Promoting Hearing Health

Abstract

Noise-induced hearing loss is a chronic illness that develops gradually over time. Occupational health nurses can intervene in meaningful ways to promote best practices to prevent hearing loss.

Hearing loss is a prevalent, chronic physical illness that affects over 48 million (20%) of the U.S. population (Hearing Loss Association of America, n.d.; National Institute for Occupational Safety and Health [NIOSH], 2018c). One out of three individuals ages 65 to 74 has some type of hearing loss. According to the U.S. Department of Labor (U.S. DOL; n.d.) and NIOSH (2018a), approximately 22 million U.S. workers are exposed to hazardous noise yearly in all industry sectors. This exposure costs U.S. businesses more than US$242 million in workers’ compensation for hearing loss disability and more than US$1.5 million in penalties for not protecting workers from noise (U.S. DOL, n.d.).

Occupational hearing loss (OHL) occurs when workers are exposed to loud noise (85 dB or higher) or ototoxic chemicals such as organic solvents (styrene, trichloroethylene), heavy metals (mercury, lead), and asphyxiates (carbon monoxide, hydrogen cyanide; NIOSH, 2018c). Nonoccupational noise can also damage one’s hearing, including noise from lawn mowers, power tools, recreational vehicles, and firearms used in hunting and shooting. Noise-induced hearing loss (NIHL) develops gradually over a period of time and often goes undetected because there are no visible symptoms. It can limit one’s ability to hear high frequency sounds, understand speech, and affect communication. Short-term exposure to loud noise can cause a temporary change in hearing that may resolve shortly after leaving the noise; continued exposure to high levels of noise can cause permanent hearing loss (U.S. DOL, n.d.).

Most hearing loss is preventable. Occupational health nurses can intervene in meaningful ways to promote best practices for hearing loss prevention. In addition to implementing a Hearing Conservation Program and complying with the OSHA Noise Standard 1910.95, nurses can educate adults to use Dangerous Decibels (http://dangerousdecibels.org), an intervention program that focuses on three strategies: (a) turn it down, (b) walk away, and (c) protect one’s ears (Murphy, Eichwald, Meinke, Chadham, & Iskander, 2018). Individuals can lower the volume on personal listening devices, reduce time listening to loud music, move away from loud sounds, use quieter consumer products, and use hearing protectors (Murphy et al., 2018).

For high noise exposure levels above 140 dB, engineering and administrative control measures may not reduce noise levels adequately. Hearing protection devices (HPDs) can provide 30 to 40 dB of noise reduction when worn correctly (Murphy et al., 2018). Occupational health nurses should educate workers on proper hearing protectors, and how to check their fit by “gently pulling on the earplug; it should not move easily. If the earplug moves easily, remove it and re-insert it deeper into the ear canal making sure that one-fourth of the earplug is outside the ear” (Wells & Khoo, 2013, para 13).

The NIOSH Sound Level Meter App is a “tool to measure sound levels in the workplace and provide noise exposure parameters to help reduce occupational noise-induced hearing loss” (NIOSH, 2018b, para 1). Occupational health and safety professionals and workers can use the app to display real-time noise exposure data, increase awareness about sounds in the work environment, make informed decisions about potential hazards to hearing, and promote better hearing health and prevention efforts.

The smartphone app and the Howard Leight by Honeywell Noise Thermometer (Honeywell Industrial Safety, 2016) can empower workers and help them make informed decisions about the importance of hearing protectors in work and home environments.