Existing approaches that explain the behavior of workers in noisy environments rarely include quantitative variables related to central factors such as noise exposure levels and workers’ hearing status. The aim of this study is to analyze the relationship among individual, contextual, and perceptual-cognitive factors and the use of hearing protection devices (HPDs). We studied 516 industrial workers exposed to noise levels greater than the Portuguese action level and developed a conceptual model for HPD use. The multivariate data analysis of the several variables considered revealed that individual risk perception and the outcome value for hearing preservation were the main direct predictors of the use of HPDs. Workers’ opinions about the company’s safety climate and their perception of noise exposure effects also play important roles as predictors. However, much of the effects of these factors are indirect (i.e., mediated by other variables). Furthermore, these results suggest that risk perception should be considered an essential issue in the design and implementation of any hearing conservation program, particularly in the development of training programs. Actual or potential applications of this research include the definition of more accurate strategies for promoting and motivating the use of HPDs.