BACKGROUND: The purpose of this cross-sectional study is to estimate the prevalence of hearing loss among noise-exposed U.S. workers during 2010-2019 within the Construction sector. METHODS: Audiograms for 26,653 workers at 833 Construction companies (and for 1.3 million other workers) were examined. Period prevalence and adjusted risk for hearing loss as compared with a reference industry (Couriers and Messengers) were estimated for the Construction sector and sub-sectors, and all industries combined. RESULTS: The prevalence of hearing loss within the Construction sector was 23% compared to 20% for all industries combined. Several sub-sectors exceeded the overall prevalence and all but two had adjusted risks significantly higher than the reference industry. The sub-sectors with the highest prevalences for hearing loss were: Highway, Street, and Bridge Construction (28%), Site Preparation Contractors (26%), New Single-Family Housing Construction (except Operative Builders) (25%), Oil and Gas Pipeline and Related Structures Construction (25%), and Other Building Finishing Contractors (25%). The sub-sectors with the highest adjusted risks were Industrial Building Construction
Other Heavy and Civil Engineering Construction
Oil and Gas Pipeline and Related Structures Construction
Finish Carpentry Contractors
and Site Preparation Contractors
with risks 62%, 61%, 60%, 59% and 58% higher than the reference industry, respectively. CONCLUSIONS: Hearing loss continues to be a significant issue within Construction. Reducing noise exposure is critical, including buying quieter equipment, keeping moving parts oiled and well-maintained, enclosing noise sources, and employing administrative controls to reduce the number of workers in noisy areas. Barriers to workers consistently and correctly wearing their hearing protection also need to be addressed. PRACTICAL APPLICATIONS: Within Construction, hazardous noise is common and the risk of hearing loss is high. This study identified the Construction sub-sectors with the highest prevalences and risks to guide interventions toward workers most in need of prevention and described strategies for reducing exposures.