Hearing protection fit-testing

Hearing protector fit-testing, also known as field attenuation estimation system (FAES), determines how effective a hearing protection device is for an individual when worn correctly. This is typically carried out using one of the available fit-testing hardware and software systems. The effectiveness is typically measured as a personal attenuation rating (PAR) which is subtracted from the known noise exposure to estimate the total noise exposure a single person has when wearing the tested hearing protection device (HPD).[1][2] The Occupational Safety and Health Administration and the National Hearing Conservation Association Best Practice Bulletin: Hearing Protection Fit-Testing: Hearing Protection- Emerging Trends: Individual Fit Testing describes existing testing methods and how to incorporate them in hearing conservation programs.

Hearing protection devices such as earplugs or earmuffs must be worn correctly for the wearer to be protected from noise.[3] Correct use of hearing protection includes:

  • Choosing the most appropriate hearing protection device, both with appropriate level of attenuation and appropriate fit for the individual.[4] Ideally, the device should limit the sound intensity that reaches the ear to levels below 85 dBA. If the attenuation does not limit the noise levels to that level, other alternatives should be sought. If the attenuation is greater than that, it can also interfere with the HPD use.[5]
  • Wearing or inserting the hearing protection device correctly so it seals the wearer's ear canal, using the "roll-pull-hold" method for foam earplugs, and ensuring earmuffs create an unbroken seal around each ear.[6]

Fit-testing hearing protection ensures both an appropriate choice of hearing protection, and allows for the professional administering the fit-test to train proper techniques for wear.[1][7][8][9][10][11]

Personal attenuation rating (PAR)

Similar to a noise reduction rating (NRR) required on hearing protection devices in the United States, a personal attenuation rating (PAR) is obtained from an attenuation measurement at one or more than one frequency. However, the PAR is regarded as more accurate than the NRR because it is calculated per individual and per hearing protection device, while NRR is a generalized estimate of potential sound reduction based on the protection provided to a small population of people. It gives the evaluator an estimate of the total noise exposure an individual is receiving when wearing hearing protection.

Fit-testing methods

Although all fit-testing systems assess hearing protection devices to give a resulting personal attenuation rating, there are a few different types of technology that have been developed, with real-ear attenuation at threshold (REAT) as the established standard under ANSI/ASA S12.6. It is important to note that the outcome measure generated by each system varies from a simple pass/fail to a quantitative personal attenuation rating (PAR) and can be interpreted differently to determine the effectiveness of hearing protection or calculate total noise exposure.[12]

The different methods used to measure the attenuation provided by HPDs are as follows:

Real-ear attenuation at threshold (REAT)

REAT is the most commonly used type of fit-testing technology used in commercial systems, and is considered the "gold standard" for fit-testing. REAT technology measures the difference in auditory (hearing) thresholds without hearing protection (unoccluded) and with hearing protection (occluded). Most REAT systems use a subjective measure to determine auditory thresholds much like a hearing test where the subject indicates when sound is heard at various frequencies. For earmuffs this must be tested in an acoustic chamber, however for earplugs, headphones can be used, making the test easier for commercial use.[12] For noncritical screening, REAT can be performed using a web browser and standard audio devices.[13]

Microphone-in-real-ear (MIRE)

Also referred to as F-MIRE (field microphone in real ear). This method measures attenuation by placing a small microphone inside the ear canal while hearing protection is worn. Sound pressure levels (SPL) are measured inside and outside of the ear simultaneously and used to calculate a PAR.[14]

Loudness balance

This method first has the subject listen to tones with headphones and "match" loudness between both ears until tones sound equally loud on both sides. Then an earplug is placed in one ear while the baseline procedure is repeated to match loudness in both ears, then the procedure is repeated a third time so both ears are tested individually with earplugs. This calculates a personal attenuation rating based on the loudness of the sound delivered to the unprotected ear when it matches the protected ear.[14]

Use of Fit-testing as a training tool

There has been evidence that including fit-testing as a part of employee training for correct hearing protection device use increases user ability for proper insertion on follow-up.[15]

See also


  1. Witt B (2007). "Fit Testing of Hearing Protectors". Occupational Health and Safety. Retrieved 2018-12-28.
  2. Trompette, Nicolas; Kusy, Alain; Ducourneau, Joël (2015-04-01). "Suitability of commercial systems for earplug individual fit testing". Applied Acoustics. 90: 88–94. doi:10.1016/j.apacoust.2014.11.010.
  3. Ntlhakana L, Kanji A and Khoza-Shangase K. (2015). "The use of hearing protection devices in South Africa: exploring the current status in a gold and a non-ferrous mine". Occupational Health Southern Africa. 21: 10–15.
  4. Murphy WJ, Themann CL, Kardous CA, Byrne DC (2018-10-24). "Three Tips for Choosing the Right Hearing Protector". NIOSH Science Blog. Retrieved 2018-12-28.
  5. Svensson, Eva B.; Morata, Thais C.; Nylén, Per; Krieg, Edward F.; Johnson, Ann-Christin (2004-11-11). "Beliefs and attitudes among Swedish workers regarding the risk of hearing loss". International Journal of Audiology. 43 (10): 585–593. doi:10.1080/14992020400050075. ISSN 1499-2027. PMID 15724523.
  6. "Are your ears really protected? Find out with NIOSH's QuickFitWeb". NIOSH Science Blog. 2008-05-12. Retrieved 2018-12-28.
  7. Murphy WJ, Themann CL, Murata TK (November 2016). "Hearing protector fit testing with off-shore oil-rig inspectors in Louisiana and Texas". International Journal of Audiology. 55 (11): 688–98. doi:10.1080/14992027.2016.1204470. PMC 5333758. PMID 27414471.
  8. Hager LD (2011). "Fit-testing hearing protectors: an idea whose time has come". Noise & Health. 13 (51): 147–51. doi:10.4103/1463-1741.77217. PMID 21368440.
  9. Schulz TY (2011). "Individual fit-testing of earplugs: a review of uses". Noise & Health. 13 (51): 152–62. doi:10.4103/1463-1741.77216. PMID 21368441.
  10. Smith, Pegeen S.; Monaco, Barbara A.; Lusk, Sally L. (2014-12-10). "Attitudes toward Use of Hearing Protection Devices and Effects of an Intervention on Fit-Testing Results". Workplace Health & Safety. 62 (12): 491–499. doi:10.3928/21650799-20140902-01. ISSN 2165-0799. PMID 25207586.
  11. Gong, Wei; Liu, Xin; Liu, Yufei; Li, Ling (2019-03-16). "Evaluating the effect of training along with fit testing on foam earplug users in four factories in China". International Journal of Audiology. 58 (5): 269–277. doi:10.1080/14992027.2018.1563307. ISSN 1499-2027. PMID 30880506.
  12. Kelechava B (2016-11-21). "ANSI/ASA S12.6-2016 – Real-Ear Attenuation of Hearing Protectors". American National Standards Institute. Retrieved 2019-02-20.
  13. "How can I test my hearing protection?". NIOSH. Retrieved 16 September 2019.
  14. Hager L (2006-06-01). "Fit Testing Ear Plugs". Occupational Health and Safety. Retrieved 2019-02-19.
  15. Gong, Wei; Liu, Xin; Liu, Yufei; Li, Ling (2019-05-04). "Evaluating the effect of training along with fit testing on foam earplug users in four factories in China". International Journal of Audiology. 58 (5): 269–277. doi:10.1080/14992027.2018.1563307. ISSN 1499-2027. PMID 30880506.
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