Objective: To evaluate the effectiveness of a Brazilian version of the Dangerous Decibels® educational program in increasing students' knowledge and positively changing their attitudes and intended behaviors related to NIHL prevention and to decrease exposures to loud sounds and the barriers related to hearing protective strategies (HPS). Design: This is a prospective longitudinal controlled study. Study sample: Third to fifth graders (n = 220) filled out a baseline questionnaire; participated in a 60 minutes Dangerous Decibels® classroom presentation; answered a follow-up questionnaire immediately after the presentation; worked with their teachers on an activity booklet about hearing health ten weeks later; and filled out a three-months follow-up questionnaire. Students that did not receive health hearing education served as a control group (n = 51). A mixed analysis of variance was performed, with time as the within-subjects independent variable, and the intervention as the between-subjects independent variable. Results: The study group exhibited significant short- and long-term improvements in knowledge, attitudes, and intended behavior related to NIHL and acoustic trauma prevention, and in decreased exposures to loud sounds and barriers to the use of hearing protective strategies. Conclusions: This study demonstrated the effectiveness of a Brazilian version of the Dangerous Decibels classroom program with an additional supplementary workbook intervention. © 2014 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.53SUPPL.2S35S42Berg, R.L., Pickett, W., Fitz-Randolph, M., Hearing conservation program for agricultural students: Short-term outcomes from a clusterrandomized trial with planned long-term follow-up (2009) Prev Med, 49, pp. 546-552Berger, E.H., Children and hearing protection: What is available and is it used? (2006) Noise-induced Hearing Loss in Children at Work & Play (Proceedings), , http://www.e-a-r.com/pdf/hearingcons/NIHLChildren.pdf, Covington, USABiassoni, E.C., Serra, M.R., Richter, U., Joekes, S., Yacci, M.R., Carignani, J.A., Abraham, S., Franco, G., Recreational noise exposure and its effects on the hearing of adolescents. Part II: Development of hearing disorders (2005) International Journal of Audiology, 44 (2), pp. 74-85. , DOI 10.1080/14992020500031728Blair, J.C., Benson, P.V.A., Hardegree, D., Necessity and effectiveness of a hearing conservation program for elementary students (1996) Educational Audiology Monograph, 4, pp. 12-15Bohlin, M., Erlandsson, S.I., Risk behaviour and noise exposure among adolescents (2007) Noise & Health, 9, pp. 55-63Chermak, G.D., Peters-Mccarthy, E., The effectiveness of an educational hearing conservation program for elementary school children (1991) Lang Speech Hear Serv Sch, 22, pp. 308-312Coelho, C.B., Sanchez, T.G., Tyler, R.S., (2007) Tinnitus in Children and Associated Risk Factors, pp. 179-191. , B. Langguth & A.R. M ø ller (eds.) Progress in Brain Research: EvierCone, B.K., Wake, M., Tobin, S., Slight-mild sensorineural hearing loss in children: Audiometric, clinical, and risk factor profi les (2010) Ear Hear, 31, pp. 202-212Costa, O.A., Axelsson, A., Aniansson, G., Hearing loss at age 7, 10 and 13 - An audiometric follow-up study (1988) Scandinavian Audiology, 17 (SUPPL. 30), pp. 25-32Crandell, C., Mills, T.L., Gauthier, R., Knowledge, Behaviors, and Attitudes about Hearing Loss and Hearing Protection among Racial/Ethnically Diverse Young Adults (2004) Journal of the National Medical Association, 96 (2 SUPPL.), pp. 176-186Crombie, R., Clark, C., Stansfeld, S.A., Environmental noise exposure, early biological risk and mental health in nine to ten year old children: A cross-sectional fi eld study (2011) Environmental Health: A Global Access Science Source, 10, p. 39El Dib, R.P., Verbeek, J.H., Atallah, A.N., Interventions to promote the wearing of hearing protection (Review) (2006) The Cochrane Database of Systematic Reviews, p. 2Eavey, R.D., Letter from the Editor, in reply to Folmer' s letter (2006) Pediatrics, 117, p. 249Erlandsson, S.I., Widén, S.E., Holmes, A., Hearing, use of hearing protection, and attitudes towards noise among young American adults (2009) Int J Audiol, 48, pp. 537-554Folmer, R.L., Hearing-loss prevention practices should be taught in schools (2008) Seminars in Hearing, 29 (1), pp. 67-80. , DOI 10.1055/s-2007-1021774Folmer, R.L., Griest, S.E., Martin, W.H., Hearing conservation education programs for children: A review (2002) J Sch Health, 72, pp. 51-57Griest, S.E., Folmer, R.L., Martin, W.H., Effectiveness of "dangerous decibels," a school-based hearing loss prevention program (2007) American Journal of Audiology, 16 (2), pp. S165-S181. , DOI 10.1044/1059-0889(2007/021)Holgers, K.-M., Pettersson, B., Noise exposure and subjective hearing symptoms among school children in Sweden (2005) Noise and Health, 7 (27), pp. 27-37Johnson, C.D., Meinke, D.K., Noise-induced hearing loss: Implications for schools (2008) Seminars in Hearing, 29 (1), pp. 59-66. , DOI 10.1055/s-2007-1021773Knobel, K.A.B., Lima, M.C.P.M., Knowledge, habits, preferences, and protective behavior in relation to loud sound exposures among Brazilian children (2012) Int J Audiol, 51, pp. S12-19Knobloch, M.J., Broste, S., A hearing conservation program for Wisconsin youth working in agriculture (1998) J Sch Health, 68, pp. 31-38Lass, N.J., Woodford, C.M., Lundeen, C., The prevention of noiseinduced hearing loss in the school-aged population: A school educational hearing conservation program (1986) J of Aud Res, 26, pp. 247-254Martin, W.H., Dangerous Decibels: Partnership for preventing noise-induced hearing loss and tinnitus in children (2008) Seminars in Hearing, 29 (1), pp. 102-110. , DOI 10.1055/s-2007-1021778Martin, W.H., Sobel, J.L., Griest, S.E., Noise induced hearing loss in children: Preventing the silent epidemic (2006) J Otol, 1, pp. 11-21Martin, W.H., Griest, S.E., Sobel, J.L., Randomized trial of four noise-induced hearing loss and tinnitus prevention interventions for children (2013) Int J Audiol, 52, pp. S41-49Martínez-Wbaldo, M.C., Soto-Vázquez, C., Sensorineural hearing loss in high school teenagers in Mexico City and its relationship with recreational noise. Las alteraciones auditivas de escolares adolescentes en la Ciudad de M éxico pueden estar relacionadas al ruido recreativo (2009) Cad Saúde Pública, 25, pp. 2553-2561Morata, T.C., Young people: Their noise and music exposures and the risk of hearing loss (2007) International Journal of Audiology, 46 (3), pp. 111-112. , DOI 10.1080/14992020601103079, PII 773301453, Focus on the Effects of Noise on HearingNeufeld, A., Westerberg, B., Nabi, S., Prospective, randomized controlled assessment of the short- and long-term effi cacy of a hearing conservation education program in Canadian elementary school children (2011) Laryngoscope, 121, pp. 176-181Niskar, A.S., Kieszak, S.M., Holmes, A.E., Esteban, E., Rubin, C., Brody, D.J., Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: The Third National Health and Nutrition Examination Survey, 1988-1994, United States (2001) Pediatrics, 108 (1), pp. 40-43. , DOI 10.1542/peds.108.1.40Plontke, S.K.-R., Dietz, K., Pfeffer, C., Zenner, H.-P., The incidence of acoustic trauma due to New Year's firecrackers (2002) European Archives of Oto-Rhino-Laryngology, 259 (5), pp. 247-252. , DOI 10.1007/s00405-002-0451-4Portnuff, C.D.F., Fligor, B.J., Arehart, K.H., Self-report and longterm fi eld measures of MP3 player use: How accurate is self-report? (2013) Int J Audiol, 52, pp. S33-40Roeser, R.J., Industrial hearing conservation programs in the high schools (protect the ear before the 12th year) (1980) Ear and Hearing, 1 (3), pp. 119-120Roeser, R.J., Coleman, T., Adams, R.M., Implementing an industrial hearing conservation program in the schools (1983) J Occup Safety Health, 53, pp. 408-411Segal, S., Eviatar, E., Lapinsky, J., Shlamkovitch, N., Kessler, A., Inner ear damage in children due to noise exposure from toy cap pistols and firecrackers: A retrospective review of 53 cases (2003) Noise and Health, 5 (18), pp. 13-18Serra, M.R., Biassoni, E.C., Richter, U., Minoldo, G., Franco, G., Abraham, S., Carignani, J.A., Yacci, M.R., Recreational noise exposure and its effects on the hearing of adolescents. Part I: An interdisciplinary long-term study (2005) International Journal of Audiology, 44 (2), pp. 65-73. , DOI 10.1080/14992020400030010Shargorodsky, J., Curhan, S.G., Curhan, G.C., Change in prevalence of hearing loss (2010) JAMA, 304, pp. 772-778Sobel, J., Meikle, M., Applying health behavior theory to hearing-conservation interventions (2008) Seminars in Hearing, 29 (1), pp. 81-89. , DOI 10.1055/s-2007-1021775Vogel, I., Brug, J., Van Der Ploeg, C.P.B., Raat, H., Young People's Exposure to Loud Music. A Summary of the Literature (2007) American Journal of Preventive Medicine, 33 (2), pp. 124-133. , DOI 10.1016/j.amepre.2007.03.016, PII S0749379707002309Olsen Widen, S.E., Erlandsson, S.I., Self-reported tinnitus and noise sensitivity among adolescents in Sweden (2004) Noise and Health, 7 (25), pp. 29-40Olsen Widen, S.E., Erlandsson, S.I., The influence of socio-economic status on adolescent attitude to social noise and hearing protection (2004) Noise and Health, 7 (25), pp. 59-70