RESUMO
OBJECTIVE: Determine hearing protection use in relation to occupational noise exposure, tinnitus, and audiometry-measured hearing loss in the United States from 1999 to 2016. STUDY DESIGN: Cross-sectional study utilizing US National Health and Nutritional Examination Survey (NHANES) 1999 to 2016 with occupation, reported occupational noise exposure, hearing protection use, tinnitus, and audiometry-measured hearing loss data. Subgroup analysis divided data into two cohorts early 2000s and 2010s. SETTING: Population-based study using NHANES database capturing representative sample of US population. PARTICIPANTS: Individuals with complete data 1999 to 2004 (nâ=â10,347) and 2011 to 2012 with 2015 to 2016 (nâ=â9,383). INTERVENTIONS: Participants self-reported occupational noise exposure lasting more than 4âh/d for more than 3âmonths. Self-reported hearing protective device uses and tinnitus frequency. Audiometric hearing loss objectively measured. MAIN OUTCOME MEASURES: Hearing protection use. Secondary measures included self-reported bothersome tinnitus and audiometrically measured hearing loss. RESULTS: Across occupations, reported occupational noise exposure was higher in 2010s [32%, 95% CI: 29.6-34.6%] than 2000s [12.5%, 95% CI: 11.2-13.9%], while hearing protection use remained low in 2000s [41.3%, 95% CI: 37.8-44.8%] and 2010s [32.8%, 95% CI: 29.8-35.8%]. Less hearing protection use was associated with absence of bothersome tinnitus. Factors associated with increased hearing protection use were younger age, male sex, college education or higher, and white race in a multivariate model. CONCLUSIONS: Reported occupational noise exposure appeared to increase from 2000s to 2010s yet hearing protection use remained stable at low use rate. As noise exposure is a major risk factor for hearing loss, significant education and reinforcement of appropriate hearing protection use for workplace noise exposures is necessary to preserve workers' hearing.