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STOPPING NOISE-INDUCED HEARING LOSS. Presented by Brad Witt. STOPPING NOISE-INDUCED HEARING LOSS. NIOSH Safe-In-Sound Award Recipient ▪ “M easurable achievements in reducing or eliminating noise-induced hearing loss” ▪ 2011 industrial recipient: Shaw Industries Group Plant WM
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STOPPING NOISE-INDUCED HEARING LOSS Presented by Brad Witt
STOPPING NOISE-INDUCED HEARING LOSS NIOSH Safe-In-Sound Award Recipient ▪ “Measurable achievements in reducing or eliminating noise-induced hearing loss” ▪ 2011 industrial recipient: Shaw Industries Group Plant WM ▪Elimination of noise-induced hearing loss (see www.safeinsound.us)
NOISE AND ACOUSTICS Hazardous noise exposures are cumulative and off the job. on the job ..…
NOISE AND ACOUSTICS Noise-Induced Hearing Loss • Causes no pain • Causes no visible trauma • Leaves no visible scars • Is unnoticeable in its earliest stages • Accumulates with each over-exposure Is permanent and 100% preventable
Noise-induced hearing loss is the most common permanent and preventable occupational injury in the world. ~ World Health Organization 1997 Report on Occupational Noise NOISE AND ACOUSTICS
NOISE AND ACOUSTICS NON-OCCUPATIONAL ► 140 dB Immediate physical damage ► 120 dB Pain threshold ► 85 dB OSHA Action Level Hearing damage possible ► 60 dB Comfortable noise level
83 dB If the noise source is doubled 86 dB The noise level only goes up 3 dB 89 dB Small increases in decibel level 92 dB Represent enormous increases in noise level and risk NOISE AND ACOUSTICS The decibel scale is a logarithmic scale, not a linear scale
NOISE AND ACOUSTICS 83dB 89dB 86dB 92 dB 95 dB
NOISE AND ACOUSTICSSound Level Meter vs. Noise Dosimeter “Area Sampling” “Personal Sampling” Sound is measured immediately in a specific area Sound is ‘averaged’ throughout the day for a sample employee or job photos courtesy of Quest Technologies
ADMINISTRATIVE CONTROLS • Rotate Workers • Extended Breaks • 2nd/3rd Shift PERSONAL PROTECTIVE EQUIPMENT NOISE AND ACOUSTICS ~ Hierarchy of Controls • ENGINEERING CONTROLS • Buy Quiet • Vibration Pads • Enclosures • Barriers • Isolation
EVALUATING NOISE REDUCTION How much noise is reaching the ear of the worker ? Noise Level =100 dB Noise Reduction Rating =30 dB That is completely unknown … (55 – 104 dB)
0 dB 0 dB 33 dB Which ear is protected?
EVALUATING NOISE REDUCTIONThe Noise Reduction Rating (NRR) • A laboratory estimate of the amount of attenuation achievable by most users when properly fit • A population-based rating … some users will get more attenuation, some will get less The NRR is only a population estimate, not a predictor of individual attenuation.
EVALUATING NOISE REDUCTIONDeveloping the NRR • 10 human subjects tested in a simulated industrial room • Tested with ears open / occluded at nine frequencies • Each subject tested 3x • NRR calculated to be population average A test subject in the Howard Leight Acoustical Lab, San Diego, CA, accredited by the National Voluntary Laboratory Accreditation Program (NVLAP)
SAFE NOISE NOISE LEVEL _ NRR =
? SAFE NOISE ? HUMAN FACTOR NOISE LEVEL _ =
Real user attenuation 0 – 38 dB EVALUATING NOISE REDUCTIONReal-World Protection May Not Equal NRR 192 users of a flanged multiple-use 27 dB earplug 50 Multiple-Use Earplug Rated for 27 dB 40 30 Retraining and refitting resulted in an average 14 dB improvement in attenuation for this group Attenuation in dB 20 10 0 -10 From Kevin Michael, PhD and Cindy Bloyer “Hearing Protector Attenuation Measurement on the End-User”
The Biggest Factors in Achieving the NRR 30 min 5 min 10 min 15 min EVALUATING NOISE REDUCTION 1.FIT 2. WEAR TIME 30dB A worker who selects an earmuff with an NRR of 30 but then removes that HPD for just … effectively reduced his 8-hour NRR to just … 15 dB 12 dB 19 dB 17 dB In noise exposures, small intervals of no protection quickly cancel large intervals of adequate protection.
EVALUATING NOISE REDUCTION 30 dB = 1000x 20 dB = 100x 10 dB = 10x 3 dB = 2x 100 dB 90 dB 80 dB 70 dB 60 dB 0 1 2 3 4 5 6 7 8 8-Hour Workday
Insufficient Protection Acceptable Protection Optimal Protection Acceptable Protection Over Protection EVALUATING NOISE REDUCTIONThe Hazards of Overprotection • Choosing a protector with an NRR higher than necessary may result in overprotection • Verbal communication may be hindered • Warning alarms, telephones, machine noises may not be heard dB • 85 • 80 • 75 • 70 Worker Exposure at the Ear With Protectors
20th % Proficient Users 80th % Minimally-trained EVALUATING NOISE REDUCTIONThe Noise Reduction Rating (NRR) Current NRR Label Mock-up of New Label
REDUCING CLAIMS Lagging Indicators vs Leading Indicators
REDUCING CLAIMS In-Ear Dosimetry Fit Testing
REDUCING CLAIMS Published Rating
REDUCING CLAIMS Personal Factors Gender Age Years in Noise Ear Canal Size Familiarity Model of Earplug Program Factors # Group Trainings # Personal Trainings What predicts a good fit?
REDUCING CLAIMS Published Rating Trying a second earplug often improves attenuation
FIT TESTING Complete Check ● 5 freqs in each ear ● Best for new users, reliability checks ● ↑ accuracy, ↑test time Report Mode ● Individual ● Historical ● Results by freq Quick Check ● 1 critical freq in each ear ● ↓ accuracy, ↓test time ● Can use with severe hrg loss Fit Training ● Videos
REDUCING CLAIMS In-Ear Dosimetry Fit Testing
In-ear dosimetry measures actual noise dose, with and without protection • Alerts when worker approaches safe limits • Only metric to measure and prevent further progression of occupationalhearing loss
IN-EAR DOSIMETRY • Dosimeter records … • Good fit • Bad fit • No fit • Indicator lights give immediate feedback of noise level and dose
Research > Alcoa Intalco Works Mean Hearing Threshold (2k, 3k, 4kHz): 2000 – 2007 (N = 46) Employees using continuous in-ear dosimetry starting in 2005
REDUCING CLAIMS In practice, identifying a shift in hearing is not a preventive action …. It is documentation of a hearing loss after the fact. How soon will an employee suffering NIHL be re-fit / re-trained ? “Best case scenario” per annual audiometric testing In-ear dosimetry “worst case” scenario … 1 Day • Audiometric test •Retest •Notification 0 2 4 6 8 10 12 14 16 Months
REDUCING CLAIMS PROS - Estimate Measure - NRR obsolete - Eliminates need for de-ratings - Medico-legal cases - Delineates non-occupational - Eliminates double protection - Provides employee feedback CONS - Cost - Time Investment - Not standardized
REDUCING CLAIMS Off-job+ On-job = Shift Off-job+ On-job = Shift
CASE STUDIES - CARPET MILL • NIOSH Safe-In-Sound Award Recipient • Engineering controls • Brought noise levels down to 100-104 dBA. • Annual fit-testing and training • Documented successful reduction of noise exposures under the hearing protector below 85 dBA for all employees. • 3. End result: reduction of STS to zero in the most recent years of annual audiometric testing.
CASE STUDIES – MILITARY INSTALLATION U.S. Navy ▪ 60 sailors experienced in earplug use - command-issued standard foam earplug OR - a second earplug of their choosing ▪Prior to testing with the “variety” earplug, sailors received brief training (less than one minute in duration) by someone modeling the correct fit of that style of earplug. ▪Despite no prior experience with the “variety” earplug, 45 of the 60 sailors (75%) achieved higher attenuation with the variety earplug over the command-issued earplug. Median attenuation for ‘variety’ earplugs = 18 dB Median attenuation for command-issued earplugs = 9 dB
CASE STUDIES - AEROSPACE Fit-Testing / 1:1 Training for 337 noise-exposed workers
CASE STUDIES - AEROSPACE • Pre-Test • Which type of hearing protectors do you normally use on the job? • 2. How would you rate your ability to fit your earplugs? • Post-Test • After this fit-test, are you better able to fit your earplugs? • 2. Did you change your choice of earplugs as a result of the fit-test? Don’t normally use on-the-job, 16% - Not sure, 1% - - Yes, 93% - Earplugs, 76% No, 6% - Earmuffs, 8% - Expert, 10% - - Good, 51% Don’t know how, 2% - Poor, 1% - - Yes, 63% No, 37% - Okay, 36% -
Hearing Loss Due To Noise Exposure Is … Painless Permanent Progressive … and very Preventable!