When the damage is done

May 15, 2000
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Are hearing-impaired workers at greater risk of accident and injury on the job? Might not seem like a question for scientific investigation. But it is one of those addressed by a study published in the Journal of the American Medical Association in December, 1997.

You might say it’s a no-brainer. A worker who can’t hear sirens, horns, whistles or the shouts of coworkers warning of danger, is obviously at greater risk of getting hit by a forklift rounding a corner. Indeed, that’s what the JAMA article authors found: "Workers with disabilities, especially sensory impairments, appear to have an elevated risk for occupational injury."

How often job accidents are attributable to a worker’s hearing loss isn’t known. The study was able to link only 3.5 percent of occupational injuries to "prior disabilities." But the study also associated work disabilities, including sensory impairments, with a 36-percent increased risk of occupational injury.

What you might not realize, however, and what makes the JAMA article timely, is that the number of workers suffering hearing loss is likely to increase in coming years.

Boomers in rockers, rockers with boom-boxes

Take a look at your workforce: Aging baby boomers—like it or not—are beginning to show signs of wear and tear, like hearing loss; and following them is a generation that has grown up in an increasingly noisy world.

To be sure, the workplace itself has become a safer place for fragile cochlea in recent decades. OSHA noise exposure regulations, engineering advances, and comfortable hearing protection have eliminated many hearing hazards of old. "If you look at hearing conservation efforts over the last 15 to 20 years, programs have progressively improved. At least among big industries, you don’t have the kind of noise exposure now that you did then," says Paul Brownson, M.D., an occupational health physician for Dow Agro Sciences, LLC, Indianapolis, Ind., and a member of the Noise and Conservation Committee of the American College of Occupational and Environmental Medicine.

But outside work, the public is on its own for protection. No agency regulates noise at NASCAR races or Rolling Stones concerts. Presently hearing loss afflicts 10 percent of Americans. Statistics indicate employers might be facing hearing-impaired workers in near-epidemic proportions.

Aging is the most certain factor. According to experts, 25 percent of people exhibit significant hearing loss by the time they reach their 60s. Between 1990 and 2050, the number of people with hearing impairments will increase at a faster rate than the total U.S. population, according to the Better Hearing Institute (www.betterhearing.org).

The problem won’t necessarily end as baby boomers retire. Noise exposure among young people is a lesser studied, but potentially more significant contributor. The Sight and Hearing Association in St. Paul, Minn., cites a recent study of hearing among students in one school district in which the incidence of hearing loss among eighth graders increased 400 percent over ten years.

Brownson says pre-placement tests he conducts of young workers now turn up higher incidence of hearing deficits than 30 years ago.

Once the damage is done

Of course, there’s nothing you can do to reverse the effects of hearing damage. But to prevent it from getting worse, safety pros can train workers to protect their hearing on and off the job. "It would benefit employers to address non-work-related noise induced hearing loss with workers," says Alex Sanchez, M.D., director of occupational medicine at the Nalle Clinic in Charlotte, N.C.

When Sanchez detects a shift in a worker’s hearing, he sits down with the individual to figure out what caused it. More often than not, he says, the shift can be linked to an off-the-job exposure like hunting, power tool use, or attending NASCAR races or loud concerts, he says. If the damage is already done, accommodations can be made to protect workers whose impairment makes them an increased safety risk. Authors of the JAMA study conclude that "further research in the design and evaluation of improved workplace accommodations for workers with disabilities like hearing loss is needed." (The JAMA authors also remind employers that the Americans with Disabilities Act requires employment decisions to be based "on an individualized assessment of the individual’s present ability" to perform the job, not "merely because of elevated risk.")

What can you do now to accommodate workers whose hearing isn’t what it used to be? Merrie Healy, vice president of risk control consulting for international insurance broker Sedgwick of Minnesota, Inc., gives this advice:

  • Tie in all your alarm systems with visual cues. For example, reverse warning signals on forklifts should be accompanied by flashing lights, as should other audible alarms, she says.

  • Consider the needs of hearing impaired workers when developing an emergency evacuation plan. Plans should be made in advance for anyone who needs special assistance.

  • Adapt phones with adjustments for the hearing-impaired.

  • Train hearing-impaired workers to be aware of the increased risk and potential hazards.

  • Work with your human resources department to make accommodations under the Americans with Disabilities Act for hearing-impaired workers with special needs.


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