# Hearing Protection Among Workers Exposed to Occupational Noise in the South African Aluminium Industry

## TL;DR

This study explores why workers in South Africa's aluminium industry don't consistently use hearing protection, despite knowing the risks, and identifies factors influencing their behavior.

## Contribution

The study provides new empirical insights into hearing protection use in the under-researched aluminium industry, identifying specific predictors of compliance.

## Key findings

- Only 51.3% of workers consistently used hearing protection devices despite high awareness of noise risks.
- Gender, type of hearing protection device, and perceived susceptibility significantly predicted consistent use.
- Workplace and demographic factors influence hearing protection compliance in high-noise environments.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Occupational noise-induced hearing loss remains a prevalent, preventable hazard affecting workers’ hearing and overall well-being.Understanding real-world patterns of hearing protection device (HPD) use identifies gaps between awareness, access, and consistent protective behaviour in high-noise industries.

Occupational noise-induced hearing loss remains a prevalent, preventable hazard affecting workers’ hearing and overall well-being.

Understanding real-world patterns of hearing protection device (HPD) use identifies gaps between awareness, access, and consistent protective behaviour in high-noise industries.

Public health significance—Why is this work of significance to public health?
Provides empirical evidence on the determinants of HPD use in the under-researched aluminium manufacturing sector, complementing mining-focused studies.Highlights how demographic, device-related, and organisational factors influence protective behaviour and ONIHL risk.

Provides empirical evidence on the determinants of HPD use in the under-researched aluminium manufacturing sector, complementing mining-focused studies.

Highlights how demographic, device-related, and organisational factors influence protective behaviour and ONIHL risk.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Effective hearing conservation programmes require multi-level strategies, including appropriate HPD selection, tailored training, and reinforcement of workplace safety culture.Monitoring, feedback, and context-specific interventions are critical to improving HPD compliance and reducing occupational hearing loss.

Effective hearing conservation programmes require multi-level strategies, including appropriate HPD selection, tailored training, and reinforcement of workplace safety culture.

Monitoring, feedback, and context-specific interventions are critical to improving HPD compliance and reducing occupational hearing loss.

Background: Occupational noise-induced hearing loss (ONIHL) remains one of the most prevalent occupational diseases globally and in South Africa. Despite awareness and regulatory frameworks, consistent use of hearing protection devices (HPDs) is suboptimal in high-noise industries. Aim: To investigate patterns of HPD use and the factors influencing compliance among workers in an aluminium manufacturing company exposed to noise levels exceeding 85 dB(A). Methods: A cross-sectional survey was conducted with 115 workers, including 68.7% males and 31.3% females. Chi-square tests assessed associations between categorical variables, and logistic regression identified significant predictors of consistent HPD use. Results: Although 94.8% of workers were aware of the risks of hazardous noise, only 51.3% reported always using HPDs. Gender, education level, type of HPD, type and duration of noise exposure, and perceived susceptibility to hearing loss were significantly associated with consistent HPD use. Logistic regression revealed that gender, type of HPD, type of noise exposure, and perceived susceptibility significantly predicted consistent use. Conclusions: Despite high awareness and access to HPDs, consistent use remains moderate and is influenced by demographic, perceptual, device-related, and workplace factors. Findings highlight the need for targeted interventions, training, and workplace strategies to improve HPD compliance and prevent ONIHL.