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National Surveillance for Occupational Hearing Loss SangWoo Tak, ScD, MPH Geoffrey M. Calvert, MD, MPH Division of Surveillance, Hazard Evaluation, and Field Studies NIOSH CDC/DHHS Chronology 2005 – National Academy of Science (Institute of Medicine) recommends national surveillance for OHL and noise exposure 2006 – NIOSH Prioritized OHL surveillance goals 2008 – OHL surveillance project proposed 2009 – NORA project awarded funding Project goal To conduct surveillance research to track occupational hearing loss To develop the first ever national surveillance system on OHL Where are the data? NHCA – audiometric service providers across the US In December 2007, a recruiting letter sent to all audiometric service provider members Six providers gave a positive response Received letters of support from five of these audiometric service providers Audiometric Service Providers Audiograms, Noise survey data Hearing loss prevention programs Employers Collection National Data Repository Workers Dissemination Preventive intervention NIOSH OHL Surveillance Stakeholders Industry Labor unions State health departments Practitioners Scientific community Interpretation By industry Analysis Incidence & Prevalence Specific aim 1 Collect audiometric data from audiometric testing service providers to develop an audiometric data repository Tasks Recruit 15 audiometric service providers across the country 1st year: 3 2nd year: 5 3rd year: 7 Retrieve historical data for those who were tested at lease once from 01/2003 to 12/2008 Identify a audiometric data repository system Data elements Demographic characteristics of the worker 1) Unique identifier (will be assigned by data provider) 2) Gender 3) Date of birth Workplace variables 1) Workplace state 2) Unique identifier 3) Industry code and literals (NAICS 2002) Audiometric testing variables 1) Date of test 2) Threshold for each pure tone frequency (500, 1K, 2K, 3K, 4K, 6K, and 8K). Specific aim 2 Estimate the rate of occupational hearing loss and changes in hearing per year by industry using NAICS codes* North American Industry Classification System Tasks Data management Cleaning Quality control Protocol for data management Descriptive data analyses by industry Report dissemination Specific aim 3 Identify specific industries associated with a high risk of occupational hearing loss in the construction and manufacturing industry sectors Definitions OHL -- average hearing threshold of 25 dB or greater at frequencies of 0.5k, 2k, 3k, and 4k Hz in either ear Standard threshold shift (STS) -- average increase from baseline of 10 dB or more (pure tone test in the frequencies of 2k, 3k, and 4k Hz in either ear) NIOSH defines STS as shift from baseline of 15 dB or more at any test frequency in either ear Tasks Comprehensive statistical analysis Risk ratios estimated for hearing loss (OHL and STS) Multilevel analysis industry level adjusted for individual factors (age & sex) Disseminate reports & at least one peer reviewed paper Outcome – 1st year (2009-2010) Initial contacts with 3 providers Data use agreement (between providers and NIOSH) Industry coding Established a secure web site for data upload/download Data retrieval in progress Outcome – 2nd year (2010-2011) Recruit 5 more audiometric service providers Design NIOSH OHL data repository Continue audiometric data management Begin analyzing audiometric data Produce reports Expected outcomes upon project completion This project is anticipated to: Measure incidence/prevalance of OHL Identify industrial sectors with the highest rates of OHL Set research priorities Guide workplace interventions Discussion -- Issues Data confidentiality is assured Audiometric data quality assurance -- work in progress More participation is needed Acknowledgement Mark Stephenson Christa Themann Theresa Schulz Thais Morata John Sestito Chandran Achutan Scott Henn Kenneth Rosenman Contact E-mail) [email protected] Phone) 513-458-7117