J Am Acad Audiol 2017; 28(01): 014-035
DOI: 10.3766/jaaa.15070
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Noise Exposure Questionnaire: A Tool for Quantifying Annual Noise Exposure

Tiffany A. Johnson
*   Hearing and Speech Department, University of Kansas Medical Center, Kansas City, KS
Susan Cooper
†   CavCom, Inc., Walker, MN
Greta C. Stamper
‡   Otorhinolaryngology, Mayo Clinic Florida, Jacksonville, FL
Mark Chertoff
*   Hearing and Speech Department, University of Kansas Medical Center, Kansas City, KS
› Author Affiliations
Further Information

Publication History

Publication Date:
26 June 2020 (online)



Exposure to both occupational and nonoccupational noise is recognized as a risk factor for noise-induced hearing loss (NIHL). Although audiologists routinely inquire regarding history of noise exposure, there are limited tools available for quantifying this history or for identifying those individuals who are at highest risk for NIHL. Identifying those at highest risk would allow hearing conservation activities to be focused on those individuals.


To develop a detailed, task-based questionnaire for quantifying an individual’s annual noise exposure (ANE) arising from both occupational and nonoccupational sources (aim 1) and to develop a short screening tool that could be used to identify individuals at high risk of NIHL (aim 2).

Research Design:

Review of relevant literature for questionnaire development followed by a cross-sectional descriptive and correlational investigation of the newly developed questionnaire and screening tool.

Study Sample:

One hundred fourteen college freshmen completed the detailed questionnaire for estimating ANE (aim 1) and answered the potential screening questions (aim 2). An additional 59 adults participated in data collection where the accuracy of the screening tool was evaluated (aim 2).

Data Collection and Analysis:

In study aim 1, all participants completed the detailed questionnaire and the potential screening questions. Descriptive statistics were used to quantify participant participation in various noisy activities and their associated ANE estimates. In study aim 2, linear regression techniques were used to identify screening questions that could be used to predict a participant’s estimated ANE. Clinical decision theory was then used to assess the accuracy with which the screening tool predicted high and low risk of NIHL in a new group of participants.


Responses on the detailed questionnaire indicated that our sample of college freshmen reported high rates of participation in a variety of occupational and nonoccupational activities associated with high sound levels. Although participation rates were high, ANE estimates were below highest-risk levels for many participants because the frequency of participation in these activities was low in many cases. These data illustrate how the Noise Exposure Questionnaire (NEQ) could be used to provide detailed and specific information regarding an individual’s exposure to noise. The results of aim 2 suggest that the screening tool, the 1-Minute Noise Screen, can be used to identify those participants with high- and low-risk noise exposure, allowing more in-depth assessment of noise exposure history to be targeted at those most at risk.


The NEQ can be used to estimate an individual’s ANE and the 1-Minute Noise Screen can be used to identify those participants at highest risk of NIHL. These tools allow audiologists to focus hearing conservation efforts on those individuals who are most in need of those services.

This work was supported by a Dissertation Fellowship from the University of Kansas Graduate School and a grant from the National Institutes of Health (NIH) National Institute on Deafness and Other Communication Disorders (NIDCD) R03 DC011367.

Portions of this work were presented at the 2013 Innovations in Noise-Induced Hearing Loss and Tinnitus Prevention in Kids Conference, St. Paul, MN, October 15–18, 2013.


  • Airo E, Pekkarinen J, Olkinuora P. 1996; Listening to music with earphones: an assessment of noise exposure. Acta Acust United Acust 82: 885-894
  • Anttonen H, Virokannas H, Sorri M. 1994; Noise and hearing loss in reindeer herders. Arctic Med Res 53 (03) (Suppl) 35-40
  • Axelsson A. 1996; Recreational noise exposure and its effects. Noise Control Eng J 44: 127-134
  • Axelsson A, Prasher D. 2000; Tinnitus induced by occupational and leisure noise. Noise Health 2 (08) 47-54
  • Banach J, Berger EH. 2003; What we do to ourselves: noise exposures beyond work. CAOHC Update 15: 6-7
  • Berger EH, Kieper RW. 1994; Representative 24-hour Leqs arising from a combination of occupational and non-occupational noise exposures. J Acoust Soc Am 95: 2890
  • Bess FH, Poynor RE. 1974; Noise-induced hearing loss and snowmobiles. Arch Otolaryngol 99 (01) 45-51
  • Carter L, Williams W, Black D, Bundy A. 2014; The leisure-noise dilemma: hearing loss or hearsay? What does the literature tell us?. Ear Hear 35 (05) 491-505
  • Chasin M. 2009. Hearing loss prevention for musicians. In: Chasin M. Hearing Loss in Musicians: Prevention and Management. San Diego, CA: Plural Publishing, 3;
  • Chung JH, Des Roches CM, Meunier J, Eavey RD. 2005; Evaluation of noise-induced hearing loss in young people using a web-based survey technique. Pediatrics 115 (04) 861-867
  • Cohen A, Anticaglia J, Jones H. 1970; ‘Sociocusis’—hearing loss from non-occupational noise exposure. Sound Vibrat 4: 12-20
  • Dobie RA. 2001. Medical-Legal Evaluation of Hearing Loss. 2nd ed. San Diego, CA: Singular Publishing Group; 138-173
  • Dobie RA. 2008; The burdens of age-related and occupational noise-induced hearing loss in the United States. Ear Hear 29 (04) 565-577
  • Environmental Protection Agency (EPA) 1974. Information on levels of environmental noise requisite to protect public health and welfare with an adequate margin of safety. EPA Rep. No. 550/9-74-004; Washington, DC:
  • Fallentin N, Juul-Kristensen B, Mikkelsen S, Andersen JH, Bonde JP, Frost P, Endahl L. 2001; Physical exposure assessment in monotonous repetitive work--the PRIM study. Scand J Work Environ Health 27 (01) 21-29
  • Flamme GA, Stephenson MR, Deiters K, Tatro A, van Gessel D, Geda K, Wyllys K, McGregor K. 2012; Typical noise exposure in daily life. Int J Audiol 51 (01) (Suppl) S3-S11
  • Fligor B. 2010; Recreational noise and its potential risk to hearing. Hear Rev 17: 48-55
  • Fligor B, Ives T. 2006 Does earphone type affect risk for recreational noise-induced hearing loss? Paper presented at Noise-Induced Hearing Loss in Children at Work and Play Conference, Cincinnati, OH, October 19, 2006
  • Franks JR, Davis RR, Kreig Jr EF. 1989; Analysis of a hearing conservation program data base: factors other than workplace noise. Ear Hear 10 (05) 273-280
  • Garcia A, Garcia AM. 1993; Measurements of noise exposure in daily life. Noise as a Public Health Problem 2: 367-370
  • Hammer MS, Swinburn TK, Neitzel RL. 2014; Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122 (02) 115-119
  • Healthy People 2020 (n.d.). Hearing and Other Sensory or Communication Disorders. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. http://www.healthypeople.gov/ . Accessed July 10, 2015.
  • Holgers KM, Pettersson B. 2005; Noise exposure and subjective hearing symptoms among school children in Sweden. Noise Health 7 (27) 27-37
  • Holt JJ, Broste SK, Hansen DA. 1993; Noise exposure in the rural setting. Laryngoscope 103 (03) 258-262
  • Institute of Medicine (IOM) 2005. Noise and Military Service: Implications for Hearing Loss and Tinnitus. Washington, DC: National Academies Press;
  • Johnson DL, Riffle C. 1982; Effects of gunfire on hearing level for selected individuals of the Inter-Industry Noise Study. J Acoust Soc Am 72 (04) 1311-1314
  • Jokitulppo J, Bjork E. 2003; Estimated leisure-time noise exposure and hearing symptoms in a finnish urban adult population. Noise Health 5 (17) 53-62
  • Jones HH, Oser JL. 1968; Farm equipment noise exposure levels. Am Ind Hyg Assoc J 29 (02) 146-151
  • Kono S, Sone T, Nimura T. 1982; Personal reaction to daily noise exposure. Noise Control Engineering 19: 4-16
  • Kujawa SG, Liberman MC. 2009; Adding insult to injury: cochlear nerve degeneration after “temporary” noise-induced hearing loss. J Neurosci 29 (45) 14077-14085
  • Landis JR, Koch GG. 1977; The measurement of observer agreement for categorical data. Biometrics 33 (01) 159-174
  • Lempert B, Henderson TL. (1973) Occupational noise and hearing 1968-1972. NIOSH Report TR-201-74. NTIS No. PB-232 284, Cincinnati, OH.
  • Lin HW, Furman AC, Kujawa SG, Liberman MC. 2011; Primary neural degeneration in the Guinea pig cochlea after reversible noise-induced threshold shift. J Assoc Res Otolaryngol 12 (05) 605-616
  • McClymont LG, Simpson DC. 1989; Noise levels and exposure patterns to do-it-yourself power tools. J Laryngol Otol 103 (12) 1140-1141
  • McCombe AW, Binnington J, Nash D. 1994; Two solutions to the problem of noise exposure for motorcyclists. Occup Med (Lond) 44 (05) 239-242
  • National Institute on Deafness and Other Communication Disorders (NIDCD) 2008. Fact Sheet: Work-Related Hearing Loss. Washington, DC: Health and Human Services;
  • National Institute for Occupational Safety and Health (NIOSH) 1998. Criteria for a Recommended Standard: Occupational Exposure to Noise. Cincinnati, OH: USDHHS, PHS, CDC, NIOSH; 98-126
  • Neitzel R, Seixas N, Goldman B, Daniell W. 2004; Contributions of non-occupational activities to total noise exposure of construction workers. Ann Occup Hyg 48 (05) 463-473
  • Neitzel R, Seixas N, Olson J, Daniell W, Goldman B. 2004; Nonoccupational noise: exposures associated with routine activities. J Acoust Soc Am 115 (01) 237-245
  • O’Brien I, Wilson W, Bradley A. 2008; Nature of orchestral noise. J Acoust Soc Am 124 (02) 926-939
  • Occupational Safety and Health Administration (OSHA) 1981; Occupational noise exposure; hearing conservation amendment. Occupational Safety and Health Administration, 29 CFR 1910.95. Fed Regist 46: 4078-4181
  • Portnuff C, Fligor B, Arehart K. 2009 Adolescent use of portable listening devices: a hazard to hearing? Paper presented at Annual Conference of the National Hearing Conservation Association, Atlanta, GA, February 13, 2009
  • Reeb-Whitaker CK, Seixas NS, Sheppard L, Neitzel R. 2004; Accuracy of task recall for epidemiological exposure assessment to construction noise. Occup Environ Med 61 (02) 135-142
  • Rice CG, Breslin M, Roper RG. 1987; Sound levels from personal cassette players. Br J Audiol 21 (04) 273-278
  • Roberts G. 1999; Noise impact from motor sport activities. Noise Control Eng J 47: 154-157
  • Ross BC. 1989; Noise exposure of motorcyclists. Ann Occup Hyg 33 (01) 123-127
  • Royster LH, Berger EH, Royster JD. 2000. Noise surveys and data analysis. In: Berger EH, Royster LH, Royster JB, Driscoll DP, Layne M. The Noise Manual. 5th ed. Fairfax, VA: American Industrial Hygiene Association Press; 165-244
  • Schmidt JH, Pedersen ER, Paarup HM, Christensen-Dalsgaard J, Andersen T, Poulsen T, Bælum J.. 2014; Hearing loss in relation to sound exposure of professional symphony orchestra musicians. Ear Hear 35 (04) 448-460
  • Schori TR, McGatha EA. 1978; A real-world assessment of noise exposure. Sound Vibrat 12: 24-30
  • Seixas N. 2004. Final report: noise and hearing damage in construction apprentices. Seattle, WA: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health and Community Medicine;
  • Smith E, Burke D, Graf E. 1975 Cabin noise in light aircraft. Proceedings of 1975 IEEE Southeastern Region 3 Conference on Electricity and Expanding Technology. Charlotte, NC: IEEE
  • Smith PA, Davis A, Ferguson M, Lutman ME. 2000; The prevalence and type of social noise exposure in young adults in England. Noise Health 2 (06) 41-56
  • Stamper GC, Johnson TA. 2015; Auditory function in normal-hearing, noise-exposed human ears. Ear Hear 36 (02) 172-184
  • Stephenson M. 1995 Noise exposure characterization via task-based analysis. Proceedings of Hearing Conservation Conference III/XX. Cincinnati, OH: March 22–25, 1995
  • Stewart M, Meinke DK, Snyders JK, Howerton K. 2014; Shooting habits of youth recreational firearm users. Int J Audiol 53 (02) (Suppl) S26-S34
  • Susi P, Goldberg M, Barnes P, Stafford E. 2000; The use of a task-based exposure assessment model (T-BEAM) for assessment of metal fume exposures during welding and thermal cutting. Appl Occup Environ Hyg 15 (01) 26-38
  • Suter A. 2000. Standards and regulations. In: Berger EH, Royster LH, Royster JD, Driscoll DP, Layne M. The Noise Manual. 5th ed. Fairfax, VA: American Industrial Hygiene Association Press; 639-668
  • Swets JA. 1988; Measuring the accuracy of diagnostic systems. Science 240 (4857) 1285-1293
  • Swets JA, Pickett RM. 1982. Evaluation of Diagnostic Systems: Methods from Signal Detection. New York, NY: Academic Press;
  • Thompson E, Berger EH, Hipskind N. 2003 Reporting 24-hour Leqs arising from the non-occupational noise exposed population in the 21st century. Poster presented at the 28th Annual Conference of the National Hearing Conservation Association, Dallas, TX, February 21, 2003
  • Tobias JV. 1969; Cockpit noise intensity: fifteen single-engine light aircraft. Aerosp Med 40 (09) 963-966
  • U.S. Office of Noise Abatement and Control 1978. Protective Noise Levels: Condensed Version of EPA Levels Document. Springfield, VA: Environmental Protection Agency;
  • Ward WD, Royster JD, Royster LH. 2000. Auditory and non-auditory effects of noise. In: Berger EH, Royster LH, Royster JD, Driscoll DP, Layne M. The Noise Manual. 5th ed. Fairfax, VA: American Industrial Hygiene Association Press; 123-148
  • Williams W. 2005; Noise exposure levels from personal stereo use. Int J Audiol 44 (04) 231-236
  • Worthington DA, Siegel JH, Wilber LA, Faber BM, Dunckley KT, Garstecki DC, Dhar S. 2009; Comparing two methods to measure preferred listening levels of personal listening devices. J Acoust Soc Am 125 (06) 3733-3741
  • Yassi A, Pollock N, Tran N, Cheang M. 1993; Risks to hearing from a rock concert. Can Fam Physician 39: 1045-1050
  • Zheng D, Cai X, Song H, Chen T. 1996; Study on personal noise exposure in China. Appl Acoust 48: 59-70