The consensus of the group was that it was necessary to broaden the discussion on noise
to include hearing and hearing health issues. Further, the group concluded that it was
impossible to limit discussions of hearing health issues to the workplace without
consideration of non-occupational exposures.
Regarding engineering controls, it was the consensus of the group that, in general,
proven technology exists and is commercially available to control worker exposure to
hazardous noise. Participants focused on the underlying reasons for lack of widespread
implementation, the barriers to effective hearing loss prevention, and the research agenda
necessary to promote the general application of engineering control and protective
State of the Art in Noise Control
Noise control technology has been developed and applied for industrial machinery and
equipment, but implementation of the technology has been limited. Reliance on hearing
conservation over engineering as the primary means for exposure control has limited
introduction of the technology to some industries, primarily larger corporations who
maintain top-down support of health and safety issues. Awareness of and interest in the
nature and availability of controls within small and medium sized businesses is limited.
Worker exposure to noise is controllable through application of noise control engineering
technology and through the proper use of hearing protection devices (HPD). The barriers to
effective implementation of current technology need to be identified.
Noise and hearing health issues are difficult to discuss because material indicators
have not been adequately defined.
Because the country's manufacturing base has changed significantly since previous
studies, the impact of this change in workplace demographics on noise exposure
distribution needs to be assessed. Equally significant, due in part to the effect of
downsizing and outsourcing, the fundamental responsibility and loyalty relationship
between employer and employee has changed. The effect of this dynamic on worker exposure
to noise and the implications to employers need to be determined.
Part of the technical surveillance effort should be the development and maintenance of
a hazardous task inventory, or a compendium of industry-specific noise hazards and noise
sources. NIOSH has initiated this effort in the construction trades, but it needs to be
expanded to cover all of industry.
The implications of the current trend of hearing loss are unknown. Real costs of
maintaining hearing health for the worker, for industry and for society in general need to
be identified. Hard costs include items such as:
Indirect costs related to hearing health merit scrutiny as well. Research into
increased risk of accidents due to impaired hearing, high noise levels, or compromised
hearing due to use of HPD; productivity analysis; research on communication ability and
related implications; and costs of under-realization of career potential (example: US Army
hearing requirements for promotion and retention) are important. Worker expectations of
maintaining full functionality need recognition. Where our fathers expected to retire
after 40 years in industry with compromised hearing, the current generation of workers
with its focus on health and wellness will likely not be so accommodating.
A national inventory of hearing critical jobs, both in the public and the private
sectors is needed. Part of this research should focus on methods for assessing auditory
functionality; methods for determining the hearing-criticality of specific jobs, tasks,
and occupations; and methods of accommodation to address workplace accessibility for the
New Technologies Agenda
A means for distribution of information, especially engineering controls, is needed. A
"best practice" compendium and an acoustical materials compendium to collect and
distribute existing, proven control technology are possible vehicles. Broad distribution
of "buy quiet" specifications to aid the purchase of quiet machines and
equipment is another aspect of best practice information distribution. These steps can
help integrate noise control into the business process.
A national exposure database linked to noisy activities, hearing loss prevention
outcomes, and hearing protection should be developed to provide a comprehensive reference.
Research into the development of low cost personal noise dosimeters or personal
exposure monitors (with a retail cost of less than $100) can make information about hazard
levels and total noise burden available to large groups of exposed people, in an
occupational or social setting.
Consideration should be given to development of inexpensive hearing screening tools
using the model of the musical greeting card. While not clinical in precision, this kind
of gross self-screening could be a great asset in raising public awareness of noise as a
hazard and in motivating the individual to maintain hearing health and function. Similar
technology can be applied to personal hearing protector fitting.
Analysis should be conducted on the effect of the redistribution of responsibilities
for hearing health. Based on current business trends, it is possible that hearing
conservation will not be an exclusive management legal responsibility. The new paradigm
will entail greater worker involvement, as the worker bears more responsibility for
healthcare. Likewise, there will be greater supplier involvement as they bear more
partnership responsibility for ensuring that their industrial consumers maintain safe and
Part of the supplier link involves consumer products as well. A labeling requirement
like an MSDS for noise that would communicate to end-users the level of hazard,
consequences of use, and appropriate self protective behaviors (e.g. using hearing
protection or limiting time of use) can close the gap between the linked exposures in the
workplace and elsewhere.
Personal Protective Equipment Agenda
Important aspects of the HPD utilization issue merit research. There is no current
definition of HPD comfort and no real definition of effectiveness. HPD fitting, or an
assessment of the protection provided by given device under given conditions to a given
individual, should be addressed with improved methods and technologies for field fit
testing and user training. Simple but reliable methods for self-assessment of fit should
be developed, with annual training and verification of appropriateness of HPD selection
part of the hearing loss prevention process.
Further study is needed on the effects of HPD on functionality in the workplace.
Analysis of the effect of HPD use on warning signal detection; localization of noise
sources; and speech and communication in the workplace are important. In addition, each of
these research aspects should be considered for both the normal-hearing and for the
New technologies integrating speech communication systems and other technologies with
HPD should be pursued, with special focus on tailoring systems for hearing impaired.
Integration of multiple technologies including chemical exposure monitoring and other
health surveillance should be considered to increase value and raise the credibility of
the use of these devices.
Social Marketing Agenda
A fundamental failure of the existing system has been the reliance on regulation and on
employers for responsibility to protect and maintain hearing health in society. Lack of a
broad based social marketing effort to raise the awareness of the public on hearing health
as a wellness issue speaks to under-valuation of hearing health in society.
The large-scale awareness campaign which will be required to raise awareness of society
in general should be based on wellness models. This effort could be started by a
consortium of professional associations to promote hearing health as wellness as a new
paradigm. Worker groups, including organized labor; employers, both large and small; and
the general population should be mobilized.
A focus on youth, using anti-smoking or other public health awareness models, could be
a great preventive measure to improve the hearing health of those entering the workforce.
Noise awareness media should be developed using tools like the tinnitus demonstration tape
employed by the Carpenters Union and hearing loss demonstration media.