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PPE: HEARING PROTECTION by NIOSH, only less than 2 percent had hearing impairment. However, among those ages 56-65 years, nearly half (48.6 percent) had some hearing impairment.” ■ Moreover, says CPWR: “Findings from the Building Trades National Medical Screening Program (BTMed), which examined construction workers with an average of more than 20 years of occupational exposure, show that over 58 percent of construction workers examined between 1996 and 2015 had material hearing impairment (1998 NIOSH definition); among welders, it was 77 percent.” According to the U.S. Department of Veterans Affairs, which has conducted long-term research on hearing loss, “\[h\]earing problems—including tinnitus, which is a perceived ringing or other type of noise in the ears—are by far the most prevalent ser- vice-connected disability among American Veterans.”11 Exposure Levels While most federal agencies mandate a PEL of 90 dBA averaged over an eight-hour work shift using a 5-decibel exchange rate, a lower limit of 85 dBA averaged over an eight-hour work shift us- ing a 3-decibel exchange rate is specified by nearly all other juris- dictions around the globe. For example, NIOSH and the U.S. Department of Defense use this lower limit and exchange rate (see Recommended Exposure Limit12). “Studies show that enforcing mandatory hearing protector use at 85 dBA TWA and louder can significantly reduce the percent- age of excess risk for acquiring noise-induced hearing loss” says Laurie Wells, AuD, Lead Regulatory Affairs Specialist at 3M, and chair of ISEA’s Hearing Protection Product Group. Wells says sustained exposure to dBA levels at 90 dBA and greater can harm your hearing over time. Employers and workers really need to make sure they’re not only well-trained on hearing protection and that they are using hearing protection conscientiously, but also that the hearing protectors are the right type to suit the task and work environment. “Once you lose your hearing, it’s gone” adds Wells. Preventing hearing loss is obviously important, but noise also has some surprising effects on human health that people should re- member, as the New York Times article referenced above points out. Stress, chronic fatigue, high blood pressure, and even digestive disorders are among those effects. Tinnitus is as well, and it’s been connected to sleep problems, brain function, anxiety, depression, fatigue, irritability, and more. Thus, hearing needs to be understood in a larger context — both for worker health and workplace safety reasons. For exam- ple, NIOSH includes “total hearing health” as an element of its Total Worker Health (TWH) Program,13 which takes a holistic approach to worker wellbeing. NIOSH “recommends an integrated approach to address the hear- ing health of workers. An integrated approach is a comprehensive consideration of risk factors intended to protect workers from work- related injury and illness and help them advance their overall health and wellbeing, on and off the job. The approach includes addressing exposures at work, environmental factors, and personal factors.” Proper Hearing Protection For workers and employers who prioritize protecting hearing, basic awareness of the need for hearing protection is common. What’s less common is knowing how to select and use hearing protection appropriately. ThThere are many types of hearing protec- tors with difffferent features for a variety of noise exposures and work environments. It takes training and skill to fifit hearing protectors in a manner that achieves the amount of noise reduction needed for the task. NIOSH shows a three-step process in this simple how-to guide: roll, pull, and hold.14 That middle step — pulling the top of the ear up and back with the opposite hand — is often skipped, which may compromise the noise reduction needed. “We now have the capability of fit testing hearing protectors on each worker. This is similar to the concept of respiratory fit testing, and it provides an opportunity to train workers to develop the skill needed to achieve the attenuation they need,” Wells notes. For complex noise environments and to improve communi- cation in noise, electronic hearing protectors feature a variety of technologies to help improve speech understanding while reduc- ing background noise. These are often integrated into communi- cation headsets or even in-ear products. There are several ISEA member companies offering hearing- protection PPE.15 These companies are more than simply a source of PPE, however. These companies not only provide PPE but also contribute insights and innovations to the OH&S community. “We encourage every employer to utilize the knowledge avail- able from manufacturers, distributors and trained occupational health and safety professionals and even arrange for on-site noise- assessment consultations,” Wells says. “ISEA member companies care about protecting the hearing of workers exposed to hazard- ous noise and are committed to being part of the solution.” Dan Glucksman is the senior director of policy for the International Safety Equipment Association (ISEA) in Arlington, Virginia, which is the trade association in the U.S. for personal protective equipment and technologies. REFERENCES 1. www.osha.gov/sites/default/files/enforcement/directives/CPL_2022-02. pdf 2. www.dol.gov/newsroom/releases/osha/osha20220510 3. www.cdc.gov/niosh/topics/noise/surveillance/manufacturing.html 4. www.osha.gov/noise/standards 5. www.osha.gov/noise 6. www.osha.gov/leading-indicators 7. www.nytimes.com/interactive/2023/06/09/health/noise-exposure- health-impacts.html 8. journals.lww.com/thehearingjournal/fulltext/2020/04000/total_ hearing_health__a_holistic_approach_to.8.aspx 9. www.cdc.gov/niosh/topics/noise/default.html 10. www.cpwr.com/research/data-center/the-construction-chart-book/ chart-book-6th-edition-occupational-diseases-noise-induced-hearing-loss-in- construction-and-other-industries/ 11. www.research.va.gov/topics/hearing.cfm 12. www.cdc.gov/niosh/topics/noise/default.html 13. www.cdc.gov/niosh/twh/default.html 14. www.cdc.gov/niosh/mining/content/earplug.html 15. safetyequipment.org/worker_protections/hearing-protection/ 34 Occupational Health & Safety | OCTOBER 2023 www.ohsonline.com