Randomized trial of a hearing conservation intervention for rural students: Long-term outcomes

Barbara Marlenga, James G. Linneman, William Pickett, Douglas J. Wood, Steven R. Kirkhorn, Steven K. Broste, Mary Jo Knobloch, Richard L. Berg

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


OBJECTIVES: We had the rare opportunity to conduct a cluster-randomized controlled trial to observe the long-term (16-year) effects of a well-designed hearing conservation intervention for rural high school students. This trial assessed whether the intervention resulted in (1) reduced prevalence of noise-induced hearing loss (NIHL) assessed clinically and/or (2) sustained use of hearing protection devices. METHODS: In 1992-1996, 34 rural Wisconsin schools were recruited and 17 were assigned randomly to receive a comprehensive, 3-year, hearing conservation intervention. In 2009 -2010, extensive efforts were made to find and contact all students who completed the original trial. Participants in the 16-year follow-up study completed an exposure history questionnaire and a clinical audiometric examination. Rates of NIHL and use of hearing protection were compared. RESULTS: We recruited 392 participants from the original trial, 200 (53%) from the intervention group and 192 (51%) from the control group. Among participants with exposure to agricultural noise, the intervention group reported significantly greater use of hearing protection compared with the control group (25.9% vs 19.6%; P=.015). The intervention group also reported significantly greater use of hearing protection for shooting guns (56.2% vs 41.6%; P = .029), but the groups reported similar uses of protection in other contexts. There was no significant difference between groups with respect to objective measures of NIHL. CONCLUSION: This novel trial provides objective evidence that a comprehensive educational intervention by itself may be of limited effectiveness in preventing NIHL in a young rural population.

Original languageEnglish (US)
Pages (from-to)e1139-e1146
Issue number5
StatePublished - Nov 2011


  • Agriculture
  • Hearing conservation
  • Noise-induced hearing loss
  • Randomized controlled trial
  • Youths


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