In occupational environments, communication failures can increase the risk of accidents. Workers exposed to noisy environments often experience difficulties understanding speech in background noise. These difficulties may stem not only from the masking effects of noise but also from auditory damage resulting from chronic noise exposure. Current audiological assessments used in occupational health are insufficient for both evaluating speech-in-noise comprehension and monitoring auditory status over time. The objective of this study was to examine the relationships between various factors potentially influencing speech-in-noise understanding and to identify the most relevant predictors. Hearing thresholds at 12,500 Hz—a frequency beyond the range of conventional audiometry—showed a strong association with speech-in-noise performance. Routine monitoring of extended high-frequency hearing could therefore allow early identification of individuals at risk and implementation of preventive or rehabilitative measures before critical auditory decline occurs.