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Published Friday August 23, 2013
m a n a gi n g
THE GROWING SILENCE
AMONG BOOMERS
P3
HEARING LOSS FACTS AND
MYTHS DEBUNKED
P6
IN THE 21ST
CENTURY
WHY WORKPLACE NOISE
COSTS EVERYONE
P12
Hazard in almost all workplaces
m an ag in g
Editor: Louise Allan
Design: Michelle Nunn
Advertising: Eithne Healy 9482 3559
2
IN THE 21ST CENTURY
This special magazine has been
developed as a joint initiative of the
Australian Institute of Occupational
Hygienists (AIOH) and The West
Australian.
The AIOH is the professional
body representing 1100 members
nationwide who are found in
industry, government departments,
universities, consultancies, and
equipment and service providers.
Its primary focus is to strive to deliver
a healthy workplace.
Occupational hygienists do this by
following the steps of recognition,
evaluation and control, and applying
these elements to physical, chemical,
biological and ergonomic hazards in
the working environment.
Occupational hygienists have a
strong interest in the management of
noise – a physical hazard – because
of its pervasive and impactful nature,
and because it is present in almost all
industrial workplaces.
This liftout is intended to lend support
for the activities that will take place in
the coming days as part of National
Hearing Awareness Week from August
25 to 31, an initiative of the Deafness
Forum of Australia.
While there are four million
Australians who suffer from
significant hearing loss, there
are many others in the form of
workmates, family, friends and
casual acquaintances who are
impacted in their dealings with those
individuals.
Communication difficulties may give
rise to a breakdown in relationships,
mistakes, annoyance and frustration
and safety issues at work or at home.
So, hearing loss affects everyone and
hearing loss is everyone’s business.
The following articles have been
prepared by experts in their
respective areas, drawn mainly from
the fields of occupational hygiene,
audiology, science and engineering.
The intention is to cover the
recognition, evaluation and control
elements of noise management –
the impact of noise on hearing, the
measurement and assessment of
noise levels and hearing loss – and
importantly the solutions that are
available in today’s world.
By Dr Barry Chesson
Immediate Past President, Australian
Institute of Occupational Hygienists
Warning signs of an invisible injury
It has been called the most common
permanent and preventable occupational
injury in the world, according to the World
Health Organisation. Yet hearing loss due
to loud noise often goes undetected for
years. In fact, victims often deny they have
any problems: “My hearing is fine...you
just need to talk louder!”
Here are some of the characteristics and early
warning signs of noise-induced hearing loss:
• Causes no pain. Unlike most other
workplace injuries, hearing loss due to loud
noise is painless. If someone complains of
pain in their ears, it is often due to medical
causes such as infection or inflammation,
unrelated to the noise exposure.
• Causes no visible trauma, leaves no visible
scars. The ears do not bleed nor bruise
when they suffer a loss. Since damage
from loud noise affects the receptor cells of
the inner ear, the outer ear, the part visible
when you look in the mirror, shows no
signs of damage since all of the damage
is internal.
• Unnoticeable in its earliest stages.
Receptor cell damage from loud noise is
immediate, but it is often so minute that it is
not noticed. It takes years of accumulated
loss to notice a change in hearing, and by
then it is too late.
• Permanent hearing loss. When people lose
hearing due to loud noise, it is most often a
permanent injury. There is no medication, no
therapy and no surgery that restores normal
hearing after injury due to loud noise.
• Clarity is affected more than volume.
Hearing loss due to loud noise does not
cause a sudden drop in volume of sound.
Instead, most victims notice a gradual but
significant decline in the clarity of sound.
The most common complaint of a person
with noise-induced hearing loss is, “I can
hear you, but I just can’t understand”.
• Tinnitus replaces hearing. Tinnitus is a
noticeable ringing or rushing sound in the
ears and is the accompanying symptom
most commonly associated with noiseinduced hearing loss. A little bit of ringing
in the ears is normal in most people,
where it comes and goes sporadically, but
those with a noise-induced hearing loss
have continuous ringing that can be quite
debilitating at times.
While hearing loss due to loud noise is
painless, progressive and permanent, it
is also preventable when proper hearing
protection is used in hazardous noise.
By Brad Witt
Director of Hearing Conservation,
Honeywell Safety Products
Did you know?
The smallest bone found in the human body, the
stapes, is located in the middle ear and is only
2.8mm long. The ear’s malleus, incus and stapes
(otherwise known as the hammer, anvil and
stirrup) are the smallest bones in the human body.
All three could fit together on a five cent piece.
Have you been told there is “nothing that can be done about it”
Come and see us – we specialise in the assessment and management of tinnitus
PH: 08 9388 8003 I www.hearingandaudiology.com.au I Subiaco Duncraig Geraldton Karratha
2065580ϖSLEH230813
Do you have ringing in your ears?
Baby boomers’ growing silence
Hearing is such a precious sense that
losing it significantly affects quality of life.
I remember well my mother’s hearing aid
transforming family life when she lived with
us. She was far from unique.
Hearing impairment is an incredibly frequent
problem affecting 360 million people
worldwide. It affects more than 3.85 million
Australians – one in six – and is predicted to
impact one in four by 2050.
The ageing of the baby boomers
As baby boomers move into retirement, the
65-84 age group will grow 3.5 per cent
each year over the next decade. There will
be 6.4 million Australians over the age of 65
by 2051.
Due to the loss of hearing that gradually
occurs in most individuals with age (termed
‘presbycusis’), this population cluster will
dominate use of the hearing health care
system.
A relationship between cognitive decline and
hearing loss
My mother was lucky to be sharp as a tack
but older adults with hearing loss also have
a rate of cognitive decline up to 40 per
cent faster than those with normal hearing,
according to a recent study in JAMA
Internal Medicine. While this link is not yet
fully understood, the possible impact of
addressing hearing loss has the potential to
be greater than hearing related quality of life
improvement alone.
While the study authors noted that not
everyone with hearing loss will suddenly
develop dementia, it appears that poorer
hearing exerts some additional influence
on cognitive ability. As the population
lives longer, over decades this effect could
become increasingly noticeable.
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IN THE 21ST CENTURY
It is theorised that when listening becomes
more challenging with hearing loss, our
brains must work harder and the increased
demand has long-term consequences for
brain health. Alternatively, it might be that
decreasing sensory input deprives the brain
of information and in turn, brings about longterm changes in brain function.
Don’t suffer in silence
Hearing impairment can occur for lots of
reasons: loud noise, infection, disease or with
ageing. Regardless, hearing checks should
be part of a regular health regime especially
for baby boomers, similarly to that of dental
or eye examinations.
There are benefits readily available with
early identification and intervention, and
appropriate management for the majority of
people with hearing loss. Devices such as
hearing aids, assistive listening devices and
cochlear implants, and services that include
social support, are accessible and have the
potential to be life changing. We should
make the most of the advances science offers
and all try to stay ‘tuned in’.
Professor Lyn Beazley
Chief Scientist of Western Australia
Hearing Awareness Week 2013
Sunday August 25 to Saturday 31, 2013.
How loud is to loud?
Hearing Awareness Week is an annual event it provides an opportunity to
raise community awareness of hearing impairment and ways to protect your hearing.
Deafness Council WA Inc was established in 1974 and is a coordinating body whose role is facilitating the work of Deaf and Hearing
Impaired people and agencies. Deafness Council has been involved in the promotion of Hearing Awareness week since 1979.
On Monday August 26, 2013 Deafness Council WA will host the Inaugural Hearing Awareness
Week Keynote Breakfast, this years keynote speaker is Senator Rachel Siewert.
Senator Siewert chaired the 2010 Senate Inquiry into hearing health in Australia (“Hear Us”) and will reflect on how far
the Committee’s recommendations have been implemented and unfinished business that will confront the next federal
government after the upcoming election. Followed by AWARD PRESENTATIONS for the Dr Harry Blackmore 2013 Award and
the Better Hearing Australia Clear Speech Award 2013.
When: Friday August 30, 2013
Time: 9am -12noon
Address: 33 Giles Road, Padbury
Contact: Christine Lee
E: [email protected]
P: 94026403
RSVP required for catering
purposes Morning Tea provided
www.waide.wa.edu.au
For further information contact Deafness Council Western Australia Inc on:
[email protected] or call Marisa 0414 853 365
2018743πSLEH230813
The WA Institute of Deaf Education has moved to its refurbished
Padbury facility at the Statewide Services Centre and invites
current and prospective parents and guests to visit and view
the new premises on:
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IN THE 21ST CENTURY
Controlling the issue at federal level
Workplace noise remains the most
pervasive occupational hazard
leading to hearing loss, and in turn
can cause incidents ranging from
misunderstood communications through
to fatal outcomes.
In 2012, a new legislative package was
introduced at a national level to deal
with occupational health and safety.
The act and regulations are supported
by codes of practice on a variety of
topics. For noise, the code provides
a step-by-step guide on all aspects of
managing the issue.
The regulations call up an Australian
Standard (AS/NZS 1269-2005
‘Occupational Noise Management’),
which then becomes part of the
legislation. The standard consists
of five parts and details things like
how to measure and evaluate noise,
controlling noise, how to select
hearing protectors, and procedures for
conducting audiometric testing.
The legislation spells out, in great
detail, the health and safety duties of
the various parties at work. It introduces
the term PCBU for a Person in Control
of a Business or Undertaking, whose
primary duty is to ensure the health
and safety of workers at work and
others in the business or undertaking
by eliminating or minimising risks to
their health and safety, so far as is
reasonably practicable.
The regulations require that where
workplace noise exceeds the exposure
standard the PCBU must control the
noise. In practice, this means in many
workplaces hearing protectors are
issued to exposed workers.
It must be remembered that hearing
protectors do not control the noise
present in the workplace, but if worn
correctly reduce the level of noise
entering a worker’s ears.
The PCBU provides the hearing
protectors and requires workers to
frequently wear them. He/she must
also provide audiometric testing within
three months of a worker commencing
work and in any event at least every
two years.
A new aspect of the PCBU’s duties is
the requirement to monitor the health of
workers and workplace conditions to
prevent illness or injury arising from the
conduct of the business or undertaking.
This requirement may have implications
where industrial chemicals are used
at work, which may affect workers’
hearing by themselves or in concert
with loud noise. These chemicals have
an ototoxic effect on hearing.
Known ototoxic chemicals include
organic solvents, such as toluene and
styrene, asphyxiants such as carbon
monoxide, pharmaceuticals of the
chemotherapy kind, heavy metals such
as lead and mercury, and organic
pesticides and herbicides.
The most common routes of entry
into the body are via inhalation or
skin absorption and to a lesser extent
ingestion due to poor personal hygiene
practices at work.
Did you know?
The roar we hear when we place a
seashell next to our ear is not the ocean
but the noises all around us, albeit
altered somewhat by the shell.
By Beno Groothoff
Managing Director and Principal
Hygienist, Environmental Directions
Hearing loss prognosis for a clear rehabilitation path
The first question on everybody’s lips after
they learn they have a hearing loss is “will it
get better?” There are two types of hearing
loss: conductive and sensori-neural. The
difference is what defines your chances of
regaining the ability to hear.
Conductive hearing loss, as the name
suggests, is a defect in how sound is
‘conducted’ to the cochlear (hearing organ).
Three common conductive hearing losses are
due to middle ear infections, torn eardrums
or arthritis in the bones of the middle ear.
These have a good prognosis for the return of
normal hearing.
An ear infection can clear up by itself, or with
the help of antibiotics, the skin of the eardrum
can heal and the bones of the middle ear
can be surgically released from the arthritis
that is restricting their movement, called a
stapedectomy, restoring the ear’s ability to
conduct sound.
Nerve cells are the only type of body cells
that cannot heal themselves. Huge numbers of
hearing nerves begin in the cochlear and once
they die cannot be repaired. For this reason,
sensori-neural hearing loss is commonly known
as ‘nerve deafness’.
Normal ageing of our bodies will unavoidably
see the demise of some of our hearing nerves,
but other controllable factors, such as exposure
to high levels of noise, will cause these nerves
to die in much larger numbers.
Excessive noise causes a particularly
devastating effect on hearing in two ways.
Firstly, the hearing nerves get pounded by
the noise. Secondly, when the battered
and bruised hearing nerve dies it releases
a chemical, causing a massacre of other
healthy nerves close to it.
Once your hearing professional has
discovered the reason for your hearing loss
there will then be a clear path forward to
rehabilitation. But remember, a hearing
aid is not the answer to all your prayers.
Like crutches, it is but one component of a
rehabilitation solution.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
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Problems go undetected for many
The moment we feel a tingle in our throat
and a sniffle in our nose, our fate is sealed.
We are falling sick. This usually sends us
scurrying to the medicine cabinet to dose up
on pills and vitamin C. How do we know
when a hearing impairment is ‘coming on’ and
what should we do?
Recognising the symptoms of noise-induced
hearing loss will allow us to identify the events
that have exposed us to hazardous noise and
help us to avoid those damaging behaviours in
the future.
Whether excessive noise exposure comes from
work or play, experiencing a temporary hearing
loss after coming from the workplace, concert
or sporting event is a sure sign that our hearing
organs have been overwhelmed with sound.
Although this may return to normal by the next
morning, hearing loss will become permanent if
this becomes a regular occurrence.
The temporary hearing loss is likely to sound
very much like the permanent one we can
expect, if we do not avoid over-exposing our
hearing to noise. The most dramatic difficulty
would be to hear high frequency sounds of
speech – specifically consonant sounds like s, f,
p, t, k, th, ch and sh. This will make a sentence
like “take four shirts to the car” sound like “ay or
ert oo the ar”.
Permanent change in hearing is a gradual
process, so many people don’t realise they
have a problem until they begin to struggle with
hearing in social situations. Most commonly,
people say they began struggling to understand
conversation in background noise, such as
in a cafe, busy restaurant or other places
where many people are talking around them.
Unfortunately, by the time they experience this,
noise has had a permanent and destructive
impact on their ears.
Another telltale symptom is ringing in the ears
(tinnitus). Most people will have experienced a
ringing in the ears after a loud recreational activity,
such as coming home from a concert or a pub,
anywhere that has music turned up, or loud sports
such as motor racing or shooting. This is the
body’s way of telling us the delicate structures in
the ear have been bruised.
Again, by the next morning it is usually gone,
but this ringing is a warning sign that the ears
have been overwhelmed by the noise. With
repeated exposures, tinnitus can become a
permanent feature rather than a temporary
disturbance.
Excessive noise exposure can also be
manifested as recurrent headaches and
increased stress or anxiety levels, although
the extent to which people experience these
symptoms varies between individuals.
If any of these experiences sound familiar, take
action immediately. If the culprit is a workplace,
work collaboratively with the people responsible
for health and safety to address the problem.
If social activities are to blame, consider
wearing earplugs on those nights spent
watching a band, or go to a book club instead!
5
IN THE 21ST CENTURY
Did you know?
Crickets have their hearing organs in their
knees while cicadas have their hearing
organs in their stomachs.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
Hearing Loss and
Brain Decline
The level of hearing loss was directly linked
to the level of cognitive decline in older
adults; those with more severe hearing
loss developed problems with memory and
problem solving on average 3.2 years
before those with good hearing.
The researchers suspected that the link was
caused by isolation and inactivity which sets
in with hearing problems.
So..........keeping our hearing good through
hearing preservation and good early
audiological help may be important not only
to our communication abilities but also our
brains.
Lin, F & Polley, D. (2013).
Hearing loss in Older Adults:
Who’s listening? JAMA Internal Medicine,
307 (11):1147-1148.
Medical Audiology Services offers
comprehensive Adult and Paediatric
hearing assessments; cochlear implant
and Baha (bone anchored hearing aid
assessments); Balance assessment,
tinnitus management, hearing aids and
rehabilitation; protective earplugs; assistive
listening devices and much more.
If you would like to receive information on
a specific topic, email or call us.
MAS Audiologists work
closely with GP’s and ENT
specialists to ensure you
receive the best care.
A referral is only
necessary if you require
a medicare rebate.
PHONE 08 9321 7746
www.medicalaudiology.com.au ❘ E: [email protected].
Medical Audiology Services • 51 Colin Street West Perth WA 6005
2057134πSLEH230813
In a recent study published in the journal JAMA
Internal Medicine, researchers in the U.S.A found
that adults with hearing loss are at a greater risk of
dementia than those with good hearing.
Facts and myths uncovered on
hearing impairment will surprise
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IN THE 21ST CENTURY
Hearing loss cannot be identified until
a child is at least three years old.
My hearing loss is not bad enough for
me to wear a hearing aid.
MYTH. Hearing loss can be identified
even in newborn babies.
MYTH. Many people delay getting their
first pair of reading glasses until their arm
is not long enough to hold the newspaper
far enough away. People also put off
getting a hearing aid.
Often an infant hearing screening is done
while the mother and baby are still in
hospital, within a couple of days of the
baby’s birth. If there is a problem, it can
be followed up as early as possible.
There is no need to clean out our ears.
FACT.There is only one thing that is
supposed to be put into our ears and that
is sweet words.
The ear is a self-cleaning apparatus and
doesn’t need any help from us. Earwax,
called cerumen, traps dust particles and
allergens and holds them until the ear
goes through its self-cleaning cycle and
the earwax moves out of the ear canal
all by itself. It is a misconception that, like
our bodies, our ears must be cleaned to
remain healthy.
Prodding, poking or picking earwax
with cotton swabs, keys, hair pins or
fingers only pushes it in deeper, causing
a disruption in the self-cleaning cycle
and creating a potential blockage or
worse, an infection. With the exception
of hearing aids and earplugs, do not put
anything in your ear that is smaller than
your elbow.
Meeting of minds inspires centre
George Jones and Winthrop Professor
Marcus Atlas met in 2005 in a seemingly
usual patient-doctor scenario.
Mr Jones, who has a distinguished career
spanning more than 35 years in mining,
banking and finance, had experienced
a series of collapses and had difficulty in
obtaining a satisfactory diagnosis.
Professor Atlas, a leading surgeon scientist
with a career-long commitment to hearing and
balance disorders, held a bold vision for future
research, education, training and services in
addition to his ongoing commitment to the
delivery of quality medical care.
Professor Atlas promptly diagnosed an
advanced form of Ménière’s disease, an
inner ear disorder affecting both hearing and
balance, and performed surgery to alleviate
Mr Jones’ condition.
Recollecting when they first met, Professor
Atlas said he was struck by the way Mr Jones
tackled the terrible problems of Ménière’s
disease with a single-minded determination
– quiet, well prepared, carefully researched
and completely decisive.
Mr Jones and his family have a strong belief
that those fortunate enough to be well-off
have a responsibility to give back to society.
This philosophy would become a cornerstone
of a new relationship with Professor Atlas and
what was then the burgeoning concept of the
Ear Science Institute Australia (ESIA).
Following Mr Jones’ recovery, he initiated
contact with Professor Atlas with a generous
offer of his time, skills and the support of the
George Jones Family Foundation. He became
an ESIA trustee, chaired the ESIA Fundraising
Committee and the now highly successful Break
the Silence Capital Fundraising Campaign.
In addition to a supported drive of the
$16 million ESIA building campaign, the
George Jones Family Foundation concluded
fundraising efforts with a $3 million donation.
Consequently, the world-class, state-of-theart medical research and clinical facility
dedicated to hearing loss, balance disorders
and ear disease, was officially opened in
February 2011 and proudly bears the name
of the George Jones Family Centre.
Professor Atlas, who considers Mr Jones
pivotal to the success of the fundraising
campaign, has now achieved his vision in the
completion of the facility in Subiaco.
“When people get to senior positions,
it’s not only money they can give, it’s also
expertise, knowledge and insights as to how
to get things done. When different skill sets
are brought to the table, exceptional things
become possible in the name of a good
cause,” Mr Jones said.
Two hearing aids are not really
necessary.
MYTH. When we hear normally, we hear
through both ears.
There are many benefits to having two
hearing aids. It allows us to localise
where sound is coming from more easily,
even if it is behind us. It also allows us to
understand speech and keeps the hearing
aids at a lower volume than if only one
was being used.
I can wear a hearing aid only when I
need it.
MYTH. Hearing aids should be worn at
all waking times.
It takes time to adapt to using a hearing
aid and the more it is used the faster the
person will adapt to using it. If it is only
used for special occasions, the person
is unlikely to develop very good skills
using it and is more likely to abandon
the hearing aid in the top drawer
permanently.
However, hearing works in partnership
with the language areas in the brain to
understand (decode) speech. The brain
is like a muscle – if you don’t use it, you
lose it. Studies have shown people who
get hearing aids early in their hearing
loss are able to return to understanding
100 per cent of speech. Those who wait
until their partner threatens to divorce
them unless they get a hearing aid may
only return to understanding 70 per cent
of what they hear.
A child is never too young to be fitted
with a hearing aid.
FACT. Even infants less than a month old
can be fitted with hearing aids.
For speech and language development
of the child, the earlier a hearing aid is
fitted the better.
Smaller the hearing aid is, the better it is.
MYTH. The best hearing aid for a
particular person will not be the right one
for another and size really has nothing to
do with it.
In fact, the hearing aids that sit behind
the ear (BTEs) have many benefits over
smaller versions. Firstly, they have a
larger case so more electronic technology
can be fitted inside, such as telecoils,
bluetooth, etc. Secondly, they are able
to accommodate larger batteries so they
can operate for longer periods and are
more powerful. Lastly, because they are
outside of the ear canal and away from
the two things that electronics don’t like
(moisture and warmth), the BTE hearing
aids tend to last longer before they need
servicing or replacing.
Tinnitus causes hearing loss.
MYTH. It is a myth that tinnitus causes
hearing loss; it is more likely that hearing
loss results in tinnitus.
While hearing damage from excessive
noise exposure is by far the most
common cause of tinnitus, it may not be
the only factor.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
“I can’t do what people like Marcus can do,
but if I can help in some small way with my time
or with financial support then it’s worthwhile.”
Professor Atlas said it had been an excellent
opportunity to work with Mr Jones, who
through his philanthropic efforts, had
contributed to advancements in medical care
and altered patient outcomes that could be
achieved for many years to come.
“Ear and balance science has much to thank
George and his family for. Personally, I have
profited by a great friendship, solid advice
and endless motivation for which I’m most
grateful,” Professor Atlas said.
Did you know?
The ear continues to hear sounds, even while
you sleep. It can even still hear when you die,
but the brain does not process the sound.
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Connected and yet different – the
lowdown on hearing and balance
Hearing and balance are very closely
connected. Although their function is quite
different, they share the same structure.
Sound must pass between three chambers
in the ear before it can be converted to a
format the brain can interpret as sound.
First, soundwaves in the form of pressure
waves are funneled into the outer ear and
onto the eardrum, otherwise known as the
tympanic membrane. As the eardrum is
moved by the pressure waves, it in turn moves
the three smallest bones in the human body
called the malleus, incus and stapes. These
bones can be found in the area called the
middle ear.
From there, the stapes push on an area
called the oval window, which transmits the
sound vibrations into the inner part of the
ear, otherwise known as the cochlear. Inside
the fluid filled cochlear are hair cells that
when moving, fire off a nerve impulse up the
acoustic nerve and a sound is heard.
Sharing the same fluid as the cochlear is a
structure called the semicircular canals, of
which there are three. Together, they are
called the vestibular system. This covers all
three dimensions of our movement and sends
information to the brain about where our
body is in space.
The brain then compares this information to
the information it is receiving from the other
two senses of sight and touch, and collates
all this information. The semicircular canals of
the vestibular system are filled with the same
fluid as the cochlear. When we move our
heads this fluid also moves causing sensory
cells to bend, which also fire an electrical
impulse up a nerve to be interpreted by the
brain.
As the cochlear of the auditory system and
the semicircular canals of the vestibular
system share the same fluid, any disruption to
this fluid will cause both hearing and balance
to be adversely affected. The most commonly
known of these disruptions is called Ménière’s
disease, where it is thought that the pressure
of the fluid becomes unusually elevated. This
causes vertigo, nausea, hearing loss and
tinnitus.
Although hearing and balance share the
same structure, they perform very different
functions, but both of these functions can
be thrown into disarray when there is a
complication in their host structure.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
Is your workplace too noisy?
Specialists in noise management in the resources industry.
• Noise surveys
• Dosimetry
• Noise management
and control
• Noise control
planning
• Awareness training
www.svt.com.au
7
IN THE 21ST CENTURY
The simple journey to treatment
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IN THE 21ST CENTURY
The journey of hearing loss begins with
accepting that there might be a problem.
However, it is comforting to know that
picking up the phone and visiting your
local hearing clinic is usually the most
difficult step.
Remember, a hearing aid is only one solution
available, so people shouldn’t be surprised if
the audiologist recommends some alternative
devices, such as higher volume doorbells,
headphones for the TV or replacing the
telephone with one with a louder volume.
One of the first signs people notice is
they struggle to understand people over
background noise. Most often people say this
is a realisation they have at a restaurant or
cafe when other people around them seem to
be able to follow the conversation, but they
themselves are merely guessing.
The audiologist may feel the patient may benefit
from taking an aural (hearing) rehabilitation
course, consisting of a few appointments to help
the patient become aware of how to make best
use of their hearing.
When visiting the hearing clinic for a hearing
check, if possible, take a close friend or
relative along. The appointment may contain
lots of detail or advice that you won’t want to
forget, so it’s always helpful to have a second
person there to help remember.
Typically, there will be three tests. Firstly, a
pure tone test, where headphones will be
worn, with the requirement to push a hand
button when a sound is heard. Secondly, the
headphones will be replaced by something
similar to a head-band women might wear to
keep hair out of their eyes. Vibrations through
this head-band will be perceived as sounds,
and again the person being tested will push
the hand button as they hear tones. Thirdly,
headphones will be used to play words into
one ear at a time, while ‘interference’ noises
are played in the other.
Once the testing is complete, the audiologist
will be able to explain the results immediately,
and be able to start making some
recommendations if they are necessary.
If a hearing aid is deemed to be
appropriate, the audiologist can provide
guidance to a hearing aid product that will
be suitable for the patient’s type of hearing
loss. The patient should remember that this is
a purchase like any other, so they should be
satisfied with the benefits they will receive
in exchange for the price of the goods. In
most cases, there is still much to be gained
from having some aural rehabilitation
appointments after the hearing aid has been
fitted and tuned correctly by the audiologist.
In a case where the patient doesn’t feel
they have been served well by the health
professional assisting them, they have every
right to take their business elsewhere.
Throughout the journey, the patient should be
resourced with the appropriate assessments,
quality advice and options in order for them
to make an informed decision about how to
combat their hearing loss.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
Noise-provoked dizziness treatable
Loud noise can cause a range of inner
ear symptoms, including hearing loss,
tinnitus and hyperacusis. Less common is
the symptom of vertigo in response to loud
noise and this can occur in individuals
affected by a condition called semicircular
canal dehiscence (SCD).
Three semicircular canals, the superior,
posterior and lateral, make up the part of
the balance system that detects rotational
movements of the head. The canals are
filled with fluid and embedded in the
temporal bones of the skull, creating a closed
environment. A dehiscence occurs when there
is a thinning of the bone surrounding the canal
creating a weak spot, which allows the fluid in
the semicircular canal to become mobile.
This ‘mobile window’ makes the balance
system sensitive to changes in pressure in
the ear. The pressure is able to disperse
through the semicircular canal and this causes
sensations of vertigo. Additionally, sufferers
of SCD may experience oscillopsia, a visual
sensation that the world is oscillating or
bouncing, in response to vestibular stimulation
by changes in pressure.
These pressure changes may be caused by
high intensity soundwaves, but may also
come from applying pressure to the ear
canal or by increasing intracranial pressure.
Interestingly, an individual affected by SCD
may only experience vertigo induced by one
particular trigger. As well as these vertiginous
symptoms, SCD can cause changes in low
pitch hearing, as it affects the transmission of
soundwaves through the inner ear.
There are two conditions that are required
to develop SCD. The first is that the bone
overlying the canal is thinner than normal,
plus an event that causes the dehiscence of
the already thin bone. This may be caused by
a series of small traumas or knocks across a
lifetime or following a sudden traumatic event,
such as a head injury or a sudden change in
pressure, perhaps brought on by vigorous nose
blowing or suddenly straining to lift.
SCD is diagnosed by an ENT specialist using
high resolution CT scans. Full audiological
assessment and vestibular assessment, an
assessment of the balance organ of the inner
ear, may also be ordered to further analyse
the symptoms of SCD and to rule out other comorbid vestibular conditions.
SCD is a treatable condition although many
people find that once they understand the
cause of their symptoms they do not need any
treatment at all. For those who are not able to
manage the condition with trigger avoidance
and who report diminished quality of life
from their symptoms, surgical intervention is
an option. Surgery involves resurfacing the
dehiscence to close the mobile third window
or plugging the dehiscent canal and can
improve symptoms.
Working in collaboration with ENT specialists,
the ESIA Balance Centre has dedicated
audiologists specialising in vestibular
conditions and provides clients with a
complete, seamless service from initial hearing
and balance assessment through to surgery.
Visit siabalance.com.au for more information.
By Lisa Giles
Senior Vestibular Audiologist, Ear
Science Institute Australia Balance Centre
Did you know?
When you go up to a high elevation, your ears
pop. This is because your eustachian tubes are
equalising the pressure between the outside air
and the air inside your ear.
Stress and tinnitus – the chicken and the egg case
Does stress cause tinnitus or tinnitus
cause stress? In short, both statements
are true.
In essence, tinnitus is any sound you
can hear, which is not actually present
in your surrounding environment.
They are sounds that originate from
within our body. People describe
these sounds as a ringing, buzzing,
hissing or pulsating sound. Many
people talk about tinnitus as if it was
a disease, but it is in fact nothing of
the sort. Tinnitus is a symptom not a
cause, a warning bell ringing to let us
know that something requires further
investigation.
Among the many potential reasons
why people may experience tinnitus,
such as diet, blood pressure, injury,
infection and exposure to high noise
levels, one factor is stress. When
people experience higher levels of
stress than usual, this is characterised
by increased levels of adrenaline in
the bloodstream. When humans have
this chemical in the bloodstream it
causes a reaction known as the ‘flight
or fight’ response.
This is a complex mechanism that,
apart from other things, sends blood
to the muscles in the arms and legs
in case we have to run away from
danger (flight) or we have to turn
and engage in battle (fight). This is a
primitive response from when humans
lived in caves, and would have to
flee from predators. The ‘flight or
fight’ response changes many settings
in the body, one in which people
describe as increased hearing acuity.
Actually, the adrenaline is responsible
for making our brain pay far closer
attention to all the sounds it hears.
Traditionally, we would use this
to hear from the furthest distance
possible whether a predator was
hunting us. People who have had
close calls cheating death will often
report hearing their own heartbeat at
the time.
When we have adrenaline in our
bloodstream but we are not being
pursued or fought, we begin hearing
sounds that we have not heard
before, but these are sounds our
bodies make all the time. We have
just never noticed them before.
This is how stress causes tinnitus.
Interestingly, when people hear these
sounds being made by their body that
they don’t recognise (tinnitus) they
start becoming anxious about what
the sounds are and whether they are
going to stop, which in turn releases
more adrenaline into the bloodstream
and the cycle continues.
The actual answer to the question
posed is that they both cause each
other, but by intervening to address
the stress, the vicious cycle can be
broken. This is when a clinician
trained in tinnitus management can be
an invaluable resource.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
m an ag in g
9
IN THE 21ST CENTURY
Did you know?
Ears are self-cleaning. Pores in the ear canal
produce cerumen or earwax, and tiny hairs
called cilia push the wax out of the ear.
m an ag in g
10
IN THE 21ST CENTURY
Efficient earplugs continue to
be preferred hearing protection
The ultimate objective of all noise
management programs should be to get rid
of the problem which is dangerous noise
levels. However, this is not always practical
and sometimes may take many years to
achieve. This is when personal hearing
protection is needed, and noise reduction
earplugs and muffs play a major role.
Plugs are often the preferred choice of
hearing protection because they can be
easily worn with other safety equipment
and are more popular for extended use,
especially in hot environments.
Earplugs have been used for over 100 years
with rubber plugs developed for use by
boilermakers in the 1880s. By the start of
World War I, naval gunners were using plugs
made of turned wood.
However, it was not until the 1970s when
big improvements were made in materials,
style and comfort that earplugs became used
by large numbers of workers.
Did you know?
If you shouted in outer space, even a person right next to
you wouldn’t be able to hear. Your ears pick up sound that
travels in invisible waves through the air. Because there’s no
air in outer space, there’s also no sound.
Connecting people with hearing loss
to the services they need
where they need them.
Now there are three main types of earplug
used by workers today. These include the
popular disposable formable plugs, mostly
made from wax or foam. These plugs provide
good attenuation of sounds, but workers need
to be trained to use them correctly to ensure
this is achieved.
There are also pre-moulded plugs made from
vinyl or silicon, which are inexpensive and
can be bought off the shelf. They are easy
to use but only last a couple of months and
tend not to provide the same levels of hearing
protection as the formable plugs.
The third type are the personally moulded
silicon plugs which are custom-made for each
worker, involving a visit to an audiologist for
ear impressions which then get sent to an ear
mould laboratory for manufacture.
Although personally moulded plugs are the
most costly, they last for a couple of years
and ensure maximum protection, ease of use
and comfort for the worker. Custom plugs
are recommended for workers who use plugs
over long periods of time.
There are also special ‘musician’s plugs’
which can be custom-made for workers in the
music and entertainment industry who need to
hear music without it being distorted by plugs
that change its pitch composition.
These plugs have filters, which can be
specially selected for the individual needs
of musicians, giving them the best frequency
response to the music.
By Dr Helen Goulios
Clinical Coordinator, Master of
Clinical Audiology Program,
The University of Western Australia
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Nonsensical excuses increase risk
You’ve heard these excuses a dozen times
or perhaps even used them yourself for
the reasons why we don’t want to wear
hearing protection in hazardous noise.
Some of the excuses are just nonsensical
(“they bother me” or “they’re uncomfortable”)
when compared to the risk of losing hearing
for life. But other excuses have just enough
credibility to almost sound plausible.
Let’s review some of the common reasons for
not wearing earplugs, and dispel some of the
myths preventing good protection. “I don’t
use earplugs because...”
1. They cause infections in the ear.
Research shows no higher incidence of
new ear infections among earplug wearers
compared to the general population. A user
is more likely to get an ear infection due
to swimming in contaminated water than
from earplug use. However, if a wearer has
an existing infection, it is best to switch to
earmuffs for a while rather than aggravate the
ear canal by inserting earplugs.
2. You can hurt your eardrum if you put
them in too far.
The human ear canal is about 35mm long,
terminating at the eardrum. Even the longest
earplugs available on the market are well
short of the eardrum when fully inserted in the
ear canal. Indeed, very few of us have ever
touched our eardrum, and we would likely be
jumping in pain if we even got close.
3. I can’t hear my co-workers when I
wear them.
For workers with normal hearing, the signalto-noise ratio actually improves when wearing
earplugs in loud noise, such that hearing a
conversation is easier when both are wearing
hearing protectors in loud noise. The easy
answer to this complaint is to simply fast
forward a few years: the unprotected worker
won’t be hearing conversations very well
in a few years after incurring noise-induced
hearing loss.
m an ag in g
11
IN THE 21ST CENTURY
4. My ears have grown accustomed to
the noise.
This excuse is particularly tempting. Some
workers actually claim their ears have
‘toughened up’ since their first week on the
job, almost as if repeated over-exposure has
built up some measure of immunity from noise
damage. But the ears don’t have this ability
to toughen up. Workers who claim their ears
have grown accustomed to the noise, and
therefore don’t need the hearing protectors,
have often lost hearing.
Dispelling the myths surrounding hearing
protection can allay the fears and address
the excuses that some use to avoid good
protection.
By Brad Witt
Director of Hearing Conservation,
Honeywell Safety Products
Did you know?
In Africa, a tribe of people called
Maabans live in such quiet that they
could possibly hear a whisper from
across a baseball field, even when
they are very old.
Workplace noise comes at a cost
m an ag in g
12
IN THE 21ST CENTURY
Noise in a workplace can cause three
types of miscommunication, each of
which impacts on the business in terms
of profit potential. These can be further
categorised into the areas of inaction,
confirmation and deviation.
Worker One: “Didn’t you hear what I just
said?” (after inaction).
These principles apply regardless of
whether hearing protection is being worn.
To illustrate, let’s consider a business
containing a production line spraying paint
onto curtain tracks. In this scenario, they are
spraying brown curtain tracks, and Worker
One shouts to Worker Two, “the next tracks
have to be green”.
Worker Two: “Ok, got it” and cleans the
track and paints it brown (deviation).
Firstly, inaction describes the situation where
a worker has given a verbal instruction to
a colleague in a noise filled workplace,
and the intended recipient hasn’t heard the
instruction, and continues working without
adopting this new piece of information.
The result in the curtain factory is numerous
tracks will be sprayed brown instead of
green. They will then have to be stripped
of paint and returned to the beginning on
the line. The number of tracks painted the
wrong colour will depend on how soon
Worker One realises Worker Two has not
heard the instruction.
When hearing aids are not enough
Exposure to excessive loud noise can cause
irreversible damage to hearing. It mainly
damages the fine organs inside the inner
ear called hair cells. Once the hair cells
are damaged, it causes varying degrees of
permanent hearing loss.
Typically, the first step is to see an
audiologist and have a pair of suitable
hearing aids fitted. Although hearing aids
are a great alternative for some people,
they may not work as well for others that
have very little hearing left or poor speech
perception. The majority of hearing losses
are partially remedied by the amplification
provided by hearing aids. However,
sometimes the damage is such that even
the most advanced hearing aids will not
resolve the problem.
Hearing aids filter and amplify sounds,
which in these cases would be inadequate
to compensate for the damage to the inner
ear. It is ultimately the role of hair cells in
the inner ear to process the signal. When
the hair cells are damaged the signal
passing through them would be amplified
and distorted giving an unclear message.
Therefore, although speech is loud enough,
it would not be clear.
Cochlear implants bypass the damaged
parts of the inner ear, stimulating the nerves
that send the sounds directly to the brain.
The cochlear implant system consists of
two parts, the internal electrodes and the
external sound processor. Incoming sounds
are processed into electrical signals, which
are then transmitted to the internal part.
The electrodes inside the cochlear then
stimulate the nerve.
Hearing loss associated with noise
exposure is much worse in high
frequencies. There is a type of implantable
device called Electro Acoustic Stimulation,
which is a combination device that allows
the use of amplification to hear the low
pitched sounds and a cochlear implant
to detect higher pitched ones. Essentially,
it’s the use of a hearing aid and cochlear
implant together.
Ear Science Institute Australia (ESIA)
Implant Centre Clinical Coordinator Ronel
Chester-Browne, who has over 20 years’
implant experience, has seen first hand
how cochlear implants transform lives.
“I have seen many clients with noise
induced hearing loss struggle for too many
years with hearing aids before having an
implant,” Mrs Chester-Browne said.
“Timing is crucial in auditory intervention to
ensure that no further deterioration occurs
in the auditory nerve as a result of hearing
loss. Better hearing outcomes are seen
when those receiving cochlear implants do
so as soon as they are no longer gaining
sufficient benefit from hearing aids.”
The ESIA Implant Centre in Subiaco has
a dedicated team of ear, nose and throat
specialists, audiologists, radiologists,
psychologists and a research team
specialising in implantable hearing
devices.
Working in collaboration with its
professional network, the ESIA
Implant Centre provides clients with a
complete seamless service from initial
hearing assessment through to surgery,
rehabilitation and ongoing care and
support over the long term.
For more information visit
esiaimplants.com.au.
By Azadeh Ebrahimi
Implant Audiologist, Ear Science Institute
Australia Implant Centre
Secondly, confirmation describes where a
worker is aware that they have not heard the
instruction and asks the colleague to repeat
the instruction. Curtain factory Worker Two
now has to ask Worker One, “What was
that?” or “Did you say…?”. Worker One has
to repeat the instruction. This is a time loss of
100 per cent; if every instruction had to be
repeated once, four hours of conversation
would take eight hours.
Thirdly, deviation describes the situation
where a worker is unaware they have
misheard the instruction and unknowingly
sets off to do the wrong task. Worker One
in the curtain factory example said, “the
next tracks have to be green”, but this was
heard by Worker Two as “the tracks have
to be clean”. So he wipes down the curtain
tracks, paints them brown and commits the
tracks to the same fate of being stripped
and repainted.
These principles need not exist in isolation
and commonly co-exist. The curtain factory
example now looks like:
Worker Two: “No, what did you say?”
(confirmation).
Worker One: “I said, the next tracks have
to be green!” (confirmation).
The conversation then repeats until the
communication breakdown is discovered.
Research shows that employees working in
high noise environments lose on average
between 20 to 60 minutes a day from
inaction and confirmation. Deviation has not
been measured, but could be argued to be
a larger cost in both dollars and potential
safety/injury.
The solution does not need to be expensive
communication headsets doubling as
hearing protection, rather workplaces can
create greater efficiency by providing
workers with training in the art of
communicating in noisy environments.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
Did you know?
The oldest mummy ever discovered
was wearing earrings.
m an ag in g
13
IN THE 21ST CENTURY
Control beats protection any day
Noise is often defined as unwanted sound
but there is no definition of how loud sound
needs to be before it becomes unwanted.
Regulations in Australia specify a noise
exposure standard of 85 decibels averaged
over eight hours, but this is not a completely
safe level of exposure for everyone. Some
people exposed to this level of noise will
suffer a small amount of hearing loss.
The exposure standard is therefore a balance
between the risk of hearing loss and the
practical challenges of implementing noise
controls in the workplace. Regardless of the
number of decibels, employers are bound by
a duty of care to reduce hazards, including
noise, to as low as is reasonably practicable.
In part, this duty of care is intended to
minimise the risk of hearing loss, but there are
other risks that should compel employers to
implement engineering noise controls instead
of relying on ear muffs or earplugs.
Noise interferes with concentration hindering
productivity and causes fatigue. This may
occur at noise levels well below the exposure
standard. Fatigue can also be exacerbated
by sleep disturbance, as anyone who has
been kept awake by a noisy air conditioner
Noise exposure is measured with a sound level meter
Picture courtesy B. Groothoff.
Supporting Hearing Awareness Week
25 - 31 August
Australian Institute of Occupational Hygienists
www.aioh.org.au
Striving for a healthy workplace
Occupational Hygiene
The art and science dedicated to the anticipation, recognition, evaluation,
communication and control of environmental stressors arising from the
workplace that may result in injury, illness, impairment or affect the well being
of workers or members of the community.
AIOH Objectives
• To promote the profession of Occupational Hygiene in industry, government
and the general community.
• To improve the practice of Occupational Hygiene and the knowledge,
competence and standing of its practitioners.
• To provide a forum for the exchange of Occupational Hygiene information
and ideas.
• To promote the application of Occupational Hygiene principles to improve
and maintain a safe and healthy workplace.
• To represent the profession nationally and internationally.
Coming Event
30th Nov – 4th Dec 2013, Sydney
Theme: The 4 Pillars – Anticipation, Recognition, Evaluation, Control
2024490πJEEH230813
AIOH 2013 - 31st Annual Conference & Exhibition
will tell you. This is a very important
consideration for employers who provide
accommodation for their workers. Also,
ear muffs and earplugs may help to reduce
hearing damage but they do nothing to
address the source of noise. They can even
introduce new problems.
Hearing protectors prevent us from hearing
things we would normally hear but they don’t
differentiate between the sounds we want to
hear and unwanted sounds. They affect our
ability to understand speech, make it more
difficult to determine where sounds are coming
from and they can block out warning signals
or noise from moving vehicles. These factors
increase the risk of accidents in the workplace.
Engineering noise control addresses
unwanted sound at its source without
interfering with the sounds we do want to
hear. So it is clear that engineering noise
control is fundamentally superior to hearing
protection in reducing risks associated with
noise exposure – whatever the level.
By Jim McLoughlin
Business Unit Leader, Acoustics SVT
Engineering Consultants
m an ag in g
14
IN THE 21ST CENTURY
Sensitive apparatus one to cherish
The notorious practice of blast fishing, as
opposed to the traditional rod and reel
approach, involves setting off explosives
for the thrill of reeling in a quick catch.
In a split moment, an abundance of fish
is yielded, but not without leaving a trail
of destruction in its wake. The rubble
remains of coral and affected ecology of
the waterway may take years to recover or
permanent damage may ensue. Sounds like
a bit of overkill, doesn’t it?
This analogy mirrors what our ears experience
every day, especially if you are immersed in
an environment with loud noise or are exposed
to blaring music. The ear hosts a very sensitive
environment. Just as recreational fishing
requires careful and gentle handling of the
fishing line as we wait to feel the tug from the
first nibble on the bait, our ears were designed
to pick up subtle cues.
Our predecessors’ sense of hearing was
primed to detect the rustling of leaves and
snapping of twigs in the forest as part of
the predator-prey instinct. In earlier times,
the world was a quiet place in contrast to
today’s standards where we are constantly
over-stimulated and bombarded by sensory
information. We work in environments where
we struggle to hear other people talk and at
the same time, continue to turn up volumes to
drown out background noise with music.
As a result of this auditory onslaught on our
ears our precarious apparatus, specifically
parts of our cochlear (inner ear), dies. Akin
to dynamite fishing, sometimes the damage
done is everlasting.
As more areas of the ear become unusable,
our hearing ability diminishes, just like those
fish that we have made extinct in the lake from
our TNT fishing. Unlike the lake, however,
once our hearing is destroyed, we don’t have
the option of moving on and finding a new
lake to exploit. We only get one set of ears,
and with it one chance at hearing.
By Ben Elsey
Did you know?
Your ears are more than just necessary for
hearing; they also help keep your balance.
Clinical Director,
Hearing Conservation Australia
Speech-friendly protectors come
to the rescue of hearing impaired
For people with normal hearing, wearing
earplugs or muffs in loud noise typically
makes it easier to hear warning signals and
conversations. But the same is not true for
workers who have already lost some hearing.
For them, wearing hearing protection
produces a double loss: the attenuation
of the earplug overlaid on their existing
hearing loss. Fortunately, manufacturers have
responded with a number of speech-friendly
hearing protectors for those with existing
hearing impairment.
1. Uniform attenuation
A conventional earplug blocks high-pitched
(treble notes on the piano) noise better than
low-pitched noise (bass notes). But this distorts
the incoming sound and makes it difficult to
understand speech and conversation when
wearing these conventional protectors.
Manufacturers now make hearing
protectors that have uniform attenuation
across all frequencies, so that wearing the
earplug reduces volume without distorting
conversations from a co-worker and speech
sounds more natural.
2. Sound restoration ear muffs
Several models of electronic ear muffs are
designed to optimise protection for those with
pre-existing hearing loss. These ear muffs
have built-in amplification circuits to amplify
speech in low level noise. However, as soon
as hazardous noise is detected, a control
circuit in the ear muff instantly compresses
the incoming signal. The hearing impaired
worker still hears what he needs to hear –
warning signals and conversations – but at
safely reduced levels.
3. Speech enhancement
Some new technologies borrow from
military applications where incoming sound
from a communication radio is digitally
enhanced to make speech more audible,
while background noise is electronically
suppressed. These ‘intelligent protectors’
are designed to pull speech out of intense
background noise to make it more intelligible
where communication on a noisy job is
critical.
These solutions run the gamut in terms of
cost, from about a dollar per pair to several
hundred dollars for the electronic intelligent
protection. But they offer the hearing impaired
worker a number of valuable options for
protecting hearing without sacrificing
situational awareness, warning signal
detection and speech intelligibility.
By Brad Witt
Director of Hearing Conservation,
Honeywell Safety Products
Win-win situation for all parties
Fitness for work can be a sensitive
topic at any time and no more so than
when there is potential for launching a
discrimination case.
Where a governing organisation has
not set a specified medical standard,
a person with significant hearing loss
needs to be assessed on their ability
to undertake the basic requirements
of the job safely and effectively, and
which do not cause undue hardship on
the employer.
However, the real crime may be a
company missing out on a quality
employee. To illustrate this, I will share
two stories from my career.
The first anecdote is an employer who
had safety concerns for an employee
with a significant hearing loss who was
working around moving machinery.
In order to wear hearing protectors,
she would remove her hearing aids,
which made it impossible for her to
communicate with her colleagues or
hear the warning beeper of a reversing
vehicle. The workplace described this
worker as “brilliant at her job” and
was desperate for a way to solve this
problem.
Technology came to the rescue. With
the purchase of a specific ear muff
and a visit to the audiologist to have
a function activated on her hearing
aids, she could wear the aids and
the earmuffs at the same time. For a
solution costing less than $100, this
employee could now work safely on
the job.
The second scenario was a workplace
that thought outside the box. They
decided to install ‘modifications,
which cause undue hardship on the
employer’. They did this so they could
safely employ a job applicant who
was deaf. Visual and tactile (vibrating)
warning devices were installed at the
company’s expense and the man was
appointed. The company described this
employee as “one of our best workers”
because he was one of their most
productive. This was a true win-win
situation.
For a small outlay in equipment, the
company was reimbursed many times
over by this employee’s productivity,
and the worker was able to do a job
he loved.
Teaming up with an expert to design
low cost solutions for fitness for work
issues has the potential to change the
landscape of how companies think
when considering the feasibility of
employing a hearing impaired worker.
By Ben Elsey
Clinical Director,
Hearing Conservation Australia
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IN THE 21ST CENTURY
Holistic approach to rehabilitation
Noise induced hearing loss is an unseen
problem: No one says, “I got industrially
deafened today”. Noise injury is gradual
in nature and workers affected by hearing
impairment may experience significant
communication difficulties and reduced
quality of life.
The belief that simply buying a hearing
aid/s will solve all of these difficulties is
a false one. The best outcomes for most
people with hearing impairments are
achieved when hearing aids are included
as part of a holistic hearing rehabilitation
program. This involves a client receiving a
full diagnostic audiological assessment, an
evaluation of their communication needs,
negotiating a suitable rehabilitation program
with their audiologist (which may include
the prescription of hearing devices), postdevice fitting follow-up including counselling,
communication training, group work and
other assistive devices.
Hearing loss is not the same as most vision
loss, which can be immediately solved
through use of glasses that can be purchased
through pharmacies or optometrists. Damage
to the hearing organ may also result in
problems in the auditory nerve pathway
and for this reason a specific rehabilitation
program provided by a professional
audiologist is necessary to ensure optimal
benefit from hearing aids. Most audiology
clinics recommend clients bring a family
member or a friend to appointments.
This not only assists clients in their selection
of any devices, but also increases awareness
in family and friends of the difficulties
experienced by their hearing impaired
partners and the strategies to overcome these.
The significant benefits of a comprehensive
hearing rehabilitation program are not readily
available if hearing aids are purchased
overseas or online, and Audiology Australia
encourages individuals to actively discuss all
the components of a rehabilitation program
with their local Australian audiologist.
By Dr Helen Goulios
Clinical Coordinator, Master of Clinical Audiology
Program, The University of Western Australia
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