MAJ Marjorie Grantham, Hearing Conservation Program Manager SGT Brian Brown,

1. Hearing ConservationISCombat Readiness Medicine MAJ Marjorie Grantham, Hearing Conservation Program Manager SGT Brian Brown, Outlying Clinic HCP Manager Dept of Preventive Medicine, Madigan Army Medical Center

2. Outline • Hearing Conservation Program Elements • HCP Management for HCO’s • Tour • DD2215’s and DD2216’s • Unit Scheduling

3. Prevention of NIHL: The Army’s Hearing Conservation Program • Noise Hazard Identification • Engineering Controls • Hearing Protectors • Monitoring Audiometry • Health Education • Enforcement • Program Evaluation

4. The effects of noise on hearing:How do we hear?

5. Which part of the ear is damaged by hazardous noise exposure? OUCH! BOOM

6. Inner Ear Hair Cells Hair cells From “Virtual Tour of the Ear,”www.neurophys.wisc.edu

7. Normal Hearing Hair Cells

8. Hearing Hair Cells Damaged By Noise

9. Hazardous Noise • Continuous noise (longer than .5 seconds) greater than 85 dBA, 8 hour TWA • Impulse/Impact noise greater than 140 dB peak SPL • Explosions • Weapons Fire • Intensity and duration are the two main factors that determine if a particular noise is hazardous

10. The purpose, advantages, disadvantages, and attenuation of hearing protectors • Earplugs • Triple-flange • Single-flange • Foam • Earmuffs • Helmets

11. The selection, fit, care, and use of hearing protectors: • Selection - fit with the right size by medically trained personnel • Fit - should never be painful • Care - PMCS for plugs is on your carrying case; earmuffs/helmet earcups must be free of cracks, tears • Use - demonstration

12. COMBAT ARMS EARPLUG • Insert YELLOW plugs for weapons fire in dismounted mode. • Insert OLIVE DRAB plugs for steady state noise in and around aircraft, noisy vehicles and watercraft, etc. • Keep filter holes free of earwax and other debris. • Check proper insertion for slight tension by gently tugging on plugs. • Ensure that plugs are cleaned with soap and water and dry when returned to case. NSN 6515-01-466-2710

13. The purpose and procedures of audiometric evaluations • What happens when noise-exposed personnel go for a hearing conservation test? • What is STS? • Why do we test three (3) times?

14. Your Audiogram Bass Treble Frequency in Hz 125 250 500 2000 4000 1000 8000 Soft 0 10 F TH A U P G 20 E M S Z V 30 K B Hearing Level in dB 40 50 60 70 80 Loud 90 100 Loudness Clarity

15. The Sounds of Combat http://www.hooah4health.com/environment/hearingEd.htm

16. Poor Hearing w/ TTS (H-3) 46m Rifle BoltClosing 210m 1000m Poor Hearing(H-2) Acceptable Hearing(H-1) 32m NormalVoice 100m 180m 0.6m Footsteps inLeaves 5.5m 100m 0 200 400 600 800 1000 Distance in Meters Detection of Sound by Hearing Ability DETECTION DISTANCE DECREASES RAPIDLY AS HEARING LOSS INCREASES.

17. Prevention of NIHL: The Army’s Hearing Conservation Program • Noise Hazard Identification • Engineering Controls • Hearing Protectors • Monitoring Audiometry • Health Education • Enforcement • Program Evaluation

18. Mandatory Requirement/Administrative Actions • Command emphasis on personnel safety • Disciplinary measures for noncompliant personnel

19. Three Foot RuleIf the sound is so loud that you must raise your voice to be understood at a distance of three feet it isPotentially Hazardous

20. HCP Management (1 of 2) • Audiologist = Hearing Conservation Program Manager (HCPM) • No Audiologist? OHN or Occ Med Physician = HCPM • Hearing Conservation Officers (HCO) (Ft Lewis) http://www.usapa.army.mil/pdffiles/p40_501.pdf • Occupational Hearing Conservationist (OHC) (all posts)

21. HCP Management (2 of 2) • Defense Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC) • MEDBASEOne (Ft Lewis⃗ DOD) • Quarterly Reports • Test Compliance • Earplug Size Distribution

22. AR 40-501, Table 7-1 Hearing Profiles

23. Shoot, Move, Communicate! Your Sense of Hearing is Essential Questions? USE HEARING PROTECTION!