Interesting thread so far! As others have already posted, nearly all hearing protection is "passive" and works by damping (absorbing) sound waves. 33 dB seems like the
upper limit of credible claims for passive noise reduction in muffs and plugs.
All amplified hearing protection does is let you hear surrounding sound through microphones. Most of these have filters that cut off when loud sounds are present. They don't increase the level of noise reduction.
With one exception that I'm aware of: the
Nacre QuietPro. This is a unique device that combines sealed foam earbuds with active noice cancelling. It monitors surrounding sounds through one set of microphones, and injects the inverse waveform into the ear canals with earbud speakers. The
specs claim 34-42 dB of noise cancellation, and based on my experience with these I believe it.
The Nacre requires an airtight seal in the ear canal. On startup it goes through a calibration procedure that plays tones in each ear to test for "leakage". If there isn't a good seal, a warning tone sounds in that ear.
Price new on these was in the $1-2k range, but they can be found in decent condition on eBay for $100-200. The replacable earbuds are hard to find, so that can be a problem.