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Current Issues in Hearing Loss Prevention

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Presentation on theme: "Current Issues in Hearing Loss Prevention"— Presentation transcript:

1 Current Issues in Hearing Loss Prevention
3M OH & ES Division Current Issues in Hearing Loss Prevention Lee Hager, Hearing Conservationist

2 Federal Regulatory Timeline
Recordkeeping 2003 Noise Control Act 1972 Hearing Conservation Amendment OSH Act 1971 FRA 2011 Click through to show progression of regulatory initiatives since 1960’s 1960 1970 1980 1990 2000 2010 EPA NRR Revision 2007 … Walsh-Healey Act 1969 MSHA 1996

3 Where do we stand today? 3M OH & ES Division
OSHA revised the way that workplace illnesses were reported early in the 2000s. One of those changes was that beginning in 2004, hearing loss would be counted as a separate illness, apart from the “all other “ category. This reflects what has been reported since with the big number for each year being the total illnesses and the small number on top being the hearing loss cases. Hearing loss has consistently been about 10 to 12% of the total recorded illnesses, and since 2004, over 200,000 US workers have received this permanent life altering disability due to noise on the job. Keep in mind that the hearing loss required to qualify as a recordable reflects true hearing impariment.

4 2nd largest specific illness
3M OH & ES Division 2nd largest specific illness Hearing loss has consistently been the 2nd largest illness OSHA calls for specifically, and in some sectors like manufacturing, hearing loss is the number 1 recorded illness.

5 Mfg Predominant

6 Exposure Assessment and Limits? Resource Allotment? Training?
3M OH & ES Division What’s the Story? Exposure Assessment and Limits? Resource Allotment? Training? Hearing Protectors? Probably all of the above and more © 3M All Rights Reserved.

7 Damage Risk Criteria – how much noise is too much?
Percent risk of material hearing loss (hearing threshold levels >= 25 dB) above that anticipated in non-noise exposed population, based on 40-year working lifetime. From NIOSH White Paper (5/2012) Selection of Audiometric Frequencies included in analysis kHz 1-2-3 kHz kHz Avg Exp Level, dBA ISO 1971 NIOSH 1972 EPA 1973 ISO 1990 NIOSH 1997 90 21 29 22 3 23 14 32 17 25 85 10 15 12 1 16 4 6 8 80 5 More recent work identifies higher frequencies as key for verbal communication Analysis-dependant – inclusion of higher frequencies increases population OSHA accepted 21% to 29% excess risk in 1981 (PEL) Revised position to 10% to 15% in 1983 (Action Level) © 3M All Rights Reserved.

8 Resource Allotment HCP Cost Implications
1976 Cost Impact Analysis $32 per worker - $ in 2011$ $12 (37% of total) for monitoring $20 for audiometric testing 1983 HCA Cost Impact Analysis $41 per worker - $91.13 in 2011$ $12-$18 (44% of total) for monitoring $10 for hearing protection devices 1992 OSHA Philadelphia Region Compliance Guide $86.60 per worker - $ in 2011$ Recent analysis for major manufacturer 1999: Automotive - $250 per noise-exposed employee per year 2011: General Industry - $350 per noise-exposed employee per year © 3M All Rights Reserved.

9 Hearing Testing Letter of Interpretation allow use of insert earpieces
Search Croft Letter on OSHA.gov Greater comfort Better tests Less issue with background noise 29CFR (g) Appendix G Specify hearing testing procedures Infer that only TDH- 39 and TDH-49 supraural headphones can be used © 3M All Rights Reserved.

10 Training…or not so much
Promote behavioral change Health Belief Model Behavior depends on perception of: Severity of a potential illness Susceptibility to that illness Benefits of taking preventive action Self-efficacy “My actions will make a difference” Barriers to taking that action © 3M All Rights Reserved.

11 Our mission? Persuade people that hearing loss is a severe impediment to lifestyle Communicate susceptibility Communicate benefits Remove barriers Real Perceived Define the decibel Beat people up for off- the-job behaviors Provide nap time during workday Check the box How? Testimony, hearing loss simulation, interactive training © 3M All Rights Reserved.

12 How about Hearing Protectors?
Intended to be last line of defense against NIHL Instead, often the ONLY protection against noise So how’s that working? © 3M All Rights Reserved.

13 Do HPD provide what we expect?
Berger, EARLog 20, 1993 Laboratory Field © 3M All Rights Reserved.

14 Is it the labeling process?
NRR EPA testing and labeling requirements Lab based Unreliability leads to derating OSHA: (NRR-7)/2 NIOSH: Variable by type Pressure on mfr. Label value is inaccurate Variability in even lab data Typical SD 3-5 dB per frequency Test Frequency 125 250 500 1000 2000 3150 4000 6300 8000 NRR Mean 37.4 40.9 44.8 43.8 36.3 41.9 42.6 46.1 47.3 29 SD 5.7 5.0 3.3 3.6 4.9 3.0 3.1 3.5 2.7 © 3M All Rights Reserved.

15 Special HPD for special noises and needs
Impulse Weapons fire Arc flash Low attenuation Flat attenuation © 3M All Rights Reserved.

16 Communication in Noise
Ambient Listening Radio Communication UHF DECT © 3M All Rights Reserved.

17 Fit testing Hearing Protectors
If we want to know how well HPD work on individuals, test them on individuals Technologies REAT Loudness Balance MIRE PAR Note: All of the approaches described today are point measures © 3M All Rights Reserved.

18 REAT Approaches Hearing test with and without HPD Existing equipment
Each frequency/each ear separately Existing equipment Audiometer phones Caveats Loudspeakers in test booth “Gold Standard” © 3M All Rights Reserved.

19 FitCheck Special headphones Pulsed 1/3 octave bands Subjective
High output High volume Pulsed 1/3 octave bands Subjective As variable as a hearing test Time consuming Background noise May be issues with HOH/tinnitus © 3M All Rights Reserved.

20 REAT-like Systems Subjective Threshold response Integrafit NIOSH
Single frequency NIOSH HPDWellFit – commercialized as FitCheck Solo Moldex, CPE QuickFit Pass/fail Web-based htm © 3M All Rights Reserved.

21 Loudness Balance Balance tones binaurally Each frequency separately
No HPD One HPD Both HPD Each frequency separately Any earplug Subjective New skill Different test tones Time consuming May be issues with HOH workers/tinnitus © 3M All Rights Reserved.

22 Loudness Balance Sperian VeriPro www.howardleight.com/veripro
* Single frequency “quick check” option © 3M All Rights Reserved.

23 MIRE Simultaneous measurement inside and outside HPD yields noise reduction (NR) Specially prepared/probed HPD Software provides stimulus, calculation and compensation MIRE (objective NR) to REAT (subjective insertion loss) © 3M All Rights Reserved.

24 E-A-RfitTM Objective Quick No issues with Specially prepared earplug
HL Background noise Specially prepared earplug EARfit.3M.com © 3M All Rights Reserved.

25 Safety Meter by Phonak Similar to EARfit Custom HPD product
Port permits msmt Headphone source © 3M All Rights Reserved.

26 What do we find when we can look?
Classic Regular N = 1665 NRR1979 = 29 dB Mean = 30 dB SD = 6.8 dB 80th = 37 dB 20th = 24 dB UltraFit N = 480 NRR1979 = 25 Mean = 26 dB SD = 5.5 dB 80th = 31 dB 20th = 22 dB Note: scale on all charts 1 to 50 PAR on X; % of tests 0% to 15% on Y © 3M All Rights Reserved.

27 DRAFT for internal use only
4/26/2017 © 3M All Rights Reserved. E-A-Rfit training 1 intro DRAFT

28 Chemical Company PAR >=20 on at least two plugs
DRAFT for internal use only 4/26/2017 Chemical Company PAR >=20 on at least two plugs © 3M All Rights Reserved. E-A-Rfit training 1 intro DRAFT

29 Consumer Products Mfr “First time good” Retraining Alternate HPD Total
88 37 24 149 59% 25% 16% 100% 29 © 3M All Rights Reserved.

30 Federal OSHA and Fit Testing
3M PSD Federal OSHA and Fit Testing Letter of Interpretation pending Current status Directed to response to Question 10 of the Q&A at: document?p_id=19194&p_table=INTERPRETATI ONS “If the employer can satisfactorily demonstrate that the protection he provides is better than these calculations*,you may use his attenuation in place of the CPL method* if the affected employees do not exhibit STS's.” *”these calculations” and “CPL method” refer to (NRR-7)/2 © 3M All Rights Reserved.

31 NEW AND IMPORTANT www.dol.gov/regulations/regreview/
OSHA seeking input Some regulations may be out of date due to technology advancements Like hearing protector testing Input sought Check postings of others and vote or agree, or Start your own string © 3M All Rights Reserved.

32 OSHA Alliance Alliance
al.pdf © 3M All Rights Reserved.

33 Alliance Individual Fit Testing Applications
Train and motivate employees Train the trainer Assign/select HPDs Provide standard-threshold-shift (STS) follow up Determine HPD adequacy/sufficiency Audit departments Demonstrate adequacy of training Provide documentation © 3M All Rights Reserved.

34 Comparability With identical octave band attenuation, different systems yield different PAR values Calculation protocols Uncertainty Data and chart courtesy of Murphy, NIOSH, from NHCA 2011 Freq 125 250 500 1000 2000 4000 8000 Att 11 13 12 17.5 27.5 33 22 © 3M All Rights Reserved.

35 … as research continues …
Making Progress Hearing loss prevention is possible New technologies New approaches New attitudes … as research continues … Courtesy Audibel © 3M All Rights Reserved.


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