Hearing conservation in the primary aluminium industry.

BACKGROUND: Noise-induced hearing loss has been an intractable problem for heavy industry. AIMS: To report our experience in reducing the incidence of age-corrected confirmed 10 dB hearing shifts (averaged over 2, 3 and 4 kHz) in employees in the primary aluminium industry in Australia over the period 2006-13. METHODS: We analysed annual audiometric data to determine the number of permanent hearing shifts that occurred in employees in two bauxite mines, three alumina refineries and two aluminium smelters. Annual hearing shift rates were calculated based on the number of employees tested per year. Hearing conservation initiatives undertaken during the study period are described. An assessment of similar exposure group noise exposures was also undertaken to determine the magnitude of noise exposure reduction during the study period. RESULTS: Across all operations, hearing shift rates declined from 5.5% per year in 2006 to 1.3% per year in 2013 (P < 0.001). The decline in shift rates was greater in mines and refineries, where baseline shift rates were higher, than in smelter workers. Modest reductions in noise exposure occurred during the study period. CONCLUSIONS: We observed a substantial decline in hearing shift rates during the study period. We describe the hearing conservation initiatives that were collectively associated with this decline. We suspect these initiatives could be deployed relatively easily and at modest cost in other industries with noise-exposed employees.

Methods for evaluating temporal trends in noise exposure.

OBJECTIVE: Hearing conservation programs have been mandatory in many US industries since 1983. Since then, three program elements (audiometric testing, hearing protection, and training) have been the focus of much research. By comparison, little has been done on noise exposure evaluation. DESIGN: Temporal trends in time weighted average (TWA) exposures and the fraction of measurements exceeding 85 dBA were evaluated by facility, by exposure group within facility, and by individual worker within facility. STUDY SAMPLE: A large dataset (> 10 000 measurements over 20 years) from eight facilities operated by a multinational aluminum manufacturing company was studied. RESULTS: Overall, exposures declined across locations over the study period. Several facilities demonstrated substantial reductions in exposure, and the results of mean noise levels and exceedance fractions generally showed good agreement. The results of analyses at the individual level diverged with analyses by facility and exposure group within facility, suggesting that individual-level analyses, while challenging, may provide important information not available from coarser levels of analysis. CONCLUSIONS: Validated metrics are needed to allow for assessment of temporal trends in noise exposure. Such metrics will improve our ability to characterize, in a standardized manner, efforts to reduce noise-induced hearing loss.

Organic solvent exposure and hearing loss in a cohort of aluminium workers.

OBJECTIVES: Organic solvent exposure has been shown to cause hearing loss in animals and humans. Less is known about the risk of hearing loss due to solvent exposures typically found in US industry. The authors performed a retrospective cohort study to examine the relationship between solvent exposure and hearing loss in US aluminium industry workers. METHODS: A cohort of 1319 workers aged 35 years or less at inception was followed for 5 years. Linkage of employment, industrial hygiene and audiometric surveillance records allowed for estimation of noise and solvent exposures and hearing loss rates over the study period. Study subjects were classified as "solvent exposed" or not, on the basis of industrial hygiene records linked with individual job histories. High frequency hearing loss was modelled as both a continuous and a dichotomous outcome. RESULTS: Typical solvent exposures involved mixtures of xylene, toluene and/or methyl ethyl ketone (MEK). Recorded solvent exposure levels varied widely both within and between jobs. In a multivariate logistic model, risk factors for high frequency hearing loss included age (OR = 1.06, p = 0.004), hunting or shooting (OR = 1.35, p = 0.049), noisy hobbies (OR = 1.74, p = 0.01), baseline hearing level (OR = 1.04, p<0.001) and solvent exposure (OR = 1.87, p = 0.004). A multivariate linear regression analysis similarly found significant associations between high frequency hearing loss and age (p<0.001), hunting or shooting (p<0.001), noisy hobbies (p = 0.03), solvent exposure (p<0.001) and baseline hearing (p = 0.03). CONCLUSION: These results suggest that occupational exposure to organic solvent mixtures is a risk factor for high frequency hearing loss, although the data do not allow conclusions about dose-response relationships. Industries with solvent-exposed workers should include such workers in hearing conservation programs.

Do ambient noise exposure levels predict hearing loss in a modern industrial cohort?

BACKGROUND: Much of what is known about the exposure-response relationship between occupational noise exposures and hearing loss comes from cross-sectional studies conducted before the widespread implementation of workplace hearing conservation programmes. Little is known about the current relationship of ambient noise exposure measurements to hearing loss risk. AIM: To examine the relationship between rates of high frequency hearing loss and measured levels of noise exposure in a modern industrial workforce. METHODS: Ten-year hearing loss rates were determined for 6217 employees of an aluminium manufacturing company. Industrial hygiene and human resources records allowed for reconstruction of individual noise exposures. Hearing loss rates were compared to ANSI 3.44 predictions based on age and noise exposure. Associations between hearing loss, noise exposure, and covariate risk factors were assessed using multivariate regression. RESULTS: Workers in higher ambient noise jobs tended to experience less high frequency hearing loss than co-workers exposed at lower noise levels. This trend was also seen in stratified analyses of white males and non-hunters. At higher noise exposure levels, the magnitude of hearing loss was less than predicted by ANSI 3.44 formulae. There was no indication that a healthy worker effect could explain these findings. The majority of 10 dB standard threshold shifts (STS) occurred in workers whose calculated ambient noise exposures were less than or equal to 85 dBA. CONCLUSIONS: In this modern industrial cohort, hearing conservation efforts appear to be reducing hearing loss rates, especially at higher ambient noise levels. This could be related to differential use of hearing protection. The greatest burden of preventable occupational hearing loss was found in workers whose noise exposure averaged 85 dBA or less. To further reduce rates of occupational hearing loss, hearing conservation programmes may require innovative approaches targeting workers with noise exposures close to 85 dBA.

Development of a new standard laboratory protocol for estimating the field attenuation of hearing protection devices. Part III. The validity of using subject-fit data.

The mandate of ASA Working Group S12/WG11 has been to develop "laboratory and/or field procedure(s) that yield useful estimates of field performance" of hearing protection devices (HPDs). A real-ear attenuation at threshold procedure was selected, devised, tested via an interlaboratory study, and incorporated into a draft standard that was approved in 1997 [J. D. Royster et at., "Development of a new standard laboratory protocol for estimating the field attenuation of hearing protection devices. Part I. Research of Working Group 11, Accredited Standards Committee S12, Noise," J. Acoust. Soc. Am. 99, 1506-1526 (1996); ANSI S12.6-1997, "American National Standard Methods for Measuring Real-Ear Attenuation of Hearing Protectors" (American National Standards Institute, New York, 1997)]. The real-world estimation procedure utilizes a subject-fit methodology with listeners who are audiometrically proficient, but inexperienced in the use of HPDs. A key factor in the decision to utilize the subject-fit method was an evaluation of the representativeness of the laboratory data vis-à-vis attenuation values achieved by workers in practice. Twenty-two field studies were reviewed to develop a data base for comparison purposes. Results indicated that laboratory subject-fit attenuation values were typically equivalent to or greater than the field attenuation values, and yielded a better estimate of those values than did experimenter-fit or experimenter-supervised fit types of results. Recent data which are discussed in the paper, but which were not available at the time of the original analyses, confirm the findings.