User:Elliespanel/sandbox

From WikiProjectMed
Jump to navigation Jump to search

Audiometric testing program [edit | edit source]

Audiometric testing is a very important part of a hearing conservation program (HCP). Audiometric testing allows for the identification of those that have lost significant hearing. Additionally, the testing allows for the identification of those who are in process of losing their hearing. Audiometric testing is most important in identifying those who have permanent hearing loss. This is called noise-induced permanent threshold shift (NIPTS).[13]

Completing baseline audiograms and periodically monitoring threshold levels is one way to track any changes in hearing and identify if there is a need to make improvements to the HCP. The Occupational Safety and Health Administration (OSHA), which monitors workplaces in the United states to ensure safe and healthful working conditions, specifies that employees should have a baseline audiogram established within 6 months of their first exposure to 85 dBA time-weighted average (TWA). If workers are unable to obtain baseline within 6 months, they are required to wear hearing protection devices (HPD) whenever they are exposed to 85 dBA or above TWA until they have obtained a baseline audiogram [1]. Under the Mine Safety and Health Administration (MSHA), which monitors compliance to standards within the mining industry, an existing audiogram that meets specific standards can be used for the employee’s baseline. Before establishing baseline, it is important that the employee limit excessive noise exposure that could potentially cause a temporary threshold shift and affect results of testing. OSHA stipulates that an employee be noise-free for at least 14 hours prior to testing [1].

Periodic audiometric monitoring, typically completed annually as recommended by OSHA, can identify changes in hearing. There are specific criteria that the change must meet in order to require action. The criterion most commonly used is the standard threshold shift (STS), defined by a change of 10 dB or greater averaged at 2000, 3000, and 4000 Hz [1]. Age correction factors can be applied to the change in order to compensate for hearing loss that is age-related rather than work-related. If an STS is found, OSHA requires that the employee be notified of this change within 21 days [1]. Furthermore, any employee that is not currently wearing HPD is now required to wear protection. If the employee is already wearing protection, they should be refit with a new device and retrained on appropriate use [1].

Another determination that is made includes whether an STS is “recordable” under OSHA standards, meaning the workplace must report the change to OSHA. In order to be recordable the employee’s new thresholds at 2000, 3000, and 4000 Hz must exceed an average of 25 dB HL [1]. MSHA standard differs slightly in terms of calculation and terminology. MSHA considers whether an STS is “reportable” by determining if the average amount of change that occurs exceeds 25 dB HL [1]. The various measures that are used in occupational audiometric testing allow consistency in standards within workplaces. Completing baseline and follow-up audiograms allows workplaces to detect hearing loss as early as possible and determine whether changes need to be made to provide a safe working environment for their employees.

Employee training and education [edit | edit source]

Proper training and education of those exposed to noise is the key to preventing noise-induced hearing loss. If employees are properly trained on how to follow a hearing conservation program, then the risk of noise-induced hearing loss is reduced. OSHA requires said training to be completed on an annual basis. Proper training is imperative since "even with a very modest amount of instruction attenuation performance can be significantly improved."[14][15]

It is important to design a program that not only provides a sufficient knowledge base on hearing conservation, but also focuses on increasing motivation to wear hearing protection [2]. By providing information on the physiological effects of noise exposure, the importance of obtaining baseline and annual audiograms, and use of appropriate hearing protection, the program will provide a thorough knowledge base for employees involved. Providing a refresher training when appropriate will ensure retention of this information as well [2]

It is also helpful to take several factors into account that can affect how participants react to the information provided. There are many factors, including personality traits, perceptions of hearing loss and HPD, and other external and internal triggers specific to the individual which may influence their motivation to comply with HPD guidelines [2]. [May go into more detail] One way to confront these variables is to design the program in a way that is most likely to motivate participants. A safe learning environment within an HCP with a focus on engaging and relevant content allows the opportunity for participants to socialize and tests knowledge in order to provide accountability [2]. Providing thorough knowledge regarding HPD within an appropriately designed educational program is a valuable way to motivate participants to protect their hearing.  

  1. ^ a b c d e f g Rawool, V.W. (2012). Hearing Conservation in Occupational, Recreational, Educational, and Home Settings. New York, NY: Thieme Medical Publishers, Inc. pp. 65–105.
  2. ^ a b c d Rawool, V.W. (2012). Hearing Conservation in Occupational, Recreational, Educational, and Home Settings. New York, NY: Thieme Medical Publishers, Inc. pp. 174–186.