HEAR on the Farm
- Need: To increase use of hearing protection among farmers and farmworkers.
- Intervention: Researchers mailed an assortment of hearing protection devices to farmers and provided web-based information (interactive or static) about hearing conservation to see which method or combination of methods was most effective.
- Results: All participants increased their use of hearing protection. The largest increase occurred among those who received a sampler of hearing protection devices in the mail.
farmworkers are exposed to loud noises, such as from
equipment and livestock, which can lead to hearing loss
and tinnitus, along with a variety of health problems,
including cardiovascular disease, high blood pressure,
weight gain, and elevated blood sugar. To protect this
population's health, researchers at the University of
Michigan conducted a nationwide study to see if mailing
hearing protection devices to farmers, providing access
to web-based information about hearing, or offering some
combination of the two led to increased use of hearing
This study was funded by the National Institute on
Deafness and Other Communication Disorders (NIDCD),
and hearing protection devices (HPDs) were donated by a
In a randomized controlled trial, 491 farm operators were
randomly placed into one of five groups to receive:
- HPDs, including earmuffs and ear plugs, through the
- Static web-based information (like an online
brochure) about hearing protection
- HPDs through the mail plus static web-based
information about hearing protection
- HPDs through the mail plus interactive web-based
information (like educational games)
- Interactive web-based
Researchers did not restrict enrollment by state, but the
farm operators came from the following states:
- North Carolina
- North Dakota
While all participants showed an increased use of hearing
protection after 6 and 12 months, the participants who
received HPDs (with or without the web-based information)
showed the largest increase in use.
HPD use was also higher among those who received HPDs and
interactive web-based information, compared to those who
received HPDs and static web-based information.
At baseline, the average use of HPDs was 29.5% of the
time when exposed to loud noise. At 6 months, this
percentage grew to 48.7% of the time. At 12 months, this
percentage grew to 49.3% of the time.
For more information about this study:
McCullagh, M.C., Banerjee, T., Cohen, M.A., & Yang, J.J.
of Interventions on Use of Hearing Protectors among Farm
Operators: A Randomized Controlled Trial.
International Journal of Audiology, 55(0),
Keeping study participants engaged over the year-long
study was challenging. However, farmers who participated
were highly responsive to requests by the research team
for continued participation. In fact, the retention of
farmers in the study far exceeded expectations, with 92%
of enrollees completing the 12-month study.
Researchers used farm organizations like the American
Farm Bureau to recruit study participants. They reported
that these partnerships helped them retain participants
over the course of the study. Many state Farm Bureau
affiliates helped participant retention by featuring the
study in their organization's newsletters and other
Researchers reported that HPD use increased at a slower
rate at 12 months than at six months and suggested other
programs might want to resupply HPDs every few months to
encourage continued use.
Marjorie C. McCullagh, PhD, RN, Professor
University of Michigan School of Nursing
Agricultural health and safety
Farmers and farmworkers
November 12, 2019
Date updated or reviewed
November 14, 2022
Suggested citation: Rural Health Information Hub,
HEAR on the Farm [online]. Rural Health Information Hub. Available at:
[Accessed 28 November 2022]
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programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
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in mind that changes to the program design may impact results.