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Standard Precaution01:26

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Noise and Occupational Medicine: Common Practice Problems.

Andrew Phillips1, Ryan Cooney, Zachary Harris

  • 1Rocky Mountain Center for Occupational and Environmental Health, University of Utah, SLC, Utah (Dr Phillips); United States Department of Labor, Occupational Safety and Health Administration, Washington, (Cooney, Harris, and Dr Hodgson); and UnityPoint Health, Des Moines Occupational Medicine, Des Moines, Iowa (Dr Myrtil).

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|October 9, 2019
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Noise-induced hearing loss (NIHL) is a common occupational disease. Many employers fail to follow proper hearing conservation practices, leading to underreported cases and missed prevention opportunities for this workplace hazard.

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Area of Science:

  • Occupational Health
  • Audiology
  • Public Health

Background:

  • Noise-induced hearing loss (NIHL) is the second most common occupational disease in the U.S.
  • The Occupational Safety and Health Administration (OSHA) has established noise exposure standards and recordkeeping requirements.
  • OSHA inspections reveal frequent violations of both noise standards and recordkeeping regulations.

Purpose of the Study:

  • To identify deviations from best practices in managing NIHL.
  • To highlight how these deviations mask the true societal costs of NIHL.
  • To underscore missed prevention opportunities and burdens on individuals and society.

Main Methods:

  • Analysis of OSHA inspection findings.
  • Description of five common deviations from good clinical practices in hearing conservation.
  • Examination of recordkeeping violations, including inappropriate case logging.

Main Results:

  • Five key deviations were identified: misattributing NIHL to nonoccupational causes, improperly clearing workplaces based on audiogram patterns, disregarding symptoms or physical findings, denying work-relatedness, and incorrect case logging on OSHA logs.
  • These practices lead to the underreporting and underestimation of NIHL's prevalence and impact.
  • Evidence suggests widespread non-adherence to recognized hearing conservation program practices.

Conclusions:

  • Deviations in clinical practices and recordkeeping obscure the true burden of NIHL.
  • Improved adherence to established guidelines is crucial for effective hearing loss prevention in the workplace.
  • Addressing these systemic issues is necessary to reduce the societal and individual costs associated with occupational hearing loss.