Development of a rehabilitation program for people affected with occupational hearing loss. 1. A new paradigm

The highly insidious character of the development of occupational hearing loss (OHL) bears several implications in terms of the nature of the resulting handicap. It calls for rehabilitative services that are adapted to the specific needs of those suffering from OHL. A paradigm for a rehabilitation program was defined using a public health model bringing about social changes. The health problem is defined in terms of reduced listening and communication abilities. Its consequences are examined for the workplace, leisure activities, social involvement, family relationship and individual well-being and self-esteem. The precursors of the problem are hierarchically determined according to their potential influences, and appropriate interventions are identified accordingly to act upon each of them. These interventions include: (a) psychosocial support to the affected workers and their families through group intervention; (b) information to the victims of OHL, their families, to workplaces, public services and the general population, and (c) skill development to facilitate listening and communication for and with the hearing-impaired person. This paradigm was used in the development of a rehabilitation program.