A fire engine siren measured 115.0 dBA just outside the cab and still about 98.2 dBA inside it in a NIOSH-funded task study of U.S. fire departments (Neitzel et al., International Journal of Industrial Ergonomics 2013). More than 40% of 425 career firefighters showed hearing loss at the noise-sensitive frequencies, yet they reported wearing hearing protection only 34% of the time it was needed (Hong, Chin and Samo, JOEM 2013). In a 2023 smartwatch study, firefighters spent a median 3.97 hours per shift at or above the 85 dBA equivalent versus 0.42 hours for non-firefighter controls (Williams et al., IJERPH 2023). We aggregated data from NIOSH Health Hazard Evaluations, CDC MMWR, NIDCD, OSHA, NFPA, the Bureau of Labor Statistics and more than a dozen peer-reviewed studies in JOEM, Ear and Hearing and the International Journal of Environmental Research and Public Health. For the wider occupational picture, compare these figures with our construction worker hearing loss statistics.
TL;DR
- Sirens and air horns measured 81 to 118 dB(A) during simulated FDNY response runs (NIOSH HETA 81-459, 1985).
- Siren noise was 98.2 dBA inside an engine cab and 115.0 dBA outside it (Neitzel et al., Int J Ind Ergon 2013).
- Firefighters logged a median 3.97 hours per shift at the 85 dBA equivalent vs 0.42 hours for controls (Williams et al., IJERPH 2023).
- Calls took about 10% of a 24-hour shift but delivered about 67% of the noise dose (Neitzel et al., Int J Ind Ergon 2013).
- More than 40% of 425 career firefighters had hearing loss at 4 and 6 kHz (Hong, Chin and Samo, JOEM 2013).
- Seoul firefighters had a prevalence ratio of 5.29 for hearing loss vs an otologically screened population (Kang et al., JESEE 2015).
- 64% of firefighter ears had absent otoacoustic emissions at two or more frequencies, even though 81% of ears had normal audiograms (Snapp et al., IJERPH 2022).
- 54% of Florida firefighters reported tinnitus and 82% had never received noise-induced hearing loss information at work (Millet et al., IJERPH 2023).
- Hearing protection was worn only 34% of the time needed (Hong, Chin and Samo, JOEM 2013).
- Training noise of 95 dBA or more carried an adjusted odds ratio of 4.96 for injury or near-miss (Neitzel et al., Annals of Occupational Hygiene 2016).
- The United States had about 1,041,200 firefighters in 2020, 364,300 of them career (NFPA U.S. Fire Department Profile 2022).
1. Siren and Air-Horn Levels Inside and Outside the Cab
The cab is not a refuge. NIOSH measured 96.5 dB(A) at the chauffeur’s position and 96.0 dB(A) at the officer’s position of FDNY pumpers, which means the people who drive and command the rig sit in a sound field close to the levels found on the open backstep. Being inside the cab cut the siren level by 16.8 dB in the Neitzel measurements (115.0 minus 98.2 dBA), but what remains still sits well above the 85 dBA reference that NIOSH uses for an 8-hour day.
The spread across studies is narrow for such different eras and countries: 99 to 116 dBA in Newburgh, New York, 104 to 108 dB in a 2014 siren-signal study, 109 dBA for one minute during airport Code 3 runs. A 2018 human-factors review adds the safety angle: “long-term exposure to sirens could damage the hearing of emergency vehicle drivers,” and siren loudness “can interrupt the communication between dispatchers and emergency vehicle drivers” (Hsiao et al., Human Factors 2018).
| Metric | Value | Source |
|---|---|---|
| Sirens, air horns and engines during simulated response runs | 81 to 118 dB(A) | NIOSH HETA 81-459, FDNY, 1985 |
| Mean level, pumper chauffeur and officer positions | 96.5 and 96.0 dB(A) | NIOSH HETA 81-459, FDNY, 1985 |
| Mean level, pumper backstep | 93.7 dB(A) | NIOSH HETA 81-459, FDNY, 1985 |
| Siren and engine noise across riding positions | 99 to 116 dBA | NIOSH HETA 81-059, Newburgh FD, 1982 |
| Siren noise inside an engine cab | 98.2 dBA | Neitzel et al., Int J Ind Ergon 2013 |
| Siren noise outside an engine cab | 115.0 dBA | Neitzel et al., Int J Ind Ergon 2013 |
| A-weighted levels of emergency vehicle siren signals | 104 to 108 dB | Gorski, Int J Occup Saf Ergon 2014 |
| Airport fire station Code 3 response, 1-minute level | 109 dBA | Tubbs, Am Ind Hyg Assoc J 1991 |
Most recent available data: the in-cab measurements come from NIOSH evaluations of the 1980s and a 2008 to 2011 field study (NIOSH HETA 81-459 report; NIOSH HETA 81-059 record). We found no large-sample study of modern enclosed cabs with electronic sirens. One outlier: an Iranian study measured siren peaks of 82.71 dB(A) at the ear, far lower than U.S. figures, with a different station and measurement setup (Yazdanirad et al., Scientific Reports 2024).
2. Daily Noise Doses: Short Bursts, Large Share of the Dose
Firefighter noise is spiky, not steady. In 24-hour dosimetry, call time made up about 10% of the shift but about 67% of the noise dose, and every valid 24-hour measurement exceeded the 24-hour equivalent of the NIOSH limit. That is why older 8-hour averages looked reassuring while audiograms did not: the average hides the minutes that do the damage.
Wearable data tells the same story at scale. Firefighters wearing Apple Watches spent about 9.5 times as many hours at the 85 dBA equivalent as non-firefighter controls (3.97 divided by 0.42) (Williams et al., IJERPH 2023). For how these dose metrics are actually measured, see our sound level meter and occupational noise monitoring statistics.
| Metric | Value | Source |
|---|---|---|
| Mean 24-hour Leq, urban California crews (4 valid samples) | 84.5 dBA vs 24-hour REL of 80.25 dBA | Neitzel et al., Int J Ind Ergon 2013 |
| Share of 24-hour noise dose delivered during calls | About 67% (in about 10% of shift time) | Neitzel et al., Int J Ind Ergon 2013 |
| Estimated 8-hour average, firefighters vs controls (median) | 81.97 vs 72.23 dBA | Williams et al., IJERPH 2023 |
| Time at the 85 dBA equivalent per 24 hours (median) | 3.97 h vs 0.42 h for controls | Williams et al., IJERPH 2023 |
| Shifts in the hazardous range (above 85 dBA) | 10.81% vs 2.08% for controls | Williams et al., IJERPH 2023 |
| Mean full-shift Leq, British Columbia firefighters (113 samples) | 81.1 dBA; 45% of samples exceeded limits | Kirkham et al., Ann Occup Hyg 2011 |
| Mean peak noise, British Columbia firefighters | 137.1 dB | Kirkham et al., Ann Occup Hyg 2011 |
| Emergency vehicle-related equipment types at or above 85 dBA | 13 of 15 | Root et al., J Occup Environ Hyg 2013 |
Context note: older 8-hour time-weighted averages were lower, 62.8 to 85.3 dBA in Newburgh (NIOSH HETA 81-059, 1982) and 60 to 82 dBA at airport stations (Tubbs, Am Ind Hyg Assoc J 1991). Wildland crews show what happens when tools dominate: 85 of 174 full-shift measurements exceeded the NIOSH daily dose and 18% of firefighters reached a 100% dose in under 30 minutes (Broyles et al., Journal of the Acoustical Society of America 2017).
3. Hearing Loss Prevalence: Firefighters vs the General Population
The prevalence figure depends heavily on the cutoff. More than 40% of career firefighters showed loss at 4 and 6 kHz in a three-state U.S. sample (Hong, Chin and Samo, JOEM 2013), while a Florida study using a 25 dB threshold found nearly 30% with at least mild loss, and noted that a 20 dB criterion would have raised detection from 29% to 80% (Millet et al., IJERPH 2023).
The comparison group matters just as much. Against otologically screened Korean men, firefighters had an age-adjusted prevalence ratio of 5.29; against unscreened men, there was no difference (Kang et al., JESEE 2015). The question is no longer whether firefighters lose hearing, it is how much of that loss is occupational and how much is ordinary life noise and aging.
| Metric | Value | Source |
|---|---|---|
| Career firefighters with loss at 4 and 6 kHz (n = 425) | More than 40% | Hong, Chin and Samo, JOEM 2013 |
| Florida firefighters with high-frequency loss, worst ear (n = 214) | 22.9% | Millet et al., IJERPH 2023 |
| Seoul firefighters with PTA1234 of 25 dB or more vs screened population | 16.3% vs 3.4% | Kang et al., JESEE 2015 |
| Age-adjusted prevalence ratio vs screened population | PR 5.29 (95% CI 3.34 to 8.39; P<0.001) | Kang et al., JESEE 2015 |
| Excess loss at 4000 Hz vs ISO databases, 90th percentile | 41 to 45 dB | Kales et al., JOEM 2001 |
| U.S. adults aged 20 to 69 with hearing loss (2011 to 2012) | 14% | NIDCD Quick Statistics, citing Hoffman et al. 2016 |
| Noise-exposed workers with hearing impairment: public safety vs all sectors | 7.32% vs 12.94% | CDC MMWR, Masterson et al. 2016 |
| Audiograms from two urban departments showing no excess loss beyond aging | 12,609 tests | Clark and Bohl, Ear and Hearing 2005 |
Outlier note: the CDC sector figure (MMWR 2016) pools police, corrections and ambulance services with fire protection, so it does not isolate firefighters. The general population benchmark comes from NIDCD Quick Statistics, which also reports 18% bilateral speech-frequency loss among adults with five or more years of very loud occupational noise vs 5.5% with none. Most recent available data for the ISO comparison and the department audiogram analysis: Kales 2001 and Clark and Bohl 2005.
4. Career Trajectory, Tinnitus and Hidden Damage
Loss starts early and grows with service. A cohort of 118 wholetime firefighters had 8% of right ears and 13% of left ears in warning or referral categories at follow-up, versus 1% at enlistment, after a mean of only 4.1 years between exams (Ide, Occupational Medicine 2011). The left ear fares worse in U.S. data too: Hong, Chin and Samo found significantly poorer hearing in the left ear than the right, and longer careers were significantly associated with worse hearing.
Standard audiograms also miss early damage. Most South Florida firefighter ears tested normal, yet nearly two in three ears had absent otoacoustic emissions in the 5 to 10 kHz range (Snapp et al., IJERPH 2022). That gap between a clean audiogram and a damaged cochlea is the same pattern described in our hidden hearing loss statistics.
| Metric | Value | Source |
|---|---|---|
| Ears in warning or referral categories at follow-up vs enlistment | 8% right, 13% left vs 1% | Ide, Occupational Medicine 2011 |
| Rate of hearing loss over time vs age-matched non-exposed men | 150% of expected | Pepe et al., Annals of Emergency Medicine 1985 |
| Hearing loss prevalence, rescuers vs drivers (Seoul) | 25.8% vs 13.8% | Kang et al., JESEE 2015 |
| Firefighter ears with normal standard audiograms | 81% (273/336) | Snapp et al., IJERPH 2022 |
| Firefighter ears with absent DPOAEs at two or more frequencies | 64% (217/340) | Snapp et al., IJERPH 2022 |
| Florida firefighters reporting ringing or buzzing (tinnitus) | 54% | Millet et al., IJERPH 2023 |
| Tinnitus after a work incident, firefighters vs controls | 26.7% vs 4% | Williams et al., IJERPH 2023 |
| WTC-exposed FDNY firefighters and EMS workers with abnormal hearing in either ear by 2016 | 37% (3,194) | Flamme et al., JOEM 2019 |
Context note: in the World Trade Center cohort, arrival on the morning of September 11, 2001 was associated with an odds ratio of 1.16 (95% CI 1.02 to 1.31) for high-frequency loss, and group differences persisted for at least 15 years (Flamme et al., JOEM 2019). Most recent available data for the longitudinal trajectories: Ide 2011 and Pepe 1985.
5. EMS and Ambulance Crews: A Different Exposure Profile
EMS noise data is thinner and far more variable than fire apparatus data. Ambulance cab noise during siren use averaged 102.5 dBA in a 1980 U.S. study, above the 90 dBA OSHA limit, while a 1998 U.S. study measured only 58 to 84 dBA across ambulance positions and found no significant hearing shift over time (Johnson et al., Annals of Emergency Medicine 1980; Price and Goldsmith, Prehospital Emergency Care 1998).
Modern Danish data shows the daily dose can stay below the action value even with routine siren use: single responses exceeded 80 dB(A), but daily averages did not (Hansen et al., Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017). The risk shifts from the daily dose to peaks and to helicopter crews.
| Metric | Value | Source |
|---|---|---|
| Ambulance cab noise during siren use (mean) | 102.5 dBA | Johnson et al., Annals of Emergency Medicine 1980 |
| Ambulance noise range, stationary rear to forward cab with siren | 58 to 84 dBA | Price and Goldsmith, Prehospital Emergency Care 1998 |
| Average level in physician response cars (urban, rural, motorway) | 72, 75 and 77 dB(A) | Hansen et al., SJTREM 2017 |
| Daily Leq8h, physician response cars | 71 dB(A), below the 80 dB(A) threshold | Hansen et al., SJTREM 2017 |
| Daily siren exposure, response car plus ambulance escort | 31.3 min plus 10.9 min | Hansen et al., SJTREM 2017 |
| Maximum peak level, helicopter EMS crew | Up to 128 dB(C) | Hansen et al., SJTREM 2017 |
| Hearing loss prevalence, Seoul fire service paramedics | 13.9% | Kang et al., JESEE 2015 |
| Correlation of threshold shift with elapsed time, EMTs and paramedics | -0.2692, not significant | Price and Goldsmith, Prehospital Emergency Care 1998 |
Most recent available data: the U.S. ambulance in-cab siren levels date from 1980 and 1998, and no recent U.S. dosimetry study of ambulance crews was found. The Danish data (collected March to August 2016) covered physicians, not paramedics driving full shifts.
6. Hearing Protection, Cab Communication and On-Scene Safety
Protection exists, but it stays in the pocket. Florida firefighters were asked how often they wear hearing protection at work, and 65% answered never to rarely (Millet et al., IJERPH 2023). The barrier is functional: crews need to hear radios, the officer and the fire. NIOSH’s FDNY evaluation recommended radio-connected earmuffs with individual volume controls, preferred earmuffs over earplugs, and called for moving warning devices away from riding positions (NIOSH HETA 81-459, 1985).
The cost of skipping protection is not only auditory. In training, noise of 95 dBA or more was linked to five times the odds of injury or near-miss (Neitzel et al., Annals of Occupational Hygiene 2016), and gear can make listening harder too: thicker particulate-blocking hoods reduced hearing ability in a 24-firefighter lab study (Kesler et al., Ergonomics 2024).
| Metric | Value | Source |
|---|---|---|
| Hearing protection worn, as share of time needed | 34% | Hong, Chin and Samo, JOEM 2013 |
| Firefighters who never or rarely wear protection at work | 65% | Millet et al., IJERPH 2023 |
| Firefighters reporting protection use during shifts | 2 of 16 | Williams et al., IJERPH 2023 |
| Training days with reported protection use / minutes above 85 dBA with protection | 28.5% / 27% | Neitzel et al., Ann Occup Hyg 2016 |
| Wildland firefighters using some protection vs trained on it | About 65% vs 19% | Broyles et al., J Occup Environ Hyg 2019 |
| Regular protection use before vs after an educational intervention | 20% vs 85% | Ewigman et al., Public Health Reports 1990 |
| Adjusted odds of injury or near-miss at 95 dBA or more vs under 90 dBA | OR 4.96 (95% CI 1.53 to 16.1) | Neitzel et al., Ann Occup Hyg 2016 |
| Fire brigade ill-health retirements due to audiological problems | 135 of 3,366 (4%) | Ide, Occupational Medicine 2007 |
Context note: only 41 of 31,274 reported fire brigade accidents or near misses (0.13%) were believed to stem from hearing problems (Ide, Occupational Medicine 2007), so the safety signal is clearer for acute noise than for chronic hearing loss. Most recent available data for the intervention effect: Ewigman 1990.
7. Standards, Limits and the Workforce They Cover
Two federal yardsticks apply, and they diverge sharply at siren levels. OSHA’s limit is 90 dBA for 8 hours with a 5 dBA exchange rate, while NIOSH recommends 85 dBA with a 3 dBA exchange rate (OSHA Occupational Noise Exposure). Under the NIOSH rule, each 3 dB increase halves the allowable time, which is why a few minutes of siren at 110 dBA or more matter so much.
NFPA has reorganized its responder health standards. The medical program standard NFPA 1582 now lives inside the consolidated NFPA 1580, and NFPA 1500 has moved into NFPA 1550, so departments citing the old numbers in hiring and annual-exam policies are pointing to stand-alone documents whose content has moved. The specific audiometric criteria are in the paid standard text, which we could not verify directly.
| Metric | Value | Source |
|---|---|---|
| OSHA permissible exposure limit and exchange rate | 90 dBA 8-hour TWA, 5 dBA exchange | OSHA Occupational Noise Exposure page |
| OSHA hearing conservation program trigger (general industry) | 85 dBA 8-hour TWA | OSHA Occupational Noise Exposure page |
| NIOSH recommended limit and exchange rate | 85 dBA for 8 hours, 3 dBA exchange | OSHA page, citing NIOSH |
| NFPA 1582 last stand-alone edition, now consolidated | 2022; content moved into NFPA 1580 | NFPA 1582 standard development page |
| NFPA 1580 current edition (combines 1581, 1582, 1583, 1584) | 2025 | NFPA 1580 standard development page |
| NFPA 1500 last stand-alone edition, now consolidated | 2021; content moved into NFPA 1550 | NFPA 1500 standard development page |
| U.S. firefighters (career and volunteer), 2020 | About 1,041,200 (364,300 career, 676,900 volunteer) | NFPA U.S. Fire Department Profile 2022 |
| U.S. firefighter jobs, 2025 | About 355,300 | BLS Occupational Outlook Handbook |
Context note: as summarized by Fire Engineering (2022), NFPA 1582 calls for a hearing evaluation for every candidate and annually thereafter, and NFPA 1500 calls for a hearing conservation program in every department. Workforce figures come from the NFPA U.S. Fire Department Profile and the BLS Occupational Outlook Handbook. Military noise exposure produces a parallel compensation story, covered in our veterans hearing loss and tinnitus statistics.
Summary: Firefighter and EMS Siren Noise by the Numbers
| Metric | Value | Source |
|---|---|---|
| Sirens, air horns and engines, FDNY simulated runs | 81 to 118 dB(A) | NIOSH HETA 81-459, 1985 |
| Pumper chauffeur position, mean | 96.5 dB(A) | NIOSH HETA 81-459, 1985 |
| Siren inside vs outside the engine cab | 98.2 vs 115.0 dBA | Neitzel et al., Int J Ind Ergon 2013 |
| Time at the 85 dBA equivalent, firefighters vs controls | 3.97 h vs 0.42 h | Williams et al., IJERPH 2023 |
| British Columbia samples exceeding limits | 45% | Kirkham et al., Ann Occup Hyg 2011 |
| Career firefighters with 4 and 6 kHz loss | More than 40% | Hong, Chin and Samo, JOEM 2013 |
| Florida firefighters with high-frequency loss | 22.9% | Millet et al., IJERPH 2023 |
| Prevalence ratio vs screened population | 5.29 | Kang et al., JESEE 2015 |
| Excess loss at 4000 Hz, 90th percentile vs ISO | 41 to 45 dB | Kales et al., JOEM 2001 |
| U.S. adults 20 to 69 with hearing loss | 14% | NIDCD Quick Statistics |
| Ears with absent DPOAEs despite mostly normal audiograms | 64% | Snapp et al., IJERPH 2022 |
| WTC-exposed responders with abnormal hearing by 2016 | 37% | Flamme et al., JOEM 2019 |
| Ambulance cab noise with siren (mean) | 102.5 dBA | Johnson et al., Annals of Emergency Medicine 1980 |
| Hearing protection worn vs time needed | 34% | Hong, Chin and Samo, JOEM 2013 |
| Injury or near-miss odds at 95 dBA or more | OR 4.96 | Neitzel et al., Ann Occup Hyg 2016 |
| OSHA PEL vs NIOSH recommended limit | 90 dBA vs 85 dBA | OSHA Occupational Noise Exposure page |
| U.S. firefighters, 2020 | About 1,041,200 | NFPA U.S. Fire Department Profile 2022 |
Methodology and Sources
- NIOSH Health Hazard Evaluation HETA 81-459-1603, City of New York Fire Department (1985)
- NIOSH Health Hazard Evaluation HETA 81-059-1045, Newburgh Fire Department (1982)
- Neitzel, Hong, Quinlan and Hulea, Pilot task-based assessment of noise levels among firefighters, International Journal of Industrial Ergonomics 2013
- Williams et al., Monitoring Occupational Noise Exposure in Firefighters Using the Apple Watch, IJERPH 2023
- Hong, Chin and Samo, Hearing Loss and Use of Hearing Protection Among Career Firefighters in the United States, JOEM 2013
- Millet et al., Prevalence of Hearing Loss and Perceptions of Hearing Health and Protection among Florida Firefighters, IJERPH 2023
- Kang et al., Hearing among male firefighters, Journal of Exposure Science and Environmental Epidemiology 2015
- Snapp et al., Subclinical Hearing Deficits in Noise-Exposed Firefighters, IJERPH 2022
- Hansen et al., Noise exposure during prehospital emergency physicians work, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017
- Neitzel et al., Injury Risk and Noise Exposure in Firefighter Training Operations, Annals of Occupational Hygiene 2016
- Broyles, Butler and Kardous, Noise exposure among federal wildland fire fighters, Journal of the Acoustical Society of America 2017
- Yazdanirad et al., Siren noise exposure, cognitive function and mental health among firefighters, Scientific Reports 2024
- Hsiao, Chang and Simeonov, Preventing Emergency Vehicle Crashes, Human Factors 2018
- CDC MMWR, Hearing Impairment Among Noise-Exposed Workers, United States 2003 to 2012 (Masterson et al. 2016)
- NIDCD Quick Statistics About Hearing
- OSHA Occupational Noise Exposure
- NFPA 1580 standard development page, plus the NFPA 1582 and NFPA 1500 standard development pages on nfpa.org
- NFPA U.S. Fire Department Profile (2022, data year 2020)
- BLS Occupational Outlook Handbook, Firefighters
- Fire Engineering, Hearing Health in the Fire Service (2022), used only for its summary of NFPA 1582 and NFPA 1500 provisions
- Abstract-level sources (PubMed/Europe PMC records): Kales et al., JOEM 2001; Clark and Bohl, Ear and Hearing 2005; Flamme et al., JOEM 2019; Ide, Occupational Medicine 2007 and 2011; Pepe et al., Annals of Emergency Medicine 1985; Johnson et al., Annals of Emergency Medicine 1980; Price and Goldsmith, Prehospital Emergency Care 1998; Gorski, International Journal of Occupational Safety and Ergonomics 2014; Kirkham et al., Annals of Occupational Hygiene 2011; Root et al., Journal of Occupational and Environmental Hygiene 2013; Tubbs, American Industrial Hygiene Association Journal 1991; Broyles et al., Journal of Occupational and Environmental Hygiene 2019; Ewigman et al., Public Health Reports 1990; Kesler et al., Ergonomics 2024
- Data watch: prevalence estimates conflict for real reasons. Hong, Chin and Samo (more than 40%) and Millet (nearly 30%, 22.9% high-frequency) use different cutoffs and samples, and Millet notes that a 20 dB criterion would move detection from 29% to 80%. Kang 2015 finds excess loss against screened controls but none against unscreened controls, and Clark and Bohl 2005 found no excess loss beyond aging in 12,609 department audiograms, while Kales 2001 found large excess loss at 3 to 4 kHz. The CDC MMWR public safety figure (7.32%) mixes police, corrections and ambulance services with fire protection. Williams 2023 has a small sample (15 enrolled firefighters, with shift counts that differ between tables). Most in-cab siren measurements predate 2012, and U.S. ambulance siren data dates from 1980 and 1998. NFPA’s exact audiometric thresholds for candidates and incumbents sit in the paid NFPA 1580 text and are not reproduced here. A 2026 JOEH study of 14 firehouses (Blando et al.) reported only qualitative findings in its abstract, so its numbers are not included.
Last updated: October 18, 2026. We update this roundup quarterly, and the next refresh is expected when NFPA publishes its next U.S. Fire Department Profile and the next edition of NFPA 1580 enters its revision cycle.