1. Facilitating Effective and Reliable Resources for Occupational Safety and Health in the Turkish metal sector Funded by the Netherlands embassy, Ankara, Turkey

2. Noice-induced hearing loss derived from Emutom e-course

3. The 5th European Working Conditions Survey shows that the physical hazards have remained a problem for the European workers in the last few years.

4. Which are the effects of physical factors? Time of exposure Level of exposure Source Worker - occupational diseases - occupational related diseases - accident of work Workplace - days of incapacity of work - a new worker - risk insurance

5. How can we protect ? Source Worker I.Reduces the PA at the source Eg: -isolation -change the device

6. How we can protect ? Source Worker II. Reduce exposure time Increase the distance

7. How can we protect ? Source Worker III. At the Worker Level E.g.: - isolation (special cabin) - individual equipment protection

8. What is the Role of the OH Physician? OH physicianPrevention Identifies the physical hazards Screening at pre-employment Monitoring health Periodical examination Treatment First aid specific/supportive

9. Noise What is noise? – a group of unwanted or/and wanted sounds which produce an unpleasant hearing sensation, sometimes disturbing, which impede communication – an annoying sound The perception depends on the listener and the circumstances (e.g. rock music can be pleasant for a person, but uncomfortable in a surgery room).

10. What is occupational noise? a complex of sounds, of variable intensities and pitches, having different characteristics, rhythmic or rhythmless, produced continuously or discontinuously by machines, tools, devices, means of transportation, the human voice, etc, during the performance of the professional activity

11. Characteristics of sounds Frequency = the peach of sound Hertz High pitches>3000 Hz Low pitches<500 Hz E.g. the woman’s voice and the man’s voice 500 and 2000 Hz are the most important for understanding speech 3000 Hz and 4000 Hz are the first to be affected by noise Intensity = the level of the sound or the sound pressure dB “0” dB does not mean the lack of any sound, but a sound level where the sound pressure is equal to that of the reference level which corresponds to 0.02 mPa. E.g. if the noise produced by a machinery is 97 dB (A), when doubling the source of noise (if we have 2 identical machineries), the noise will increase by 3 dB, it will not be doubled! Loudness = the subjective human response to sound dependent on sound pressure and, then, on frequency

12. What is the Threshold Limit Value? The Threshold Limit Value (TLV) depends on the work specificity (International Standard, ISO 1999-1990). The Law establishing this is the Directive 2003/10/EC of the European Parliament and of the European Council. This directive is to be transposed into the national legislation of all Member States. In the European countries the maximum admitted values (Leq - weekly equivalent acoustic level) at the workplace with normal neural-sensorial solicitation are between 85 and 90 dB (A).

14. What are the Health Effects? http://www.hse.gov.uk/noise/vid eo/hearingvideo.htm

15. What are the Health Effects? Auditory Acute : tinnitus acoustic trauma Chronic: hypoaccousia Noise Induced Hearing Loss (NIHL) Non-auditory sleep disturbances general effects (cardiovascular, metabolic changes) behavioural effects

16. The audiogram - records both ways of sound transmission: air and bone conduction Normal audiogram

17. NIHL

18. Treatment 1. Ceasing the exposure to noise and other toxic substances (Hg, SC2, toluene, Gentamycin, Kanamycin etc) 2. Medication: antioxidants, vitamins 3. Hearing aids in severe cases

19. How can we protect from noise? Source I.Reduces the N at the source E.g.: -isolation -change the device Technical and organizational measures Worker III. At the worker level E.g.: - isolation (special cabin) - individual equipment protection (ear plugs or ear muffs) II. Reduce exposure time Increase the distance

20. How can you protect from noise? Medical measurements Pre-employment examination Periodical examinations – Audiometric testing Risk assessment Risk management

21. Ultrasounds and infrasound Ultrasounds > 20000 Hz = inaudible Where to be found? (workplaces) - industry (used in detecting defects, cleaning of pieces etc) medicine (ultrasounds, dental scaling, therapy) devices against thieves, pests etc Infrasound 1-20 Hz = inaudible Where to be found? (workplaces) natural sources: – geological (earthquakes, landslides, avalanches) or – meteorological events (storms, tornadoes) artificial sources: – industrial machines – ventilation systems, air conditioning – aircraft – rail traffic

22. What are the health effects of ultrasounds and infrasound? Ultrasounds Acute effects: 18-30 kHz headache, fatigue at the end of the day, sleepiness during day time, the feeling of pressure inside the ear, walking disturbances, numbness, and sensitivity disturbances. Chronic effects: vascular disturbances, increase of the central and skin temperatures, hyperglycemia, increased number of eosinophiles Infrasound Acute exposure: to intensities high enough to be heard, it can determine a decrease in vigilance Chronic exposure: to normal levels present in the environment, there is not enough evidence

23. How do we protect from ultrasounds and infrasound? By respecting the technical prophylactic measurements concerning noise exposure In case of ultrasounds, wearing rubber cotton gloves may be of help