Mark Stephenson, Ph.D. National Institute for Occupational Safety and Health DEVELOPING A HEARING LOSS PREVENTION PROGRAM FOR CONSTRUCTION WORKERS.

Mark Stephenson, Ph.D.Mark Stephenson, Ph.D.

National InstituteNational Institutefor Occupational Safetyfor Occupational Safety

and Healthand Health

DEVELOPING A HEARING LOSS DEVELOPING A HEARING LOSS PREVENTION PROGRAM FOR PREVENTION PROGRAM FOR

CONSTRUCTION WORKERSCONSTRUCTION WORKERS

NIOSH HIERARCHY OF CONTROLSNIOSH HIERARCHY OF CONTROLS

Remove the hazardRemove the hazard

Remove the workerRemove the worker

Protect the workerProtect the worker

OVERVIEWOVERVIEW

• REVIEW OF THE PROBLEMREVIEW OF THE PROBLEM

• WHAT WE’VE LEARNED SO FARWHAT WE’VE LEARNED SO FAR

• WHERE WE’RE GOINGWHERE WE’RE GOING

The construction industry The construction industry DOESDOES have a standard: have a standard:29 CFR 1926.52… 29 CFR 1926.52… “Workers exposed to TWAs >90 dBA“Workers exposed to TWAs >90 dBAmust be provided protection.”must be provided protection.”

BUTBUT

Many of the requirements in the manufacturing Many of the requirements in the manufacturing industry standard (29 CFR 1910.95) do not apply:industry standard (29 CFR 1910.95) do not apply:• Periodic noise monitoringPeriodic noise monitoring• DosimetryDosimetry• Periodic audiometric testingPeriodic audiometric testing• Regular worker educationRegular worker education

THE PROBLEMTHE PROBLEM::

So what…People lose their hearing

anyway as they age.

0102030405060708090

500 1000 2000 3000 4000 6000

Hea

ring

Los

s 40 Y.O.50 Y.O.60 Y.O.

Even by age 60, the average healthy Even by age 60, the average healthy person does not have impaired hearing!!person does not have impaired hearing!!

0

10

20

30

40

50

60

70

80

90

500 1000 2000 3000 4000 6000

Dec

ibel

s of

Hea

rin

g L

oss

No Noise

90 dBA

95 dBA

100 dBA

Hearing Levels in 60 Year Old Males asHearing Levels in 60 Year Old Males asa Function of Noise Exposurea Function of Noise Exposure

500 1000 2000 4000 8000

10

0

-10

60

50

40

30

20

20 years in stamping plant

Predicted Hearing LevelsNo Occupational Exposure

Even where the OSHA HCA is being applied, workers are still

losing their hearing!

What Have We Learned So Far?What Have We Learned So Far?

• Noise Levels

• Hearing Levels

• Cost

• Health Communications

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

$1,000,000,000

It Would Cost It Would Cost One Billion DollarsOne Billion Dollars to Provide to ProvideHearing Aids to Every UBC MemberHearing Aids to Every UBC Member

Who Needed Them (Who Needed Them (batteries not includedbatteries not included)!)!

Don’tDon’t talk to me about talk to me about

decibels, tell me aboutdecibels, tell me about MONEYMONEY ! !

Cost: What kind of money are we talking about?Cost: What kind of money are we talking about?

Cost of hearing aidsCost of hearing aidsVs.Vs.

Cost of an HCPCost of an HCP

What about workers’ compensation?What about workers’ compensation?

Health Communication Theory = MarketingHealth Communication Theory = Marketing

Health Communications:Health Communications:

Once a noise hazard is identified, why don’t we Once a noise hazard is identified, why don’t we just pass out ear muffs or set out boxes of ear just pass out ear muffs or set out boxes of ear plugs? plugs?

Without proper training, any hearing Without proper training, any hearing protector that can be worn wrong, protector that can be worn wrong,

will be worn wrong!will be worn wrong!

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

People have MANY reasons for not using hearing protectors. (AKA: You can lead a person to hearing protectors, but you can’t get him/her to wear them.)

• Comfort• Convenience• Cost • 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!

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

Blah, blah, blah…Blah, blah, blah...

Education and Training Must NOT JustFill a Square

How do you know what How do you know what the workers’ concerns the workers’ concerns and beliefs are?and beliefs are?

Just ask me.I’ll tell you

what I need.

Barriers cited by coal miners

for not wearing HPDs:

Comfort Poke Out Eardrum

Communication Cords Get Caught

Convenience Earcup Too BigRoof “Talk” Warning Sounds

47

33

52

63

0

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20

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50

60

70

Pre Post

Non-STSSTS

Percent of Workers Who Wore Hearing Percent of Workers Who Wore Hearing ProtectorsProtectors

INFLUENCING HEARING PROTECTORINFLUENCING HEARING PROTECTORUSE AMONG WORKERSUSE AMONG WORKERS

Health communication theory has proven educationand training must address two concepts:

Remove Barriers Develop Self-Efficacy

uoGp

uoEssaenLl

ORDB

NESE

MFTN

A YD

Conduct FocusGroups

MeasureSPLs & HTLs

ObserveBehaviors

Analyze Audio-metric Data

AdministerSurvey

Analyze Data

Develop Training

Re-administerSurvey

Analyze Data

Modify Training

Removing Barriers andDeveloping Self-Efficacyis an Iterative Process

How Do You Remove Barriers & Develop Workers’How Do You Remove Barriers & Develop Workers’Self-Efficacy?Self-Efficacy?

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 Carol Merry-StephensonMark R. Stephenson Carol Merry-Stephenson(513) 533-8144 (513) 533-8144 (513) 533-8581 (513) [email protected]@cdc.gov [email protected] [email protected]