1. Mark Stephenson, Ph.D. National Institute for Occupational Safety and Health DEVELOPING A HEARING LOSS PREVENTION PROGRAM FOR CONSTRUCTION WORKERS

2. NIOSH HIERARCHY OF CONTROLS Remove the hazard Remove the worker Protect the worker

3. OVERVIEW REVIEW OF THE PROBLEM REVIEW OF THE PROBLEM WHAT WE’VE LEARNED SO FAR WHAT WE’VE LEARNED SO FAR WHERE WE’RE GOING WHERE WE’RE GOING

4. The construction industry DOES have a standard: 29 CFR 1926.52… “Workers exposed to TWAs >90 dBA must be provided protection.” BUT Many of the requirements in the manufacturing industry standard (29 CFR 1910.95) do not apply: Periodic noise monitoring Periodic noise monitoring Dosimetry Dosimetry Periodic audiometric testing Periodic audiometric testing Regular worker education Regular worker education THE PROBLEM:

5. So what… People lose their hearing anyway as they age.

6. Even by age 60, the average healthy person does not have impaired hearing!!

7. Hearing Levels in 60 Year Old Males as a Function of Noise Exposure

8. 5001000200040008000 10 0 -10 60 50 40 30 20 20yearsinstampingplant PredictedHearingLevels NoOccupationalExposure Even where the OSHA HCA is being applied, workers are still losing their hearing!

9. What Have We Learned So Far? Noise Levels Hearing Levels Cost Health Communications

11. The Average 25 Year Old Carpenter Has 50 Year Old Ears!

12. $1,000,000,000 It Would Cost One Billion Dollars to Provide Hearing Aids to Every UBC Member Who Needed Them (batteries not included)!

13. Don’t talk to me about talk to me about decibels, tell me about MONEY ! MONEY ! Cost: What kind of money are we talking about? Cost of hearing aids Vs. Cost of an HCP What about workers’ compensation?

14. Health Communication Theory = Marketing

15. Health Communications: Once a noise hazard is identified, why don’t we just pass out ear muffs or set out boxes of ear plugs?

16. Without proper training, any hearing protector that can be worn wrong, will be worn wrong!

18. People have MANY reasons for not using hearing protectors. (AKA: You can lead a person to hearing protectors, but you can’t get him/her to wear them.) Comfort Convenience Cost Communications / hear important sounds THERE ARE OVER 200 DIFFERENT HEARING PROTECTORS. EVERYONE CAN FIND A PROTECTOR THAT MEETS THEIR NEEDS. THE BEST HEARING PROTECTOR IS THE ONE THAT’S WORN!

19. Effect of not wearing your hearing protector on the amount of effective noise reduction

20. Blah, blah, blah… Blah, blah, blah... Education and Training Must NOT Just Fill a Square

21. How do you know what the workers’ concerns and beliefs are? Just ask me. I’ll tell you what I need. Barriers cited by coal miners for not wearing HPDs: Comfort Poke Out Eardrum Communication Cords Get Caught Convenience Earcup Too Big Roof “Talk” Warning Sounds

22. Percent of Workers Who Wore Hearing Protectors

23. INFLUENCING HEARING PROTECTOR USE AMONG WORKERS Health communication theory has proven education and training must address two concepts: Remove BarriersDevelop Self-Efficacy

24. Conduct Focus Groups Measure SPLs & HTLs Observe Behaviors Analyze Audio- metric Data Administer Survey Analyze Data Develop Training Re-administer Survey Analyze Data Modify Training Removing Barriers and Developing Self-Efficacy is an Iterative Process How Do You Remove Barriers & Develop Workers’ Self-Efficacy?

25. This is your ear. This is your ear on noise. Any questions? NIOSH Toll-Free Number: (800) 35-NIOSH http://www.cdc.gov/niosh/homepage.html Mark R. Stephenson Carol Merry-Stephenson (513) 533-8144 (513) 533-8581 mos9@cdc.gov cem3@cdc.gov