns
      • 1031 Dangerous Decibels
      • 1032 Listen to your Buds
      • 1033 Cheers for Ears
      • 1034 It's a Noisy Planet Protect Their Hearing
      • 1035 Sound Sense
    • 104 Effectiveness & Program Evaluation
  • 11 Other Regulatory Agencies
  • 12 See also
  • 13 References
  • 14 External links

Program requirementsedit

The OSHA standard contains a series of program requirements

  • Engineering Controls: 29 CFR 191095b1 requires that "feasible administrative or engineering controls shall be utilized If such controls fail to reduce sound levelspersonal protective equipment shall be provided and used to reduce sound levels"
  • Monitoring: 29 CFR 191095d requires that monitoring be conducted when "any employee's exposure may equal or exceed an 8-hour time-weighted average of 85 decibels
  • Testing: 29 CFR 191095g requires an "audiometric testing program" for "all employees whose exposures equal or exceed an 8-hour time-weighted average of 85 decibels"
  • Hearing Protectors: 29 CFR 191095i states that "employers shall make hearing protectors available to all employees exposed to an 8-hour time-weighted average of 85 decibels or greater at no cost to the employees"
  • Training: 29 CFR 191095k mandates an annual "training program" for "all employees who are exposed to noise at or above an 8-hour time-weighted average of 85 decibels" and mandates certain aspects of the training that must be included This includes the effects of noise on hearing; purpose, advantages, disadvantages, and attenuation of different types of hearing protectors; purpose audiometric testing
  • Record Keeping: 29 CFR 191095m states that employers "shall maintain an accurate record of all employee exposure measurements"

Sound surveyedit

A sound survey is often completed to determine areas of potential high noise exposure This type of survey is normally completed using a sound level meter SLM There are three types of sound level meters Type 0 is precision instrument normally used in laboratories A type 1 is for precision measurements taken in the field Type 2 sound level meters are less precise than type 1 and are often used to take all-purpose sound level measurements Noise monitoring is generally completed using a noise dosimeter that integrates "all continuous, intermittent and impulsive sound levels"3 to determine a person's noise exposure level

Surveys must be repeated when there are significant changes in machinery and/or processes that would affect the noise level4

Engineering and administrative controlsedit

Engineering controls and administrative controls are the preferred method to prevent noise exposure Normally, they do not require personal protective equipment and therefore are normally more protective However, it is not always feasible to use administrative and engineering controls as the only ways to prevent noise over-exposure The key is to maintain an 8-hour time-weighted average of less than 85 dBA so that personal protective equipment is not required On October 19, 2010, the US Department of Labour proposed that the term "feasible" be interpreted as that which is capable of being done, thus enhancing OSHA's ability to enforce this aspect of the standard5

Hearing protection deviceedit

If engineering controls fail to maintain an 8-hour time-weighted average below 85 dBA, then a hearing protection device HPD is required There are two general types of HPDs: earplugs and earmuffs Each one has its own benefits and drawbacks The selection of the proper HPD to be worn is commonly done by an industrial hygienist so that the proper amount of noise protection is worn OSHA requires that HPD be given free of charge6

Earplugsedit

There are four general classes of earplugs These include: premolded, formable, custom molded and semi-insert

  • Premolded earplugs do not require the plug to be formed before it is inserted into the ear This prevents the plugs from becoming soiled before insertion
  • Formable earplugs are made of a variety of substances However, all each substance shares the common feature of being able to be shaped by the user prior to insertion One drawback of this is the obvious need for the user to have clean hands while shaping the earplug They do have the advantage of forming to the users ear, while many premolded earplugs do not accomplish this very well
  • Custom molded ear plugs are unique for each person, since they are cast from each user's own ear canals Therefore, they provide a personalized fit for each individual
  • Semi-inserts are generally a soft earplug on the end of band The band aides in maintaining the earplug in position They are often useful since they can be quickly removed and inserted

Earmuffsedit

Earmuffs are another type of HPD The main difference between earmuffs and earplugs, is that earmuffs are not inserted inside the ear canal Instead the muffs create a seal around the outside of the ear to prevent noise from reaching the inner ear Earmuffs are easy to wear and often provide a more consistent fit than an earplug There are earmuffs available that use the principle of active noise control to help reduce noise exposures However, the protection earmuffs offer may be mitigated by large sideburns or glasses as the seal of the earmuffs may be broken by these objects7

Noise reduction ratingsedit

The United States Environmental Protection Agency EPA requires that all hearing protection devices be labeled with their associated noise reduction rating NRR8 The NRR provides the estimated attenuation of the hearing protection device However, it has been found that the "labeled manufacturers' noise reduction ratings NRRs substantially overestimated the actual field attenuation performance"910 To determine the amount of noise reduction afforded by a hearing protection device, OSHA recommends that 7 db be subtracted from the NRR The NRR is generally given in a C-weighted format, so to obtain the A-weighted reduction, one must subtract 7 db OSHA also recommends a 50% safety factor, therefore the final OSHA recommended reduction would be NRR-7/211

Fit Testing for Hearing Protection

The NRR now has some help Fit testing devices on the market that will verify a proper fit of an HPD hearing protection device The fit of a hearing protector is very important, because if the HPD is not worn properly, the NRR becomes irrelevant Products that will verify proper fit include: 3M EARFit Validation System, FitCheck, FitCheck Solo, INTEGRAfit, SafetyMeter, and VeriPro Fit-test systems provide a Personal Attenuation Rating PAR that is currently dependent upon the company that manufactures the fit-testing system Most fit test systems provide an A-weighted PAR, which means that the attenuation can be subtracted from the A-weighted noise exposure assessment of the employee or hearing protector user12

System Method Test Frequencies Test Signal To Use PAR with

A-weighted Noise

Additional Notes
3M EARFit

Validation System

F-MIRE 125–8000 Hz Broadband Noise Subtract Directly Provides 20th and 80th percentile

Confidence Interval

Michael & Assoc

FitCheck

REAT

under headphones

125–8000 Hz 1/3 Octave Band Noise Subtract directly
Michael & Assoc

FitCheck Solo

REAT

under headphones

125–8000 Hz 1/3 Octave Band Noise Subtract directly Provides a 95% confidence interval
Workplace Integra

INTEGRAFIt

REAT

under headphones

05, 1, & 2 KHz Tone Subtract directly
Phonak SafetyMeter

Fit-TestSystem

F-MIRE 125–8000 Hz Broadband Noise Subtract 7 dB from PAR

then subtract directly

Subtract directly from

C-weighted noise levels

Honeywell

VeriPRO

Loudness Balance

under headphones

250–4000 Hz Tone alternating ears Subtract directly

Table: Fit-testing systems, PAR measurement method and application to estimate protected exposure level12

Audiometric testing programedit

Audiometric testing is a very important part of a hearing conservation program Audiometric testing allows for the identification of those that have lost significant hearing Additionally, the testing allows for the identification of those who are in process of losing their hearing Audiometric testing is most important in identifying those who have permanent hearing loss This is called noise-induced permanent threshold shift NIPTS13

Completing baseline audiograms and periodically monitoring threshold levels is one way to track any changes in hearing and identify if there is a need to make improvements to the HCP The Occupational Safety and Health Administration OSHA, which monitors workplaces in the United states to ensure safe and healthful working conditions, specifies that employees should have a baseline audiogram established within 6 months of their first exposure to 85 dBA time-weighted average TWA If workers are unable to obtain baseline within 6 months, they are required to wear hearing protection devices HPD whenever they are exposed to 85 dBA or above TWA until they have obtained a baseline audiogram14 Under the Mine Safety and Health Administration MSHA, which monitors compliance to standards within the mining industry, an existing audiogram that meets specific standards can be used for the employee’s baseline Before establishing baseline, it is important that the employee limit excessive noise exposure that could potentially cause a temporary threshold shift and affect results of testing OSHA stipulates that an employee be noise-free for at least 14 hours prior to testing14

Periodic audiometric monitoring, typically completed annually as recommended by OSHA, can identify changes in hearing There are specific criteria that the change must meet in order to require action The criterion most commonly used is the standard threshold shift STS, defined by a change of 10 dB or greater averaged at 2000, 3000, and 4000 Hz14 Age correction factors can be applied to the change in order to compensate for hearing loss that is age-related rather than work-related If an STS is found, OSHA requires that the employee be notified of this change within 21 days14 Furthermore, any employee that is not currently wearing HPD is now required to wear protection If the employee is already wearing protection, they should be refit with a new device and retrained on appropriate use14

Another determination that is made includes whether an STS is “recordable” under OSHA standards, meaning the workplace must report the change to OSHA In order to be recordable the employee’s new thresholds at 2000, 3000, and 4000 Hz must exceed an average of 25 dB HL14 MSHA standard differs slightly in terms of calculation and terminology MSHA considers whether an STS is “reportable” by determining if the average amount of change that occurs exceeds 25 dB HL14 The various measures that are used in occupational audiometric testing allow consistency in standards within workplaces Completing baseline and follow-up audiograms allows workplaces to detect hearing loss as early as possible and determine whether changes need to be made to provide a safe working environment for their employees

Employee training and educationedit

Proper training and education of those exposed to noise is the key to preventing noise-induced hearing loss If employees are properly trained on how to follow a hearing conservation program, then the risk of noise-induced hearing loss is reduced By providing information on the physiological effects of noise exposure, the importance of obtaining baseline and annual audiograms, and use of appropriate hearing protection, the program will provide a thorough knowledge base for employees involved Providing a refresher training when appropriate will ensure retention of this information as well15 OSHA requires said training to be completed on an annual basis Proper training is imperative since "even with a very modest amount of instruction attenuation performance can be significantly improved"1617

Motivating Employees to Follow a Hearing Conservation Programedit

Even with training and education, the workers need to be motivated to use hearing protection on a regular basis for the hearing conservation program to be successful12 Even if workers are aware that noise can cause hearing loss, that does not guarantee that they will take the necessary actions to preserve their hearing12

There are several reasons why a worker may choose not to adopt the protocols of a hearing conservation program Employees may not follow protocol because they feel that noise induced hearing loss will not happen to them12 They may believe this because they think the level of sound that they are exposed is not loud enough to cause hearing loss or that loud noise just toughens their ears They might also think hearing loss is not a serious condition and can easily be fixed with hearing aids12 Another reason is the worker may believe that hearing protection does not actually work and that he/she may still develop noise-induced hearing loss even with hearing protection12 If the employee feels that hearing protection may impinge his/her work, whether it be missing important warning signals or the ability to communicate, he/she is less likely to wear it12 Finally, the comfort of the hearing protection offered through the hearing conservation program18 If the hearing protection is uncomfortable, it is unlikely that the worker will adhere to the policies18

Motivational techniques can be implemented to promote hearing conservation program compliance and the use of hearing protection One suggestion is continued education at the workers' audiometric screening18 They should be asked to bring along their current hearing protection device to the screening If the results are normal and the inspection of the hearing protection device is good, praise can be given for following protocol If there is a shift in their hearing, instruction can be given again about the proper use of hearing protection and the importance of wearing them Audiograms can be very useful in showing workers how noise can affect their hearing One specific way to do this is to perform two hearing test on an employee on two different days18 One day the hearing test will be after wearing hearing protection all day and the other will be after not wearing hearing protection for the day The difference can then be discussed with the worker and he/she has a tangible way to see how noise affects hearing Another technique is using "internal triggers" to motivate employees to comply to the hearing conservation program12 If the individual already suffers from tinnitus and/or hearing loss they are probably more likely to use hearing protection because he/she does not want that problem to progress with noise exposure Finally, the hearing protection offered should be comfortable so the worker will wear it It is suggested that workers have a variety of hearing protection devices available to them, including at least one type of earmuff and two different forms of earplugs, to fit the individual needs and wants of the workers18

Record keepingedit

OSHA requires that records of exposure measurements and audiometric tests be maintained Records are also required to have the following:

  • name and job classification
  • date of the audiogram
  • examiner's name
  • calibration date
  • employee's most recent noise exposure assessment
  • background sound pressure levels in audiometric test booths

Noise exposure measurement records must be maintained for at least 2 years Audiometric test records must be retained for the duration of the affected employee's employment Additionally, employees, former employees, representatives designated by the individual employee and the Assistant Secretary all must have access to these records19

Program evaluationedit

Proper program evaluation is important in maintaining the health of hearing conservation program The National Institute for Occupational Safety and Health NIOSH has created a checklist to help evaluate the effectiveness of a hearing conservation program It can be found on their website20 NIOSH recommends that fewer than 5% of exposed employees should have a 15 dB Significant Threshold Shift in the same ear and same frequency

The National Institute for Occupational Safety and Health is pushing a higher emphasis on a hearing loss prevention program rather than a hearing conservation program While this change may seem superfluous, it is important to note the advancement Prevention implies a response by the workplace caused by initial signs of employee hearing loss rather than instilling a new set of policies such as "buy quiet" and thinking such as hearing protection training and education to decrease the possibility of occupational hearing loss from happening in the first place

The Buy Quiet policy is an easy way to progress towards a safer work environment Many traditionally noisy tools and machines are now being redesigned in order to manufacture quieter running equipment, so a "buy quiet" purchase policy should not require new engineering solutions in most cases21 As a part of the "buy quiet" campaign, the New York City Department of Environmental Protection released a products and vendor guidance sheet in order to assist contractors for achieving compliance with the New York City Noise Regulations

In order to make these plans effective, employees and administration need to be educated in occupational noise-induced hearing loss prevention It is also necessary to identify and examine sources of noise first before being able to control the damage it may cause to hearing For example, the National Institute for Occupational Safety and Health has conducted a study and created a database on handheld power tools for the sound power levels they expose their operators to This Power Tools Database allows contractors in a trade-skill profession to monitor their exposure limits and allow them preparation to prevent permanent hearing damage

Hearing conservation for childrenedit

Overviewedit

Due to increased worry among both parents and experts regarding Noise-induced hearing loss NIHL in children, it has been suggested that hearing conservation programs be implemented in schools as part of their studies regarding health and wellness The necessity for these programs is supported by the following reasons: 1 Children are not sheltered from loud noises in their daily lives, and 2 Promoting healthy behaviors at a young age is critical to future application22 The creation of a hearing conservation program for children will strongly differ from those created for the occupational settings discussed above While children may not be exposed to factory of industrial noise on a daily basis, they may be exposed to noise sources such as firearms, music, power tools, sports, and noisy toys All of these encounters with noise cumulatively increases their risk for developing Noise-induced hearing loss With NIHL being a fully preventable ailment, providing children with this type of education has the potential to reduce future incidence of this condition There are multiple organizations in existence that provide educators with the appropriate material to teach this topic; teachers simply need to be proactive about accessing them23 Below are examples of hearing conservation programs that have been designed specifically for children

Creation of Programsedit

This is the primary goal of most hearing conservation programs at the elementary, middle, and high school levels is to spread knowledge about hearing loss and noise exposure When an educational program is being created or adapted for use with children, behavior change theories are often employed to increase effectiveness Behavior theorydisambiguation needed identifies possible obstacles to change while also highlighting factors that may encourage students to change18 The following are elements that are also considered during the implementation of a new program for children:

1 Adaptation of the program for the specific population age, demographic, etc

2 Use of interactive games, lessons, and role-playing

3 Time to apply the skills that are taught

4 Reoccurring lessons on the same topic area18

Examples of Programs & Campaignsedit

Dangerous Decibelsedit

Dangerous Decibels is a program designed to teach concepts related to the prevention of noise-induced hearing loss Proven to be effective for children in 4th through 7th grade, children are engaged in hands-on activities during this 50-minute presentation The class will learn about what sound is, how their ears hear and detect it, and how they can protect their hearing from dangerous decibels Throughout the program, the class focuses on three strategies: Turn it Down, Walk Away, and Protect your Ears24

Listen to your Budsedit

Created by the American Speech-Language-Hearing Association, this campaign aims to teach children and their parents about practicing safe listening routines when listening to music through personal devices, such as an iPod With the help of sponsors, ASHA hosts an educational concert series to promote safe music listening25

Cheers for Earsedit

Run by the Ear Science Institute of Australia, this school program was created to educate elementary-age children on the risks of high listening levels and the effects of hearing loss Program has a mascot named Charlie and utilizes sound level meters, computer games, apps, and take-home packets to teach the concepts Teachers also receive addition activities and worksheets for continued learning opportunities26

It's a Noisy Planet Protect Their Hearingedit

Organized by the United States National Institutes of Health, this is a campaign created with the aim to increase parental awareness of both the causes and effects of noise induced hearing loss By targeting parents instead of children, the goal is for adults to influence the behaviors of their children before bad habits are even created Resources provided include web-based games and puzzles, downloadable graphics, and tips for school and home environments27

Sound Senseedit

Created by The Hearing Foundation of Canada, the Sound Sense classroom program teaches children how hearing works, how it can stop working, and offers ideas for safe listening The classroom presentation satisfies the requirements for the science unit on sound taught in either grade 3 or 4, as well as the healthy living curriculum in grades 5 and 6 In addition, the webpage provides resources & games for children, parents, and teachers28

Effectiveness & Program Evaluationedit

Just as program evaluation is necessary in workplace settings, it is also an important component of educational hearing conservation programs to determine if any changes need to be made This evaluation may consist of two main parts: assessment of students' knowledge and assessment of their skills and behaviors To examine the level of knowledge acquired by the students, a questionnaire is often given with the expectation of an 85% competency level among students If proficiency is too low, changes should be implemented If the knowledge level is adequate, assessing behaviors is then necessary to see if the children are using their newfound knowledge This evaluation can be done through classroom observation of both the students and teachers in noisy classroom environments such as music, gym, technology, etc29

Other Regulatory Agenciesedit

The Mine Safety and Health Administration MSHA requires that all feasible engineering and administrative controls be employed to reduce miners' exposure levels to 90 dBA TWA The action level for enrollment in a hearing conservation program is 85 dBA 8-hour TWA, integrating all sound levels between 80 dBA to at least 130 dBA MSHA uses a 5-dB exchange rate the sound level in decibels that would result in halving if an increase in sound level or a doubling if a decreasein sound level the allowable exposure time to maintain the same noise dose At and above exposure levels of 90 dBA TWA, the miner must wear hearing protection At and above exposure levels above 105 dBA TWA, the miner must wear dual hearing protection Miners may not be exposed to sounds exceeding 115 dBA with or without hearing protection devices MSHA defines a standard threshold shift as an average decrease in auditory sensitivity of 10 dB HL at the frequencies 2,000, 3,000, and 4,000 Hz 30 CFR Part 6230

The Federal Railroad Administration FRA encourages, but does not require, railroads to use administrative controls that reduce noise exposure duration when the worker exceeds 90 dBA TWA The FRA defines the action level for employee enrollment in a hearing conservation program as an 8-hour TWA of 85 dBA on certain railroads, integrating all sound levels between 80 dBA and 140 dBA FRA uses a 5-dB exchange rate Those employees who are always at or above 90 dBA TWA are required to wear hearing protection such that sound levels are attenuated below 90 dBA TWA 49 CFR Part 22931

The US Department of Defense DOD specifies that engineering controls are preferential when reducing the noise levels at the source The use of hearing protective devices is considered an "interim protective measure" while engineering controls are developed The goal of these controls is to reduce ambient steady-state noise levels to 85 dBA regardless of TWA exposure and to reduce impulse noise levels to below 140 dBP The DOD requires that personnel be entered into a hearing conservation program when continuous snd intermittent noise levels ale grs greater than or equal to 85 dBA TWA, when impulse SPL are at or in excess of 140 dBP, or when the personnel is exposed to ultrasonic frequencies The DOD integrates all sound levels between 80 dBA to a minimum of 130 dBA when determining an individual or representative noise dose When used, hearing protectors must be capable of attenuating worker noise exposure below 85 dBA TWA Hearing protection is required to be carried by personnel who work in designated noise areas, such as those exposed to gunfire or ordnance tests and Service musicians The DOD defines a significant threshold shift as a 10 dB average decrease in hearing thresholds at 2,000, 3,000, and 4,000 Hz in either ear, with no age corrections It is further specified that a shift in 15 dB at 1,000, 2,000, 3,000, or 4,000 Hz is an early warning sign for an STS; follow-up retraining is required in this case DOD Instruction 60551232

The European Union EU requires a hearing conservation program be implemented when the worker exposure levels exceed 80 dBA TWA Note that this is more strict than hearing conservation regulations in the United States The EU specifies several different exposure action values: a "lower" value of 80 dBA at which the employer must make hearing protection devices available to the employee; an "upper" value of 85 dBA at which the employee is required to wear hearing protection; and an "exposure limit" value of 87 dBA, under which the individual's noise exposure shall be limited to preserve hearing The directive also defines a weekly noise exposure level which is applied to individuals working in circumstances of inconstant noise exposure Finally, the EU also recommends a variety of noise reduction methods, including administrative controls to reduce worker exposure duration, the provision of quieter equipment, and adequate maintenance of machinery and other noise sources European Parliament and Council Directive 2003|10|EC33

See alsoedit

  • Hearing impairment
  • Audiometry
  • Exposure Action Value
  • Noise-induced hearing loss
  • Safe-In-Sound Award
  • List of occupational health and safety awards

Referencesedit

  1. ^ 29 CFR 191095c1
  2. ^ 30 CFR § 62150
  3. ^ 29 CFR 191095d2i
  4. ^ OSHA 191095 appendix G
  5. ^ Federal Register / Vol 75, No 201 / Tuesday, October 19, 2010 / Proposed Rules
  6. ^ 29 CFR 191095i1
  7. ^ Stephenson, Carol Merry "Choosing the Hearing Protection That's Right For You" Retrieved 2017-02-03 
  8. ^ 40 CFR code of Federal Regulations, Part 211, Product Noise Labeling, Subpart B - Hearing Protection Devises
  9. ^ Park, MY; Casali, JG December 1991"A controlled investigation of in-field attenuation performance of selected insert, earmuff, and canal cap hearing protectors" Human Factors 336: 693-714
  10. ^ Berger EH, Franks JR, Behar A, Casali JG, Dixon-Ernst C, Kieper RW, Merry CJ, Mozo BT, Nixon CW, Ohlin D, Royster JD, and Royster LH 1998 Development of a new standard laboratory protocol for estimating the field attenuation of hearing protection devices Part III The validity of using subject-fit data J Acoust Soc Am, 102:665-672
  11. ^ CPL 02-02-035 - CPL 2-235A - 29 CFR 191095b1, Guidelines for Noise Enforcement; Appendix A
  12. ^ a b c d e f g h i Murphy, William 2013 "Comparing Personal Attenuation Ratings for Hearing Protector Fit-test Systems" PDF CAOHC Update Retrieved June 13, 2016 
  13. ^ Noise and Hearing Conservation Technical Manual Chapter: Noise and Health Effects App I:C
  14. ^ a b c d e f g Rawool, VW 2012 Hearing Conservation in Occupational, Recreational, Educational, and Home Settings New York: NY: Thieme Medical Publishers, Inc pp 65–105 
  15. ^ Rawool, VW 2012 Hearing Conservation in Occupational, Recreational, Educational and Home Settings New York: NY: Thieme Medical Publishers pp 174–186 
  16. ^ Williams, W 2004 "Instruction and the improvement of Hearing Protector Performance" Noise and Health Oct-Dec;725:41-77 http://wwwnoiseandhealthorg/articleaspissn=1463-1741;year=2004;volume=7;issue=25;spage=41;epage=47;aulast=Williams
  17. ^ Joseph A, Punch J, Stephenson M, Wolfe E, Paneth N, Murphy W 2007 The Effects of Training Format on Earplug Performance Int J Audiology 46:609-618
  18. ^ a b c d e f g Martin, William Hal; Sobel, Judith; Griest, Susan E; Howarth, Linda; Yongbing, Shi 2006-06-01 "Noise Induced Hearing Loss in Children: Preventing the Silent Epidemic" Journal of Otology 1 1: 11–21 doi:101016/S1672-29300650002-9 
  19. ^ 29 CFR 191095m
  20. ^ Noise and Hearing Loss Prevention: Hearing Conservation Program Checklist National Institute for Occupational Safety and Health
  21. ^ John R Franks; Mark R Stephenson; Carol J Merry, eds 1996 "PREVENTING OCCUPATIONAL HEARING LOSS — A PRACTICAL GUIDE" PDF US DEPARTMENT OF HEALTH AND HUMAN SERVICES 
  22. ^ Rawool, Vishakha Waman 2012 Hearing Conservation Theime Medical Publishers p 283 
  23. ^ Folmer, Robert 2008-02-01 "Hearing-Loss Prevention Practices Should Be Taught in Schools" Seminars in Hearing 29 1: 067–080 ISSN 0734-0451 doi:101055/s-2007-1021774 
  24. ^ "The Dangerous Decibels Classroom Presentation" 
  25. ^ "Listen to Your Buds" 
  26. ^ "Cheers for Ears" 
  27. ^ "It's a Noisy Planet Protect Their Hearing" 
  28. ^ "Sound Sense" 
  29. ^ Rawool, Vishakha Waman 2012 Hearing Conservation New York, NY: Theime Medical Publishers, Inc pp 292–293 
  30. ^ "30 CFR Part 62" eCFR - Code of Federal Regulations 
  31. ^ "49 CFR Part 229" eCFR - Code of Federal Regulations 
  32. ^ "DOD Instruction 605512" PDF 
  33. ^ "DIRECTIVE 2003/10/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL" PDF 

External linksedit

  • Occupational Health & Safety Administration
  • National Hearing Conservation Association
  • NIOSH Power Tools Database
  • NIOSH Hearing Protector Compendium
  • New York City Contractor Vendor List Guidelines

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