Hearing protection with hearing loss, tinnitus and hearing aids

This guide summarises a workplace safety rule. It is not medical advice. If you have ear problems, talk to your occupational physician or an ENT practice.

First: ask about ear problems

Before hearing protection is used for the first time, employees must be asked about existing ear problems, such as irritation of the ear canal or ongoing medical treatment (section 6.6 of DGUV Rule 112-194). If there are such findings, medical advice on the choice must be obtained first. It belongs to occupational health checks for noise.

With hearing loss

• Selection is made with particular care, if possible with the octave band or HML method (calculating the residual level).
• The attenuation must reliably be achieved at work; medical advice is to be observed.
• Warning signals are to be checked by listening tests.
• Earplugs with a very flat frequency response (marking X) are to be preferred (markings explained).
• With a recognised inner-ear damage, hearing protection must be worn consistently from 80 dB(A) under the German TRLV Lärm.

People with hearing loss understand speech less well even without hearing protection. Communication may no longer be possible below 85 dB(A). The risk assessment must then be adapted, for example with visual signals, radio or hand signals (section 7.7.5).

With tinnitus

People with tinnitus must be protected especially from further noise exposure and must wear hearing protection consistently (section 6.7.2). The rule points to a danger: workplace noise often masks the tinnitus, so deliberate leaks can occur that greatly reduce the protection. Hearing protection with low attenuation or with a radio can be used for masking if there are no safety reasons against it.

With hyperacusis

With this hypersensitivity to sound, the pain threshold is reached at unusually low levels. The attenuation therefore has to be matched precisely to how the person hears. Selection is made together with the person concerned and with listening or wearing trials. Different hearing protectors may be needed for different tasks (section 6.7.3).

Hearing aids in noise areas

• Conventional hearing aids should in principle not be worn in a noise area (sections 4.7 and 7.8).
• Switched-off hearing aids do not count as hearing protection.
• Earmuffs over a hearing aid are not recommended because moisture can damage the electronics.
• Exception: a custom-moulded earplug in combination with a switched-off hearing aid has been tested and certified (among others under DIN EN 352-2) and is suitable for the workplace level.

Approved hearing aids for noisy workplaces have an ear tip that acts as a custom-moulded hearing protector and a workplace-safety programme in programme slot 1 that is active automatically when switched on. Their sound pressure level is limited: up to a product-specific criterion level, the exposure value of 85 dB(A) is not exceeded with average speech communication (section 4.7). In Germany hearing aids are class IIa medical devices.