Image of a woman wearing ear muffs.

The Silent Hazard

In order to successfully eliminate hearing loss, more needs to be known about its true prevalence in the workforce. NIOSH is spearheading the effort.

For years, industry has called for a change or update to the Environmental Protection Agency's Noise Reduction Rating (NRR) system. Most recently, when EPA solicited comments for its proposed revisions to NRR labeling regulations, manufacturers overwhelmingly spoke up. One of the most vocal was the National Hearing Conservation Association (NHCA), which called on EPA to specify simpler labels and base its values on ANSI S12.6-2008 Method B rather than Method A. But in order to truly regulate occupational hearing loss, safety professionals must gain an understanding of its true impact in the workforce.

In 2005, the National Academies Institute of Medicine (NAIM) evaluated the NIOSH Hearing Loss Research Program and made many key recommendations. Among those recommendations was a call for better hearing loss surveillance data. Currently, the United States does not have a national surveillance or injury reporting system for hearing loss. Instead, regulators depend on hearing loss standard threshold shifts reported on OSHA Form 300, which many professionals agree are not representative of the true magnitude of occupational hearing loss.

Surveillance Program
In response, NIOSH has launched many efforts to both acquire better data and to disseminate the importance of good hearing loss prevention programs. Foremost is the development of a surveillance program of occupational hearing data.

"Surveillance can begin at many different points," said SangWoo Tak, ScD, MPH, an epidemiologist at NIOSH's Surveillance Branch. "You can start collecting new data, which is starting from scratch. But this time, we're looking for more efficient ways. We looked for who had the data. There is somebody out there that is collecting data. If those people, those agencies or bodies, are willing to share their data, we could start surveillance from there and then improve from there.

NIOSH felt the best place to start was with NHCA, which has more than 40 audiometric service providers as members. "Right now we have six service providers who are working with us. We know how many companies are involved and how many workers are covered in this program," Tak said. "We're talking probably more than ten million data points for this year."

As this data is compiled and analyzed, NIOSH will first send its findings to its participants for their use and then publish the results. "We'll produce some very detailed statistics for manufacturing. So each of the industry business employers will be able to see where they are located. If their data was used in the surveillance, they will have specifically some sort of benchmarking results," Tak said. "But if they're not, they can simply look at their distribution of the hearing loss and then compare their companies to these national samples."

While providing an exorbitant amount of data, those six providers are just the start. By 2012, a total of 15 providers will be recruited to participate in this surveillance program. The hope is that this program will continue to grow so that eventually all industries are represented, especially those that are traditionally unknown.

"For example, we know the manufacturing industry sector is at highest risk, but we don't really know what kind of specific industries are affected," Tak said. "From my experience, one of those examples is actually the printing industry. There has been a couple of studies in that past that show this industry has a higher risk of getting occupational hearing loss, but we really don't have the statistics or data. So, that kind of information is the one we will be creating and producing."

One key to growing this program is NIOSH's partnership with NHCA. These two entities have a history of working together. In 2006, they collaborated to create the Safe-in-Sound Award to recognize excellence in hearing loss prevention. "NIOSH has been a very good partner with us," said NHCA President Rick Neitzel, Ph.D., CIH. "It seems natural to take that partnership to the next level and join them in developing these Safe-in-Sound awards. We've actually hosted various seminars and workshops around the country that have been partially supported by NIOSH over the years, so it's not the very first partnership we've developed, but I think one of the most fruitful and one that I certainly look to be ongoing."

Thais Morata, a research audiologist at NIOSH's Hearing Loss Prevention Section, said the positive applications of this award are numerous. "One main objective is to recognize companies or institutions that can demonstrate that they are doing something that really works to prevent hearing loss," Morata said. "The other is to learn from their experiences and share this information with the community at large so those that may not have distinguished sources to develop those strategies may learn something, or may be able to adapt and implement an effective hearing loss prevention initiative."

The first Safe-in-Sound awards were presented in February 2009 at NHCA's annual conference. Currently, there is a limit of four awards given, but if four recipients cannot be found that meet its requirements, an award won't be given. "We had made a decision to really hold the award to high standards, so if one year we don't have a good application, we might not even give the award," Morata said.

The response has been so positive that NIOSH and NHCA are considering adding an award for environmental noise. The current awards focus only on occupational hearing loss, with one exception: the fourth award is given in recognition of innovations, which can extend into non-occupational hearing loss exposure. "One of the winner's last year, the Domtar Paper Company, they won the award because they could prove that not only did they have an excellent connection to all of the components of a hearing loss prevention program, but they did a whole lot of work to include non-occupational exposure," Morata said. "For instance, they knew some of the workers were musicians, so they would encourage them to take the hearing protection home and to wear and to also educate their kids and inform the community about problems with noise."

Each of the award winners present their stories at the ceremony. Their presentations are posted online at the Safe-in-Sound Web site, Also, their information is being gathered together to be made into education materials that other companies can use for their benefit. Morata said he expects the materials from last year's winners to be available this summer. The next awards will be presented at the NHCA Annual Conference, which will take place later this month in Orlando at Rosen Plaza Hotel.

For more information on NIOSH's hearing loss prevention efforts, including its ongoing surveillance program, visit

This article originally appeared in the February 2010 issue of Occupational Health & Safety.

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