DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

Summary

Exposure to high noise levels among fire 

fighters is well documented and increases the risk for noise-induced hearing loss. 

NIOSH recommends measures to promote better hearing health through the 

use of quieter equipment, better work 

practices, hearing protection devices, and 

implementation of effective hearing loss 

prevention programs.

Promoting Hearing Health

among Fire Fighters

Description of 

Exposure

More than 1.1 million fire fighters 

work in the United States (330,000 career fire fighters and 800,000 volunteer 

fire fighters) [BLS 2011; NFPA 2010]. 

Firefighters are exposed to many hazards as part of their job, including 

noise. The main sources of noise are 

fire sirens, alarms, communication devices, audio equipment in cabs, engine 

pumps, rotary and chain saws, ventilation fans, and pneumatic tools used 

in emergency ventilation and extrication (see Table 1). In addition, fire 

fighters are also exposed to chemicals 

and combustion by-products that may 

have ototoxic effects and exacerbate the 

onset of hearing loss [Lees 1995; Morata 2003]. Such activities often result in 

fire fighters being exposed to noise that 

exceeds occupational exposure limits 

[Neitzel 2012; Tubbs 1991]. Fire fighters who are repeatedly exposed to high 

noise levels risk developing work-related hearing loss [Ide 2011; Kales et al. 

2001; Tubbs 1991].

Exposure Limits

The NIOSH recommended exposure 

limit (REL) for noise is 85 A-weighted 

decibels (dBA) as an 8-hour timeweighted average (TWA) using a 3-dB 

exchange rate (for every 3-dB increase, exposure time should be cut in 

half). Exposures at or above this level 

are considered hazardous. In addition, 

NIOSH recommends that exposure to 

continuous, intermittent, varying, or 

impulsive noise not exceed 140 dBA 

[NIOSH 1998].

Job description/source

Average noise levels

(dBA)

Maximum noise levels

(dBA)

Driver 84–88 106–109

Jump seat 85–88 105–106

Tiller 75 97

EMS 78 100

Ventilation (sawing/blower) 87–109 110–114

Vehicle extraction (chisels/spreaders) 90–106 98–115

Fire suppression (ladders/water pumps) 89–91 84–98

Fire station (testing alarm/tools/engine) 88–101 92–116

Fire station (break room) 67 68

Table 1. Summary of noise level measurements from fire department surveys

Sources: NIOSH 1990; NIOSH 1994; Neitzel et al. 2012
The Occupational Safety and Health Administration (OSHA) 

permissible exposure limit (PEL) for noise is 90 dBA, and 

the action level is 85 dBA, both as an 8-hour TWA using a 

5-dB exchange rate [29 CFR 1910.95]. This means that hearing protection, administrative and engineering controls, and 

annual monitoring are required. The OSHA occupational 

noise standard also recommends that exposures to impact or 

impulsive noise not exceed 140 dB peak sound pressure level. 

Since fire fighters in the United States commonly work 

24-hours shifts with 48 hours off, noise exposure limits need to be adjusted [see Table 1‒1 in NIOSH 1998 and 

OSHA Table G-16A in 29 CFR 1910.95]. For instance, 

the NIOSH REL for 24 hours would be 80.3 dBA and the 

OSHA Action Level would be 77.1 dBA (OSHA does not 

require adjustment to the PEL).

In addition, the National Fire Protection Association (NFPA) 

Standard on Fire Department Occupational Safety and 

Health (NFPA 1500) and Standard on Comprehensive Occupational Medical Programs (NFPA 1582) recommend 

that fire departments establish hearing conservation programs that reduce or eliminate harmful sources of noise and 

require hearing protection when noise exceeds 90 dBA as 

well as entry and periodic audiometric evaluations for all fire 

fighters [NFPA 2013].

NIOSH Investigations

NIOSH conducted several Health Hazard Evaluations (HHE) 

[NIOSH 1982, 1988, 1990, 1991, 1994, 1995, 2008] that examined noise exposures and documented hearing loss 

among fire fighters (Figure 1). The first HHE examined 55 

fulltime fire fighters from the Newburgh Fire Department 

and showed marked hearing loss in noise sensitive frequencies. Although the 8-hour TWAs were generally less than 

NIOSH and OSHA exposure limits, intermittent noise exposures during emergency response reached between 99−116 

dBA [NIOSH 1982]. Pure tone audiometry conducted on 

333 self-selected fire fighters attending an International 

Association of Fire Fighters convention showed 163 (49%) 

with normal hearing, 125 (38%) with mild to moderate hearing loss, and 45 (14%) with moderately severe to profound 

hearing loss [NIOSH 1991]. Audiometric results from 2 

investigations (197 fire fighters at 2 fire stations serving the 

Memphis International Airport and 424 fire fighters at the 

Pittsburgh Bureau of Fire) indicated noise-induced hearing 

loss (NIHL) among fire fighters and a statistical correlation 

between hearing loss and the years of service [NIOSH 1990, 

1994]. In addition to hearing loss, 35% of the Pittsburgh 

fire fighters reported tinnitus (ringing in the ears) [NIOSH 

1994]. A study of audiometric data of 55 fire fighters at the 

Hamilton Fire Department tested in 1983 and again in 1989 

showed a decline in their hearing ability at higher frequencies, a pattern characteristic of NIHL [NIOSH 1995].

Other Studies

A study of 319 fire fighters in Massachusetts (average age 

39.5 ± 6.9 years) showed 46 (14%) fire fighters with highfrequency hearing loss compared with 5% of the general population with similar age distribution [Kales et al. 

2001]. A focus group study at 2 fire departments found that 

although fire fighters were aware of the damaging effects 

of loud noise, they did not use hearing protection regularly [Hong et al. 2008]. The two fire departments had no hearing conservation programs in place, and the fire fighters 

viewed NIHL as an unavoidable part of the job and a smaller 

risk compared with other hazards. They believed HPDs interfered with their ability to communicate during emergency operations, interfered with other required safety equipment, and were generally forgotten when gearing up. Clark 

and Bohl [2005] examined 12,609 audiograms at two fire departments specifically selected for having rigorous hearing 

conservation programs and found no evidence of hearing 

loss among their fire fighters. A task-based study conducted 

at 3 fire departments found average noise levels that ranged 

from 82−109 dBA. The NIOSH REL of 85 dBA over an 8-hr 

work shift was exceeded in less than one hour for certain 

firefighting tasks such as the use of saws and pneumatic 

chisels [Neitzel et al. 2012].

Recommendations

To prevent fire fighters from developing a hearing impairment, NIOSH recommends fire departments establish and 

maintain department-specific hearing loss prevention programs that include the following elements:

 Engineering and administrative controls to limit fire 

fighters’ overall exposure to noise from equipment or in 

Figure 1. NIOSH researcher examines noise levels generated by fire truck siren and engine.
the work environment. Fire departments should incorporate noise emission limits in their purchasing agreements 

for new equipment [Neitzel et al. 2012; Duffy et al. 1992; 

Tubbs 1991]. The “Buy Quiet” process recommended by 

NIOSH encourages a purchaser to compare the noise 

emission levels of different models of equipment and, 

whenever possible, buy the quieter model [Hayden 2012].

 Training about harmful noise levels from various tasks 

and equipment, the effects of noise exposure, and hearing 

loss [Duffy et al. 1992].

 Training about appropriate hearing protection devices, 

especially electronic devices designed specifically for fire 

fighters and that provide enhanced communication capabilities and block harmful noise.

 Individualized training on the proper use of hearing protection devices using commercially available fit-test systems [Murphy et al. 2011]. Fit-testing allows for easy and 

accurate measurement of hearing protection effectiveness 

just as they are being used in the field.

Although most of these recommendations are aimed at promoting hearing health among traditional structural fire 

fighters, they are mostly applicable to others types of fire 

fighting applications such as wildland fire fighting, aircraft 

and shipboard rescue and fire fighting, and technical rescue 

and hazardous materials operations.

Acknowledgments

This document was prepared by Chucri A. Kardous and 

Susan E. Afanuh, NIOSH

References

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

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For More Information

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Public Safety Sector, and the NORA Hearing Loss Program can be 

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http://www.cdc.gov/niosh/nora/councils/pubsaf/default.html

http://www.cdc.gov/niosh/programs/hlp/goals.html

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Promoting Hearing Health among Fire Fighters

DHHS (NIOSH) Publication No. 2013−142

Safer • Healthier • PeopleTM May 2013