AbstractBackgroundTo estimate the prevalence of workplace noise exposure and use of hearing protection devices (HPDs) at noisy work, NIOSH analyzed 1999–2004 data from the National Health and Nutrition Examination Survey (NHANES).MethodsA total of 9,275 currently employed workers aged ≥16 years were included in the weighted analysis. Hazardous workplace noise exposure was defined as self‐reported exposure to noise at their current job that was so loud that the respondent had to speak in a raised voice to be heard. Industry and occupation were determined based on the respondent's current place and type of work.ResultsTwenty‐two million US workers (17%) reported exposure to hazardous workplace noise. The weighted prevalence of workplace noise exposure was highest for mining (76%, SE = 7.0) followed by lumber/wood product manufacturing (55%, SE = 2.5). High‐risk occupations included repair and maintenance, motor vehicle operators, and construction trades. Overall, 34% of the estimated 22 million US workers reporting hazardous workplace exposure reported non‐use of HPDs. The proportion of noise‐exposed workers who reported non‐use of HPDs was highest for healthcare and social services (73.7%, SE = 8.1), followed by educational services (55.5%).DiscussionHearing loss prevention and intervention programs should be targeted at those industries and occupations identified to have a high prevalence of workplace noise exposure and those industries with the highest proportion of noise‐exposed workers who reported non‐use of HPDs. Am. J. Ind. Med. 52:358–371, 2009. Published 2009 Wiley‐Liss, Inc.