While not all older adults have hearing loss, the likelihood of noise-induced hearing loss and other hearing impairment increases as we age.

Listen Up: Training Older Workers

The first thing we think of with respect to accommodations are for those with mobility impairment, but what about workers with hearing impairment?

By 2020, almost 37 percent of the workforce is predicted to be age 55 or older. Many of those workers are in your workforce now and have provided years of productivity to your organization, and many will continue to deliver value to your organization for years to come. How do you -- and how will you -- manage them in your Hearing Conservation Program (HCP)?

According to the U.S. Bureau of Labor and Statistics, the trend during the past two decades and projected forward reveals the number of younger workers decreasing and the number (and percentage) of older workers increasing. The trends show a decreasing portion of workers 16-44 and significant increases in the percentage of workers above 55 years of age, and even in the group above 75 years old, as well!1

While not all older adults have hearing loss, the likelihood of noise-induced hearing loss (NIHL) and other hearing impairment increases as we age. The U.S. Current Population Survey (CPS), a monthly survey of about 60,000 “non-institutionalized adults” households conducted by the Bureau of the Census for BLS, provides a comprehensive body of data on the labor force, employment, unemployment, persons not in the labor force, hours of work, earnings, and other demographic and labor force characteristics.2 Since June 2008, the CPS has asked questions to gather more details about disabilities. The questions are broad and apply to anyone in the household. Regarding hearing loss, each household is asked "Is anyone deaf or have serious difficulty hearing?"

  • Adults older than 55 were eight times more likely to answer "Yes."
  • Less than 1 percent (0.97 percent) of respondents age 16-54 answered "Yes."
  • Almost 8 percent (7.8 percent) of respondents age 55 or older answered "Yes."
  • Looking only at employed respondents, adults older than 55 were more than four times as likely to answer "Yes."
  • Of those 54 and younger, 0.71 percent answered "Yes," whereas 3.28 percent of those over 55 answered "Yes."

Of course, not all hearing loss is noise-induced. However, we do not want to add to the prevalence of hearing loss. No matter the cause, these workers still must be protected from hazardous noise exposures, and accommodations may be necessary to ensure a safe working environment.

Beliefs/Training Methods for Older Workers
Workers aged 55 years and older bring a different set of values to the table than younger workers. Their needs are often different, as well. Having been around a while, they've garnered more work and life experiences -- but that also means they perhaps have developed some habits, attitudes, and physical conditions during their working years that predispose them to a different way of interacting within their work environment.

This is not to say older workers are resistant or challenging. Like any other good employee, they want to work hard and perform well for their employer. Rather, what it means is that the employer needs to be insightful and flexible in order to take full advantage of the value an older employee has to offer.

Hearing conservation testing and training may take on new dimensions with older employees. Instead of dreading what many might perceive as extra challenges with this population, a prepared and insightful employer will see this as an opportunity and take advantage of it. Many workplaces use the annual hearing test in their HCP to retrain workers on the use of hearing protective devices or to brush up prior training. When identified during the annual evaluation, older workers with an existing hearing loss are often more engaged in the process if the HCP manager indicates a willingness to help the worker make the best use of his or her remaining hearing, whether or not they are wearing hearing aids. The fact that this individual is in the workforce is a positive sign; older persons with hearing loss who have given up, don’t care, or are defensive about their hearing loss are usually socially withdrawn and unlikely to remain employed. The older worker who remains is motivated to do so and is more likely to be motivated to mitigate any hurdles imposed by the hearing loss.

Seeing this opportunity, a creative HCP manager can modify the use of an instrument such as the Client-Oriented Scale of Improvement (COSI™) – it is commonly used to assess hearing aid intervention -- to evaluate individual communication needs and challenges.3 The COSI is tailored to the individual and is designed to identify specific communication problems, guide targeted solutions, and gauge improvement. It is geared toward obtaining outcomes and sends a message that the HCP manager cares. Adaptation of the COSI doesn’t have to be limited to hearing-impaired workers; any worker with communication issues due to noise in his work environment and/or the use of HPDs can use the COSI to identify areas of difficulty. Nor does the COSI need to be relegated solely to hearing issues. Older workers without serious communication difficulties may have other physical conditions that require some adaptation in HCP training. A common one is marginalized manual dexterity, making the use of roll-down ear plugs difficult. Another is reduced range of arm motion that impedes the over-the-head pinna-pull technique many use for placement of ear plugs.

Once his or her individual needs are identified, the worker should be involved in the resolution. This gives the worker some ownership and makes follow through more likely. At the point of success, as gauged by the follow-up "Assessment of Improvement" phase of the COSI, and with some sense of ownership established, an older worker may be encouraged to fulfill the role of "ambassador" for the HCP.

Unique to the motivation of older workers, by virtue of age and experience, are opportunities and challenges for mentoring others, both age peers and younger workers.4 The role of ambassador or mentor can be realized in several ways -- as a special HCP team member to work with others on the same issues identified in their own COSI assessment, or in a buddy system with an age peer or younger worker who is new to the HCP -- with a goal of involving the worker in teaching others to value their hearing and the program. The teaching component of being a mentor is important: When one teaches, one learns twice. This concept makes the worker a better HPD user, improves the overall effectiveness of the HCP, extends the reach of the program manager, and can make his or her job easier in the long run.

What Motivates This Population?
How might we motivate these workers to prevent noise-induced hearing loss as the years go by?

The reasons older workers remain in the workforce are varied, ranging from financial need to social needs. Individuals are motivated by different factors, so one solution will not work for all. We must have a variety of tools and strategies to maintain the hearing health of workers.

  • Money as a motivator. Regardless of the primary reason for an older worker to remain in the workforce, pay is probably a factor. According to a recent national survey by the Better Hearing Institute of more than 40,000 households, hearing loss has a deleterious impact on earnings and unemployment rates. There is a $14,100 income differential between respondents with mild versus severe hearing loss. People with untreated hearing loss lose as much as $30,000 annually, depending on their degree of hearing loss.5
  • Tinnitus as a motivator. Most of us have experienced tinnitus at some point and many have a constant ringing in their ears. Demonstrating the annoyance of tinnitus might get the attention of those workers who are not (yet) suffering from tinnitus. One way to demonstrate tinnitus is to nonchalantly turn on a recording of tinnitus during a training session (sound files are available on the Internet that mimic common tinnitus sounds). Do not mention it until an audience member says something about it. Keep it playing for a while, explaining that tinnitus is often one of the symptoms of noise damage, and although it can sometimes be controlled and treated, prevention is the best cure.
  • Testimonials and mentoring. Consider having someone who suffers from hearing loss share their experiences. It is best to ask members of the workforce or someone whom the workers respect and admire speak with them. Hearing stories about how hearing loss can affect quality of life can be emotional and therefore more memorable. As mentioned above, involving older workers to help train, motivate, and monitor younger workers and peers has benefits for both the mentor and the mentored.
  • Missing out. There are many jokes about hearing-impaired people misunderstanding a word or phrase, but in reality it can be anything but funny. Studies show that hearing-impaired people earn less than normal-hearing counterparts. Misunderstanding a word or not hearing a warning clearly can be a safety hazard or, worse, life threatening. Consider using posters such as those shown here to raise awareness of the consequences of noise-induced hearing loss.

Accommodations for Older Workers
The next generation of older workers will be relatively more safety conscious and tech savvy. They will expect the employer to provide a safe and accessible work environment. The first thing we think of with respect to accommodations are for those with mobility impairment, but what about workers with hearing impairment?

Accommodations include the ability to hear communications and vital warning and informational sounds. Solutions for workers could include a different hearing protector that allows clearer communication or a telephone or communication adaptation that provides better communication. In cases of life-critical communication, intelligent hearing protection is both an accommodation and required personal protective equipment. Intelligent hearing protection combines a communication system with an appropriate HPD to provide smart personal hearing protection, verifiable personal noise exposure measurement, and the clearest communication throughout a full range of work environments and types of noise. It transforms a worker's hearing and ability to communicate clearly from a point of vulnerability to a productivity advantage.

The workers you have now might eventually become the "older workforce," so get them engaged now to be part of the solution in both the short term and the long term.

References
1. http://www.bls.gov/emp/ep_table_304.htm
2. http://www.bls.gov/cps/cpsdisability_faq.htm
3. http://www.nal.gov.au/outcome-measures_tab_cosi.shtml
4. http://safetydailyadvisor.blr.com/archive/2008/09/12/training_older_workers_motivating_aging_workforce.aspx
5. http://journals.lww.com/thehearingjournal/Fulltext/2010/10000/MarkeTrak_VIII__The_efficacy_of_hearing_aids_in.4.aspx#P53

This article originally appeared in the May 2012 issue of Occupational Health & Safety.

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