It is apparent and not surprising that NIHL is a very large part of the personal lives of most farmers. Therefore, annual hearing tests should begin in the rural farming communities at 10 years of age. Hearing should be monitored on an annual basis throughout a farmworker's life. It is recommended that educational programs regarding hearing loss prevention should start in elementary school and continue through the 12th grade. It is also suggested that audiologists provide hearing tests at farm shows and other public agricultural events as a way of identifying individuals with existing hearing loss or those with a potential risk for NIHL.

Free earplug samples and hearing protection literature should be included in most intervention programs targeting farmers. This introduces the farm family to HPDs and allows them to use a protector the next time they are exposed to high intensity noise. It is important that the farmers be informed of local, regional or mail-order resources for purchasing additional hearing protection once the outreach effort is completed.

A large percentage of farmers have substantial NIHL hearing loss and will experience the personal and social consequences of the impairment. Consequently, it is important that any outreach effort include strategies to motivate farmers to accept their hearing loss and seek rehabilitative help, including the purchase of hearing aids. Local medical and audiological professional resources should be identified in advance of the intervention effort.

Female members of the farm family appear to have the most influence on the acquisition and utilization of health services for their spouses and children. Therefore, hearing loss prevention and hearing rehabilitation education should directly involve the woman in the farm family. She may be in the best position to encourage family members to practice better health protective behaviors, such as the regular and proper use of hearing protectors. Encouragement and praise appear to be needed to reinforce healthful behaviors (27).

Ultimately, each of us has a potential role to play in the effort to identify hazardous agricultural sound, decrease individual noise exposures, and minimize the long-term personal, social, and financial impact of hearing-impairment on farm workers. Every farmer, regardless of age, deserves the opportunity to appreciate the rural farm soundscape, filled with early morning bird songs, wheat beards brushing in an afternoon breeze, and cricket chirps signaling the end of a long day in the field.

Acknowledgment. Portions of this chapter were published in Advance for Audiologists 4(5): 34-37 and are reprinted here with permission of Merion Publications Inc.

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