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National Conference to Prevent Hearing Loss in Construction:

P R O C E E D I N G S

Address: Preventing Hearing Loss in the Construction Trades: A Best Practices Conference

MAX LUM
Director of Health Communications
NIOSH

Alternate description

MR. FOWLER: Our final presenters are Max Lum and Marin Allen. Max is the director of Health Communications for NIOSH. Marin is the chief of Office of Health Communication and Public Liaison for the National Institute on Deafness and Communication Disorders, which is part of the National Institute of Health.

They have been working closely together now for the past 2 years on a national campaign to prevent hearing loss in the U.S. called the WISE EARS! Program. We recognize that one of the fundamental problems that we face is that most people do not take this problem seriously and that they will not until we begin to change public perception about this, much like they have done in Europe.

This is what the campaign is all about and why we wanted to end the conference with this.

DR. LUM: Thank you. I am going to be very brief today because I want to leave enough time for those in the audience who wish to visit the NIOSH mobile Hearing Van to get their hearing tested. Over half of conference attendees have had their hearing tested. I think that is a good start but it would be nice to have everyone participate. We have not had an opportunity to have the NIOSH Van at a conference site before , strong participation today will help us schedule more of these opportunities.

Dr. Marin Allen will be talking with you in a moment about an NICDC initiative in movie theaters. NIOSH will be joining NIDCD for an additional effort: teaching vocational students the importance of protecting their hearing.

The National Institute for Occupational Safety and Health included a number of questions concerning noise induced hearing loss on the CDC sponsored Healthstyles survey. Healthstyles is a comprehensive annual survey conducted by Porer/Novelli, Inc. of the health related beliefs, attitudes, and behaviors of American adults. In 1998, the Healthstyles survey was sent to a representative sample of 3,638 people. Of these, 2,681 people responded, a response rate of 74 percent. To compensate for differential non-response rates in various demographic categories, the data were weighted to mirror the demographic characteristics of the adult US population.

The preliminary data revealed that adults in the United States know that hearing loss is a problem and that they appear to understand the implications of hearing loss.<.p>

  • 48% of U.S. adults believe they have suffered some hearing loss, including 35% of those 18 to 29 years old.
  • 48% of adult Americans know that hearing loss is not part of growing old.
  • 79% believe hearing loss can interfere with a person’s social life and personal relationships.

Many American are not knowledgeable about sources of hazardous noise at home or work.

  • 32% of U.S. adults say that while they regularly use noisy equipment around the house (e.g. lawn mower or vacuum cleaner), they do not believe that their use of this equipment could damage their hearing.

Approximately 30 million workers are exposed to hazardous noise on the job and an additional 9 million are at risk for hearing loss from other agents such as solvents and metals encountered on the job.

Noise induced hearing loss is one of the most common occupational diseases and the second most self-reported occupational illness or injury. Industry specific studies reveal the following:

  • 44% of carpenters and 48% of plumbers reported that they had a perceived hearing loss.
  • 49% of male, metal/nonmetal miners will have a hearing impairment by age 50 (vs. 9 % of the general population), rising to 70% by age 60.

We conducted many focus groups, and did a lot fact-finding and general information gathering before we joined NIDCD in the "Wise Ears" effort. Many workers told us, "Well, you know if we lose our hearing, at least it will be quiet." We heard that a lot. "If I lose my hearing, maybe I will get some workers' compensation”. Of course, it is often not quiet as our first speaker clearly pointed out. I do not know how you feel about Bill Duke's presentation, but I thought he touched every human issue that we have to deal with in providing information. This information is essential for workers to make intelligent choices about protecting their hearing and about talking to their employers. Good communication will not solve all our problems, but it is obvious we need to know much more about our workers and their workplaces.

We have learned a great deal about reaching specific audiences in our brief joint effort with NIDCD through the Wise Ears campaign. We really have to know a lot more about what people are thinking, and how better to motivate people inside and outside the workplace.

While any worker can be at risk for noise-induced hearing loss in the workplace, some industries have higher exposures to dangerous levels of noise. Industries with high numbers of exposed workers include agriculture, mining, construction, manufacturing and utilities, transportation, and the military.

What can we tell these workers and their employers?

Messages we utilize include the following: get your hearing tested; try out and use hearing protectors; know your dBA risk number; know your lifestyle risks; buy quiet, and, of course, engineer out noise. Yet there is no one message that seems to work with everyone. We need to try different messages depending on the particular workers and employers that we are focusing on and most importantly involve them in the communication process.

NIOSH has done a lot of work on noise induced hearing loss. Our 1998 criteria document, reevaluates and reaffirms the recommended exposure limit (REL) for occupational noise exposure that we established in 1972. The recommendations in this document go beyond attempts to conserve hearing by focusing on prevention. For workers whose noise exposures equal or exceed 85dBA, NIOSH recommends a hearing losss prevention program that includes exposure assessment, engineering and administrative controls, proper use of hearing protectors, audiometric evaluation, education and motivation, recordkeeping, and program audits and evaluations.

Dr. Rosenstock, spoke a little about our new "easy to read" hearing protection documents and how important partnerships are in reaching workers at risk. Our recent partnership with the National Safety Council allowed us access to their members and to small business partners to reach important employer audiences. Through this collaboration our document was received by over 50,000 small businesses.

Removing hazardous noise from the workplace through engineering controls (eg. installing a muffler or building an acoustic barrier) is the most effective way to prevent noise induced hearing loss.

Hearing protectors such as earplugs and ear muffs should be used when it is otherwise not feasible to reduce noise to a safe level. NIOSH recommends hearing loss prevention programs for all workplaces with hazardous noise assessments, engineering controls, audiometric monitoring of workers’ hearing, appropriate use of hearing protectors, worker education, recordkeeping.

When you have the opportunity I urge you to visit the NIOSH web site. We have a topic page on noise. We created this special noise page because we felt it would be a good way to organize and disseminate information about noise induced hearing loss. It also allows us to know how many people visit our site and what information is most important to them. The Internet is not the best mechanism for providing information to all audiences. However, we did have 25,000 hits in the first 2 months after we launched this site. Our challenge at NIOSH is to make the Internet more available and acceptable to workers as a mechanism for providing information that workers need and want to know.

Again, the key point is that partnerships are absolutely essential.  One particular example comes to mind.

NIOSH and researchers form Michigan State University have been working with the United Mine Workers of America to increase hearing protection behaviors among coal miner in the eastern United States. Using a theoretical framework for message adoption or rejection, the study will examine methods to motivate miners to take the necessary individual steps to protect their hearing. A randomized study design will be used to determine which of four possible messages is the most effective at encouraging changes in behavioral intention related to hearing protection among the target population.

Information, though, is not enough. The focus and role of health communication is greatly affected by key partnerships in the client community. Communicating to inform is a two-way process. Meaning is not transmitted by experts so much as it is determined by listeners. Active communication in the occupational health field involves more than just providing hazard information, Partnership-based communication involves raising awareness of a new or acute health problem, helping to reduce fear, raising or maintaining interest in an on going health problem, reporting health trends, and facilitating informed decision making. Working closely with workers and their representatives is critical for identifying and targeting specific at-risk populations and for maximizing the use of resources. Communicating to inform workers and employers requires increase attention to the two-way nature of such communication and to the need to engage these audiences in the process. The increased use of Internet sites and e-mail, along with continued intense news media interest, will increase the availability and demand for occupational safety and health information.

I thank you for your continued support of NIOSH that helps us manage the increasingly complex health communication issues and the demands for scientific certainty and action.

Lastly, I want to thank Scott Schneider for all of his efforts in organizing this meeting. I know Scott is getting a big head here, with all our compliments but he truly deserves it. Scott looks remarkably calm don’t you think? It’s either denial or new medication. Seriously, he has done a great job.

Finally, I want to thank everyone not only for coming to this meeting, but particularly for this last session of the day. Thank you for staying.

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