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A Roundtable on Hearing Conservation Programs by Examinetics
Examinetics, a leading moble onsite occupational health screening and testing service, provides audiometric tests and compliance exams to workers and workplaces across the country. Over the last few months, the group has collected information from audiologists (see participants below) on hearing conservation programs and hearing health in general. Read the Q&A below!
Participants:
Cindy Bloyer, AuD, CCC-A, CPS/A - A seasoned audiologist, Dr. Bloyer has worked in hearing conservation for 29 years and serves as the Manager of Audiology Services for Examinetics. She is a licensed and certified audiologist, a CAOHC Certified Course Director and a CAOHC Certified Professional Supervisor.
Diane Bachman, MS, CCC-A - An audiologist since 1986, Diane has worked solely in the area of hearing conservation for 16 years. She works with facilities nationwide ensuring regulatory compliance and program excellence. Additionally, Diane is a member of the National Hearing Conservation Association, a CAOHC Certified Course Director, a CAOHC Certified Professional Supervisor and a certified member of ASHA.
Cassie Ford, M.A., CCC-A - Cassie’s background includes public health, pediatrics, geriatrics, diagnostic and rehabilitative audiology, but she has worked exclusively in occupational audiology since 2000. She is a CAOHC certified Course Director and Professional Supervisor of the Audiometric Monitoring and holds the Certificate of Clinical Competence from the American Speech Language and Hearing Association.
What tips do you have for someone running a hearing conservation program?
CB - Don’t lose sight of individual employees when building and managing your HCP. While it’s easy to think of the big picture, often individuals are overlooked that have an impact on the big picture. We see this with both employers and employees.
Often, employers may think the best hearing protector is the one with the highest noise reduction rating. Unfortunately, that is rarely the case. Other factors need to be considered. For example, noise levels in the workplace or listening needs of the employee while in noise. Some jobs may require the worker to hear speech clearly to work safely, while other roles may only require workers to hear warning alarms. Also, it’s very important to consider employee comfort.
On the employee side, they need to buy in to programs and understand the depth of noise damage. When their hearing is damaged, it not only affects them, it affects those around them. Noise harms hearing slowly over time. A person with hearing loss may not notice it until it is quite significant. Hearing damage can be easily prevented when it is properly prioritized.
CF - Focus on training throughout the year, not just testing day. The success of everything else you do in a hearing conservation program hinges on your employees understanding why it is important to protect their hearing. As Cindy said, their “buy-in”. Employees have to buy into the need for hearing protection in order for it to truly work effectively, and talking about it all year long creates that engagement.
DB – Employers should value the importance of good noise data. This allows you to accurately identify which employee’s noise exposure meets the 85 dBA action level and should be included in the hearing conservation program. It also allows you to better evaluate if the employee’s hearing protection provides the appropriate amount of attenuation. Ultimately, noise data gives you the ability to evaluate feasible noise controls or administrative controls for any noise exposures equal to or greater than 90 dBA.
What do you think is the future of protecting workers from noise-induced hearing loss?
CF - In the short term, I see the future of protection in noise control. There are often relatively inexpensive changes that can be made to reduce employee exposure levels. The best way to protect employees from noise-induced hearing loss is just to not expose them to damaging levels of noise. In the long term, there is a lot of interesting research into pharmacological agents that can help protect people from noise-induced hearing loss or can help with the recovery of hearing when people experience traumatic noise exposure.
CB - Like Cassie mentioned, I’m excited about the possibility of oral supplements that may be used both as a preventative and a possible “day-after” treatment. Over the past decade or so, there are strides towards certain antioxidants as both a preventative and a treatment for hearing. However, this process won't be completed for years as clinical trials need to be completed with costly prices. There is also the fact that any oral supplement needs to be taken to be effective. It’s one thing for an employer to mandate HPD’s. It’s a different issue for an employer to mandate employees to ingest something.
DB – On the other end of the spectrum, technology and artificial intelligence will drive the availability of small in-the-ear devices that provide hearing protection and enhanced speech understanding in noise. These devices will provide feedback regarding daily noise exposure doses reaching the ear and warning the employee when the daily dose has been exceeded.
What question do you get asked most by clients?
CB – We get a variety of questions daily. However, one of the most frequent questions I get is, “How can this hearing loss be work-related if the employee wears hearing protection?” Hearing protection isn’t the perfect solution to workplace noise. There are always many variables involved.
DB - I often hear, "Am I required to record an employee on my OSHA 300 log when the employee has a history of several non-occupational noise exposures?" The Examinetics Recordable Shift Questionnaire allows for documentation of non-occupational noise exposures. However, the presence of non-occupational noise exposure all by itself does not justify a case to be determined not work-related.
CF – I also get a lot of work-related vs non-occupational noise exposure questions. It’s important to remember that noise can damage hearing wherever it occurs. Also, noise damage depends on the loudness and length of exposure. The employee may be doing noisy things when off the job, but they are exposed to workplace noise normally for at least 40 hours a week.
What is the most unexpected question or situation you have received from a client?
CB - Funnily enough, a few times every year I receive a phone call from a plant wanting to discuss their STD rates. It always takes me a second to realize they mean STS.
However, the weirdest – and scariest – question was from a plant nurse. She had an employee – a young father - who wanted to know what type of earplug would be best for his 9-month baby to wear while the baby rode on his lap when dad was on the riding lawn mower. While I don’t condone the idea of a baby on a lawnmower and counseled against that, at least dad realized he needed to protect his child’s hearing from dangerously loud noises.
CF - It wasn’t the weirdest, but it was definitely one of the most disconcerting. One time, I had a plant nurse call me to ask if they could require all employees to wear earmuffs and not allow earplugs at all. The safety manager felt this was the only way they could verify easily that employees were wearing their hearing protection.
I explained that the OSHA hearing conservation amendment requires that the employer provide a variety of hearing protection devices and just providing more than one earmuffs really didn’t comply with the regulation. This site was located in a warmer part of the country, so I suspected that the warmth of earmuffs would lead to many employees removing them when in noise. I suggested additional training on hearing protector fitting and periodic monitoring.
DB - I had a similar experience to Cassie. A plant management team decided to place all of their employees in custom earplugs. The occupational nurse wanted know how to handle a case where an employee preferred her previous foam hearing protection over the mandatory custom earplug. The foam earplug was perceived as providing better attenuation even after the custom earplug had been remade in an attempt to obtain a better fit. The employee reported the foam earplug stayed in the ear better while the custom earplug often lost the seal. This was frustrating. The nurse understood the employee was performing better with the use of foam earplugs, however she couldn’t use foam earplugs as management had made an executive decision for uniform hearing protection.
To reiterate, the OSHA standard states a variety of hearing protectors must be provided. One hearing protector for all employees can be the result of good intentions from management but results in problems for individual employee perceptions and needs. The working environment noise exposure, type of work performed, critical tasks, convenience and comfort are all variables to evaluate when selecting hearing protection.
What are some successful HCP’s you’ve seen?
DB - In general, non-specific terms, I believe several factors contribute to successful HCP’s. First and foremost, recognition of the importance of audibility and communication is critical to the employee’s safety and prevention of removing HPD to understand conversations while in noise. When our clients have developed and implemented engaging educational programs that go beyond the annual OSHA required training, the results are also impressive. At the core, encouraging a strong team approach from plant management, occupational nurses, safety manager and individual workers and each recognizes their role in the success of the program is the key to success.
CF – One of our clients won the Safe-in-Sound Excellence in Hearing Loss Prevention award recently. They actually included hearing loss prevention as one of their corporate sustainability goals at least partially because use of disposable hearing protectors increases the waste created by facilities significantly. They were able to take large numbers of employees out of their hearing conservation program by making very simple inexpensive changes to their equipment and processes.
CB - One that comes to mind for me is a packaging client. That team has also won awards for their HCP. After implementing engineering controls to reduce and eliminate workplace noise levels, the resulting noise levels still required the use of hearing protection. One of the things they do is bring Examinetics in on an annual basis for a week of hands-on HPD training of employees and the folks responsible for the ongoing HPD fitting at the plant. They work hard to get every individual employee involved.
What is one thing you wish people understood about workplace hearing loss?
CF - It is always important to protect your hearing when in noise. It often seems that employees and employers think that once an employee has experienced a significant hearing loss, any further change in their hearing cannot be work-related. However, even when an employee has a hearing loss that has been attributed to a non-occupational cause, they are still at risk of further hearing damage due to noise exposure. In fact, it’s probably even more important that we focus on protecting these employees in order to protect the hearing they still have left.
DB - Noise-induced hearing loss is 100% preventable. Noise-induced hearing loss can affect relationships in many ways. Hearing and our ability to engage effectively with the environment around us are critically important for maintaining relationships and activities. New research shows that untreated hearing loss has a profound effect on mental health including reduced social interaction, increased frustration and anger, loss of spontaneity, reduced cognitive function, increased brain aging and increased risk of dementia.
CB - My “make-a-wish” is that everyone would truly understand the value of their hearing. Workplace hearing loss is 100 percent preventable, but it takes “buy-in” by both the employer and the employee. The employer can’t simply rely on being “compliant,” and the employee needs to take personal responsibility in wearing HPDs consistently and correctly whenever in noise.
As Diane said, whether you have normal hearing or already have some hearing loss, it is your ability to hear that connects you most intimately with people. Certainly hearing words is important, but so is the ability to “hear” intonations and inflections in those words. Imagine not being able to hear a child’s laughter or the wind through the trees or the contented sigh of a loved one. Allowing yourself to lose your hearing is allowing yourself to lose out on so much of life.
For more information on Examinetics and its efforts during the COVID-19 pandemic, go here.