Effect of Powered Air-Purifying Respirators on Speech Recognition Among Health Care Workers

UMMS Affiliation

Department of Otolaryngology

Publication Date


Document Type



Equipment and Supplies | Health Communication | Health Services Administration | Infectious Disease | Otolaryngology | Virus Diseases


Powered air-purifying respirators (PAPRs) are used as personalized protective equipment for health care personnel. PAPRs offer health care workers added protection when dealing with patients who have high-risk infectious disease such as COVID-19. Unfortunately, PAPRs can produce notable levels of background noise. We hypothesize that PAPR use may be associated with increased hearing thresholds and impaired word discrimination and may ultimately have a negative impact on effective communication. Herein, we (1) determined sound levels generated by PAPRs and (2) measured hearing thresholds and word discrimination with and without operational PAPRs. All participants had normal hearing. When the PAPR was operational, mean +/- SD thresholds increased from 4.5 +/- 3.6 to 38.6 +/- 5.6 dB HL (P < .001). Word discrimination dropped from 100% in all participants in quiet to a mean 48% +/- 14% with operational PAPR (P < .001). Thus, we find that use of PAPR hoods results in hearing impairment comparable to moderate to severe hearing loss, and we suspect that users will experience communication difficulties as a result. Level of Evidence. Prospective study.


COVID-19, PAPR, PPE, noise level, hearing, speech recognition

DOI of Published Version



Kempfle JS, Panda A, Hottin M, Vinik K, Kozin ED, Ito CJ, Remenschneider AK. Effect of Powered Air-Purifying Respirators on Speech Recognition Among Health Care Workers. Otolaryngol Head Neck Surg. 2020 Jul 21:194599820945685. doi: 10.1177/0194599820945685. Epub ahead of print. PMID: 32689877. Link to article on publisher's site

Journal/Book/Conference Title

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

Related Resources

Link to Article in PubMed

PubMed ID