Transcript noise-induced hearing loss in asia - National Hearing Conservation

NOISE-INDUCED HEARING LOSS IN
ASIA
Adrian Fuente, Ph. D.
UQ Postdoctoral Research Fellow
School of Health and Rehabilitation Sciences
The University of Queensland
Australia
Aim of the presentation
To discuss the current situation of noise-induced hearing
loss in Asia.
Agenda
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Background
The current situation of NIHL in Asia
Research on NIHL in Asian countries
Summary
ASIA- Background
• Asia comprises 47 countries.
• It is rich in natural resources, such as petroleum, forests,
fish, water, rice, copper and silver.
• Manufacturing in Asia has traditionally been strongest in
East and Southeast Asia, particularly in mainland China,
Taiwan, South Korea, Japan, India, Philippines and
Singapore.
ASIA -Background
• It is the world’s largest and most populous continent.
• Four billion people which represents 60% of the World’s
current human population.
• For countries such as Bangladesh, Nepal, and Pakistan,
the informal sector represents 70 per cent of the total
employment (ILO, 2003).
• Huge range of different cultures, income level,
environments, historical ties and government systems.
ASIA- Background
• Japan and South Korea continue to dominate in the area
of multinational corporations, but increasingly mainland
China, and India are making significant inroads.
• KEY ISSUE
• Many companies from Europe, North America, South
Korea and Japan have operations in Asia's developing
countries to take advantage of its abundant supply of
cheap labour and relatively developed infrastructure.
The current situation of NIHL loss in Asia
DALYs
Common scenario
Legislation
DALYs
Common Scenario
Common Scenario
• Despite the existence in many countries of regulations that
establish maximum limits of noise in the workplace, these
regulations are under enforced.
• Some other Asian developing countries still lack legislation
regarding noise exposure in the industry.
• A common characteristic in developing Asian countries is
the limited resources spent in implementing hearing
conservation programmes and in controlling noise sources
through engineering techniques.
Common Scenario
• Other variables that make a hard task the implementation
of hearing conservation programmes in the developing
world are the lack of hearing health care professionals, the
absence of awareness of the ill-effects induced by noise,
and a not minor one, the low educational level of laborers
Legislation
Taiwan
• In Taiwan, the decrease of noise exposure has been
indicated as the second most crucial issue for safety and
hygiene of labours’ workplace.
• Article 2 of the Labour Safety and Health Law
Enforcement Rules of Taiwan defined noise over 85 dB(A)
as “extraordinary hazard to health”.
• A noise-induced hearing loss surveillance system with
periodic annual audiometric examinations for workers who
are exposed to noise >85 dB(A) was also established in
Taiwan in 1995.
Compensation
• Saudi Arabia
– NIHL is compensated by the General Organisation for Social
Insurance (GOSI). It includes hearing loss as a result of all
operations, occupations and industries which are associated with
the generation of noise and loud sounds that are liable to affect
hearing.
– Calculation: The monaural impairment for each ear must be
calculated. Average threshold values of 0.5, 1, 2, 3 kHz. Then 25
must be subtracted from the previous result.
India
• NIHL has been a compensable disease in this country
since 1948, but it was only in 1996 that the first case was
compensated.
• The first case was an air conditioning plant compressor
operator (compensated in 1996)
• The second case was a textile mill worker (compensated
in 1997)
India
• As per Indian laws, a worker presenting with NIHL and a
history of working in a noisy environment is eligible to
receive compensation provided he/she gets a certificate
from any medical practitioner. The affected worker does
not have to prove a cause-and-effect relationship.
• The permissible exposure limit by Indian laws is 90 dB for
an 8-hour shift.
India
• So why???.. Lack of awareness among the workers and
indeed
among
the
health
professionals.
The
undergraduate curriculum in India does not equip doctors
to diagnose occupational diseases and there are no
postgraduate courses in occupational health in India.
RESEARCH ON NOISE-INDUCED HEARING LOSS IN
ASIA
Characterisation of the Population
Prevalence
Sources of Noise
Industries
Hearing Conservation
Programs
New Approaches on the
Prevention of NIHL
-Genetics
-Protection against NIHL
- Susceptibility
Efficacy/
effectiveness
PubMed entries
• Noise-induced hearing loss in Asia
– 120 entries
• 8 reviews
• Noise-induced hearing loss in the United States
– 819 entries
• 76 Reviews
• Noise-induced hearing loss in Europe
– 626 entries
• 25 reviews
MeSH NIHL, Asia (93 valid entries)
Categories
• Susceptibility:
– Genetics, covariates, associations
• HCP
– Awareness of NIHL, use of HP, Policies, new methods or approaches to
hearing conservation
• Prevalence
– Prevalence of NIHL is specific industries or globally in a specific country.
• Environment
– Noise levels in cities, noise exposure of police officers, construction
workers
• Others
– New methods for the diagnosis of NIHL, histological studies in animals,
antioxidants
Susceptibility (7 valid entries)
HCP (13 valid entries)
Prevalence (49 valid entries)
Environment (11 valid entries)
Others (11 valid entries)
Web of Science (1016 valid entries for NIHL)
Web of Science –NIHL and affiliation of authors
Summary
• Asia is a heterogeneous world region NIHL is a big issue
in Asia
• Legislation does exist in some Asian countries
• Legislation under enforced
• Lack of awareness of NIHL among employers and
employees
• Research on NIHL is still mainly focused on prevalence,
though in a few number of countries
Thanks for your attention
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