{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:02:50Z","timestamp":1790744570566,"version":"4.1.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Noise-induced hearing loss (NIHL) remains an important occupational health problem, especially in high-intensity noise work settings. Although disposable foam earplugs (DFE) are widely used, the protection they provide depends on how well they are fitted. We examined initial earplug attenuation in military aviation personnel, the change observed after individualized on-site instruction and repeat fitting among participants initially below target, and the association between previous instruction and baseline attenuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single-center observational study analyzed routinely collected occupational-health fit-testing data from 183 military aviation personnel evaluated between 2020 and 2022. Mean age was 22.84 \u00b1 6.23 years, and 91.3% were male. Earplug attenuation was measured using the 3M E-A-Rfit Dual-Ear Validation System. Participants with mean binaural attenuation below 20\u202fdB received individualized on-site instruction and repeated the fitting procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During initial fitting, 118 participants (64.5%) did not achieve the 20\u202fdB target. In this group, mean binaural attenuation rose from 14.47 to 22.57\u202fdB after instruction and repeat fitting, an improvement of 8.10\u202fdB (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Participants who reported having received previous earplug-use instruction also had higher baseline attenuation than those without previous instruction (19.47 vs. 16.52\u202fdB;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Quantitative fit testing identified inadequate initial attenuation in nearly two-thirds of the personnel assessed. Brief individualized instruction followed by repeat fitting was associated with a substantial improvement in attenuation among those initially below target. Incorporating personal fit testing and targeted instruction into occupational hearing-conservation programs may improve protection against NIHL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1955670","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:53:41Z","timestamp":1790744021000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Personal earplug fit testing identifies below-target attenuation in nearly two-thirds of military aviation personnel: a retrospective analysis of results before and after individualized instruction"],"prefix":"10.3389","volume":"14","author":[{"given":"Moshe","family":"Argaman","sequence":"first","affiliation":[{"name":"The Adelson School of Medicine, Ariel University","place":["Ariel, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Ben-Ari","sequence":"additional","affiliation":[{"name":"The Adelson School of Medicine, Ariel University","place":["Ariel, Israel"]},{"name":"Carmel Medical Center","place":["Haifa, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1016\/S0140-6736(13)61613-X","article-title":"Auditory and non-auditory effects of noise on health","volume":"383","author":"Basner","year":"2014","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.3390\/jcm12062347","article-title":"Noise-induced hearing loss","volume":"12","author":"Natarajan","year":"2023","journal-title":"J Clin Med"},{"key":"ref3","article-title":"Safety at Work Regulations (Prevention of Hazards from Noise Sources - Jerusalem, Israel)","year":"1984"},{"key":"ref4","article-title":"Understand Noise Exposure. Centers for Disease Control and Prevention","year":"2026"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/978-1-60761-145-5_37","article-title":"Noise-induced hearing loss: implication for tinnitus","author":"Henderson","year":"2011","journal-title":"Textbook of Tinnitus"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1136\/bmj.304.6826.522","article-title":"Noise induced hearing loss","volume":"304","author":"Alberti","year":"1992","journal-title":"BMJ"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.3390\/ijerph18062982","article-title":"The immediate and long-term impact of military aircraft noise on hearing: a cross-sectional comparison of fighter pilots and ground staff","volume":"18","author":"Kuo","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1177\/216507999704500806","article-title":"Noise exposures. Effects on hearing and prevention of noise induced hearing loss","volume":"45","author":"Lusk","year":"1997","journal-title":"AAOHN J"},{"key":"ref9","article-title":"3M E-A-R classic earplugs: product specifications. 3M United States","year":""},{"key":"ref10","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1080\/14992020701438805","article-title":"The effects of training format on earplug performance","volume":"46","author":"Joseph","year":"2007","journal-title":"Int J Audiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"8482","DOI":"10.3390\/ijerph19148482","article-title":"A tester to evaluate the correct placement of earplugs","volume":"19","author":"Kozlowski","year":"2022","journal-title":"IJERPH"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3242","DOI":"10.3390\/ijerph17093242","article-title":"Individual fit testing of hearing-protection devices based on microphones in real ears among Workers in Industries with high-noise-level manufacturing","volume":"17","author":"Chiu","year":"2020","journal-title":"IJERPH"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"231","DOI":"10.4081\/gimle.464","article-title":"Experimental measurement of the \u2018PAR\u2019 of seven ear plugs","volume":"42","author":"Cassano","year":"2025","journal-title":"G Ital Med Lav Ergon"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"393","DOI":"10.2486\/indhealth.46.393","article-title":"A trail of individual education for hearing protection with an instrument that measures the noise attenuation effect of wearing earplugs","volume":"46","author":"Tsukada","year":"2008","journal-title":"Ind Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"132","DOI":"10.4103\/1463-1741.77215","article-title":"Effects of training on hearing protector attenuation","volume":"13","author":"Murphy","year":"2011","journal-title":"Noise Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.cobeha.2017.11.012","article-title":"Current issues related to motor sequence learning in humans","volume":"20","author":"Doyon","year":"2018","journal-title":"Curr Opin Behav Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"4667","DOI":"10.3390\/ijerph17134667","article-title":"Productivity burden of occupational noise-induced hearing loss in Australia: a life Table modelling study","volume":"17","author":"Si","year":"2020","journal-title":"IJERPH"},{"key":"ref18","article-title":"Effective Use of Earplugs among Military Personnel","author":"Argaman","year":"2026"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1955670\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:54:00Z","timestamp":1790744040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1955670\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":18,"alternative-id":["10.3389\/fpubh.2026.1955670"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1955670","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1955670"}}