The effects of hearing protection devices on spatial awareness in complex listening environments

Abstract

Hearing protection devices (HPDs) remain the first line of defense against hazardous noise exposure and noise-induced hearing loss (NIHL). Despite the increased awareness of NIHL as a major occupational health hazard, implementation of effective hearing protection interventions remains challenging in at-risk occupational groups including those in public safety that provide fire, emergency medical, or law enforcement services. A reduction of situational awareness has been reported as a primary barrier to including HPDs as routine personal protective equipment. This study examined the effects of hearing protection and simulated NIHL on spatial awareness in ten normal hearing subjects. In a sound-attenuating booth and using a head-orientation tracker, speech intelligibility and localization accuracy were collected from these subjects under multiple listening conditions. Results demonstrate that the use of HPDs disrupts spatial hearing as expected, specifically localization performance and monitoring of speech signals. There was a significant interaction between hemifield and signal-to-noise ratio (SNR), with speech intelligibility significantly affected when signals were presented from behind at reduced SNR. Results also suggest greater spatial hearing disruption using over-the-ear HPDs when compared to the removal of high frequency cues typically associated with NIHL through low-pass filtering. These results are consistent with reduced situational awareness as a self-reported barrier to routine HPD use, and was evidenced in our study by decreased ability to make accurate decisions about source location in a controlled dual-task localization experiment.

Prevalence of Hearing Loss and Perceptions of Hearing Health and Protection among Florida Firefighters

“…This is consistent with findings showing that military personnel were concerned about using HPDs because of reductions in situational awareness, interference in detection and localization of auditory cues, and because of incompatibility with other military gear [42]. Furthermore, recent evidence demonstrated that the use of HPDs does disrupt spatial hearing, specifically in localization performance and in monitoring speech signals [43]. Overall, HPDs are often avoided because they cause an increase in listening effort, variability in sound-localization ability, and reduction of effective communication [42][43][44].…”

“…Furthermore, recent evidence demonstrated that the use of HPDs does disrupt spatial hearing, specifically in localization performance and in monitoring speech signals [43]. Overall, HPDs are often avoided because they cause an increase in listening effort, variability in sound-localization ability, and reduction of effective communication [42][43][44]. Adoption and acceptance of HPDs in the fire service continue to be low [45], despite longstanding efforts to address hazardous noise in occupational groups [1,46,47] and, in particular, the fire service [48][49][50].…”

Targeted therapeutic hypothermia protects against noise induced hearing loss

“…HPDs can attenuate situational awareness, which may reduce compliance to using them as standard personal protective equipment. ( Snapp et al, 2023 ). Various promising pharmacologic agents have also been identified for NIHL intervention, including antioxidants ( Bielefeld et al, 2007 ; Campbell et al, 2011 ; Fetoni et al, 2013 ), glutamate antagonists ( Hu et al, 2020 ), cell death regulators ( Wilson et al, 2014 ), and anticonvulsive drugs ( Bao et al, 2013 ).…”

Incidental detection of bilateral cochlear implants on panoramic radiography: Case report associated with antecedent traumatic brain injury

“…1 Specifically, unmanaged chronic auditory loss may predispose to learning, language, and psychosocial maldevelopment; voice quality impairment; tinnitus; dementia; and self-harm due to a reduced capability of situational awareness. 2,3 Thus, efforts to improve hearing competence may mitigate pathophysiologic decline and may be warranted. A variety of modalities are available to regain partial to complete hearing proficiency, involving nonsurgical options with use of hearing aids and assistive listening devices, and surgically-implanted devices, particularly cochlear implants and auditory brainstem implants.…”

“…Traumatic brain injury outcomes may range from complete recovery to persistent cognitive, systemic, neuromuscular, and neurosensory deficits 1 . Specifically, unmanaged chronic auditory loss may predispose to learning, language, and psychosocial maldevelopment; voice quality impairment; tinnitus; dementia; and self‐harm due to a reduced capability of situational awareness 2,3 . Thus, efforts to improve hearing competence may mitigate pathophysiologic decline and may be warranted.…”