The cafeteria study: Effects of facial masks, hearing protection, and real-world noise on speech recognition.

The objective of this study was to evaluate the impact of wearing various types of personal protective equipment on speech recognition in a real-world, noisy listening environment. Groups of four young, normal-hearing adults participated in a live version of the Modified Rhyme Test in a noisy public cafeteria with and without the use of a non-medical disposable facial mask or combat earplugs in two different modes. Speech recognition, response time, and subjective difficulty were measured per individual. In addition, the signal-to-noise ratio was estimated during the interval when the talker spoke the target word. Results showed that the listeners' speech recognition performance declined not only when the listener wore earplugs, but also when the talker wore earplugs. The measured signal-to-noise ratio significantly decreased when the talker wore earplugs, suggesting that occlusion may have caused the talkers to reduce their voice levels. Results also showed a decline in speech recognition performance when the talker wore a facial mask. Listeners rated all conditions in which talkers and listeners wore personal protective equipment as more difficult than the baseline condition. These data suggest that speech recognition in real-world listening environments can be impaired by personal protective equipment worn by both talkers and listeners.

Attenuation characteristics of an extended-wear hearing aid: Impulse and continuous noise.

The extended-wear hearing aid (EWHA) is a hearing assistive device that combines a low-power analog amplification circuit with a soft biocompatible foam plug that allows it to remain in the ear canal for several months at a time without replacement. EWHAs fit snugly in the ear canal and are not vented and so produce insertion losses comparable to a passive earplug when inserted into the ear canal with the active circuitry turned off. However, EWHAs are not marketed as hearing protection devices, and other than a general warning to users that the device will have impaired auditory awareness when the device is inserted in the "off" mode, relatively little has been reported about the attenuation characteristics of EWHAs. In this study, commercially-available EWHAs were evaluated using the ANSI standard procedures for measuring hearing protector attenuation in impulse noise [ANSI (2010). S1242-2010, Methods for the Measurement of Insertion Loss of Hearing Protective Devices in Continuous or Impulsive Noise Using Microphone-In-Real-Ear or Acoustic Text Fixture Procedures (American National Standards Institute, New York)] and in continuous noise [ANSI (2006). S12.6, Methods for Measuring the Real-Ear Attenuation of Hearing Protectors (American National Standards Institute, New York)]. Attenuation values were also measured in double and triple protection conditions that combined EWHAs with traditional earplugs and earmuffs. The results show that properly-fit EWHAs can provide passive attenuation comparable to conventional passive earplugs, which may make it possible to use them to provide persistent protection from intermittent noise sources.

Using a boothless audiometer to estimate personal attenuation rating in a military hearing conservation clinic.

Hearing protection device (HPD) fit-testing is considered "best practice" for hearing conservation programs in the military. Yet many hearing conservation personnel do not have access to dedicated fit-test equipment. In this study, estimates of personal attenuation rating (PAR) obtained with a boothless audiometer are compared to those obtained with a field-microphone in a real ear (F-MIRE) system. Results suggest that boothless audiometers can be used to make accurate PAR estimates. The ability to perform HPD fit-testing with multipurpose boothless audiometers has the potential to greatly expand the accessibility of earplug verification and ultimately to improve the effectiveness of hearing conservation programs.

Development and Evaluation of a Body-Worn Dosimeter for Continuous and Impulsive Noise.

Noise exposure is encountered nearly everyday in both recreational and occupational settings, and can lead to a number of health concerns including hearing-loss, tinnitus, social-isolation and possibly dementia. Although guidelines exist to protect workers from noise, it remains a challenge to accurately quantify the noise exposure experienced by an individual due to the complexity and non-stationarity of noise sources. This is especially true for impulsive noise sources, such as weapons fire and industrial impact noise which are difficult to quantify due to technical challenges relating to sensor design and size, weight and power requirements. Because of this, personal noise dosimeters are often limited to a maximum 140 dB SPL and are not sufficient to measure impulse noise. This work details the design of a body-worn noise dosimeter (mNOISE) that processes both impulse and continuous noise ranging in level from 40 dBA-185 dBP (i.e. a quiet whisper to a shoulder fired rocket). Also detailed is the capability of the device to log the kurtosis of the sound pressure waveform in real-time, which is thought to be useful in characterizing complex noise exposures. Finally, we demonstrate the use of mNOISE in a military-flight noise environment. Clinical Relevance- On-body noise exposure monitoring can be used by audiologists industrial hygiene personnel and others to determine threshold of injury adequate hearing protection requirements and ultimately reduce permanent noise-induced hearing loss.