Hearing-loss Prevention Programs And Services Flashcards
NIHL
Noise induced hearing loss
Year of passage of Hearing Conservation Amendment to the OSH Act
1983
NIHL caused by occupational exposure has been a compensate occupational disease since…
The 1950s
NIHL has been identified as…
- One of the most common occupational diseases
- Second most self reported occupational illness or injury
Estimated number of workers exposed to hazardous noise levels
30 million
Key industries with high numbers of workers exposed to hazardous noise
- Agriculture
- Mining
- Construction
- Manufacturing and utilities
- Transportation
- Military
Noise exposure has been associated with the following:
- Anxiety
- Depression
- Blood pressure
- Heart rate changes
- Myocardial infarction
Hearing loss programs are designed to do the following:
- Prevent noise induced hearing loss
- Reduce worker exposure to harmful noise
- Identify progression of hearing loss so preventive measures can be taken
- Identify temporary hearing loss before it becomes permanent
- Comply with federal regulations or state OSHA plans
OSHA noise standard
CFR 1910.95
OSHA regulations limit work site noise exposure to….
90 dBA time weighted average (TWA) over an 8 hour shift
Mandatory components of OSHA Noise Standard
- Hearing loss prevention programs
- Hearing protection devices (HPD)
- Engineering controls
Hearing loss prevention programs are mandatory in an environment where….
Daily noise level equals or exceeds 85dBA over an 8 hour time weighted average
Hearing conservation recommendations based on TWA in dBA
84 or below
Workers included in HCP: no
HPD utilization: voluntary
HPD selection options: free choice
Hearing conservation recommendations based on TWA in dBA
85-89
Workers included in HCP: yes
HPD utilization: optional
HPD selection options: free choice
Hearing conservation recommendations based on TWA in dBA
90-94
Workers included in HCP: yes
HPD utilization: required
HPD selection options: free choice
Hearing conservation recommendations based on TWA in dBA
95-99
Workers included in HCP: yes
HPD utilization: required
HPD selection options: limited choice
Hearing conservation recommendations based on TWA in dBA
100 or above
Workers included in HCP: yes
HPD utilization: required
HPD selection options: very limited choice
Rationale for and benefits of a worksite HLPP
- Reduced worker risk for NIHL and other health conditions
- Better labor management relations
- Decreased likelihood on antisocial behaviors resulting from annoyance
- Greater job satisfaction
- Increased productivity
- Better quality of life
- Reduced worker fatigue and irritability resulting in improved worker efficiency and job performance
- Reduced accident rates, illnesses and lost work time
- Reduced risk of workers compensation claims
- Reduced loss of trained and experienced personnel
Hearing loss prevention programs can benefit
- Management
2. Employees
How can prevention, early detection and reducing noise hazard benefit employees?
- Health
2. Improve workplace morale
How can prevention, early detection and reducing noise hazards benefit management
- Improved employee morale
- Greater job satisfaction
- Improved occupational safety
An effective hearing loss prevention program requires the following:
- Support, cooperation and participation of all levels of management
- Support of workers
- Cooperation of union leaders and/or person responsible for work site safety
- Review of the OSHA standard
- Review of recommendations for compliance
Resource for recommendations for compliance with OSHA standard
NIOSH Practical Guide to Preventing Hearing Loss
Specifically appendix A- OSHA Standard Compliance Checklist
Management roles related to Hearing Loss Prevention Programs
- Developing and implementing a HLPP policy
- Identifying program personnel and defining responsibilities
- Providing personnel, space, supplies and funding for the program
- Providing all elements of program free of charge
- Ensuring workers exposed are compliant with program
- Make a good faith effort to eliminate or reduce sources of noise
- Posting appropriate warning signs and ear protection requirements at entrances to areas with noise levels exceeding 85dBA
- Conducting and reviewing annual program evaluations
Component of HLPP policy that must be implemented
Disciplinary action for noncompliance
Program personnel needed for HLPP
- Qualified physician, otolaryngologist or audiologist to supervise program
- Program coordinator and other personnel responsible for program components
Responsibilities of hearing loss prevention coordinator
- Acquiring certification in hearing conservation
- Determining workers who qualify for program
- Taking a brief health and aural history on each worker
- Performing otoscopic exam and audio metric testing
- Coordinating testing schedule and follow-up procedure
- Keeping accurate, clear and complete testing and counseling records
- Selecting, fitting and monitoring the wearing of appropriate hearing protection devices
- Acting as liaison between workers and other members of the team
- Educating and training workers on how to protect themselves from hearing loss
- Referring workers to outside sources for further testing or medical treatment when indicated
- Seeking workers’ input for evaluation of program
- Providing regular updates annually to management regarding the HLPP program
Success of hearing loss prevention program depends on workers’ active participation by doing the following:
- Provide information relative to current ear conditions, ear diseases and treatments, and ototraumatic exposure histories
- Cooperate by following audiometric tester instructions
- Inform the audiometric tester if instructions are unclear or if there are personal or environmental interferences
- Comply with program by wearing appropriate hearing protection
- Encourage coworkers to wear hearing protection
- Report difficulties of safety hazards related to hearing protection use and/or changes in noise levels in work areas
If reliable information indicates noise exposure at the worksite……..
Noise measurements should be conducted
Noise measurements should be performed by:
- Acoustical engineer
- Industrial hygienist
- Occupational audiologist
- Professional proficient in noise-level measurement
Only sound-level meters or noise dosimeters that meet ———— should be used
The American National Standards
A sampling strategy that will pick up all —————– is needed
Continuous, intermittent and impulse sound levels from 80 to 130dBA is needed
All sound levels in the ——— should be used
Total noise measurement
———- should be permitted to observe monitoring
Workers and their representatives
Workers who are exposed to noise at or above ———- must be notified
8-hour TWA of 85dBA
Sound survey results are used to:
- Identify areas of the worksite where hazardous noise levels exist
- Identify workers to be included in the HLPP
- Classify workers’ noise exposures to define policies for hearing protection devices and prioritize areas for noise-control efforts
- Identify safety hazards in terms of interference with speech communication and warning signal detection
- Evaluate noise source for noise control purposes
- Document noise levels for legal purposes
Noise control measures include:
- Engineering controls
- Administrative controls
- Personal protective equipment
Engineering controls
The most effective and the most desirable long term solutions
To determine the engineering control that should be used, it is recommended that ——- be assessed
The noise characteristics
Common engineering controls for noise control are:
- Elimination of noise source
- Redesign of the process to be quieter
- Isolation of the machinery to prevent vibrations and noise from radiating
- Building an enclosure around noisy machinery
- Using absorptive materials on walls and ceilings
- Erecting a barrier or noise-reducing curtain around the noisy area
- Adding a muffler to noisy tools
- Keeping machinery well-balanced, oiled and in good repair
Administrative controls
Include work practices and are implemented when engineering and work practice controls are not feasible
May be used in conjunction with other strategies
Examples of administrative controls
- Rotating workers to less noisy areas
2. Performing high-noise tasks when fewer workers are present
Personal protective equipment is provided when….
Engineering and administrative controls are not feasible and may be used in conjunction with other strategies
Workers should be provided with appropriate hearing protection devices such as:
- Earplugs
- Muffs
- Helmets
Hearing protection devices should be provided…
- In appropriate styles and types
2. At no cost to workers
When should training be conducted for workers who are included in the HLPP?
Initially for new hires and then annually
Components of HLPP training program
- Interpreters should be provided for ESL employees
- The characteristics of sound should be described
- Workers should be told where noise is found
- Multiple effects of noise should be described
Sound is defined as…
A complex combination of pure tones found in the environment that result in a vibratory disturbance in the pressure of fluid in the ear and capable of being detected by the organs of hearing
How do you tell workers where noise is found?
- Cite occupational, recreation and environmental sources
- Include that there are cumulative effects from multiple sources
- Provide examples of different types of noise from actual locations at the worksite
Noise level of jet plane
140 dBA
Noise level of gunshot blast (impulse)
140dBA
Noise level of automobile horn
120 dBA
Noise level of rock band
110dBA
Noise level of chain saw
110dBA
Noise level of car racing
110dBA
Noise level of motorcycle
100dBA
Noise level of subway
90dBA
Noise level of average factory
80-90dBA
Noise level of noisy restaurant
80dBA
Noise level of busy traffic
75dBA
Noise level of conversational speech
65dBA
Noise level of average home
50dBA
Noise level of quiet office
40dBA
Noise level of soft whisper
30dBA
Effect of exposure to 80dBA noise
Usually will not cause permanent hearing loss
Effect of exposure to 110dBA noise
Long exposure over 90dBA may eventually cause permanent hearing loss
Effect of exposure to 110dBA noise
Noise induced hearing loss
Effect of exposure to 140dBA noise
Pain threshold
Acoustic trauma
May cause permanent damage to the delicate hair cells of the cochlea
Physical problems of noise exposure
- Hearing loss
- Effects on cardiovascular system
- Effects on gastrointestinal system
- Headache
- Stress
- Fatigue
Psychologic problems of noise exposure
- Annoyance
- Feeling of isolation among workers
- Masking of warning shouts and signals
- Interference with speech communication
Awareness of hearing loss usually does not occur until….
The loss is significant
Tinnitus
Aka ringing in the ear
A sign of an overtaxed auditory system
Perception that ——— is often a sign of hearing loss
Others are mumbling
Occupational hearing loss is usually
Bilateral
Hearing loss to only one ear may be caused by…..
Pathologic processes other than occupational exposures or acoustic trauma to that ear
Function of the outer ear
Collects sound waves and funnels them into the ear canal
Function of the middle ear
Sound impinged in e ear drum and is mechanically transmitted to the bones of the middle ear. Ossicular movement creates vibrations in the fluid-filled cochlea in the inner ear
Components of the middle ear
Ossicular chain which consists of:
- Malleus
- Incus
- Stapes
Function of the inner ear
Transmits sound waves through hair cells in the cochlea that send electrical impulses to the auditory nerve, which transmits the signals to the brain where the sound is interpreted
Types if hearing loss
- Acoustic trauma
- Sensorineural
- Conductive
Hearing loss from acoustic trauma
- results from a single exposure such as a loud, explosive blast or a blow to the head
- may rupture the eardrum and damage the middle and inner ear
Sensorineural hearing loss
- results in changes in the receptive cells; occurs from long-term exposure to noise
- is usually bilateral
- is not usually apparent until hearing loss is severe
- is usually irreversible, it’s severity depending in the intensity, frequency and duration of noise exposure
Conductive hearing loss
- occurs from obstruction of sound through the outer and inner ear
- may be caused by wax buildup, presence of foreign body, ruptured eardrum, infection, otosclerosis or injury
- may be reversed or stabilized by appropriate treatment or surgery
