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To assess the risk of hearing loss among workers using earphones as communication devices at noisy worksites, we compared temporary threshold shifts (TTS) between ears on which workers wore earphones and ears on which no earphones were worn. We measured ambient noise and personal noise exposure as well as noise generated by and passed through earphones by applying frequency analysis at three pinball facilities during their hours of actual operation. We assessed hearing levels before and after a work shift (prework and postwork) of 54 workers by pure tone audiometry at six frequencies. The time-weighted averages for ambient noise and personal noise exposure exceeded 85 dB(A) and 90 dB(A), respectively. Overall sound pressure levels generated by and passing through earphones reached 109 dB(A). The one-third octave band spectrum of the earphone noise during the shift exceeded 90 dB(SPL) in the range of 315-2000 Hz. The number of ears demonstrating a TTS, defined as a shift of 10 dB or more in postwork over prework hearing thresholds, was significantly greater at 1500 and 2000 Hz among ears with earphones (P &lt; 0.05 and P &lt; 0.01, respectively) compared to those without. The reverse was observed at 4000 Hz for ears without earphones (P &lt; 0.01). Workers wearing earphones or headsets as communication devices in noisy environments are exposed to high risk of hearing loss, particularly at the frequencies of 1500 and 2000 Hz. Ideally, hearing conservation programs for such workers should account for potential hearing losses at frequencies of 2000 Hz or lower frequencies induced by amplified voice signals.

Temporary Threshold Shifts at 1500 and 2000 Hz Induced by Loud Voice Signals Communicated Through Earphones in the Pinball Industry