Individual Fit Testing of Hearing-Protection Devices Based on Microphones in Real Ears among Workers in Industries with High-Noise-Level Manufacturing.

Hearing-protection devices (HPDs) are particularly important in protecting the hearing of workers. The aim of this study was to prevent hearing damage in workplaces in Taiwan. It was conducted to determine the actual sound attenuation of the personal attenuation rating (PAR) values when wearing HPDs via measurements from field microphones in workers' real ears (F-MIRE). Across 105 measurement trials for the Classic™ roll-down foam earplug HPDs worn by the workers, there were 23 cases of ineffective protection (including caution and fail); the proportion was 20% (including the first measurement and re-wear of HPDs after education and training). In addition, re-education and training in how to wear the HPDs was provided, improving wearing skills. A total of 29 testees wearing the Classic™ roll-down foam earplug HPDs failed to meet the pass standard for the first PAR test, and 6 of them improved and subsequently passed the PAR test. The improvement rate was 20%. These 23 testees switched to another HPD, namely Kneading-Free Push-Ins™ earplugs. From this group, 16 effective sound attenuation values were obtained, with an improvement rate of 70%. However, seven testees failed to pass the PAR test, and after education, training, and replacement of HPDs with different types, they still could not pass the PAR test. At that time, even if the UltraFit™ pre-molded earplugs were adopted again for wear and replacement, they were still unable to pass the PAR test. This HPD was eventually replaced with the PELTOR X4A Earmuff HPD and then tested again, with these HPDs finally passing the PAR test. In Taiwan, the use of fit testing has been increasing but it is not a common practice, and few studies on hearing-protection fit testing have been conducted in this country. The goal of this study was to gain more insight into the current hearing protection situation, including field attenuation of HPDs obtained by workers, the effects of training on improving the attenuation of HPDs after F-MIRE measurements, and the awareness of hearing health and motivation on the use of HPDs in a high-noise-level environment.