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Rural Health Information Hub

Tomah Hearing Loss Prevention Outreach

  • Need: Farmers are highly susceptible to permanent hearing loss due to prolonged exposure to loud machinery and livestock.
  • Intervention: Faculty and students from the audiology department at the University of Wisconsin-Madison supplied earplugs, free hearing testing, and hearing loss prevention education to attendees and participants at an annual tractor pull event.
  • Results: Between 2014 and 2019, the audiology team distributed more than 16,000 pairs of earplugs; attendees were receptive to the hearing loss prevention education provided by the team.


Promising (About evidence-level criteria)


Faculty and graduate students from the University of Wisconsin-Madison Department of Communication Sciences and Disorders developed an initiative to reach out to rural farmers and tractor pull fans on the issue of permanent hearing loss. An audiology team attended the Tomah Tractor Pull annually from 2014 to 2019, in order to hand out hearing protection and educate the attendees and participants, particularly farmers, on the risks of prolonged, unprotected exposure to high-decibel noises coming from tractors, other loud machinery, and even livestock.

UW-Madison hearing tips booth

This outreach was supported by a mini-grant from the Baldwin Wisconsin Idea Endowment, several Wisconsin Idea grants, and the UW Speech and Hearing Clinic.

Services offered

A team of two audiology clinical professors (audiologists) and audiology graduate students talked with tractor pull attendees, participants, and workers about healthy hearing habits and distributed hearing protection at this very loud event.

The grant money allowed the team to purchase an audiometer and calibrated sound level meter, which enabled them to measure the sound levels of the trucks and tractors throughout the event. This helped raise awareness of hearing loss by showing this visual display of high-decibel activity to the attendees and educating people on what decibel levels call for ear protection.



This program accomplished two goals:

  • Gave an immediate means of hearing protection (earplugs) to people at risk for hearing loss
  • Educated attendees on ways to prevent permanent, noise-induced hearing loss

Program staff also informed the tractor pull attendees on the cumulative nature of hearing and the precautions one should take to protect hearing, even at an older age, to prevent further damage.

For more information on the audiology team's successful efforts:

Buhr-Lawler, M. (2017). A Hearing Loss Prevention Outreach Program for Farmers and Motorsports Enthusiasts. Seminars in Hearing, 38(2), 212-222.


There is an ingrained cultural attitude among tractor pull attendees that discourages the use of hearing protection in this environment. Additionally, many of the attendees experience high levels of noise exposure in their work and other recreational activities. Most farmers are not required to participate in a mandatory hearing loss prevention program, so there are many at the tractor pull who have not considered using hearing protection as an important safety factor.

Free earplugs signs


Program coordinators recommend securing grant funding or financial support and a supportive employer. It's also important to establish a community partnership with the event organizers, since their support is invaluable in guaranteeing program success, and to have energetic and willing volunteers.

Distributing earplugs
UW-Madison volunteers distribute earplugs to tractor pull attendees.

Contact Information

Melanie Buhr-Lawler, Au.D., CCC-A, Clinical Professor of Audiology
University of Wisconsin-Madison
UW Speech and Hearing Clinic

Agricultural health and safety
Farmers and farmworkers
Health screening
Hearing impairment
Wellness, health promotion, and disease prevention

States served

Date added
November 23, 2015

Date updated or reviewed
November 9, 2023

Suggested citation: Rural Health Information Hub, 2023. Tomah Hearing Loss Prevention Outreach [online]. Rural Health Information Hub. Available at: [Accessed 20 April 2024]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.