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Ana Claudia Fiorini, PhD Catholic University of São Paulo PUC-SP Brazil

Occupational hearing loss in Brazil: state of art. Ana Claudia Fiorini, PhD Catholic University of São Paulo PUC-SP Brazil. BRAZIL. 26 states and Brasília (DC) 170 million habitants

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Ana Claudia Fiorini, PhD Catholic University of São Paulo PUC-SP Brazil

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  1. Occupational hearing loss in Brazil: state of art Ana Claudia Fiorini, PhD Catholic University of São Paulo PUC-SP Brazil

  2. BRAZIL 26 states and Brasília (DC) 170 million habitants Occupational Activities: mining, manufacturing, industrial services, construction, trade, service, public administration and farming. 2008: 40 million formal employees

  3. BRAZILMajor Occupational Disease Repetitive Strain Injury (RSI) Occupational Hearing Loss

  4. BRAZILIAN POLICIES Departments Health Benefits Work OSH • 2002: The National Network of Total Worker´s Health Care • 2004: Ordinance to regulate compulsory notification of work related accidents and diseases

  5. Brazilian Occupational Safety and Health Organization NR-15: exposure limits NR-6: individual protectors NR-9: safety program NR-7: health program Portaria 19: audiometric test

  6. Brazilian Occupational Safety and Health Organization Ordinance 19: audiometric test • Rules to perform and follow-up audiometric test (PTA from 500- 8kHz, air and bone conduction) • Pre-employment, after six months and, after that, Annual PTA • Baseline audiogram • STS follow-up

  7. Lav 85 dB(A) ------ 8 h 86 dB(A) ------ 7 h 87 dB(A) ------ 6 h 88 dB(A) ------ 5 h 89 dB(A) ------ 4 h 30 min 90 dB(A) ------ 4 h 91 dB(A) ------ 3 h 30 min 92 dB(A) ------ 3 h 93 dB(A) ------ 2 h 30 min 94 dB(A) ------ 2 h 15 min 95 dB(A) ------ 2 h 96 dB(A) ------ 1 h 45 min 98 dB(A) ------ 1 h 15 min 100 dB(A) ------ 1 h 102 dB(A) ------ 45 min 104 dB(A) ------ 35 min 105 dB(A) ------ 30 min 106 dB(A) ------ 25 min 108 dB(A) ------ 20 min 110 dB(A) ------ 15 min 115 dB(A) ------ 7 min NR - 15 5 dB: Maximum Level: continuous or intermittent noise Impact noise: 130 dB (linear).

  8. NHO 01 Fundacentro (2001)

  9. PREVALENCE OF HL Until 1990  Textile: 37%  Metallurgy: 40%  Cellulose: 36%  Glass: 39%  Stones/mining: 32% • Plastic: 42% • Farmer drivers: 56% Andrade e Schochat, 1988; Costa et al., 1989

  10. PREVALENCE OF HL Now  Hearing Loss in Industry: 18-40% Cross-sectional household survey was conducted with 2427 persons in Southern Brazil, using WHO Ear and Hearing Disorders Survey: moderate (5.4%), severe (1.2%) and profound (0.2%) HL= 6,8% Béria et al., 2007 – Pan Am J Public Health. 2007;21(6):381-7

  11. Hearing Loss Prevention Program – TextilesGeneral guidelines • Implemented in 1997 • 5 plants in Brazil (manufacture denim) • Main occupational hazards: cotton dust, noise and vibration (2000 workers) • Associated to the company´s environmental manegment • There is a safety engineer, a safety technician, na occupational phisician and na audiologist

  12. Hearing Loss Prevention Program – TextilesGeneral guidelines Non-occupational activities

  13. Workplace *Specific program for selection, recommendation, fitting and follow-up of hearing protectors

  14. Hearing ProtectionProgram's stages * It determines the HP that may be used in the workplace, taking scientific research and new technologies (NIOSH´s rules and field survey)

  15. Hearing Protector Approval • Ear muffs (three types, NRRsf > 18 dB) • Sample: 20 subjects (normal hearing) • Noise measurement: 3 dose/3 days (average bellow 80 dBA to be accepted) • Questionnaire (protector's use, comfort and attenuation): after one month (score above 80%) • Three types are always approved

  16. HP TEST (dBA) HP DOSE DOSE DOSE Right WP Left 1 78.4 93.3 78.7 2 79.6 92.7 81.1 3 78.0 93.7 75.7

  17. Evaluation of Hearing Protector • Individual training • Group training • Guide • User satisfaction survey (questionnaire) • Maintenance program • Regular replacement of HP

  18. Guide on how to protect your ears

  19. Guide on how to protect your ears

  20. Example: OAE test Before exposure

  21. Example: OAE test After exposure

  22. Hearing Loss Prevention Program Non-occupational Activities: identifying workers´leasure (personal music players, shows and others) Epidemiological Surveillance: the performance and analysis of audiometric testing is standardized (longitudinal studies to check onset and worsening of HL)

  23. Results • Normal group remains around 80% • Maximum STS: 0.27%

  24. Thank you!! acfiorini@pucsp.br

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