quality of life as a person ages, while age-related hearing loss may create workplace safety issues. Some ideas for expanding hearing conservation towards a Total Hearing Health approach include: Encouraging workers to get to know their noise exposures both on- and off-the-job Making hearing protectors available for off-the-job noise exposures Counseling workers about hearing risks among their family members Companies that have implemented this concept at their worksites have successfully increased employee engagement in hearing loss prevention and reduced noise levels. Browse through the winners of the Safe-In-Sound awards to read more about success stories at workplaces such as Domtar in Kinsgsport Mill, TN, 3M in Hutchinson, MN, and Northrop Grumman in Linthicum, MD. Hearing conservation for workers with hearing-impairment Overview There are currently no standards or regulations for workers that already have a hearing loss. OSHA provides recommendations only for addressing the needs of these employees who are exposed to high noise levels. Communication and the use of hearing protection devices with hearing aids are some of the issues that these workers face. Hearing protection use Hearing protection is required to protect the residual hearing of workers, even if there is a diagnosis of severe to profound deafness. Specialized hearing protectors are available: passive hearing protectors that supply no amplification to the users active hearing protectors that contain a power supply communication headsets Appropriate hearing protection should be determined by the worker with the hearing-impairment, as well as the professional running the conservation program. Hearing aids that are turned off are not acceptable forms of hearing protection. Hearing aid use Not only do hearing aids amplify helpful sounds, but they also amplify the background noise of the environment the worker is in. These employees may want to continue to wear their amplification because of communication needs, or localization, but amplifying the noise may exceed the OSHA 8-hour permissible exposure limit (PEL) of 90 dBA. Professionals in charge of the hearing conservation program may allow workers to wear hearing aids under earmuffs on a case-by-case basis. However, when in hazardous noise, hearing aids should not be worn. Audiometric testing Hearing aids must be removed and audiometric testing requirements must be followed (see above). Employers should consider using manual techniques to obtain thresholds instead of a microprocessor audiometer. This is dependent on the severity of the hearing loss. Hearing aids can be worn during the testing instructions, but then should be