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(c) 2018 Jon L Gelman, All Rights Reserved.

Tuesday, February 7, 2017

Hearing Loss Remains a Significant Problem at Work


Today's post is shared from the cdc.gov:


"Noise-induced hearing loss is a significant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss."


Noise-induced hearing loss is a significant health problem among U.S. adults, is more prevalent among males, and increases with age. Persons with auditory damage caused by noise frequently do not recognize it; one in four U.S. adults who reported excellent or good hearing had an audiometric notch. Among persons who reported work exposure to loud noise, one third had a bilateral or unilateral notch.

Noise exposure is the second most common cause of acquired hearing loss (after aging). An estimated 24% of hearing loss in the United States has been attributed to workplace exposures. Noise exposure is associated with numerous adverse health effects, and reducing noise exposure is likely to improve health. A recent study suggested that reducing environmental noise exposure might save lives by decreasing the prevalence of cardiovascular heart disease (10). Avoiding exposure to loud environments and effective use of personal hearing protection devices (earplugs or earmuffs) have been shown to prevent hearing loss. Evidence also exists that stronger occupational regulation leads to decreased noise levels . Persons who already have impaired hearing from noise exposure can benefit from clinical rehabilitation, such as amplification through hearing aids, learning to read lips, and other compensation strategies. Use of technology, such as smart phone apps to measure sound level, provides new ways of informing decisions and actions.

Noise reduction and avoidance can prevent hearing loss or slow its progression. This can be accomplished by avoiding high volumes on personal listening devices; reducing listening time to high volumes of music; taking breaks from exposure; requesting lower volumes in public settings (restaurants, movie theaters); using quieter products (e.g., household appliances, power tools, recreational vehicles); reducing equipment noise by replacing worn or unbalanced machine parts; moving as far as possible from the loudest sound-producing source, such as loudspeakers or cannons at college stadiums; and using hearing protection devices ). Hearing protectors need to fit well to reduce noise exposure effectively.

Noise exposure at younger ages needs particular attention. Damage to hearing accumulates over time so that hazardous exposure that begins earlier in life has the potential to be more damaging as persons age. The high prevalence of audiometric notches (one in five) among persons aged 20–29 years suggests that early life interventions need to be developed.

Hearing screenings can help reduce delays in diagnosis and improve access to hearing aids for those with hearing loss, thus improving health-related quality of life, yet a 2014 report found that only 46.0% of adults who had any trouble hearing had seen a health care professional about their hearing in the past 5 years (5). Hearing loss often progresses for years before being self-perceived or diagnosed. Talking to one’s personal health care provider about hearing loss symptoms, tests, and ways to protect hearing, might support early diagnosis and access to hearing rehabilitation if needed.

During routine exams, primary care providers can examine patients’ hearing; ask about patients’ hearing and noise exposures and inform them about the benefits of hearing protection; monitor patients with hearing loss symptoms, recommend or provide hearing tests when indicated; and counsel patients with hearing loss. Studies indicate, however, that 40%–77% of primary care providers have not asked about or screened for hearing loss. Patients reporting hearing-related symptoms or risk factors such as noise exposure need to be referred for objective hearing assessment., Although there is currently a lack of data to support the benefits of regular hearing screening in adults aged >50 years, the American Speech-Language-Hearing Association (ASHA) recommends that adults be screened at least every decade through age 50 years and every 3 years thereafter. Healthy People 2020 includes objectives to increase the proportion of adults who have had a hearing examination in the past 5 years and to increase the number referred by their health care provider for hearing evaluation and treatment.

Although there are no federal regulations regarding exposure to nonoccupational noise, a 1974 Environmental Protections Agency report identified 70 dB over 24 hours (75 dB over 8 hours) as the average exposure limit for intermittent environmental noise. World Health Organization (WHO) 1999 Guidelines for Community Noise recommend avoiding noise exposure levels that exceed 70 dB(A) over a 24-hour period or 85 dB(A) over a 1-hour period. CDC’s National Institute for Occupational Safety and Health (NIOSH) has established an 8-hour, time-weighted average 85 dB(A) recommended exposure limit to protect most workers from developing hearing loss from noise exposure over a 40-year career. However, at that sound pressure level [85 dB(A) time-weighted average], approximately 8% of workers could still develop hearing loss, and thus NIOSH recommends that hearing protection be worn whenever noise levels exceed 85 dB(A), regardless of the length of exposure.

The U.S. Department of Health and Human Services (DHHS) and WHO are raising awareness about noise-induced hearing loss. DHHS is collecting data on hearing status and risk factors, as well as developing guidelines on hearing aids. WHO is developing guidelines on noise exposure. Other public entities, such as states and counties, partner with community groups to reduce noisy environments and use evidence to inform policies that decrease noise exposures. Other ways to reduce environmental noise exposure include using sound-absorbent materials in office buildings and public venues, erecting highway barriers, and passing noise ordinances. Managers and owners of public venues can decrease the loudest sound levels at those locations to help decrease noise exposure.


Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades the
Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

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