Transcript No Slide Title

DEVELOPING A HEARING LOSS
PREVENTION PROGRAM FOR
CONSTRUCTION WORKERS
Mark Stephenson, Ph.D.
National Institute
for Occupational Safety
and Health
NIOSH HIERARCHY OF CONTROLS
Remove the hazard
Remove the worker
Protect the worker
OVERVIEW
• REVIEW OF THE PROBLEM
• WHAT WE’VE LEARNED SO FAR
• WHERE WE’RE GOING
THE PROBLEM:
The construction industry DOES have a standard:
29 CFR 1926.52… “Workers exposed to TWAs >90 dBA
must be provided protection.”
BUT
Many of the requirements in the manufacturing
industry standard (29 CFR 1910.95) do not apply:
• Periodic noise monitoring
• Dosimetry
• Periodic audiometric testing
• Regular worker education
So what…
People lose their hearing
anyway as they age.
Even by age 60, the average healthy
person does not have impaired hearing!!
Hearing Loss
500
0
10
20
30
40
50
60
70
80
90
1000
40 Y.O.
50 Y.O.
60 Y.O.
2000
3000
4000
6000
Hearing Levels in 60 Year Old Males as
a Function of Noise Exposure
Decibels of Hearing Loss
500
0
1000
2000
3000
4000
6000
10
20
30
No Noise
40
90 dBA
50
95 dBA
60
100 dBA
70
80
90
-10
Even where the OSHA HCA
is being applied, workers are still
losing their hearing!
0
10
20
30
40
50
60
20 years in stamping plant
Predicted Hearing Levels
No Occupational Exposure
500
1000
2000
4000
8000
What Have We Learned So Far?
• Noise Levels
• Hearing Levels
• Cost
• Health Communications
The Average 25 Year Old Carpenter
Has 50 Year Old Ears!
It Would Cost One Billion Dollars to Provide
Hearing Aids to Every UBC Member
Who Needed Them (batteries not included)!
$1,000,000,000
Cost: What kind of money are we talking about?
Don’t
talk to me about
decibels, tell me about
MONEY !
Cost of hearing aids
Vs.
Cost of an HCP
What about workers’ compensation?
Health Communication Theory = Marketing
Health Communications:
Once a noise hazard is identified, why don’t we
just pass out ear muffs or set out boxes of ear
plugs?
Without proper training, any hearing
protector that can be worn wrong,
will be worn wrong!
Available protection vs. the amount of
protection obtained by untrained workers.
30
Decibels
25
20
29
15
21
10
5
26
23
26
22
17
13
7
2
0
Plug A
Plug B
Plug C
5
Plug D
8
1
Plug E
Plug F
5
Plug G
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 protector
on the amount of effective noise reduction
Education and Training Must NOT Just
Fill a Square
Blah, blah, blah…
Blah, blah, blah...
How do you know what
the workers’ concerns Just ask me.
and beliefs are?
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
Roof “Talk”
Earcup Too Big
Warning Sounds
Percent of Workers Who Wore Hearing
Protectors
70
63
60
50
52
47
40
33
Non-STS
STS
30
20
10
0
Pre
Post
INFLUENCING HEARING PROTECTOR
USE AMONG WORKERS
Health communication theory has proven education
and training must address two concepts:
Remove Barriers
Develop Self-Efficacy
How Do You Remove Barriers & Develop Workers’
Self-Efficacy?
Conduct Focus
Groups
Removing Barriers and
Developing Self-Efficacy
is an Iterative Process Administer
Measure
SPLs & HTLs
Survey
Analyze Audiometric Data
Modify Training
Analyze Data
Observe
Behaviors
Analyze Data
Develop Training
Re-administer
Survey
This is your ear.
This is your ear on noise.
Any questions?
NIOSH Toll-Free Number: (800) 35-NIOSH
http://www.cdc.gov/niosh/homepage.html
Mark R. Stephenson
(513) 533-8144
[email protected]
Carol Merry-Stephenson
(513) 533-8581
[email protected]