Effects of hearing protection Hearing protection may have its greatest effect at high MEK inhibitor clinical trial ambient noise levels. Workers exposed to higher noise intensities are obliged to wear hearing protection and click here are more bothered by ambient noise, making them more consistent in wearing their protection (Rabinowitz et al. 2007). In lower ambient noise levels HPDs may interfere with communication, jeopardizing the consistency of usage (Suter 2002). Current analysis shows that 84.4% of the employees exposed

to noise levels exceeding 90 dB(A) indicated to use HPDs versus 53.6% of the employees exposed to noise levels between 80 and 90 dB(A). Regression analysis shows a positive association of hearing loss and HPD use; employees

using HPDs had on average 1.4 dB higher PTA3,4,6 values than non-users. Bauer et al. (1991) also found a positive association between of the usage of HPDs and hearing loss by analysing a very large population of workers exposed to occupational noise. This can be explained by the suggestion that workers with beginning hearing problems are better motivated to use HPDs more consistently than their colleagues without hearing problems. When workers are divided into highly exposed employees and employees exposed to moderate noise levels (80–90 dB(A)), HPD usage only shows a significant association with hearing in the moderately R788 supplier exposed group (data not shown). HPD use does not contribute significantly to the multivariate regression model for PTA3,4,6 in the highly exposed group, despite the assumption that these are more consistent users. In this study, HPD

usage was scored as a binary variable, while the actual consistency of usage would be a more suitable predictor. The individual fitting of HPDs, the consistency of HPD usage and exposure level during use and non-use are crucial elements in determining the actual noise dose (Seixas et al. 2005). In addition, HPD data are based on employees’ self-report, which can be subject to reporting bias and social desirability (Griffin et al. 2009). These uncertainties can lead to misclassification, thereby overestimating HPD usage and underestimating the true effect of hearing protection second (Davies et al. 2008). Unfortunately, data about the effectiveness of the HPDs and about the consistency of usage were unavailable. Effects of noise exposure time The relationship of hearing loss and exposure time, defined as years of employment in construction, is also explored. Exposure time is positively related to hearing threshold levels; longer exposure times are associated with higher PTA3,4,6 values. This effect was about 0.09 dB loss in PTA3,4,6 for each year of exposure, after adjustment for age, noise intensity, and other risk factors.