for how workers typically wear protection relative to how manufacturers test the protector's attenuation in the laboratory. For all types of hearing protection, OSHA's derating factor is 50%. If used with C-weighted noise, the derated NRR will become NRR/2. If used with A-weighted noise, OSHA applies the 7-dB adjustment for C-A weighting first then derates the remainder. For example, a protector with 33-dB attenuation would have this derating: Derated NRR = (33 – 7)/2 NIOSH has proposed a different method for derating based upon the type of protector. For earmuffs, the NRR should be derated by 25%, for slow-recovery foam earplugs the derating is 50% for all other protection, the derating is 70%. NIOSH applies the C-A spectral compensation differently than OSHA. Where OSHA subtracts the 7-dB factor first and derates the result, NIOSH derates the NRR first and then compensates for the C-A difference. For example, to find the derated NRR for an earmuff by using the NIOSH derating system, the following equation would be used: Derated NRR = (Original NRR x (1-.25)) – 7 Painful discomfort occurs at approximately 120 to 125 dB(A), with some references claiming 133 dB(A) for the threshold of pain. Active ear muffs are available with electronic noise cancellation that can reduce direct path ear canal noise by approximately 17–33 dB, depending on the low, medium, or high frequency at which attenuation is measured. Passive earplugs vary in their measured attenuation, ranging from 20 dB to 30 dB, depending on whether they are properly used, and if low pass mechanical filters are also being used. In practice Using both ear muffs (whether passive or active) and earplugs simultaneously results in maximum protection, but the efficacy of such combined protection relative to preventing permanent ear damage is inconclusive, with evidence indicating that a combined noise reduction ratio (NRR) of only 36 dB (C-weighted) is the maximum possible using ear muffs and earplugs simultaneously, equating to only a 36 - 7 = 29 dB(A) protection. Some high-end, passive, custom-molded earplugs also have a mechanical filter inserted into the center of the earmolded plug, with a small opening facing to the outside; this design permits being able to hear range commands at a gun range, for example, while still having full rating impulse noise protection. Such custom molded earplugs with low pass filter and mechanical valve typically have a +85 dB(A) mechanical clamp, in addition to having