title: Speech intelligibility and passive, level-dependent earplugs.
abstract: OBJECTIVE
  Noise-induced hearing loss is one of the most common occupational diseases. Military personnel are at especially high risk due to the broad range of military noise hazards and the frequency of exposure. Hearing protectors are vital for this particular workforce, yet they can impede the ability to understand necessary communication in the field. Level-dependent hearing protectors are designed to protect the auditory system from the hazards of impulse noise, while preserving the ability to hear speech and other important auditory signals. The aim of this study was to evaluate the effect of two different passive, level-dependent earplugs (Combat Arms Earplugs; Sonic II Ear valves) on speech understanding of normal-hearing listeners in the presence of low-level background noise. The Combat Arms Earplug, developed specifically for use by military personnel, represented devices that attenuate impulse noise using small orifices and the Sonic II ear valve represented devices using an internal diaphragm.
  
  
  METHODS
  This study used a repeated-measures experimental design. Four scrambled lists of each of the four Northwestern University No. 6 50-word lists were presented in random order at 65 dB SPL in the presence of quiet and two different types of background noise: multitalker and military vehicle noise; using three ear conditions: NP (open ear), CA (Combat Arms Earplugs), and SO (Sonic II earplugs); and three signal-to-noise ratios (SNRs): -10, 0, and +10 dB. Word recognition scores (WRSs) of 18 native English-speaking adults with normal hearing sensitivity were measured in all test conditions. The percentage of words correctly repeated was used to determine differences between the two different level-dependent devices, types of background noise, and SNRs.
  
  
  RESULTS
  Results showed a statistically significant increase in WRS as SNR increased from -10 to +10 dB. A repeated-measures analysis of variance for ear condition × noise × SNR indicated a significant main effect for SNR but not for type of noise or ear condition. A slight but significant interaction was found for SNR and ear condition.
  
  
  CONCLUSIONS
  SNR had great impact on the ability of listeners to understand speech in the presence of background noise; however, the type of noise and the type of level-dependent device used did not. The results of the study support the notion that individuals potentially subjected to high-level impulse noise should be able to use level-dependent earplugs in low-level continuous noise without compromising speech understanding. More specifically, the passive, level-dependent earplugs currently used by military personnel do not appear to be detrimental to speech communication for listeners with normal hearing when the speech is at an average conversational level and the listener is actively attending to the signal.
authors.affiliation: The Hearing and Speech Agency, Baltimore, Maryland 21215, USA. jnorin@hasa.org
authors.forename: Julie A
authors.initials: JA
authors.lastname: Norin
authors.forename: Diana C
authors.initials: DC
authors.lastname: Emanuel
authors.forename: Tomasz R
authors.initials: TR
authors.lastname: Letowski
mesh_terms: D000328:Adult; D001309:Auditory Threshold; D004430:Ear Protective Devices; D004867:Equipment Design; D005260:Female; D006309:Hearing; D006317:Hearing Loss, Noise-Induced / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008889:Military Personnel; D009623:Noise, Occupational / Q000009:adverse effects / Q000517:prevention & control*; D059629:Signal-To-Noise Ratio; D013063:Speech Discrimination Tests; D013065:Speech Intelligibility; D055815:Young Adult