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Workplace Hearing Loss

Posted on by Captain William Murphy, PhD, and SangWoo Tak, ScD, MPH

worker with power saw and ear protectionWork-related hearing loss continues to be a critical workplace safety and health issue. It is estimated that over 22 million workers are exposed to hazardous noise on the job and an additional nine million are at risk for hearing loss from other agents such as solvents and metals. The National Institute for Occupational Safety and Health (NIOSH) has a long history of working to prevent workplace hearing loss. While noise-induced hearing loss is 100 percent preventable, once acquired, hearing loss is permanent and irreversible.

Surveillance

Surveillance of occupational hearing loss and noise exposure is vital to prevention. It can identify the most problematic industries, occupations, and work activities, and can be used to evaluate the effectiveness of intervention activities. The National Academies Institute of Medicine evaluated the NIOSH Hearing Loss Research Program in 2005. While the program received high marks, the National Academies concluded that it was difficult for NIOSH to establish and prioritize research goals due to the lack of surveillance data on occupational hearing loss and noise exposure for U.S. workers. Currently the U.S. does not have a national surveillance or injury reporting system for hearing loss. The Bureau of Labor Statistics annually reports recorded hearing loss* on OSHA Form 300. However, BLS data are not representative of the true magnitude of occupational hearing loss due to several barriers to the reporting system. The Michigan Sensor program is one possible model for collecting reliable and representative data on hearing loss, but funding is lacking. As such, comprehensive data on the prevalence and economic impact of hearing loss are not available. To address this issue, NIOSH published two articles to estimate the national burden of hearing difficulty among workers in the U.S.: “Exposure to Hazardous Workplace Noise and Use of Hearing Protection Devices Among U.S. Workers—NHANES, 1999–2004”1 and “Hearing Difficulty Attributable to Employment by Industry and Occupation: An Analysis of the National Health Interview Survey—United States, 1997 to 2003.”2 The articles extrapolate data from the National Health and Nutrition Examination Survey (NHANES) of 9,275 employed workers to the entire working population. The analysis revealed:

  • More than 22 million U.S. workers were exposed to hazardous workplace noise.
  • Workers in the mining industry had the highest prevalence of workplace noise exposure with almost 3 out of 4 mining industry workers exposed. The mining industry has the second highest prevalence of hearing difficulty among all industrial sectors.
  • Over one third of all manufacturing workers (5.7 million workers total) reported exposure to loud noise.
  • One in four manufacturing workers exposed to loud noise reported non-use of hearing protection devices.

To get a better picture of the full extent of workplace hearing loss, NIOSH has developed an ongoing surveillance program of occupational hearing loss in collaboration with audiometric services providers. NIOSH will develop a database and protocols to manage and analyze individual level audiometric data. Data from this surveillance effort will be used in several important ways. It will help to identify emerging hearing loss problems, including those associated with new industries, new technologies, or new pieces of equipment. The analysis of the data will also produce national reference statistics for the incidence (or prevalence) rate of occupational hearing loss across industry and occupations. By 2012, a total of 15 providers will be recruited to participate in this surveillance program. For more information about this surveillance program or if you are interested in participating in the surveillance program, send an e-mail to dvo9@cdc.gov.

Prevention

Better surveillance can help NIOSH and others provide better prevention programs. As mentioned earlier, noise-induced hearing loss is entirely preventable but once acquired, hearing loss is permanent and irreversible. Therefore, prevention measures must be taken by employers and workers to ensure the protection of workers’ hearing. There are many solutions for eliminating noise in the workplace. Engineering noise control is the best approach to eliminate the problem. If that is not possible, administrative control of exposure and hearing protection are essential elements of a hearing conservation program. The NIOSH Noise and Hearing Loss Prevention Topic Page contains a Hearing Conservation Program Evaluation Checklist, a Hearing Conservation Toolbox, and a Compendium of Hearing Protection Devices, among other useful tools.

In 2006 NIOSH partnered with the National Hearing Conservation Association (NHCA) to create the Safe-in-Sound Award—an award for excellence in hearing loss prevention. The objectives of this award are to recognize organizations that document measurable achievements in hearing loss prevention programs, obtain information on their real-world successes, and widely disseminate information on how others can use these successful strategies.

Input

NIOSH is interested in strengthening its efforts to prevent hearing loss in the workplace. Through this blog, NIOSH would like to learn more about:

  • Practices that have proven useful to promote the use of noise control in the workplace
  • Government policies that can be improved to promote effective hearing conservation practices
  • Tools that have been effective in promoting the use of hearing protection with workers
  • Successes in integrating hearing protectors into hearing conservation programs
  • Mechanisms that have been effective in training and engaging workers’ participation in the hearing conservation program
  • Economic benefits from quieting the environment (noise control) over using hearing protection. For example, has the elimination of the hearing conservation program due to the control of noise in the workplace led to a reduction in accidents, increased cost savings from not having to buy hearing protection and scheduling annual audiograms, or increased worker morale?

Please provide your input in the comment section below. Thank you.

Dr. Murphy is the co-leader of the Hearing Loss Prevention Team in the NIOSH Division of Applied Research and Technology and is a Captain in the Commissioned Corps of the U.S. Public Health Service.

Dr. Tak is an epidemiologist in the NIOSH Division of Surveillance, Hazard Evaluations, and Field Studies.

*Original sentence edited to improve accuracy

References

  1. Tak S, Davis R, Calvert G. Exposure to Hazardous Workplace Noise and Use of Hearing Protection Devices among US Workers — NHANES, 19992004. American Journal of Industrial Medicine, 2009, Vol 52, No 5, pp 358-371.
  2. Tak S, Calvert GM. Hearing difficulty attributable to employment by industry and occupation: an analysis of the National Health Interview Survey United States, 1997-2003. Journal of Occupational and Environmental Medicine, 2008, Vol 50, No 1, pp 46-56.
Posted on by Captain William Murphy, PhD, and SangWoo Tak, ScD, MPHTags

34 comments on “Workplace Hearing Loss”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    It would be helpful if all equipment (power tools, lawn equipment, lab equipment, firearms, etc) came with a decible level on them. This would help the employer know if a hearing protection program is needed and/or engineering controls or PPE is needed. If not on the equipment, could NIOSH post the decibles somewhere?

    We agree that labeling of this sort would be helpful, however at present there are no regulations in the U.S. that require such labeling. Many consumer appliances are now being sold on the basis of how quiet they are. Dishwashers, for instance, are tested for sound power (sound power is like the wattage rating of a light bulb). Many dishwashers have ratings of about 50 dB and some very quiet ones have ratings less than 50 dB. Similarly, IT equipment has been tested for its noise production. A noisy computer in a quiet office space is less likely to be accepted than a quiet computer. Some years ago, a major computer vendor was advertising that its computer was only 37 dB. Unfortunately, no descriptors of where that level was measured or whether all of the fans on the computer were running during the measurement was given.

    Recently, there has been a movement to work out a consumer label for noise production that would inform the public and hopefully push the market to producing quieter equipment. At NIOSH, the Hearing Loss Prevention Team has conducted tests of more than 120 different electric powered hand tools and published the database of measurements on the NIOSH web site, http://wwwn.cdc.gov/niosh-sound-vibration/. These tools have been measured in both the loaded and unloaded condition. The loaded tests were conducted by actually operating the tool with real material for cutting, grinding, drilling etc. Unloaded tests were conducted with the tool running without it being in contact with a work-piece.

    With respect to firearms, NIOSH has been involved in conducting measurements and Health Hazard Assessments of shooters at firing ranges. In 2009, NIOSH published an Alert on Preventing Occupational Exposures to Lead and Noise at Indoor Firing Ranges, http://www.cdc.gov/niosh/docs/2009-136/pdfs/2009-136.pdf. As a part of that document noise levels from ten weapons measured at an indoor firing range were presented. The peak sound pressure levels ranged from about 156 dB to 170 dB. A recent article in Sound and Vibration magazine describes a detailed series of measurements for a rifle, http://www.sandv.com/downloads/0908rasm.pdf. As can be seen in that paper, the noise levels around the rifle vary considerably. Additional papers may be found in the October 2009 issue of Noise and Health regarding the risk of hearing loss due to civilian firearms and fireworks http://www.noiseandhealth.org/currentissue.asp.

    Measuring and rating firearms (or fireworks) is far more complicated than sound power measurements of tools. One must consider the transient nature of the weapon’s discharge, the proximity to the source and the nonlinear effects of sound propagation. Suffice it to say, hearing protection is recommended for use with firearms every time the weapon is discharged. If one is planning to do a considerable amount of target practice, then double hearing protection is recommended. No single metric has been developed to rate the level of a weapon.

    Re Elizabeth’s comment: Some countries do have this information on tools. Although it is helpful it cannot be taken as gospel as the noise level will increase as the tool becomes older & worn. ALso it is the output of the tool itself, as soon as it is USED (eg an angle grinder) the noise level rises, in some cases dramatically.

    NIOSH, the regulatory authorities and national and international standards-setting organization, along with trade associations representing high noise industries, must work together to encourage equipment manufacturers to lower the decibels. If only quiet machines and equipment are available for purchase, much of the hearing loss problem will disappear.

    One policy that I think is a good idea is to require the use appropriate hearing protection whenever exposures may occur to sound levels exceeding the occupational exposure limit, regardless of the duration of the exposure. Many private companies do not follow that policy, only prescribing hearing protection whenever exposure times at a given sound level would result in an overexposure.

    The Europeans have had quiet jackhammers for decades. As soon as there is a market manufacturers will adapt. One problem is OSHA doesnt enforce the noise standard in construction.

    I wonder if OSHA could promulgate a standard whereby businesses are required to perform an annual noise survey of their premises or at least demonstrate that there is no noise hazard at their business. Since hearing loss is preventable, it seems that a proactive approach could be useful and might spur noisy industries to do more.

    The small and handy instrument EAR SEAL can be used for ear protection to reduce noise by about 17 dB. It is very economical and is easily available in the market. During working hours people can use this small instrument as a safety measure.

    Apart from this, Clinical examination of people who are more exposed to excessive noise can be accomplished by audiometric testing by which temporary or permanent hearing loss or the extent of reduction in hearing capacity can be found out.

    Re: Tim Sheehan’s comment,
    That is a good policy but often workers do not wear hearing protectors correctly so they only get minimal attenuation. Quieting the tool or quieting the process would be the best solution, if at all possible. Many tool manufacturers sell in the European Union where the noise regulations are more comprehensive. It would be great if they would adapt their EU tools to the American market.

    Policies and regulations are helpful for many workers. Our agriculutral workers though are often self-employed and working in isolation. Often they do not have access to occupational health, hearing services, or financial resources in the rural community. Rural physicians and providers of audiometric services need to work with the local agricultural community to assess the population, describe the need, work for affordable, local access of acceptable products for hearing conservation, and identify funding sources for those who need assistance.

    Decibel Noise levels should be labelled on all power tools.

    If you were to go the tool review of FineWoodworking.com you can find a small sander at 82 dBA and another sander at 87 dBA. Both remove the same material and cature dust equally and cost the same.

    There is more than just noise exposure in the workplace, chronic exposure to carbon monoxide to welders or foundry workers could cause a synergiqtic effect to hearing loss.

    There should be an insentive program to reduce noise. There will certainly be a long term competative to those that do.

    Does anyone have any information on hearing loss and amusement ride workers, such as haunted houses. Often there are loud soundtracks palying with loud noises used to scare the patrons. Hundreds of actors are positioned throughout theses places and some are stationed right near the speakers.

    Can anyone help me in this area?

    Maybe hearing loss is not attributable to the work place!

    To tie hearing loss measured through an audiometric surveillance program to workplace noise one must have the workplace noise characterized accurately and quantitatively. This includes general noise surveys (e.g. sound level mapping) combined with personal dosimetry over several years.

    Employers avoid proper workplace noise profiling due to a perceived cost issue. Having a consultant come in a perform sound level surveys and personal dosimetry in a strategic way is less costly when compared to the high productivity losses, and the short and long term health care costs due to hazardous noise. NIOSH, OSHA and the AIHA will be able to correlate hearing loss to the workplace only when an audiometric surveillance program is combined with a properly characterized workplace noise profiling plan. NIOSH should audit the hazardous noise program of each employer it receives audiometric surveillance inputs from to identify true noise levels for each SEG.

    Workplace hearing loss is indeed a major problem facing our workers today. Although hearing protection should always be worn, I do understand that it is not always possible.

    Major scientific studies have now shown that taking the correct vitamins and minerals before or immediately after exposure to the loud noises can help prevent hearing loss from occurring. I realize that this sounds spammy but it’s not. The company I work for put out the product called “The Hearing Fix” to help combat hearing loss in just such a way.

    References for this hearing protection can be found below.

    ◦http://www.sciencedaily.com/releases/2008/11/081110112103.htm
    ◦http://www.hearinglossweb.com/Medical/cures/drug/abh/ambio2.htm
    ◦http://www.sciencedaily.com/releases/2009/02/090212093704.htm
    ◦http://www.sciencedaily.com/releases/2010/06/100630071258.htm

    Currently, several products are undergoing clinical trials and research studies. Some of the studies suggest that taking different forms of vitamins and minerals will prevent some hearing loss. However, other studies have found the protective effect to be minimal and not statistically significant. Noise induced hearing loss is still considered permanent and irreversible. The only way to prevent it is by eliminating/reducing exposure to harmful levels of noise.

    Note: References to products or services do not constitute an endorsement by NIOSH or the U.S. government

    The National Hearing Conservation Association (NHCA)and the Council on Accreditation of Occupational Hearing Conservation (CAOHC) are sponsoring a Webinar on September 16, 2010 at 11:00 AM EDT on “Pharmacologic Protection from Noise Induced Hearing Loss (NIHL): Current Status” given by Kathleen Campbell, Ph.D., Southern Illinois University School of Medicine. A review of the current state of research on otoprotective and rescue agents for NIHL will be presented as well as a discussion of the development and regulatory processes involved in taking these pharmacologic agents through the bench-to-bedside process, including regulatory and intellectual property issues. This is the first such webinar co-sponsored by these organizations.
    For more information visit
    [http://www.hearingconservation.org/]

    @Travis Eliott : Thank for the links, it is really interesting. I’m involved with high exposure to noise and it is necessary to care about this problem

    It is not only important to target large industry workplaces such as mining and manufacturing but to also target smaller companies such as lawn care businesses where the permanence of hearing loss is not understood by business owners and employees.

    I think it should be compulsory for every employee in the UK to have a Test for Hearing. This will help reduce the amount of problems they may have later in life and prolong their hearing.

    Very interesting thread.
    We recently compiled incidence rates of hearing loss across various industries (by the time workers reach 50 years of age) and the results are quite staggering:
    [http://wp.me/p1yDhL-1J]

    Public fireworks displays tend to use very loud aerial concussion shells to make the very loud booming effect similar to thunder. Unfortunately if they are discharged too close to spectators they can cause irrparable harm to hearing as they are thought to produce between 125 and 150 decibels.

    Sound pressure decreases inversely as the square of the distance from the point of explosion, so it would be useful if NFPA or other appropriate standards agency would include a hearing loss prevention standard within the NFPA 1123 and 1126d pyrotechnic display standards which presently do not deal with hearing loss threats. The table in the NFPA 1123 standard specifies distance from the point of launch by an aerial mortar to the outer perimeter of a safety zone, that is measured in terms of the diameter of the mortar (e.g., for a six inch mortar, the diameter of the safety zone is 840 feet or 420 feet from the point of launch to the edge of the zone. . For an eight inch mortar the zone diameter increases to 1120 feet or 560 feet to the edge of the safety zone. This anticipates fallout from debris of the exploded shell. Some Agency Having Jurisdiction [AHJ]at the state or local government level should also be given a standard to enforce that ensures the safety of spectator’s hearing by calculating maximum decibel levels reaching the spectator from a given explosive report shell. Preferably, a sound pressure not exceeding 90 decibels might be appropriate for such detonations. However the experts will need to determine what is safe for unprotected hearing of spectators, and consider that children are three times more likely to suffer hearing loss from fireworks explosions than adults, and that men are more susceptible than women.

    Thanks for any advice you can provide.

    Thank you for your comment. Some of our researchers have actually made sound level pressure measurements in conjunction with fireworks celebrations at the National Mall in Washington, D.C. Since NIOSH makes recommendations for the prevention of work-related illnesses and inquiries, these measurements were in the context of assessing the safety for National Park Service officers and employees. The potential risk for hearing loss is low for Park Service and other workers who are occasionally at holiday fireworks shows. Unless there’s repeated and prolonged exposure to fireworks, or some accidental close discharge, the likelihood of developing a noise-induced hearing loss is not very high.Local governments and municipalities are responsible for addressing noise issues for spectators.

    We are going to conduct a population base survey to find out the prevalence of occupational hearing loss in Bangladesh. For this we need a standardized survey question form. can you pls help us in this matter?

    The noise goes beyond the workplace….in some cases I am closer to the source than others who are on the jobsite. And when no body will or can enforce restrictions . even if the workers are shifted around, I am in my home the whole time. Where is the voice for this kind of abuse going to come from?

    Sort of like smoking. Can’t smoke indoors. Then smoke floats. so they say no smoking within x feet of doors…. but how will we protect people who happen to be in the range of excessive noise if some kind of something does not get enforced? I have had before 8 am Easter sunday circular saw cutting granite counter tops . Chain saws 9pm cutting trees, wood saws 8pm thinking they would stop at dark. WRONG> Not till after 11:15 pm.

    Only I live right across the street that amazingly a whole row of townhouses are owned by weekenders who have totally gutted each one, some of them more thasn once, torn out tile that has onlyu been there 8 months….always something. The owners are family and friends. I am not a worker but practically on the sight…it is not only my hearing but tranquility nerves anxiety …the din when they leav There is harm to not only workers but to others around.. Smoke from cigarettes reaches far, so does noise. I have long been convinced that it is possible to make much much quitter tools. If France can have a quiet jack hammer then we can have q quiet circular saw. It is not just workers….ie: QUIET….HOSPITAL ZONE.

    We must not always put the dollar above everything.

    Public fireworks displays tend to use very loud aerial concussion shells to make the very loud booming effect similar to thunder. Unfortunately if they are discharged too close to spectators they can cause irrparable harm to hearing as they are thought to produce between 125 and 150 decibels.

    Although NIOSH has not assessed the noise levels for professional pyrotechnicians, the loud impulse noise generated by fireworks can pose a hazard to hearing. Those setting off the fireworks are closest to the explosions and have the added risk of working multiple events with repeated exposures.

    Measurements of Flash-bang explosives used by law enforcement can produce impulse levels in excess of 180 dB peak sound pressure level (dB peak SPL). Most sound level meters are limited to measurements of about 140 or 145 dB peak SPL due to the microphone, preamplifier and voltage supply. NIOSH has been conducting research on the effects of impulse noise and has recommended that workers exposed to impulse noise above 140 dB wear double protection. In this case, the need for communication between pyrotechnicians is an essential part of the safety plan. Electronic earplugs linked to a communication system would help improve the signal to noise ratio. Electronic earmuffs worn overtop the earplugs will help to reduce the communication barrier for those persons not connected with the communication system. Appropriate caution must be taken so that communication systems do not interfere with or initiate the firework ignition.

    If pyrotechnicians are concerned about their noise exposures they may consider requesting an evaluation by NIOSH to examine exposures in their workplace and provide recommendations for hearing loss prevention.

    Our lawn care company offers gear to prevent our workers from being affected by the noises however, they usually opt out of the use of such gear. At [name removed] we always want to take every precaution in protecting our lawn care professionals.

    I think there may well be another side to the discussion. If you post a measure, standard, etc., you have to live up to that measure and it must be readily repeatable and managed. This is perhaps the largest hindrance to safety, in general, here in America. Many would rather not trace accountability for fear of having to manage the said accountability. It is always easier to say, “We weren’t aware.” This is something I have been fighting most of my career. I try my best to champion safety and I consider a safe environment to be the highest compliment you can afford any worker. Safety standards or adherence should not be based on socioeconomics or status quo. Safety is our responsibility to our workers and their families.

    Just my two cents.

    Understand the types of noises that can cause damage, particularly those above 85 decibels.Avoid situations where noises are too loud, too long, or too close. Wear protective earplugs when attending sporting events or music concerts. Take a “quiet” break, particularly when at noisy restaurants, concerts, parties or other loud places.

    Great post very informative! I work for a company called Sonolab specialising in hearing protection so I love to hear everyone’s thoughts on this subject.

    According to the Judicial Studies Board Guidelines, if an employee suffers hearing loss caused by noise in the workplace, he or she could be entitled to the following based on the seriousness of the injury. These figures exclude loss of earnings and other expenses:
    – Slight £5,225 to £8,800
    – Mild £8,800 to £10,450
    – Moderate £10,450 to £20,900
    – Severe £20,900 to £31,900

    Noise induced hearing loss can be caused by prolonged exposure to excessive noise, and if this is experienced in the workplace, the employer could be found to be at fault. This is because employers have a legal duty to provide a safe place of work. This includes ensuring that either noise is kept at safe levels or if this is not possible, then to provide hearing protection to employees.
    The employer is also legally required to have insurance cover, which means that the insurance company also requires their insureds to do all in their power to ensure that they are not subject to claims that might be made against them due to unsafe work practices.

    As a rule of thumb, if you have to raise your voice to speak to someone two metres away from you, it is likely the noise in your workplace is exceeding regulations.

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