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Our main purpose was to investigate any relationship between noise exposure levels in the workplace, degree of hearing loss (HL), and the relative risk of accident (OR of single or multiple events).We conducted a retrospective study of 52 982 male workers aged 16–64 years with long-standing exposures to occupational noise over a 5-year period, using “hearing status” and “noise exposure” from the registry held by the Quebec National Institute of Public Health. Information on work-related accidents was obtained from the Quebec Workers’ Compensation Board. Hearing threshold level measurements and noise exposures were regressed on the numbers of accidents after adjusting for age.Exposure to extremely noisy environments (Leq8h (equivalent noise level for 8 h exposure) ≥90 dBA) is associated with a higher relative risk of accident. The severity of hearing impairment (average bilateral hearing threshold levels at 3, 4 and 6 kHz) increases the relative risk of single and multiple events when threshold levels exceed 15 dB of hearing loss. The relative risk of multiple events (four or more) is approximately three times higher among severely hearing-impaired workers who are exposed to Leq8h ≥90 dBA.Single and multiple events are associated with high noise exposure and hearing status. This suggests that reducing noise exposure contributes to increased safety in noisy industries and prevents hearing loss. Hearing-impaired workers assigned to noisy workstations should be provided with assistive listening devices and efficient communication strategies should be implemented.