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
DONALD J. GARVEY, CIH, CSP
St. Paul Fire & Marine Insurance Company
St. Paul, MN
The following comments are my own. They are not necessarily the St. Paul’s and I am not a representative of the construction industry. These are my own observations from dealing with and talking to contractors in the field.
The main barrier is, right now hearing conservation is not perceived as an immediate problem. This is not because contractors do not care, or think hearing is not important, but there are other problems, just as important, pulling for their attention and time. Hearing loss does not have many of the characteristics necessary to stand out as a high profile problem. This makes it a difficult problem to deal with.
There are minimal OSHA regulations regarding noise and no major enforcement efforts as compared to things like silica and lead which have on going Special Emphasis Programs or respirator use with its brand new standard. As the saying goes, “The squeaky wheel gets [remarks missing].
It is not an immediate issue - there is no blood on the ground when hearing loss occurs - as opposed to a crane failure, vehicle accidents or fall protection. Hearing loss will not make the 5:00 o’clock news. One of these things will.
Hearing loss is a very technical issue - decibels, NRR, exchange rate, threshold levels. Most construction superintendents, or project managers don’t understand these things They can understand a guard rail has to be 38” to 45” high. They can understand an anchor point has to be able to hold 5000 lbs. They understand inches and pounds. Like most people, we shy away from things we don’t understand, and work hard and well on things we do understand.
Some people state that contractors should be interested in hearing conservation and put a strong effort into it because it can help lower workers compensation rates. At least with the St. Paul’s history, that does not appear to be the case. The average incurred loss (total of all costs associated with a claim) for hearing claims is around $2000-$4000. That is not a significant amount of money from a claims standpoint. Just the ambulance ride alone for my simple broken wrist cost $1000. That did not include the emergency room and follow-up doctor appointments. Our resident crane expert figures that the cost of a single crane accident will usually end up costing at least $1 million and probably at least one fatality. Plus so far there have not been that many hearing claims. I think the St. Paul has had less than 200 claims nationwide in the last 10-15 years. The low cost should not be surprising - hearing loss does not prevent a person from working, the person usually files the claim at or near retirement so there is minimal lost wages, there are minimal doctor costs, no ambulance rides, no admissions to the hospital, minimal tests and medications - all the things that add to a big compensation claim cost.
Also, in regards to workers compensation, many states require the employer of last exposure to pick up the compensation costs - regardless if they were responsible for the health claim or not. New York is an example. We air monitored silica on a 3 year project. Quarterly samples. Significant expenditure for engineering controls to reduce airborne silica. At only one location on the site were the results ever above the TLV and that was still less that twice the TLV. All the rest were typically 50% of the TLV or less. The one area with high results had only 1 worker there, and he was in a respirator from the start of the project. At the end of the project 8 sand hogs claimed silicosis. They had it. No doubt, no one disputes they have silicosis and should be compensated, but should it be our contractor who has to pay? We had documentation that they were not overexposed. But, because of the compensation laws, and because there was an exposure to silica (not an overexposure, just that there was an exposure) our insured was responsible for the claims. Even when they did everything right, they were still had the compensation claims go against their record because of the laws.
The construction safety director is going to spend his/her time on things that show immediate results: back claims, slips and trips, falls, vehicular accidents. Hearing loss does not fit into this immediate results group.
Another problem with developing an effective program is worker exposure assessment.
The construction site is in a constant state of change which makes assessment difficult if not impossible. One possible solution is task based exposure assessment -where individual tasks are monitored and combinations of tasks can then be modeled to predict exposure. NIOSH and others are working on developing these techniques now.
Audiometric testing programs, like that in general industry would be difficult to set up in construction. The mobile nature of the worksite - some jobs are literally in the middle of nowhere. The mobile nature of the workforce - in the refineries and papermills, a worker may be hired for a shutdown that lasts only 2 weeks. After that he or she is off on another site with another employer. A large 2 year job - a contractor may start with 100 workers but by the end of the job have hired a total of 250 to replace those who leave or are fired or whatever. You could end up having to do weekly audiograms.
What would be the value of the audiogram? Because of the transient nature of the construction worker, many workers would just have a series of baseline audiograms with different employers. If a worker was hired and tested on 1 January 1999, leaves after 6 months and returns to the same contractor in June 2001, should the original baseline be used? or should a new one be taken? If a threshold shift it identified, that is important for the worker to know and this is a good thing, but tells us nothing about the effectiveness of that contractor’s hearing conservation program. Should the employer who has not seen this worker for 18 months be held accountable for a threshold shift that occurred during that time? Evaluating the effectiveness of the program is one of the main reason for the audiometric testing program in general industry.
The main barrier to hearing conservation is that at this point it is not seen as a critical issue. Not because contractors do not care or are cold and callous, but there are so many other issues - equally important - fighting for attention. Hearing loss does not carry the attention getting features of these other issues - it is not immediate, it is 20 years from now; it is not costly at this point compared to other accidents and injuries; it is a technical issue that can be difficult to understand; it is not an OSHA compliance issue like silica or lead.