Introduction:The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment.Materials and Methods:Personal Attenuation Ratings (PARs) following self-fitted (SELF-Fit) HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female) across four test protocols (1-, 3-, 5-, and 7- frequency). SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]). EXP-Fit was intended to provide a perception (dubbed “ear canal muscle memory”) of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance.Results:A one-way analysis of variance (ANOVA) (N=320) showed that SELF-Fit means differed significantly between protocols (P < 0.001). Post-hoc analyses showed that the 1-freq SELF-Fit mean was significantly lower than all other protocols (P < 0.03) by 5.6 dB or more. No difference was found between the multi-frequency protocols. For recruits who were followed up with EXP-Fit (n=79), across all protocols, a significant (P < 0.001) mean improvement of 25.68 dB (10.99) was found, but PARs did not differ (P = 0.99) between EXP-Fit protocols. For recruits in the 3-freq and 5-freq protocol groups who experienced all three PAR test methods (n=33), PAR methods differed (P < 0.001) but no method by protocol interaction was found (P = 0.46). Post hoc tests showed that both EXP-Fit and SUB Re-Fit had significantly better attenuation than SELF-Fit (P < 0.001), but no difference was found between EXPFit and SUB Re-Fit (P = 0.59). For SELF-Fit, the 1-freq protocol resulted in a 35% pass rate, whereas the 3-, 5-, and 7-freq protocols resulted in >60% pass rates. Results showed that once recruits experienced how HPDs should feel when inserted correctly, they were able to properly replicate the procedure with similar results to the expert fit suggesting “ear canal muscle memory” may be a viable training strategy concomitant with HPD verification. Fit-test duration was also measured to examine the tradeoff between results accuracy and time required to complete each protocol.Discussion:Results from this study showed the critical importance of initial selection and fitting of HPDs followed by verification (i.e., fit-testing) at Navy and Marine Corps accession points. Achieving adequate protection from an HPD is fundamentally dependent on obtaining proper fit of the issued HPD as well as the quality of training recruits receive regarding HPD use.

Objective: The purpose of this fit-testing study in the field was to systematically compare three Hearing Protection Device (HPD) fit-training methods and determine whether they differ in the acquisition of HPD fitting skill and resulting amount of earplug attenuation. Design: Subjects were randomly assigned to receive HPD fit-training using one of three training methods: current, experiential HPD (eHPD), and integrated. Personal Attenuation Ratings (PARs) were acquired via HPD fit-testing and used to verify attenuations pre-and post-training. Study Sample: US Marine training recruits (n ¼ 341) identified via HPD fit-testing for remedial HPD fittraining and assigned to three cohorts. Results: The post-training HPD fittest passing rate differed by training method, with pass rates ranging from 50% (current) to nearly 92% (eHPD). The difference between group delta PAR values were significantly higher (>9 dB) in both the eHPD and integrated methods compared to the current method. Conclusion: The HPD fit-training methods that teach "what right feels like" (eHPD and integrated) provided a greater number of trainees with the skill to achieve noise attenuation values required for impulse noise exposures encountered during basic training. The attenuation achieved by those methods was significantly greater than the current training method.

Objectives To investigate the change in hearing and perceived comfort over 1 year related to using an active hearing protection device (HPD) among United States Marine Corps (USMC) personnel routinely exposed to hazardous noise. Methods USMC Weapons Instructors (n = 127) were issued an active earmuff that met military standards and was compatible with other protective equipment. These participants completed pre- and post-hearing tests and comfort surveys. A control cohort (n = 94) was also included to compare individual changes in high-frequency pure tone average (HF-PTA) over 1 year. Results The control group’s HF-PTA was 3 dB worse than the intervention group after only 1 year. Survey responses revealed perceived improvements in the ability to hear and understand, situational awareness, and safety. Conclusions Active HPDs can reduce hearing loss and improve hearing-related occupational tasks.