Dominique Stone, lead audiologist at The Hearing Clinic UK, explains why hearing protection in construction cannot be overlooked
CONSTRUCTION can create an incredibly noisy working environment, and despite significant improvements in regulation and awareness, noise-induced hearing loss remains one of the most common occupational health conditions I encounter in clinical practice. It is also one of the most preventable.
As an audiologist, I regularly see patients who have spent their careers in construction and related industries. Many only seek help later in life, once hearing loss has begun to affect their day-to-day communication and quality of life. Unfortunately, by that stage, the damage is permanent, and the focus shifts from prevention to management.
Construction sites expose workers to sustained and often intense noise. Equipment such as jackhammers, concrete breakers, saws and heavy machinery routinely exceed safe listening levels.
From a clinical perspective, hearing is placed at risk once noise exposure reaches 85 decibels (dB). To put this into context, a jackhammer can reach between 100 and 120dB, while heavy machinery commonly operates between 90 and 105dB. As noise levels increase, the length of time the ear can tolerate exposure without damage reduces sharply, in some cases to only a few minutes.
This is why legislation in Scotland is so clear. Under the Control of Noise at Work Regulations 2005, employers are required to assess noise risks, provide appropriate hearing protection and carry out health surveillance where necessary. At 85dB, suitable hearing protection must be provided. The legal exposure limit is 87dB, which applies after the effect of hearing protection is taken into account, meaning exposure must not exceed this level once PPE is applied. These requirements are not arbitrary. Once hearing is damaged, it cannot be restored.
One of the challenges with noise-induced hearing loss is that it develops gradually. Early changes often go unnoticed or are dismissed. A common early sign is tinnitus, or ringing in the ears, particularly following noise exposure. While this may initially be temporary, repeated exposure prevents recovery, and permanent hearing loss can develop over time.
In clinic, we see very specific patterns on hearing tests that indicate noise damage, particularly affecting the frequencies required to understand speech. Many of the construction workers I assess are already retired. The effects of noise exposure may only become obvious years later, long after the opportunity for prevention has passed.
Excessive noise affects more than hearing alone. Prolonged exposure is associated with activation of the body’s stress response, including increased heart rate and strain on the nervous system. Over time, this has been linked to an increased risk of wider health impacts.
There are also important safety considerations. Construction workers rely heavily on sound to maintain awareness of their surroundings, including approaching vehicles, machinery and warning signals. Untreated hearing loss, especially when one ear is affected more than the other, reduces the ability to judge sound direction. In busy, high-risk environments, this loss of awareness can increase the likelihood of accidents.
In everyday terms, early hearing damage often presents as difficulty following conversations in noisy or group settings. People may miss parts of speech, particularly softer sounds, without realising why. Over time, this can lead to frustration and withdrawal from conversations and social situations. Identifying these changes early is crucial.
Hearing protection is therefore essential, but its effectiveness depends on fit and consistent use. Foam earplugs are widely used on construction sites and can offer protection, but their performance varies significantly. Poor fit, discomfort and inconsistent use all reduce their effectiveness.
From a clinical perspective, and based on my experience in practice, custom-moulded earplugs offer one of the most reliable solutions for hearing protection in construction environments. Made specifically for the individual, they provide a secure and comfortable fit, which can improve both protection and compliance. Many include acoustic filters that reduce harmful noise while allowing important sounds, such as speech and warning signals, to remain audible. In particularly noisy environments, combining moulded earplugs with over-ear defenders can offer additional protection without compromising safety.
Regular hearing assessments also play a vital role. Establishing a baseline hearing test, followed by ongoing monitoring, allows changes to be identified early. Symptoms such as persistent tinnitus, difficulty hearing in noise or a difference between ears should always be assessed promptly.
At The Hearing Clinic UK, we support individuals at every stage, from preventative hearing protection to the assessment and management of established hearing loss. This includes professional hearing tests conducted in soundproof conditions, custom-moulded hearing protection and tailored long-term care.
Protecting hearing is not simply a regulatory requirement. It is a matter of long-term health, safety and quality of life, both during a working career and well beyond it. Hearing loss may be permanent, but in the vast majority of cases, it is preventable when the right steps are taken early.
