HeaHreianrigng PPrrootetcteiocn tion Can You Hear Me Now? Assessing exposure and implementing successful interventions By Louise Vallee, Michael Ruddy and Kristin Bota

NOISE HAS BEEN RECOGNIZED as an occupation - grams are missed al since the 1700s, but only recently has the opportunities to pre - Nadditional impact of recreational source contribution vent hearing loss. To across generations been revealed. Studies suggest that identify and address half of all baby boomers are experiencing some degree those gaps, needed inter - Abstract: Noise-induced of hearing loss as a result of workplace and/or recre - ventions include program hearing loss is 100% ational noise sources. Additionally, they are hesitant to audits, follow-up on problem preventable. Workplace seek hearing testing and remediation measures, such audiograms and action plans. SH&E professionals hearing conservation as hearing aids (Trads & Glasscock, 2006). can directly affect the success of these programs by programs are a key With the advent of personal mobile telephones focusing attention on hearing conservation program frontline defense to and music devices, generation X-ers and millenials, performance. identify and control the as well as boomers, are at additional risk for greater impact of noise-induced hearing loss than previous generations. Under- Noise: A Chronic Problem hearing loss. Gaps in standing of the impact of recreational noise on life - Sound results from pressure changes in air due to these programs are long hearing is limited. Noise as unwanted sound is vibration. Overexposure to noise, whether of industri - missed opportunities to a by-product of many industrial operations. Noise as al or recreational origin, results in hearing loss. prevent hearing loss. wanted or unwanted sound is an intended outcome Hearing loss can occur from exposure to a single, or by-product of many recreational activities (Table extremely loud event but more typically is a result of 1). For example, attendance at a rock concert may chronic or ongoing overexposure. result in exposures to loud but desirable sound, The extent of hearing loss depends on exposure while target shooting results in loud, undesirable loudness, duration and frequency. Chronic overexpo - noise accompanying an enjoyed activity. sure to noise can result in permanent hearing loss, Noise-induced hearing loss is 100% preventable. called a permanent threshold shift (PTS). PTS can Workplace hearing conservation programs are a key result from workplace or recreational noise sources. frontline defense to identify and control the impact Noise-induced hearing loss can start out as a tempo - of noise-induced hearing loss. Gaps in these pro - rary effect from short-term exposure with recovery Louise Vallee, CSP, CIH, CPE, is an executive research and development specialist for occurring after removal from the noise. This effect is the Chubb Group of Insurance Cos. based in Whitehouse, NJ. She holds an M.S. in called a temporary threshold shift (TTS) (NIOSH, Industrial Hygiene from the Harvard School of and a B.S. in Environ- 1998). mental Science from the University of Massachusetts at Amherst. Vallee has 32 years’ Hearing loss is insidious: irreversible and unrec - loss prevention experience. She is a professional member of ASSE’s New Jersey Chapter. ognized detrimental effects develop over time with no precursor warning signals. , ringing in the Michael Ruddy, CSP, is a senior property and casualty risk engineer/product liability ears, can also be experienced. Hearing loss makes it specialist for the Chubb Group of Insurance Cos. based in Indianapolis, IN. He holds a difficult to communicate with coworkers, family B.S. in Occupational Safety from the University of Wisconsin, Platteville, with a members and others, which can produce feelings of minor in manufacturing and production management. Michael has nearly 30 years’ isolation. Overexposure to noise can result in stress- loss prevention experience. He is a professional member of ASSE’s Indiana Chapter. induced illness, high blood pressure and loss of Kristin Bota, CSP, is a senior property and casualty risk engineer for the Chubb sleep. Noise and hearing loss in the workplace caus - Group of Insurance Cos. in Dallas, TX. She holds a B.S. in Applied Biology with a es reduced safety awareness and increased accident minor in chemistry and a B.S. in Industrial and Management potential. Distracting and excessive noise levels are from Ferris State University. She has 23 years’ loss prevention experience. Bota is a linked to lowered productivity, both in industrial and professional member of ASSE’s Southwest Chapter. office settings (CCOHS, 2008; EPA, 2009). 26 PROFESSIONAL SAFETY NOVEMBER 2010 www.asse.org TaTabblee1 1 Common Noise Levels

ing use of hearing protective devices (HPD) for affected employees, HPD re- fitting and , and a clinical audio - logical or an otological exami - nation, as deemed Note. Adapted from “Noise Meter,” by NIOSH, 2009. appropriate. Bureau of Labor Statistics (BLS, 2004-07) data reflect reduction trends following the implementation of the more rigorous OSHA reporting requirements. As Table 2 shows, recordable cases dropped 19% within the private A 2005 University of Washington industry sector from 2004 to 2007. study found that most of the partici - As a common industrial exposure, noise is fre - pating companies had substantial quently part of an OSHA inspection. Table 3 shows shortcomings in their hearing loss pre - the significant number of OSHA citations for non - vention programs (Daniell, Fulton-Kehoe, compliance with 1910.95 each year. This standard is Cohen, et al., 2002). Lack of exposure moni - the 12th most frequently cited OSHA standard for toring, hearing protection enforcement and fol - the manufacturing sector, according to OSHA. For low-up on audiometric tests all result in ineffective example, one company was fined $89,750 for failure management of potential hearing loss. Other studies to protect workers against haz - have shown that hearing loss can directly affect ards ($63,000 for failure to provide required medical household income. Estimates suggest that the finan - evaluations; $24,750 for failure to maintain and mon - cial impact of unaddressed hearing loss in the U.S. itor a hearing conservation program; and $2,000 for Despite reduction exceeds $100 billion annually (Kochkin, 2007). failure to meet recordkeeping requirements) (Smith, trends that emerged Hearing Loss Trends 2002). Although these penalties can be significant for in the wake of more an individual company, they pale in comparison to rigorous reporting Depending on the definition of exposure and the cost of work-related hearing loss illnesses. requirements (Table impairment, NIOSH estimates that 5 to 30 million A 2004 study estimated that half of the 76 million 2), OSHA’s occupa - workers in the U.S. are exposed to noise levels at work baby boomers (born between 1945 and 1964) in the tional noise exposure which put them at risk of hearing loss. Noise is a com - U.S. are experiencing some degree of hearing loss standard remains one mon industrial safety hazard and noise assessments (Trads & Glasscock, 2006). The magnitude of this of the most frequent - are a frequent focus of industrial hygiene consulta - hearing loss is more than 2.5 times that of previous ly cited standards tions. Most noisy workplaces are familiar with OSHA’s estimates. The increased rate of generational hearing (Table 3). general industry noise standard (29 CFR 1910.95), but many are not in full compliance, which negatively affects employee potential hearing loss. Requirements TaTabblee2 2 for permissible noise exposures and controls under the standard, 1926.52 and 1926.101, are the BLS Hearing Loss Data, same as those in the general industry standard (OSHA, “Noise and Hearing Conservation”). Recordable Cases Hearing loss is the second highest specific report - ed occupational illness (Hager, 2009b). Interestingly, the incidence of hearing loss recordable cases is decreasing while some companies report seeing workers’ compensation claims for hearing loss for the first time. This is due to a change in OSHA’s hear - ing loss recordkeeping criteria, which has prompted earlier identification of hearing loss trends. TaTabblee3 3 Beginning Jan. 1, 2003, employers were required to record workers with an average hearing loss of 10 OSHA Noise-Related Citations decibels (dB) at 2000, 3000 and 4000 Hz, and whose hearing level threshold after the change averaged 25 dB or more at 2000, 3000 and 4000 Hz on the OSHA 300 hearing loss column. Such a loss is called a stan - dard threshold shift (STS). Before 2003, hearing loss was recorded when an average loss of 25 dB was noted at 2000, 3000 and 4000 Hz. Under OSHA’s Note. OSHA noise-related citations, October 2007 to September 2008. Data from “Fre- standard, with recognized hearing loss, the employ - quently Cited Standards,” by OSHA, Washington, DC: Department of Labor, Author. er must take additional protective measures, includ - www.asse.org NOVEMBER 2010 PROFESSIONAL SAFETY 27 TaTabblee4 4 Noise Exposure Standards & Doubling Rates aspects directly affect the threshold at which work- related hearing loss is determined to be compensable. In the U.S., American Medical Association or American Academy of Otolaryngology compensation criteria is utilized. OSHA requires that work-related - ness be determined by a physician or other licensed health professional. Hearing loss determination is based on medical history, physical exam, audiogram and data to determine whether hearing loss exists and to identify any workplace causation. Usually, a percentage of hearing loss is established that translates to a percentage of com - A 3 dB doubling rate loss was attributed to workplace and recreational pensability (U.S. Chamber of Commerce, 2008). indicates that each factors and, to a lesser degree, to aging and medical Case submissions can be affected by factors noise level doubling conditions (Trads & Glasscock, 2006). beyond noisy . These factors include a change in results in a 3 dB Previous and aging also may affect filing requirements, plant closings or layoffs, or mil - increase and is more hearing. The Institute of Medicine released a study itary duty. A notable two-fold increase in the number conservative than a in 2005 highlighting hearing loss among war veter - of workers’ compensation hearing loss claims in 5 dB doubling rate. ans. Vietnam veterans are 40% more likely to have Washington state occurred between 1984 and 1998 sustained high-frequency hearing loss than other due to a 2-year window restriction on the filing of veterans (Humes, Joellenbeck & Durch, 2005). hearing loss claims post initial diagnosis (Daniell, et Veterans, particularly those with tactical and al., 2002). Many of these claims were from workers artillery experience, may come into the workplace older than 65. Military veterans also often file claims with preexisting hearing loss. Gun sports, motorcy - for hearing loss. Seventy-three thousand new cases cles, power tools, lawn mowers and racing have were added to government rolls in 2003. In 2004, been associated with the potential for hearing loss as payments to veterans for hearing loss and tinnitus has the use of personal music electronics (NIOSH, totaled $850 million (Humes, et al., 2005). 2009; McCombe, 2003). Hearing loss can accelerate There has not been a high incidence of fraudulent from the cumulative exposure to all of these sources. hearing loss claims. Fraud is suspected when incon - sistent audiogram responses are recorded or when Hearing Loss & Compensability sudden hearing loss is reported after prior normal Workers’ compensation statistics likely underesti - audiograms with no specific linking event. Conver- mate the magnitude of workplace-induced hearing sational abilities better than predicted by audiomet - loss (NIOSH, 2001). Lower STS criteria may result in ric testing are another potential fraud indicator. earlier filing of workers’ compensation claims, but Traditionally work-induced hearing loss audio - workers’ compensation hearing ability thresholds grams show a detriment within the higher frequen - are unaffected by OSHA’s regulatory changes. An cy range (2000 to 8000 Hz), with a “dip” at 4000 Hz STS does not automatically document the basis for a (Nordstrom). As noted, a physician’s determination workers’ compensation claim. of a work-related hearing loss case is based on sub - In the U.S., individual states have different hear - stantiated noise exposure and measurement data, ing loss thresholds for workers’ compensation par - consistent audiometric and physical findings, and tial and total disability, as well as various positions prior audiogram results. Equivocal or absent docu - on workplace causation or aggravation of preexist - mentation may invalidate the finding of a work- ing conditions. Each state has developed compens - related claim (Nordstrom). ability laws and requirements. Presbycusis, the term for hearing loss due to aging, is taken into account Noise Exposure Limits by most states, but it is excluded in at least 13 states. In the U.S., initial noise monitoring efforts are con - Some states require documentation that workplace ducted to identify employees exposed to noise levels noise levels exceed 90 dBA (U.S. Chamber of that exceed an 8-hour shift OSHA action level of Commerce, 2008). This emphasizes the need to care - 85 dBA for hearing conservation program inclusion. fully conduct and document noise assessments since Average noise level measurement for shift exposures past survey data may be requested as part of a com - above the OSHA permissible exposure limit (PEL) of pensability evaluation. 90 dBA determine enforcement actions for appropri - Workers’ compensation benefits can vary dramati - ate hearing protection attenuation and engineering cally. For total loss of hearing in one ear, benefits lev - control efforts. The action level for 10- and 12-hour els can range from $5,520 in California to $101,502 in shifts are reduced to 83 dBA and 82 dBA, respective - Oregon above replacement. For cases involving ly, based on Table G-16A of 1910.95. OSHA’s current total loss of hearing in both ears, the benefit levels policy is not to reduce PELs for extended shifts. range from $35,860 in Alabama to $250,985 in Illinois OSHA specifies that employee exposure to (U.S. Chamber of Commerce, 2008). impulsive or impact noise not exceed 140 dBA. The definitions of total hearing loss or occupational American Conference of Governmental Industrial deafness and the degrees of hearing loss also can vary Hygienists (ACGIH) noise threshold limit values, as differing criteria are applied at the state level. These NIOSH recommended exposure limits and many 28 PROFESSIONAL SAFETY NOVEMBER 2010 www.asse.org TaTabblee5 5 TaTabblee6 6 NIOSH Hearing Impairment Allowable Time Interval Research Estimates Noise Exposure Levels

Note. NIOSH hearing impairment research estimates (1-2-3-4 kHz). Data from Criteria for a Recommended Standard: Occupational Noise Exposure, by NIOSH, 1998, Washington, DC: U.S. Department of Health & Human Services, CDC, Author.

European standards are more conservative than ing conservation programs, while others seek to elim - OSHA has an OSHA’s standard, with an 85 dBA 8-hour exposure inate any unnecessary expense and oversight. In 85 dBA action level. limit and 3 dB doubling rate. Table 4 compares expo - either case, noise monitoring is needed to identify and However, NIOSH sure limits and 3 or 5 dB doubling rates. A 3 dB dou - demarcate noisy areas for compliance enforcement, research estimates bling rate indicates that each noise level doubling including the selection of hearing protection with the that the noise- results in a 3 dB increase and is more conservative correct attenuation. Noise levels may change due to exposed population at than a 5 dB doubling rate. plant expansion or new equipment. OSHA requires risk of hearing impair - OSHA adopted the 85 dBA action level due to con - that noise monitoring be repeated whenever a change ment at exposure lev - cerns for potential hearing loss between 85 and 90 that may increase employee noise exposure occurs on els up to 90 dBA is dBA (Table 5). NIOSH research estimates that the production, processes or controls. three times greater noise-exposed population at risk of hearing impair - Noise monitoring must include all continuous, than those exposed ment at exposure levels up to 90 dBA is three times intermittent and impulsive noise within an 80 to 130 up to 85 dBA (Table 5) greater than those exposed up to 85 dBA. Table 6 dB range and it must be performed on a typical As Table 6 indicates, shows that OSHA’s standard allows two to four times work day. Area or personal monitoring may be per - OSHA’s standard allows greater noise exposure than NIOSH and ACGIH lim - formed, with personal monitoring being best for two to four times its, which is an appreciable difference (ACGIH, 2009; variable noise exposure. greater noise exposure NIOSH, 1998; Health and Safety Executive, 2005). than NIOSH and ACGIH Monitoring Equipment limits, which is an Noise Monitoring Typical noise monitoring equipment includes appreciable difference . An employer must implement a workplace noise sound level meters, noise integrating dosimeters, monitoring program when information indicates that impact noise monitors and octave band analyzers. an employee’s exposure to noise may exceed a time- OSHA specifies that sound level meters and noise weighted work shift average of 85 dBA (the OSHA dosimeters use a 5 dB exchange rate and minimally action level). Having to “speak up” to be heard in nor - meet ANSI Type 2 standards (general purpose use) mal conversation is a common noise overexposure with an accuracy of ±2 dB. OSHA requires use of the assessment rule of thumb, according to OSHA’s noise A slow scale setting for measure - eTool. Typically, the first step is a noise exposure esti - ments. Type 1 meters have greater accuracy and are mation via a preliminary assessment. This entails tak - preferred for work. ing a series of measurements in noisy areas to validate Noise exposures are typically measured with prioritization for further monitoring. either a sound level meter or a noise dosimeter. The sound level meter measures instantaneous noise Noise Surveys intensity. Such a device is often selected for meas - Noise levels may be marked on a floor plan to urements of continuous noise with little variation, identify noisy areas and boundaries, as well as to such as printing presses or for preassessment work. select employees for full-shift monitoring. Noisy Sound level meter measurements must be taken at areas where employees’ exposures may exceed a different task locations and times in order to track time-weighted average of 85 dBA can then be target - the full range of potential employee noise exposures. ed for more extensive noise monitoring. Variable noise is best monitored by noise dosime - A noise survey aims to determine: ters, which automatically integrate and store meas - •employees’ work shift noise exposure; urements as a time-weighted average result. Noise •hearing conservation and hearing protection dosimeters offer various exposure display results enforcement areas; including peak and dose, and the instruction manual •necessary hearing protection attenuation; should be carefully reviewed for results of interest. •noisy equipment and areas, and engineering Variable noise exposures arise from tasks involving control options. equipment with fluctuating noise levels or a that Where & When to Monitor requires frequent task or location changes. Noise Representative worker noise monitoring should dosimeters have a sound level meter function in be completed to accurately assess exposures above addition to datalogging features. and below the OSHA action level and PEL of 90 Impulse or impact noise response meters or filters dBA. Employees who are overexposed to noise and are designed for peak and integrated impulse meas - not identified during monitoring surveys may suffer urements. Octave band analyzers are used to take hearing loss. frequency band noise level measurements to deter - Some companies conservatively choose to include mine the appropriate type of noise control material employees who work just outside noisy areas in hear - or application (OSHA, 1910.95, Appendix III: A). www.asse.org NOVEMBER 2010 PROFESSIONAL SAFETY 29 It is well worth taking time in advance of noise Noise dosimeters should be placed in secure surveys to become familiar with monitoring equip - mode during testing to prevent tampering. They ment and features. Instruction manuals should be should be checked frequently to verify operating reviewed (if missing, check manufacturers’ web - condition and correct placement during the testing sites). An entire survey day can be wasted by human period. Because it is possible that an employee will errors such as failure to depress the dosimeter run remove a unit or that the microphone element will mode button. Equipment batteries should be come unplugged or sustain damage, the consultant checked regularly as well. Avoid storing the devices must remain on site for the duration of the test to in extreme temperature conditions, such as an auto - oversee equipment and maintain chain of custody. mobile trunk, as this can affect battery life. Chain of custody should be carefully documented as In addition, noise dosimeter microphones must well since this issue regularly surfaces as an area of be properly positioned in the hearing zone; they are questioning in legal depositions. typically clipped to workers’ shirt collars. Manu- The final noise report is the product of a complex facturers’ instructions for sound level meter micro - consultation involving the preassessment, noise sur - phone positioning should be followed as well. vey and hearing conservation compliance. The re- Perpendicular incidence microphones should be port should include the following elements: pointed at the noise source (Cheremisinoff, 1996). •executive summary; Sound level tests are usually taken in close proximi - •table of contents; ty to workers’ ears and head to measure actual expo - •introduction and visit purpose; sure. Different brands and models offer various •plant contacts; operational mode selections and display features •methods and equipment model and serial num - and settings should be reviewed for compliance bers; with survey goals. Floor plans and recordkeeping •calibration information and chain of custody; sheets should be organized and prepared in advance •areas and tasks monitored; during equipment setup as well. •result data tables with comparison to allowable Calibration is a critical quality control procedure. It limits; involves checking instrument measurement against a •individual employee result for employee file; known noise source emitted by the calibrator unit. •discussion of findings; Noise monitoring equipment should be calibrated •OSHA 1910.95 compliance audit; before and after each usage with appropriate docu - •recommendations; mentation completed and maintained. Calibration •photos; errors can occur if the calibrator is not turned on or if •floor layout plan marked with locations and the microphone/calibrator interface is not tight. Such results monitored. errors most frequently cause dosimeters to report The report must be specific regarding survey goals readings in excess of actual levels. All noise measure - and objectives and methods used to accomplish ment and calibration equipment should be calibrated them. Details supporting assessment accuracy must to National Institute of Standards and Technology be provided, including equipment serial numbers, standards annually or at manufacturer recommended calibration documentation and chain of custody. intervals (NIOSH, 1998). Monitored tasks, measurement representativeness If employees are to be fitted with noise dosimeters, and periods monitored must be clearly identified. hold a short explanatory meeting with a Q&A session Any equipment problems should be discussed as the day before or morning of the noise survey. well. Results should incorporate an audit against the Common employee misconceptions include fears that provisions of OSHA 1910.95 with recommendations conversations are being recorded or that placing the generated for any gaps noted. dosimeter next to a loud radio for a few moments will Audiometric Testing & Intervention skew results. Normal activities should be encouraged. A baseline and annual audiometric test program Since equipment should not be worn off premises, must be established for employees exposed to noise arrangements should be made to remove and refit exceeding the OSHA action level within the first equipment based on employee lunch plans. 6 months of employment or within the first year if a Belt-worn dosimeters have a 3-ft cable that mobile van testing service is used. Baseline and annu - attaches to the microphone. This cable must be al hearing tests are then compared to detect early signs secured so that it will not become entangled while of hearing loss and enact appropriate follow-up the employee is working. Tangled cable can detach action. These tests must be conducted by qualified from the dosimeter and present safety . New professionals using calibrated test equipment as spec - cableless designs clip directly to the shirt collar to ified by OSHA 1910.95. Qualified professionals avoid these problems. include licensed or certified audiologists, otolaryngol - Employees should be given the consultant’s ogists, physicians and Council of Accreditation in name and cell phone number and be instructed to Occupational Hearing Conservation (CAOHC) certi - call should a need to leave work early arises or if fied technicians under appropriate supervision. equipment problems occur. Under OSHA’s stan - Baseline audiograms should be accomplished in dard, employees must be allowed to observe moni - a timely manner. Continuous efforts must be made toring activities and receive results. to administer the audiometric test program so that 30 PROFESSIONAL SAFETY NOVEMBER 2010 www.asse.org employees with hearing loss do not “slip between expensive equipment retrofits that require a high the cracks” or that new employees with preexisting level of expertise. Common hearing loss are identified early on. Employees may include vibration control and isolation, sound be sent to an offsite audiology clinic or an audiology absorption and insulation, enclosures and sound booth/van can be brought to the worksite for audio - attenuators. , such as job metric testing. Audiometric test rooms must meet rotation, can pose scheduling challenges. OSHA 1910.95 Appendix D requirements. Noise can be controlled at the source generating OSHA 1910.95(g)(5)(iii) and (iv) mandate that the noise, along the path between the source and the employees’ audiometric testing must be preceded by receiver, or through the use of hearing protection 14 hours of either no exposure to workplace noise or worn by the receiver. Noise control at the source sur - working while wearing hearing protection. In addi - passes path and receiver controls. tion, employers must instruct employees to avoid “Buying quiet” is an excellent noise control policy. high levels of nonoccupational noise exposure for the Noise contribution and additional control options same 14-hour period. These practices will reduce the should be considered at purchase time. Retrofitting likelihood of a TTS being identified as hearing loss. noise controls after purchase can be expensive and Hearing Audiology professionals prepare a report of each time consuming, and may deliver only partial suc - employee’s results and identify problem audio - cess. “” programs begin with the purchaser protection fit grams. Experience shows that the quality and com - supplying the vendor with a target noise level and pleteness of these reports vary widely so they noise testing requirements. Vendors must supply and enforce- should be carefully reviewed (Nordstrom). The noise control plans and validation that the controls employer should understand test results, implica - will be effective. Purchase payments may be subject ment are tions and next steps after reviewing the reports. to validated, agreed-on testing with a specified con - All employees with an STS in hearing need to be tract penalty for discrepancies (Wilson, 2009). often over- identified and their cases followed. Employees must When engineering controls are infeasible or do be informed of an STS within 21 days. Employees not work, the employer must provide employees looked with STS may be retested by the employer within 30 with HPDs. These devices are labeled with a noise days because OSHA will not allow the retest to stand reduction rating (NRR) that should be evaluated aspects and in place of the initial exam if it is completed after 30 according to OSHA 1910.95, Appendix B. The NRR days. Typically, the employee also is medically eval - provides estimates, in decibels, of the reduction in sufficient uated for other ear problems that may obstruct hear - noise exposure. Enforcement of hearing protection ing, refitted with hearing protection and retrained in usage is required when an employee’s 8-hour time time should hearing conservation. These interventions may cause weighted average exposure exceeds 90 dBA or when the hearing loss determination to be reversed or help an employee with an STS is exposed above 85 dBA. be spent with prevent further hearing loss. EPA is currently updating its NRR rule (40 CFR Training 211 Subpart B). The agency says the new rule will each worker align with updated ANSI standards and that the OSHA requires that all employees exposed to noise above 85 dBA receive annual training as part new rule will consider the actual variability of HPD to make of a hearing conservation program. According to performance. Criticisms of the NRR rule include the OSHA, this training must address the effects of noise original use of the C scale versus OSHA’s A scale sure s/he on hearing, hearing loss prevention, hearing protec - requirement and the lack of confidence in field HPD tion types and fitting, and audiometric testing pur - performance. Both factors resulted in OSHA inspec - understands pose and procedures. tors derating the NRR by 7 dB, then afterwards by a Hearing protection fit and enforcement are often 50% factor. proper fitting overlooked aspects and sufficient time should be Application of new NRR rules is expected to spent with each employee to make sure s/he under - eliminate derating, making HPD selection easier. techniques. stands proper fitting techniques. In addition, train - The new rule will provide a potential NRR range, ing should cover recreational noise and sources, as allowing for variability factors. However, the range well as the retail availability of hearing protection option will likely create some confusion. Users will devices for exposures outside of work. need to decide whether to adopt the conservative Employees are more likely to use hearing protec - lower end of the range or develop confidence to tion properly and consistently if they perform train - select the higher end of the range. ing exercises with instructor feedback. Hearing New personal hearing protection testing technol - protection must be worn 100% of the time in order to ogy has been developed that will help determine the be effective. Resistance to HPD use, such as claims of actual degree of protection. These individual fit test - discomfort or communication issues, must be ing systems, much like respiratory protection fit test addressed (NHCA/OSHA, 2008). systems, provide a personal protection factor that incorporates individual variations. Such testing pro - Noise Control & Hearing Protection vides greater confidence in noise reduction level, As noted, OSHA requires that employers first providing individual customized feedback on fit investigate engineering and administrative controls adequacy. Ultimately, good fit and continuous usage to reduce employee overexposure to noise. Engi- enforcement are key to hearing conservation pro - neering controls range from simple enclosures to gram success (Hager, 2009a). www.asse.org NOVEMBER 2010 PROFESSIONAL SAFETY 31 Some facilities have found success by demarcat - Erdreich, J. Analysis of audiometric database shows evidence ing HPD enforcement areas. Management and of employee fraud. Acoustical Society of America Journal, 114 (4), should demonstrate support for en- 2373-2374. Hager, L.D. (2009a, Fall). EPA proposes changes to the noise forcement by wearing HPDs while within the area reduction rating for hearing protectors. CAOHC Update, 21 (3). perimeter and enforcing employee HPD use. Retrieved Sept. 21, 2010, from http://www.caohc.org/updatearti Enforcement should include identification and cor - cles/fall2009/epa_changes.php . rection of policy violators. Hager, L.D. (2009b, Winter/Spring). BLS occupational hearing loss report for 2007. CAOHC Update, 21, 7-8. Hearing Loss Association of America. (2010). Legislative. Intervention Tools Bethesda, MD: Author. Retrieved Sept. 21, 2010, from http:// Comprehensive hearing conservation program www.hearingloss.org/advocacy/legislative.asp . audit and intervention guidance are key to effective Health and Safety Executive. (2005). Noise at work: Regula- program management. NIOSH has developed a tions. London: Author. Retrieved Sept. 21, 2010, from http:// www.hse.gov.uk/noise . comprehensive program evaluation that Humes, L.E., Joellenbeck, L.M. & Durch, J.S. (2005). Noise includes training and , involve - and military service: Implications for hearing loss and tinnitus. ment, noise measurement, administrative and engi - Washington, DC: National Academies Press. neering controls, monitoring and , Kochkin, S. (2007). The impact of untreated hearing loss on referrals, hearing protection devices and administra - household income. Washington, DC: Better Hearing Institute. tive matters. It can be found at http://www.cdc Retrieved Sept. 21, 2010, from http://www.hearing.org/up loadedFiles/Content/impact _of _untreated _hearing _loss _on .gov/niosh/topics/noise/solutions/hearing _income.pdf . checklist.html . OSHA’s noise eTool is found at McCombe, A. (2003). Hearing loss in motorcyclists: Occupa- http://www.osha.gov/dts/osta/otm/noise/ tional and medicolegal aspects. Journal of the Royal Society of index.html . Medicine, 96 (1), 7-9. NHCA/OSHA. (2008). Hearing protection-emerging trends: Individual fit testing [Best Practices Bulletin]. Washington, DC: Conclusion U.S. Department of Labor, OSHA. Noise and hearing loss have long been recog - NIOSH. Hearing loss prevention. Washington, DC: U.S. nized as safety issues and compliance efforts often Department of Health and Human Services (DHHS), CDC, fall into a rut that impedes their success. Increasingly Author. Retrieved Sept. 21, 2010, from http://www.cdc.gov/ niosh/programs/hlp/risks.html . thorough intervention strategies are being recog - NIOSH. (1998). Criteria for a recommended standard: nized as a critical element of a complete hearing con - Occupational noise exposure (NIOSH Publication No. 98-126). servation program. Washington, DC: U.S. DHHS, CDC, Author. SH&E professionals engaged in the audit and man - NIOSH. (2001). Work-related hearing loss (NIOSH Publication agement of hearing conservation programs will spur No. 2001-103). Washington, DC: DHHS, CDC, Author. 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