NOISE-INDUCED HEARING LOSS NOISE-INDUCED HEARING LOSS IN THE CONSTRUCTION INDUSTRYIN THE CONSTRUCTION INDUSTRY

For ACCSH Meeting 3/15/01For ACCSH Meeting 3/15/01

Carol Merry Stephenson, Ph.D.Carol Merry Stephenson, Ph.D. Mark Stephenson, Ph.D.Mark Stephenson, Ph.D.

National Institute for Occupational Safety & HealthNational Institute for Occupational Safety & HealthCenters for Disease Control & PreventionCenters for Disease Control & Prevention

OVERVIEWOVERVIEW

• Review of the problemReview of the problem

• Highlights from recent and ongoing research Highlights from recent and ongoing research

• What’s new in technology and at NIOSH?What’s new in technology and at NIOSH?

HOW BIG IS THE PROBLEM?HOW BIG IS THE PROBLEM?

Hearing loss from noise is the Hearing loss from noise is the most common occupational most common occupational illness (NIDCD), and the illness (NIDCD), and the 2nd-most self-reported 2nd-most self-reported occupational illness for Americanoccupational illness for American workers.workers.

NIHL accounts for about 1 in 5 NIHL accounts for about 1 in 5 losses severe enough for a person losses severe enough for a person to report trouble hearing (AAA).to report trouble hearing (AAA).

Construction noise: many sources, hours, variable levels; dynamic

NeitzelNeitzel

Which Construction Workers are at Risk?

• Highest Risk:

– Projects: road construction, carpentry,

concrete

– Trades: carpenters, laborers, operators,

ironworkers, sheet metal workers

– Stage: excavation, erection, finish

• Studies small; need comprehensive assessmentsNeitzelNeitzel

Hammer DrillHammer DrillHammer DrillHammer DrillChain SawChain SawChain SawChain Saw

Chop SawChop SawChop SawChop SawMiter SawMiter SawMiter SawMiter Saw

Impact WrenchImpact WrenchImpact WrenchImpact WrenchTile SawTile SawTile SawTile Saw

Circular SawCircular SawCircular SawCircular Saw

Hand DrillHand DrillHand DrillHand DrillMetal ShearMetal ShearMetal ShearMetal Shear

RouterRouterRouterRouter

PlanerPlanerPlanerPlaner

Belt SanderBelt SanderBelt SanderBelt Sander

Table SawTable SawTable SawTable SawOrb. Sand.Orb. Sand.Orb. Sand.Orb. Sand.MortisingMortisingMortisingMortising

75 80 85 90 95 100 105 110 115

Tas

k/T

ool

Noise Levels forNoise Levels forCommon ToolsCommon Tools

Impulsive Peaks by Trade

0

5

10

15

20

25

30

No.

Pea

ks >

140

dBA

carpenterscarpenters laborerslaborers ironworkersironworkers electricianselectriciansoperatorsoperators

NeitzelNeitzel

Hearing Loss Among Male CarpentersHearing Loss Among Male Carpentersas a Function of Ageas a Function of Age

So what…People lose their hearing

anyway as they age.

The Average 25 Year Old CarpenterThe Average 25 Year Old CarpenterHas 50 Year Old Ears!Has 50 Year Old Ears!

• Noise monitoringNoise monitoring• Controlling excessive noiseControlling excessive noise• Individually fitted protectionIndividually fitted protection• Education/TrainingEducation/Training• Baseline & annual audiometryBaseline & annual audiometry• Procedures for preventingProcedures for preventing

additional hearing lossadditional hearing loss• Record KeepingRecord Keeping

OSHA OSHA 06/29/1992 06/29/1992 Compliance Compliance

LetterLetter

OSHA Standard for Construction: 29 CFR 1926.52 OSHA Standard for Construction: 29 CFR 1926.52 PEL of 90 dBAPEL of 90 dBA

What Constitutes A Hearing Conservation Program?What Constitutes A Hearing Conservation Program?

How can hearing How can hearing conservation conservation programs be programs be developed for developed for construction that construction that follow prevention follow prevention guidelines and guidelines and regulations regulations without without ignoringignoring the the concerns of laborconcerns of laborand management?and management?

THE CHALLENGE:THE CHALLENGE:

NIOSH HIERARCHY OF CONTROLSNIOSH HIERARCHY OF CONTROLS

Remove the hazardRemove the hazard

Remove the workerRemove the worker

Protect the workerProtect the worker

Photo Courtesy of Rick Neitzel

0

10

20

30

40

50

60

70

80

90

Audiometry Monitoring HPDs

SmallMediumLarge

PREVALENCE OF PROGRAM ASPECTSPREVALENCE OF PROGRAM ASPECTSBY COMPANY SIZEBY COMPANY SIZE

010

2030

4050

607080

Agriculture

Construction

Manufacturing

MiningTransportation

Percent of Companies in Michigan That Provided Percent of Companies in Michigan That Provided Monitoring Hearing Tests - 1999Monitoring Hearing Tests - 1999

Percentage of Time Hearing Percentage of Time Hearing Protectors are Worn “Most of the Protectors are Worn “Most of the

Time” When Working in Loud NoiseTime” When Working in Loud Noise

0

20

40

60

80

100

Hearing Conservation Professionals

Carpenter Safety Trainers

Carpenters

Don’t make the mistake ofDon’t make the mistake ofthinking your job is over if thinking your job is over if you simply provide hearing you simply provide hearing protection and periodic protection and periodic hearing tests.hearing tests.

Without Without trainingtraining workers how to workers how to recognize noise recognize noise hazards, utilize noise hazards, utilize noise controls, and use controls, and use hearing protectors, hearing protectors, you may be wasting you may be wasting your money.your money.

Factors Affecting Behavioral Change:

Individual LevelIndividual Level

• Knowledge/beliefs• Attitudes/values• Readiness for change• Decision-making style• Skills/ Self-efficacy

Organizational LevelOrganizational Level

• Worksite norms- safety culture• Union/ management priorities

(TIME!)• Modeling by trainers &

foremen• OSH curricula during

apprenticeship• Environmental support

INFLUENCING HEARING HEALTHINFLUENCING HEARING HEALTHBEHAVIOR AMONG WORKERSBEHAVIOR AMONG WORKERS

Studies utilizing a health communication/ promotionStudies utilizing a health communication/ promotionapproach indicate that education and training approach indicate that education and training must address two concepts:must address two concepts:

Remove BarriersRemove Barriers Develop Self-EfficacyDevelop Self-Efficacy

Research by NIOSH, Drs. Lusk, Kerr, Lankford & others!Research by NIOSH, Drs. Lusk, Kerr, Lankford & others!

67

33

0 0 00102030405060708090

100

PE

RC

EN

T

Strongly Agree

Agree Strongly Disagree

DisagreeNeither

I believe exposure to loud noise can hurt my hearing.

UBCUBC

43 45

102 00

102030405060708090

100

PE

RC

EN

T

Strongly Agree

Agree Strongly Disagree

DisagreeNeither

I think my hearing is being hurt by exposure to loud noise at work.

What are some of the barriers cited by construction workers and their supervisors?

THE FOUR C’s•Comfort• Convenience• Cost (personal & $) • Communications / hear important sounds

THERE ARE OVER 200 DIFFERENT HEARING PROTECTORS.

EVERYONE CAN FIND A PROTECTOR THAT MEETS THEIR NEEDS. THE BEST HEARING PROTECTOR IS THE ONE THAT’S

WORN!

RESULTS OF FOCUS GROUPSRESULTS OF FOCUS GROUPS

Workers may be less Workers may be less concerned about gettingconcerned about gettinga hearing loss then about a hearing loss then about developing tinnitus.developing tinnitus.

““I expected to lose my I expected to lose my hearing. But, I thoughthearing. But, I thoughtit would be quiet.”it would be quiet.”

94%

6%

Tinnitus

No Tinnitus

21%

79%

Tinnitus

No Tinnitus

Non-Noise Exposed WorkerNon-Noise Exposed Worker

Noise Exposed WorkersNoise Exposed Workers

Percent of People With TinnitusPercent of People With Tinnitus

American Tinnitus AssociationAmerican Tinnitus Association

Does this research-based communication stuff result in education & training programs that really work? You bet !

72

20

5

25

7

37

55

11

31

0102030405060708090

100

PE

RC

EN

T

Pre Training

Post Training

Strongly Agree

Agree Strongly Disagree

DisagreeNeither

I think it will be hard to hear warning signals (like back-up beeps) if I am wearing hearing protectors.

6 3

43

20

3039

15

28

6 70

102030405060708090

100

PE

RC

EN

T

Pre Training

Post Training

Strongly Agree

Agree Strongly Disagree

DisagreeNeither

Wearing hearing protectors is annoying.

What Training Approaches & What Training Approaches & Messages Make Sense to Messages Make Sense to

Construction Workers/ Managers? Construction Workers/ Managers?

• Get their attentionGet their attention

• Raise their consciousness Raise their consciousness

• Provide Information that enables people Provide Information that enables people to do the right thingto do the right thing

Engage All Stakeholders

“Engage persons having an investment in what will be learned ...and what will be done with the knowledge”

Agree on expected effects of the training:

• Increase use of HPDs• Decreased incidence of hearing loss

• Increase use of controlsIncrease use of controls

Use Credible Data- Site Specific If Possible

• Perceived by stakeholders as believable

• Useful, feasible, accurate, & representative of crafts at site

Blah, blah, blah…Blah, blah, blah...

Share and Apply Lessons Learned

Training does not automatically translate into action--it takes effort. •All stakeholders need feedback. •Need a “Champion” to actively follow-up

This is your ear.This is your ear. This is your ear on noise.This is your ear on noise.

Any questions?Any questions?

Raise AwarenessRaise Awareness

It’s Really Pretty Simple…..It’s Really Pretty Simple…..

• Wear this now...Wear this now... • Or wear this later!Or wear this later!

Get their attentionGet their attention

29

21 2326 26

2217

137

25

1

85

0

5

10

15

20

25

30

Dec

ibel

s

Plug A Plug B Plug C Plug D Plug E Plug F Plug G

Available protection vs. the amount of protection obtained by untrained workers.

Likely protection as worn by untrained worker

Amount of protection listed on the box

Effect of not wearing your hearing protectorEffect of not wearing your hearing protectoron the amount of effective noise reductionon the amount of effective noise reduction

TRAINING HELPS YOU AND YOUR WORKERSTRAINING HELPS YOU AND YOUR WORKERSMAKE SMART CHOICES ABOUT HPDs.MAKE SMART CHOICES ABOUT HPDs.

Protectionin thereal

world

Abilityto hear criticalsounds

UNDER PROTECTIONUNDER PROTECTION OVER PROTECTIONOVER PROTECTION

Perhaps Best of ALL--Perhaps Best of ALL--Education & training will enable you to take advantageEducation & training will enable you to take advantageof exciting new and emerging technologies.of exciting new and emerging technologies.

Dose = X 100CT

__n

i=1

i

i

• HPD rating methodsHPD rating methods

• “ “Flat” attenuation HPDsFlat” attenuation HPDs

• Communication devicesCommunication devices

• Fit-testingFit-testing

• TTS monitorsTTS monitors

• Personal noise monitorsPersonal noise monitors

• Records/Information management Records/Information management

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6

16

1

5

15

18

6

0

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10

15

20

25

EAR EP-100 V-51R UF1 Muff

LabFit

Subj.Fit

OSHAderate

Estimated Hearing Protection in an A-WeightedNoise Environment as a Function of Rating Method

New Flat Attenuation New Flat Attenuation &&

Communication DevicesCommunication Devices

New Methods for Estimating Actual PerformanceNew Methods for Estimating Actual Performance

FIT-TEST METHODFIT-TEST METHOD• Fit-test system feasible for Fit-test system feasible for

field usefield use

• Using fit-test enabled Using fit-test enabled workers to learn to workers to learn to correctly fit a new plugcorrectly fit a new plug

• Knowledge gained and Knowledge gained and consciousness raisedconsciousness raised

TTS Monitoring

• New Devices

• Training exercises to teach self-monitoring

(RADIO exercise)

Noise dose: Ambient vs. Inside ESPIndustrial Sand Mine

020406080

100120

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31

Measurement Number

Per

cen

t d

ose Ambient Inside ESP

PERSONAL NOISE MONITORINGPERSONAL NOISE MONITORING

HearSaf 2000 Information Management System http://www.safe-at-work.com

New NIOSH Noise Efforts Relevant to Construction

• Developed with input from NORA Hearing Loss Team

• Involves cross-division collaborations with staff from Pittsburgh, Cincinnati, and Spokane.

Possible External Partners:We Are Seeking Others!

• LABOR– UMWA– USWA– UAW– UBC&J

• Equipment Manufacturers– JOY – Fletcher– Others …

• Operators & Trade Associations– BCOA, NMA, NSA– CONSOL, Newmont, others

OVERALL EMPHASIS OF NIOSH NOISE PROGRAM

• Assess workplace factors and existing knowledge

• Conduct and evaluate intervention efforts

• Disseminate information and evaluate efforts

ADDITIONAL SPECIFIC AIM

Convene workshops, meetings, and symposia to obtain input, facilitate collaboration, and disseminate findings.

NO NOISE!

PROGRAM SUMMARY• Individual projects capitalize on the strengths of

existing facilities and expertise throughout the Institute• Strong linkages to existing projects and external

partners from labor, industry, academia, etc. • Data collection activities will support multiple projects• Projects are designed to take advantage of unique

opportunities and to address historic barriers• Outcomes from projects satisfy both short and long

term needs in hearing loss prevention

The New NORA Projects

1) National Surveillance of Noise Exposure and Hearing Loss/ John Franks

2) Definition and Assessment of Engineering Noise Controls/ David Podobinski

3) Web-based outreach to small constuction and mining/ Carol Merry Stephenson

4) Accommodation of Noise-Exposed, Hearing-Impaired Workers/ Thais Morata

5) Noise Sampling strategies and Exposure-Response Models/ Mary Prince

Web-Based Outreach to Small Construction & Mining

Noise Control and Hearing Loss Prevention

Assess the quality and availability of current information.

Determine new information needs.

Create an appropriate web-site to meet identified needs & coordinate on-going output from all aspects of NIOSH noise program.

Evaluate the web-site & products

www.nidcd.nih.gov

www.hearingconservation.org

This is your ear.This is your ear. This is your ear on noise.This is your ear on noise.Any questions?Any questions?

NIOSH Toll-Free Number: (800) 35-NIOSHNIOSH Toll-Free Number: (800) 35-NIOSHhttp://www.cdc.gov/niosh/homepage.htmlhttp://www.cdc.gov/niosh/homepage.html

Mark R. Stephenson, Ph.D. Carol M. Stephenson, Ph.D.Mark R. Stephenson, Ph.D. Carol M. Stephenson, Ph.D.(513) 533-8144 (513) 533-8581(513) 533-8144 (513) 533-8581 mos9@cdc.gov cem3@cdc.govmos9@cdc.gov cem3@cdc.gov

Just a Few Just a Few Wise-Wise-EarsEars Web Links Web Links

www.nidcd.nih.gov

www.cdc.gov/niosh

www.aearo.com

www.3m.com

www.howardleight.com

www.hearnet.com

www.hearingconservation.org