Historically, the construction industry has been very proactive in utilizing personal protection equipment to prevent injury. Hard hats, gloves and safety eyewear are now common, and the use of dust masks, respirators, and harnesses to prevent falls are standard operating procedure. Hearing protection devices (HPDs) are not nearly as evident, however, as many construction workers consider noise-induced hearing loss part of their job.

The construction industry has been exempt from the Department of Labor's Occupational Safety and Health Organization's hearing conservation standard since 1983, and no regulation has meant little or no compliance. As a result, recent studies have shown that up to 60 percent of construction workers have suffered a significant decline in hearing. By the age of 41, only one in five have normal hearing, and after 16 to 25 years on the job, the average worker has the hearing of someone 20 years older than their actual age.

Recent efforts by OSHA to revisit the standards issue have only served to highlight the difficulties of bringing workable regulation to this industry. The construction field is different from others in many respects. Employee turnover is high, employment terms are generally shorter, and the industry contains a large number of small contractor and subcontractor businesses, making it difficult to track workers' hearing over an extended period of time. Also, noise levels on a typical construction site are often unpredictable and constantly changing, adding difficulties in monitoring HPD usage.

Culture, too, plays an important role. Construction is traditionally a "non-corporate" industry. Workers tend to be more individualistic, and are more likely to resist new regulations. Many feel that wearing HPDs will limit their ability to hear other sounds on the job, such as communication from fellow workers, warning signals, and even the change in the sound of a cement mixer when the mix is ready. Workers do not understand how hearing loss occurs, and there is a machismo among construction workers that accepts hearing loss as "the price to pay" for their work.

Nonetheless, as more companies embrace the idea of total workplace safety as a core business value, increased attention is being paid to hearing conservation. In addition, the ability to protect construction workers has advanced significantly in the last few years. Innovations in monitoring equipment and HPDs, as well as a heightened understanding of how to manage competing hazards, can help employers dramatically improve hearing conservation efforts in both the construction and other trade industries.

The two key questions employers ask are: "How do I know when protection is needed?" and "What do I do about it?"

Hearing damage from loud noise depends on two key variables: the level of noise, and the duration of exposure. For other industries, OSHA defines the permissible exposure limit for noise exposure as 90 dB averaged over an eight-hour work shift (time-weighted average). The limit is even lower for a 10- or 12-hour workday. Construction site noise varies greatly, in type, decibel level, and duration of exposure. But measuring it is not impossible—it just requires a more focused approach.

Construction noise is often specific to a particular tool, task, job title or area, and methods of noise monitoring must adapt to those variables. Sound level meters with standard A-weighting and slow meter response are available nationally for less than $40 (though meters that comply with all OSHA noise measurement requirements typically cost several hundred dollars). A sound level meter answers the question, "How loud is this equipment, or this area?"

For tasks with variable noise levels, or for workers who move about a site, measuring personal noise with a dosimeter is the most accurate monitoring method. A dosimeter averages noise exposure over time as it is worn by a sample worker throughout the day. Dosimeters answer the question, "What is this worker's average daily exposure?" or "What is the average noise level for this 30-minute task?"

But since sound levels on construction sites are so variable, some have argued against spending time and resources in detailed monitoring. One industry group recommends using published noise exposures for particular tools and job titles, and only using meters to measure specific areas. Others suggest operating under the assumption that all workers on the site are at risk and that measurement should be used only to identify safe areas.

Regardless of the methods used, workers are advised to follow hearing conservation's rule of thumb: if you must shout over the background noise to be understood by a co-worker standing an arm's length away, you are likely in 90 dB of noise, and need to wear hearing protection.

As noted, construction workers are not the most amenable to wearing new apparel, such as hearing protectors. But their culture and individuality can also be used to advantage. For example, construction workers are also tool users by nature. They are not comfortable on the job without their tool belts and various other gear, including gloves, hard hats, steel-toed boots and other personal protective equipment.

If HPDs can be accepted as another tool, the battle will be more than half won. Studies have also shown that once workers see their hearing data in an audiogram and understand the nature of the risk, they become much more willing participants in protection programs.

The key is to understand the human element of this problem and bring the right tools to bear on it—in terms of policy, programs, and protection products—which understand how workers view noise, how they need to function on the job, and how they can actually apply hearing safety in a meaningful way.

These factors are the four Cs of hearing protection—caring, comfort, convenience, and communication—and they are the recommended benchmarks for developing hearing protection programs and in providing HPDs to implement them.

Caring is largely a job for education. Unlike other occupational injuries, noise-induced hearing loss causes no immediate pain or trauma, leaves no scars or bruises, and is unnoticeable at its earliest stages. It accumulates over time with each additional over-exposure, and the damage caused is permanent. However, it is also completely preventable. But we live in a culture that seems to increasingly accept noise as a fact of life, and making people understand when and how noise can be dangerous requires much effort and iteration.

Caring has other dimensions as well. As "tool guys," construction workers not only want to have and wear tools, they think tools are cool. They appreciate style, and, as has been demonstrated with safety glasses, are much more likely to use HPDs they feel are stylish.

Style also factors into the two Cs of comfort and convenience. Workers will not wear hearing protection if it is uncomfortable or inconvenient. This is especially true on a construction site where workers are likely to be in a range of locales, and are also likely to be occupied when a noise event occurs.

Several new earmuffs are designed to make hearing protection more comfortable and convenient. For example, earmuffs are available that attach to hard hats, or incorporate neckbands rather than headbands for wear with welding shields, hard hats and other equipment. Some new styles offer high visibility with brightly colored earcups and reflective headbands. Others are available with built-in AM/FM radios and CD jacks.

Earplugs can also provide a comfortable alternative on construction sites, especially where work in confined spaces is involved. Models are available with cords that allow them to hang around the neck when not in use, or with convenient carrying cases for re-use. Other new designs require no "rolling down" prior to insertion for instant protection, or incorporate rigid stems to facilitate insertion. Placing earplug dispensers in noisy areas around the job site can also encourage use, as can posting noise-hazard signs, insisting on "top down" compliance, and a number of other techniques.

But the most common complaint workers everywhere have about HPDs is that they obstruct their hearing. This may seem ironic, but it is also a major impediment to use. Workers need to communicate on the job, and they need to hear co-workers and warning signals.

New design and material technology is providing solutions. For high-end applications, earmuffs are available with electronic communications capability, and even with the ability to block excessively loud sounds while electronically amplifying voice sounds. And for normal, more everyday applications, several new products are designed to block out more low-frequency sounds while allowing higher-frequency sounds, such as human voices, to be heard more naturally.

The bottom line is that regardless of when or whether OSHA regulates hearing conservation for the construction industry, noise-induced hearing loss among construction workers can be reduced. By focusing on the human element, by understanding worker needs and preferences, and taking advantage of developments in hearing protector technology and style, employers and safety professionals can develop effective hearing conservation programs to protect workers now.