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San Francisco Fire DepartmentHearing Conservation Training
Shawn Holle, Safety AnalystCCSF Department of Public HealthOccupational Safety & Health Section
05/03/23 DPH/OSH 2
Overview
Sound v Noise Ear Anatomy Cal-OSHA Regulations SFFD Hearing Conservation Program Evaluation Medical Surveillance Noise Control
05/03/23 DPH/OSH 3
Sound v Noise
What’s The Difference Between Sound & Noise?
05/03/23 DPH/OSH 4
Sound
Pressure Waves in AirWaves Have:
Physical Size Intensity (Frequency)
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How Do We Measure It?
Decibel (Db) Expresses Intensity of Sound Three Different Scales - A, B, & C
Hertz (Hz) Unit of Measurement for Sound Frequencies Human Hearing Ranges From 20 Hz & 20,000 Hz
High Frequency: Dog Whistle, Siren Low Frequency: Engine Idling, Bass Drum
05/03/23 DPH/OSH 6
Typical Sound Levels
Decibel Level Examples
0 Quietest Sound One Can Hear
30 Whisper: Quiet Library
60 Normal Converstation, Sewing Machine, Typewriter
90 Lawnmower, Shop Tools, Truck Traffic (8 Hours Per Day Maximum Exposure)
100 Chain Saw, Pneumatic Drill, Snow Mobile (2 Hours Per Day Maximum Exposure)
115 Sandblasting, Rock Concert, Air Horn (15 Minute Per Day Maximum Exposure)
140 Shotgun, Jet Engine (Noise Causes Pain & Possible Exposure Injury)
05/03/23 DPH/OSH 7
Fire Department Sound LevelsApproximate Decibel
Level Examples
73-120 Test Box
134 Air Horn (Morning Test)
112-117 Air Tank Bleed (4 Feet from Truck)
75-95 Engine Idling (Measured in Cab)
80-99 Engine Accelerating (Measured in Cab)
92-109 Air Horn (Measured in Cab)
104-108 Jaws of Life
93-104 Cement Cutter
103-105 Chainsaw
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Time Weighted Average (TWA)
Average Noise Level During 8-hour Period
05/03/23 DPH/OSH 9
Hearing Loss TypesWhat Are Threshold Shifts?
Temporary Threshold Shift (TTS) Permanent Threshold Shift (PTS)
Change in Hearing Threshold Compared toBaseline Audiogram: Average of 10 Db or More inEither Ear At:
2000 Hz 3000 Hz 4000 Hz
05/03/23 DPH/OSH 10
05/03/23 DPH/OSH 11
Indicative of noise exposure
05/03/23 DPH/OSH 12
Human Ear:Anatomy & Mechanics
05/03/23 DPH/OSH 13
Cochlea Contains Hair Cells Cells Can Be DestroyedDestroyed Cells Don’t GROW BACK
05/03/23 DPH/OSH 14
Human Ear: Hair Cells
05/03/23 DPH/OSH 15
Human Ear: Healthy Hair Cells
05/03/23 DPH/OSH 16
Human Ear: Damaged Hair Cells
05/03/23 DPH/OSH 17
Hearing Loss
Cumulative - Over Time Permanent Totally Preventable
05/03/23 DPH/OSH 18
Hearing Loss:Important Factors
Genetics / Heredity Illness (Measles) Medications Trauma Pressure Changes Age Lifestyle
05/03/23 DPH/OSH 19
Hearing Loss: Not Just At WorkNon-Occupational Noise
MusicGunsMotorcyclesMuscle CarsEtc.
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Hearing Loss: Important Factors
Hearing Can’t Be Turned On & Off Hearing Must Be Protected At All Times Workplace Standards
05/03/23 DPH/OSH 21
Can I Toughen Up My Ears?
NO
05/03/23 DPH/OSH 22
Firefighter Hearing Losses
8%
15%
22%
55%
Normal Hearing Mild High Frequency Hearing Loss
Moderate High Frequency Hearing Loss Severe High Frequency Hearing Loss
05/03/23 DPH/OSH 23
Cal-OSHATitle 8: 5097 Hearing Conservation Standard
Noise Exposure Greater than 8 Hour TWA of 85 dBA to be Covered
Responsibilities Evaluation & Surveillance of Work Environment Medical Surveillance - Annual Tests Noise Control Methods Training Program Evaluation Recordkeeping
05/03/23 DPH/OSH 24
Evaluation & SurveillanceWork Environment
Monitoring Results of Fire Stations Indicate Noise Levels on the Job Exceed 85 dBA Over 8 Hours
05/03/23 DPH/OSH 25
Medical Surveillance
Annually Audiogram Results Available on Request
05/03/23 DPH/OSH 26
Audiometric Test Results
Fire Fighters Notified of Standard Threshold Shift >10 dBA 25 dBA Loss Requires Doctor’s First Report (Work Comp) STS >10 dBA & Loss of 25 dBA Requires Retest OHS Keeps Permanent Records Abnormal Tests Submitted to Department Physician & Entered In
Medical Record
05/03/23 DPH/OSH 27
Controlling Noise
Engineering, Administrative, PPENoise Reduction Rating (NRR)AttenuationFitting & Using Hearing ProtectionHearing Protection Maintenance
05/03/23 DPH/OSH 28
Hearing Protection: PPEPlugs Baby
Noise Reduction Rating (NRR) Rates Noise Reduction Amount Provided by
Hearing ProtectionAttenuation
Estimated Sound Reduction Provided by Hearing Protection
05/03/23 DPH/OSH 29
Demonstration: Wearing Hearing Protection
05/03/23 DPH/OSH 30
Inspecting Hearing Protection
Small Holes (Let In High Frequency Noise) Cracks On Earmuff Covers Reduce Insulation
Effectiveness Oils, Dirt, Soot Degrade Protection Clean Regularly: Manufacturer Specifications Use Mild Soap & Water Solution
05/03/23 DPH/OSH 31
Hearing Protection Mandatory
On All Department Vehicles Engines Running Fireboat Jaws of Life Jack Hammers Cement Cutters Outboard Motors Equipment Tested Outside Siren & Air Horn Testing Prohibited in Stations Officers Accountable for General Order
Compliance
05/03/23 DPH/OSH 32
SFFD Hearing Protection
Earmuffs Canal Caps When Overhauling, Testing, Using
Equipment Disposal Plugs
05/03/23 DPH/OSH 33
Personal Protective EquipmentHearing Protection
Supplemental Hearing Protection OK Lost Equipment Replaced at Employee Expense Firefighters Responsible for Hearing Protection
Maintenance
Heat Stress
05/03/23 DPH/OSH 35
Overview
What Is Heat Stress? Normal Cooling Mechanisms First Aid Risk Factors & Evaluating Risk Prevention & Management Your Responsibility
05/03/23 DPH/OSH 36
What Is Heat Stress?
Heat Buildup in Body Generated by Muscles During Work Coming From Hot & Warm Environments Happens When Heat Load Too High
05/03/23 DPH/OSH 37
Normal Cooling Mechanisms
When Body Core Temperature Rises Increased Blood Flow to Skin Surfaces Increased Sweating Increased Heart Rate Increases
When This Works Well Core Temperature Drops or Stabilizes
05/03/23 DPH/OSH 38
Body Core v Peripherals
Core: Heart, Lungs, & Other Vital Organs
Periphery: Extremities Core & Periphery Compete With
Each Other for Blood Supply
05/03/23 DPH/OSH 39
When Cooling Mechanism Fails
Dehydration Results Body Cannot Cool Itself Core Temperature Rises Salt Loss Causes Heat Cramps Blood Flows to Periphery…Organs Shut Down
05/03/23 DPH/OSH 40
Environmental / Task Factors Contributing to Heat Stress
Ambient Temperature > 75ºF ^Relative Humidity Sources of Heat (Fire) Clothing (Heat Entrapment / Weight) Workload Microenvironment Physical Fitness
05/03/23 DPH/OSH 41
Heat Stress Categories
Categories: Heat Rash Sunburn Heat Strain / Cramps Heat Stress / Exhaustion Heat Stroke
05/03/23 DPH/OSH 42
Heat Rash
Skin Irritation or EruptionsRed Clusters of Pimples or BlistersOccurs in Skin Creases
05/03/23 DPH/OSH 43
Sun Burn
Premature Aging of Skin Skin Cancer (Melanoma) Symptoms Include:
Red Skin (Discomfort) Blisters (Infection) Fever (Thermo-Regulation) Pain (2º or 3º Burns)
05/03/23 DPH/OSH 44
Heat Strain / Cramps
Involuntary Muscle Contractions Caused by Not Replacing Fluids or Electrolytes
Occurs Usually in the Legs or Abdomen, Which Warn That Heat Stress Is Developing
05/03/23 DPH/OSH 45
Imbalance Between Heat Gain & Body Heat Loss Environmental & Workload Conditions Place
Excessive Demand on Temperature Regulation
Heat Stress / Exhaustion
05/03/23 DPH/OSH 46
Heavy Sweating Pale Nausea & Vomiting Headache Blurred Vision Dizziness & Fainting More Susceptible
Heat Stress / Exhaustion Symptoms
05/03/23 DPH/OSH 47
Heat Stroke
Body Unable to Control Temperature Oral Temperature Above 105 F in 10 to 15 Minutes Death or Permanent Damage If Untreated Heat Stroke Kills 4,000 Americans Annually
05/03/23 DPH/OSH 48
Heat Stroke Symptoms
Oral Temperature Over 105FNo SweatingRed, Hot, Dry SkinThrobbing HeadacheDizzinessNauseaUnconsciousness
05/03/23 DPH/OSH 49
Sunburn Treatment
Apply Cold Compresses to Burned Areas Apply Moisturizing Lotions to Affected Areas No Butter, Ointment, or Lard Do Not Break Blisters
05/03/23 DPH/OSH 50
Heat Rash Treatment
Provide Cooler, Less Humid, Environment Keep Affected Areas Dry Apply Powder Avoid Ointments & Creams
05/03/23 DPH/OSH 51
Heat StressFirst Aid
Cool Victim Rest in Cool Place Drink Cool Water Loosen Clothing Remove Unnecessary Clothing Shower or Sponge With Cool Water
05/03/23 DPH/OSH 52
Heat StrokeFirst Aid
Immediate , Aggressive, Effective Cooling Immerse Victim in Tub of Cool Water Place in Cool Shower Spray With Cool Water From a Hose Wrap in Cool, Wet Sheet & Fan Rapidly
Nothing by Mouth – It Won’t Stay Down Transport to Hospital
05/03/23 DPH/OSH 53
Risk Factors
Overweight Small Body Size Poor Nutrition Poor Physical Condition Previous Heat Illnesses
Lack of Acclimatization Over 40 Heart Disease High Blood Pressure Diabetes
05/03/23 DPH/OSH 54
Risk Factors for Individuals
Recent Immunization Alcohol During Previous 24 Hours Medications That Limit Sweating Excessive Caffeine Intake Low-Salt Diet
05/03/23 DPH/OSH 55
Weather
Temperatures Above 70F During the Day, 80F at Night
Direct Sunlight Can Equal an Increase up to 130F in Air Temperature
High Humidity Little Air Movement
05/03/23 DPH/OSH 56
Job Risk Factors
Heavy Work Prolonged Shifts Heavy Clothing Protective Gear & Respirators Exposure to Any Toxic Agent
05/03/23 DPH/OSH 57
Prevention & Management
Traditional Controls Clothing & Personal
Protective Equipment (PPE) Work Assignments, Work
Cycles Acclimatization Additional Controls
05/03/23 DPH/OSH 58
Clothing & PPE
The More Clothing Worn, the Longer It Takes Evaporation to Cool the Skin
Coated & Non-woven Personal Protective Garments Block Evaporation of Sweat
05/03/23 DPH/OSH 59
PPE Selection
Use Lightweight Garments & Respirators Light-Colored Garments Absorb Less
Heat From Sun Cooling Vests
05/03/23 DPH/OSH 60
Work Rest Cycles
05/03/23 DPH/OSH 61
Acclimatization
Increases the Amount of Sweat Produced Speeds Up Onset of Sweating Resets Internal Thermostat Regulates Content of Sweat to Conserve Electrolytes Increases Blood Flow to Extremities Reduces Heart Rate Burns Fat Conserves Carbohydrates Reduces Core & External Temperatures 7 to 10 Days to Achieve Lost in 2 to 3 Days
05/03/23 DPH/OSH 62
Worker’s Responsibilities
Hydration Being Alert for Symptoms in Themselves & Others Getting Adequate Rest & Sleep Carrying Out Instructions & Training for
Controlling Heat Stress
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