Cost-Effective Hearing Conservation: Regulatory and Research Priorities

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.