Noise-Induced Hearing Loss in Textile Workers: Hearing Protection Effectiveness, and Determinants of Moderate-Severe Loss

Noise-induced hearing loss (NIHL) is among the most consequential preventable occupational diseases globally, with substantial burden in textile industries where high-intensity continuous noise exposure (typically 95-110 dBA) intersects with limited regulatory enforcement of hearing conservation programmes. South Asian textile manufacturing employs approximately 45 million workers with substantial NIHL burden. We conducted a cross-sectional audit of 412 textile workers across six mill sites with structured noise exposure measurement and audiometric evaluation. Hearing loss severity distribution was substantial: 32.0% mild (26-40 dB), 24.8% moderate (41-55 dB), 14.1% moderately severe (56-70 dB), and 7.8% severe or worse only 21.4% had normal hearing. Cumulative noise exposure was strongly correlated with high-frequency hearing threshold (r = 0.68). Strongest predictors of moderate or worse NIHL included high cumulative noise exposure, loom-floor operator role, long exposure duration, inadequate hearing protection, elderly age, concurrent ototoxic medications, smoking, and diabetes. Consistent hearing protection use and engineering noise controls were strongly protective. The findings support continued investment in hearing conservation programmes, engineering noise reduction, personal protective equipment availability, and structured medical surveillance.