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Cost-Effective Hearing Conservation: Regulatory and Research Priorities.

Robert A Dobie¹

¹Department of Otolaryngology - Head and Neck Surgery University of Texas Health Science Center at San Antonio Texas, USA.

Ear and Hearing

|December 19, 2017

Summary

Hearing conservation programs (HCPs) may only be cost-effective for noise exposures of 90 dBA or higher. Improving enforcement and engineering controls can enhance the value of these occupational safety programs.

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Area of Science:

Occupational health
Health economics
Audiology

Background:

Mandated by the Occupational Safety and Health Administration (OSHA), U.S. hearing conservation programs (HCPs) cost approximately $350 per worker annually.
A cross-sectional model was developed to assess the cost-effectiveness of HCPs, incorporating methods for estimating hearing impairment and age-related/noise-induced hearing loss.

Discussion:

The model simulated cost per quality-adjusted life year (QALY) saved for individuals in HCPs across various noise exposure levels.
Results suggest that HCPs are potentially cost-effective only at time-weighted average (TWA) noise exposures of 90 dBA or higher.

Key Insights:

Current HCP cost-effectiveness may be limited, particularly at noise levels below 90 dBA TWA.
Improving regulatory enforcement, implementing engineering noise controls, and enhancing hearing protection device performance are crucial for increasing cost-effectiveness.

Outlook:

Future research should focus on employer compliance, risks for workers excluded from current regulations, and developing cost-effective HCPs for mobile industries.
Extending cost-effectiveness analyses to include broader assumptions and sensitivity analyses is recommended.