Management of occupational noise induced hearing loss in the mining sector in South Africa: Where are the audiologists?

OBJECTIVE: This study was conducted to explore the scope of practice for occupational audiologists in the mining industry and the audiologists' involvement in hearing conservation programmes in South African mines. Additionally, this study investigated the mining industry's role in the audiologists' involvement, and assessed the audiologists' levels of preparedness for working in occupational audiology. METHODS: In-depth, qualitative telephone and face-to face interviews were conducted with seven occupational audiologists involved in the management of occupational, noise-induced hearing loss (ONIHL) in the South African mining sector. Snowball sampling was utilized to recruit possible participants for this study. Data were analysed using inductive thematic analysis. RESULTS: The following themes were identified: scope-context misalignment, juniorization of the experts, audiologists are important... but for what?, and limited training in occupational audiology. CONCLUSIONS: Our evidence highlights important gaps in HCPs in South Africa. The fact that the audiologists responsible for the management of ONIHL are only minimally and peripherally involved may play a significant role in the lack of progress reported in the management of ONIHL in the South African mining sector.

[Turnover of full-time occupational physicians in Japan in the period 2002-2008: a component model survey].

OBJECTIVE: Recently, the number of occupational physicians has greatly increased compared to other types of physician in Japan, and the number of unfilled job vacancies remains high, suggesting a higher turnover of occupational physicians. Job turnover and seniority are important indices for measuring the balance of vacancies and applicants, as well as for improving occupational health services; however, job turnover and career moves of occupational physicians are currently not known. METHOD: Based on a component model study of physicians, dentists and pharmacists, we made a component model of 4 levels (national, prefectural, urban, and municipal levels) and estimated the turnover and regional migration of occupational physicians. As a reference for the component models, we used the 2008/2006 cross-tabulation data of each type of physician published by the Ministry of Health, Labour and Welfare. RESULTS: The municipality level component model fitted the data best. The increase in occupational physicians for the 2 yr was 283-348, and the decrease was 202-222, indicating that 55-65% of occupational physicians quit their post within 2 yr. CONCLUSIONS: The propensity for short tenure is observed not only in occupational medicine, but also in emergency and rehabilitation medicine. It is suspected that 80% of new occupational physicians, except those graduating from the University of Occupational and Environmental Health, quit their positions within two years. This is a remarkably short tenure period compared to the 5.6 yr average seniority of physicians reported in the Basic Survey of Wage Structure. The reasons for the high job turnover of occupational physicians are thought to be unrelated to income or license renewal. We need to survey the actual reasons for the short tenure of occupational physicians to provide insights into lifetime education and career organization of occupational physicians.