3M OH & ES Division Current Issues in Hearing Loss Prevention Lee Hager, Hearing Conservationist...

3M OH & ES Division

Current Issues in Hearing Loss Prevention

Lee Hager, Hearing Conservationist

517.290.1907/[email protected]

Federal Regulatory Timeline

Walsh-Healey Act1969

OSH Act1971

Noise Control Act1972

Hearing Conservation Amendment1981-1983

MSHA1996

FRA 2011

1960 20102000199019801970

EPA NRR Revision2007 …

Recordkeeping2003

Where do we stand today?3M OH & ES Division

2nd largest specific illness3M OH & ES Division

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Mfg Predominant

6© 3M 2013. All Rights Reserved.

3M OH & ES Division

What’s the Story?

Exposure Assessment and Limits? Resource Allotment? Training? Hearing Protectors?

Probably all of the above and more

Resource AllotmentHCP Cost Implications

1976 Cost Impact Analysis $32 per worker - $124.69 in 2011$

• $12 (37% of total) for monitoring• $20 for audiometric testing

1983 HCA Cost Impact Analysis $41 per worker - $91.13 in 2011$

• $12-$18 (44% of total) for monitoring• $10 for hearing protection devices

1992 OSHA Philadelphia Region Compliance Guide $86.60 per worker - $136.72 in 2011$

Recent analysis for major manufacturer 1999: Automotive - $250 per noise-exposed employee

per year 2011: General Industry - $350 per noise-exposed

employee per year


Hearing Testing

29CFR1910.95(g) Appendix G

Specify hearing testing procedures

Infer that only TDH-39 and TDH-49 supraural headphones can be used

Letter of Interpretation allow use of insert earpieces Search Croft Letter on

OSHA.gov

Greater comfort Better tests Less issue with background

noise9

© 3M 2013. All Rights Reserved.

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Training…or not so much

Promote behavioral change Health Belief Model

Behavior depends on perception of:

• Severity of a potential illness

• Susceptibility to that illness

• Benefits of taking preventive action

Self-efficacy“My actions will make a difference”

• Barriers to taking that action


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Our mission?

Define the decibel Beat people up for off-

the-job behaviors Provide nap time during

workday Check the box

Persuade people that hearing loss is a severe impediment to lifestyle

Communicate susceptibility Communicate benefits Remove barriers

Real Perceived

How? Testimony, hearing loss simulation, interactive training


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How about Hearing Protectors?

Intended to be last line of defense against NIHL

Instead, often the ONLY protection against noise

So how’s that working?


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Do HPD provide what we expect?

Berger, EARLog 20, 1993

Laboratory

Field


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Is it the labeling process?

NRR EPA testing and labeling

requirements Lab based Unreliability leads to

derating• OSHA: (NRR-7)/2• NIOSH: Variable by

type Pressure on mfr.

Label value is inaccurate Variability in even lab

data Typical SD 3-5 dB per

frequency

Test Frequency 125 250 500 1000 2000 3150 4000 6300 8000 NRR

Mean 37.4 40.9 44.8 43.8 36.3 41.9 42.6 46.1 47.3 29

SD 5.7 5.0 3.3 3.6 4.9 3.0 3.1 3.5 2.7


Special HPD for special noises and needs

Low attenuation Flat attenuation

Impulse Weapons

fire Arc flash


Communication in Noise

Ambient Listening Radio Communication

UHF DECT


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Fit testing Hearing Protectors If we want to know how well HPD work on individuals, test

them on individuals Technologies

REAT Loudness Balance MIRE

PAR Note:

All of the approaches described today are point measures


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REAT Approaches Hearing test with and without HPD

Each frequency/each ear separately

Existing equipment Audiometer phones

• Caveats Loudspeakers in test booth

“Gold Standard”


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FitCheck

Special headphones High output High volume

Pulsed 1/3 octave bands Subjective

As variable as a hearing test Time consuming Background noise May be issues with HOH/tinnitus http://www.michaelassociates.com/fitcheck/fitcheck.htm


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REAT-like Systems Subjective Threshold response Integrafit

Single frequency http://www.integrafit.com/

NIOSH HPDWellFit – commercialized as FitCheck Solo

• Moldex, CPE QuickFit

• Pass/fail• http://www.cdc.gov/niosh/mining/pubs/pdfs/2009-112.pdf

Web-based• http://www.cdc.gov/niosh/mining/topics/hearingloss/quickfitweb

.htm


http://www.integrafit.com/

http://www.cdc.gov/niosh/mining/pubs/pdfs/2009-112.pdf

http://www.cdc.gov/niosh/mining/topics/hearingloss/quickfitweb.htm

http://www.cdc.gov/niosh/mining/topics/hearingloss/quickfitweb.htm

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Loudness Balance

Balance tones binaurally No HPD One HPD Both HPD

Each frequency separately Any earplug Subjective New skill

Different test tones Time consuming May be issues with HOH workers/tinnitus


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Loudness Balance

Sperian VeriPro www.howardleight.com/veripro

* Single frequency “quick check” option


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MIRE

Simultaneous measurement inside and outside HPD yields noise reduction (NR)

Specially prepared/probed HPD Software provides stimulus, calculation

and compensation MIRE (objective NR) to REAT

(subjective insertion loss)


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E-A-RfitTM

Objective Quick No issues with

HL Background noise

Specially prepared earplug

EARfit.3M.com


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Safety Meter by Phonak

Similar to EARfit Custom HPD product

Port permits msmt

Headphone source

http://www.phonak-communications.com/en/hearing-protection/hearing-protection-products/safetymeter-fit-testing-system/


What do we find when we can look?

Classic RegularN = 1665NRR1979 = 29 dBMean = 30 dBSD = 6.8 dB80th = 37 dB20th = 24 dB

Classic Reg

0%

2%

4%

6%

8%

10%

12%

14%

5048464442403836343230282624222018161412108642

PAR (dB)

% o

f te

sts

UltraFit

0%

2%

4%

6%

8%

10%

12%

14%

5048464442403836343230282624222018161412108642

PAR (dB)

% o

f te

sts

UltraFitN = 480NRR1979 = 25Mean = 26 dBSD = 5.5 dB80th = 31 dB20th = 22 dB

Note: scale on all charts 1 to 50 PAR on X; % of tests 0% to 15% on Y


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Chemical CompanyPAR >=20 on at least two plugs

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Consumer Products Mfr“First time

good”

Retraining Alternate HPD

Total

88 37 24 149

59% 25% 16% 100%

Screening Test

8837

24

“First time good”

Retraining

Alternate HPD

29


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Federal OSHA and Fit Testing Letter of Interpretation pending Current status

Directed to response to Question 10 of the Q&A at: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=19194&p_table=INTERPRETATIONS

“If the employer can satisfactorily demonstrate that the protection he provides is better than these calculations*,you may use his attenuation in place of the CPL method* if the affected employees do not exhibit STS's.”

*”these calculations” and “CPL method” refer to (NRR-7)/2

3M PSD


http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=19194&p_table=INTERPRETATIONS



NEW AND IMPORTANTwww.dol.gov/regulations/regreview/ OSHA seeking input Some regulations may be out of date due to technology

advancements Like hearing protector testing

Input sought Check postings of others and vote or agree, or Start your own string


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OSHA Alliance

Alliance http://www.hearingconservation.org/docs/

AllianceRecommendationForFitTesting_Final.pdf


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Alliance Individual Fit Testing Applications

Train and motivate employees Train the trainer Assign/select HPDs Provide standard-threshold-shift (STS) follow up Determine HPD adequacy/sufficiency Audit departments Demonstrate adequacy of training Provide documentation


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Comparability

With identical octave band attenuation, different systems yield different PAR values Calculation

protocols Uncertaint

yFreq 125 250 500 1000 2000 4000 8000

Att 11 13 12 17.5 27.5 33 22

Data and chart courtesy of Murphy, NIOSH, from NHCA 2011


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Making Progress

Hearing loss prevention is possible New technologies New approaches New attitudes

… as research continues …

Courtesy Audibel


3M OH & ES Division Current Issues in Hearing Loss Prevention Lee Hager, Hearing Conservationist...

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