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DEVELOPING A HEARING LOSS PREVENTION PROGRAM FOR CONSTRUCTION WORKERS Mark Stephenson, Ph.D. National Institute for Occupational Safety and Health NIOSH HIERARCHY OF CONTROLS Remove the hazard Remove the worker Protect the worker OVERVIEW • REVIEW OF THE PROBLEM • WHAT WE’VE LEARNED SO FAR • WHERE WE’RE GOING THE PROBLEM: The construction industry DOES have a standard: 29 CFR 1926.52… “Workers exposed to TWAs >90 dBA must be provided protection.” BUT Many of the requirements in the manufacturing industry standard (29 CFR 1910.95) do not apply: • Periodic noise monitoring • Dosimetry • Periodic audiometric testing • Regular worker education So what… People lose their hearing anyway as they age. Even by age 60, the average healthy person does not have impaired hearing!! Hearing Loss 500 0 10 20 30 40 50 60 70 80 90 1000 40 Y.O. 50 Y.O. 60 Y.O. 2000 3000 4000 6000 Hearing Levels in 60 Year Old Males as a Function of Noise Exposure Decibels of Hearing Loss 500 0 1000 2000 3000 4000 6000 10 20 30 No Noise 40 90 dBA 50 95 dBA 60 100 dBA 70 80 90 -10 Even where the OSHA HCA is being applied, workers are still losing their hearing! 0 10 20 30 40 50 60 20 years in stamping plant Predicted Hearing Levels No Occupational Exposure 500 1000 2000 4000 8000 What Have We Learned So Far? • Noise Levels • Hearing Levels • Cost • Health Communications The Average 25 Year Old Carpenter Has 50 Year Old Ears! It Would Cost One Billion Dollars to Provide Hearing Aids to Every UBC Member Who Needed Them (batteries not included)! $1,000,000,000 Cost: What kind of money are we talking about? Don’t talk to me about decibels, tell me about MONEY ! Cost of hearing aids Vs. Cost of an HCP What about workers’ compensation? Health Communication Theory = Marketing Health Communications: Once a noise hazard is identified, why don’t we just pass out ear muffs or set out boxes of ear plugs? Without proper training, any hearing protector that can be worn wrong, will be worn wrong! Available protection vs. the amount of protection obtained by untrained workers. 30 Decibels 25 20 29 15 21 10 5 26 23 26 22 17 13 7 2 0 Plug A Plug B Plug C 5 Plug D 8 1 Plug E Plug F 5 Plug G Likely protection as worn by untrained worker Amount of protection listed on the box People have MANY reasons for not using hearing protectors. (AKA: You can lead a person to hearing protectors, but you can’t get him/her to wear them.) • Comfort • Convenience • Cost • Communications / hear important sounds THERE ARE OVER 200 DIFFERENT HEARING PROTECTORS. EVERYONE CAN FIND A PROTECTOR THAT MEETS THEIR NEEDS. THE BEST HEARING PROTECTOR IS THE ONE THAT’S WORN! Effect of not wearing your hearing protector on the amount of effective noise reduction Education and Training Must NOT Just Fill a Square Blah, blah, blah… Blah, blah, blah... How do you know what the workers’ concerns Just ask me. and beliefs are? I’ll tell you what I need. Barriers cited by coal miners for not wearing HPDs: Comfort Poke Out Eardrum Communication Cords Get Caught Convenience Roof “Talk” Earcup Too Big Warning Sounds Percent of Workers Who Wore Hearing Protectors 70 63 60 50 52 47 40 33 Non-STS STS 30 20 10 0 Pre Post INFLUENCING HEARING PROTECTOR USE AMONG WORKERS Health communication theory has proven education and training must address two concepts: Remove Barriers Develop Self-Efficacy How Do You Remove Barriers & Develop Workers’ Self-Efficacy? Conduct Focus Groups Removing Barriers and Developing Self-Efficacy is an Iterative Process Administer Measure SPLs & HTLs Survey Analyze Audiometric Data Modify Training Analyze Data Observe Behaviors Analyze Data Develop Training Re-administer Survey This is your ear. This is your ear on noise. Any questions? NIOSH Toll-Free Number: (800) 35-NIOSH http://www.cdc.gov/niosh/homepage.html Mark R. Stephenson (513) 533-8144 [email protected] Carol Merry-Stephenson (513) 533-8581 [email protected]