title: Predictors of hearing protection use in construction workers.
abstract: OBJECTIVE
  Although noise-induced hearing loss is completely preventable, it remains highly prevalent among construction workers. Hearing protection devices (HPDs) are commonly relied upon for exposure reduction in construction, but their use is complicated by intermittent and highly variable noise, inadequate industry support for hearing conservation, and lax regulatory enforcement.
  
  
  METHODS
  As part of an intervention study designed to promote HPD use in the construction industry, we enrolled a cohort of 268 construction workers from a variety of trades at eight sites and evaluated their use of HPDs at baseline. We measured HPD use with two instruments, a questionnaire survey and a validated combination of activity logs with simultaneous dosimetry measurements. With these measurements, we evaluated potential predictors of HPD use based on components of Pender's revised health promotion model (HPM) and safety climate factors.
  
  
  RESULTS
  Observed full-shift equivalent noise levels were above recommended limits, with a mean of 89.8 +/- 4.9 dBA, and workers spent an average of 32.4 +/- 18.6% of time in each shift above 85 dBA. We observed a bimodal distribution of HPD use from the activity card/dosimetry measures, with nearly 80% of workers reporting either almost never or almost always using HPDs. Fair agreement (kappa = 0.38) was found between the survey and activity card/dosimetry HPD use measures. Logistic regression models identified site, trade, education level, years in construction, percent of shift in high noise, and five HPM components as important predictors of HPD use at the individual level. Site safety climate factors were also predictors at the group level.
  
  
  CONCLUSIONS
  Full-shift equivalent noise levels on the construction sites assessed were well above the level at which HPDs are required, but usage rates were quite low. Understanding and predicting HPD use differs by methods used to assess use (survey versus activity card/dosimetry). Site, trade, and the belief that wearing HPD is not time consuming were the only predictors of HPD use common to both measures on an individual level. At the group level, perceived support for site safety and HPD use proved to be predictive of HPD use.
authors.affiliation: Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98205, USA. jedelson@u.washington.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Edelson
authors.forename: Richard
authors.initials: R
authors.lastname: Neitzel
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
authors.forename: William
authors.initials: W
authors.lastname: Daniell
authors.forename: Lianne
authors.initials: L
authors.lastname: Sheppard
authors.forename: Bert
authors.initials: B
authors.lastname: Stover
authors.forename: Noah
authors.initials: N
authors.lastname: Seixas
mesh_terms: D000328:Adult; D004430:Ear Protective Devices / Q000706:statistics & numerical data*; D004784:Environmental Monitoring / Q000379:methods; D005160:Facility Design and Construction / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion / Q000379:methods; D006317:Hearing Loss, Noise-Induced / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009623:Noise, Occupational; D009784:Occupational Diseases / Q000517:prevention & control*; D016273:Occupational Exposure / Q000032:analysis / Q000517:prevention & control