Transcript hearing loss

OCCUPATIONAL MORBIDITY DUE
TO NOISE EXPOSURE IN ROMANIA
Adriana Todea, Aurelia Ferencz
Occupational Health Department-Institute of Public
Health, Romania
Event: European Week 2005
STOP THAT NOISE!
Under this slogan European occupational and
safety week has taken place during October
20-26th 2005
http://osha.eu.int
HISTORY
The adverse effects of noise exposure upon
hearing are well known and mentioned as
back as 1731, in workers in copper and
copper alloys mines.
EU Directive 2003/10/EC

contains minimum requirements to
encourage improvements, especially in
working environment, in order to guarantee
a better level of occupational health and
safety of the workers.
EU Directive 2003/10/EC

The requirements are applicable to activities
during which the workers are or have a risk
to be exposed, through the nature of their
activity, to noise induced risks.
EU Directive 2003/10/EC
Limit Value of noise exposure:
LEX,8h = 87 dB(A)
EU Directive 2003/10/EC

The level of noise exposure can be
efficiently reduced through preventive
measures regarding the design of work
stations and work places, selecting the
equipments, procedures in order to give the
priority to reducing risk at source.
 Collective protection measures have priority
compared to individual protective measures.
EU Directive 2003/10/EC – health
surveillance

Regarding health surveillance, the EU
Directive specifies the obligation to
adequate surveillance of workers’ health
when risk evaluation show a risk for health.
 Specified requirements regarding medical
surveillance
must
be
implemented
according to national laws and practices.
ROMANIAN LEGISLATION
General Labor Protection Norms/2002 (Title
VI, Chapter VII, Noise) contain mentions
regarding:
 measurement
• threshold limit values
• protective measures for protection of
employees.
ROMANIAN LEGISLATION
General Labor Protection Norms/2002 Annex
no 2 contains:
Table of occupational diseases that must be
reported (position 28: hearing loss due to
exposure to noise exceeding the TLV and
ototoxic substances).
ROMANIAN LEGISLATION
General Labor Protection Norms/2002
Annex no 3 contains the list of work-related
diseases induced by noise exposure:
 high blood pressure
 digestive diseases
 nevrosis and other neurological-mental
diseases.
ROMANIAN LEGISLATION
General Labor Protection Norms/2002
Annex no.7
File 109 -the Noise
ROMANIAN LEGISLATION File 109 -the
Noise
Medical examination prior to
hiring :
 general clinical examination
 nose-ear-throat examination
 audiogram (tonal liminal
audiometry)
c) The diseases impeding the
hiring:
 chronic diseases of the medium
and inner ear
 psychopathies,
manifested
nevrosis
 medium, severe high blood
pressure with risk factors, stage
II and III.
Periodical medical examination :
 –
general clinical examination
– annually
 –
audiogram (tonal liminal
audiometry) – at 3 months from
hiring and than annually
 –
nose-ear-throat examination,
depending on the results of the
audiogram
 –
psychological examination
every 3 years.
HEARING LOSS

Symptoms occur in exposure to noise
exceeding 87 dB(A) daily personal
exposure. The first signs consists in
difficulties in hearing high pitch sounds,
followed by difficulties in hearing low level
sounds.
 The impairment is bilateral and irreversible
HEARING LOSS

The hearing loss can be high in short
exposures to impulsive noise (gunfire),
resulting in hearing loss and continuous
tinnitus.
 In these circumstances, the impulsive noise
can cause tympanum rupture, which is
painful and reversible.
HEARING LOSS

Tinnitusul can sometimes be the first sign of
hearing loss due to noise exposure.
NOISE AND CHEMICAL AGENTS
EXPOSURE

The exposure to toxic substances such as
toluene, styrene, carbon disulphide, lead,
mercury, arsenic, can damage the hearing,
these substances being ototoxic.
 The combined exposure to noise and ototoxic
substances results in a high risk of hearing
loss, greater than each risk alone.
NOISE AND PREGNANT WORKERS
EXPOSURE

The exposure to noise of pregnant women
can induce damages of the fetus
(subsequent hearing impairment and other
effects due to low frequence exposure).
NOISE EXPOSURE AND WORK
ACCIDENTS
Noise increases the risk of work accidents:
 – interference with speech communication
and with the perception of warning signals
 – masking the warning sounds (vehicles);
 – annoyance and increasing risk of error.
NOISE INDUCED HEARING LOSS
- It’s a permanent occupational loss of the
hearing threshold (definitive hearing loss)
at the frequence of 4096 Hz, with more
than 30 dB, after correction for
presbycusis, perceptive, bilateral and
symmetric,
without
damaging
the
conversational frequencies.
OCCUPATIONAL DEAFNESS

It’s the permanent occupational loss of
the hearing threshold (definitive hearing
loss), at conversational frequencies, with
more than 25 dB (arithmetic mean of
values on 500-1000-2001 Hz), after
correction for presbycusis, perceptive,
bilateral and symmetric.
ROMANIAN OCCUPATIONAL
MORBIDITY (1)

The number of new cases of noise induced
occupational diseases had a constant
increase during the last 10 years.
ROMANIAN OCCUPATIONAL
MORBIDITY (2)
1000
900
800
700
600
500
400
300
200
100
0
nr. cazuri noi
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
ROMANIAN OCCUPATIONAL
MORBIDITY (3)
Occupational Disease
Number of new cases
2004
Occupational diseases
due to noise exposure
-hearing loss
- occupational deafness
258
185
73
ROMANIAN OCCUPATIONAL
MORBIDITY (4)

In 2004, occupational hearing loss occurred
after a mean of 21.48 years of exposure and
occupational deafness after 23.27 years of
exposure.
ROMANIAN OCCUPATIONAL
MORBIDITY (5)
District
No. of cases
Alba
39
Mean years
exposure
16,5±7,1
Braila
30
23,3±5,6
Harghita
24
21,8±7,3
Cluj
23
26 ±8,9
of
CONCLUSIONS (1)
The quality of workers’ life suffering from
irreversible hearing loss due to
occupational noise exposure over the TLV
is diminished and those affected by it are
“condemned” to a communication
impaired life.
CONCLUSIONS (2)
The only treatment for hearing loss is
PREVENTION
through
technicaladministrative measures of reducing noise.
CONCLUSIONS (3)
The health and safety of noise exposed worker
is nowadays a priority.
STOP THAT NOISE!