The ER20XS Universal Fit High-Fidelity Earplugs from Etymotic Research come with a pair of standard triple-flange eartips, a pair of large triple-flange eartips, a pair of foam eartips, a neck cord, and a carrying case. The eartips are interchangeable and replaceable. They feature 20 dB of noise reduction and a low-profile design that fits snugly in the ear without protrusion, making the earplugs comfortable to wear under hats, helmets, and other headgear. A small, flexible pull tab allows for easy removal. The earplugs reduce the potential for hearing damage from machinery, vehicles, tools, sporting events, and concerts. The foam eartip option works in conjunction with technology in the ER20XS earplugs to provide both hearing protection and clear communication.