What I Learned from the 2023 Technology for a Quieter America Workshop 

Date published:

By Jim Thompson  

Many people perceive occupational noise as something that only happens in heavy industry. They are wrong. At the recent Technology for Quieter America (TQA) Workshop, I learned a lot about occupational noise. Here a few thoughts I wanted to pass along.  

This past October a Technology for a Quieter America (TQA) Workshop was held with the support of the National Academy of Engineering in Washington, DC. This was the thirteenth in a series of workshops organized and conducted by the TQA team. The previous workshop reports are summarized at https://www.inceusa.org/publications/technology-for-a-quieter-america/. The full report for this latest workshop will be available later this year on the same site.

I participated in the organization of this workshop along with the TQA team: Adnan Akay, Patricia Davies, Eric Ducharme, Gregg Fleming, Robert Hellweg, and Eric Wood. This workshop was titled ” Occupational Noise Exposure – Risks and Controls.” A unique aspect of this workshop is that it brought together those working in many aspects of occupational noise. The participants included government regulators, the National Institute for Occupation Safety and Health (NIOSH), engineering noise control experts, medical researchers working on means to prevent or reverse noise induced hearing loss (NIHL), occupational health nurses, industrial hygienists, and others. The program is summarized below.

Tuesday, October 24, 2023

  • Opening Remarks, Alton Romig, NAE
  • Keynote: The state of occupational noise exposure in the US, Richard Neitzel, University of Michigan
  • OSHA presentation on the status of worker exposure, Melanie Hayes, Occupational Safety and Health Administration (OSHA)
  • Occupational noise exposure: Considerations and challenges, Christa Themann, NIOSH
  • Overview of hearing loss – causes and effects, Greg Flamme, SASRAC
  • Hearing loss: is prevention or reversal a realistic goal, Colleen G. Le Prell, University of Texas-Dallas
  • Updating the NIOSH noise exposure criteria document, David Byrne, NIOSH
  • Keynote: Surveillance of noise and occupational hearing loss in the United States     , Elizabeth Masterson, NIOSH
  • Financial and economic impacts of noise exposure on individuals, employers, and the nation, Jennifer Tufts, University of Connecticut
  • Hearing Loss and cognition, Frank Lin, Johns Hopkins University
  • Noise exposure and occupational injuries, Richard Neitzel, University of Michigan
  • Impact of NIHL in the military, Amy Blank, US Army

Wednesday, October 25, 2023

  • Keynote: Models for the Prevention of Occupational Noise-Induced Hearing Loss      Deanna K. Meinke, University of Northern Colorado
  • Considerations for implementing hearing protector fit testing, William Murphy, SASRAC
  • HPD usage and mechanisms to Increase Usage, Marjorie McCullagh, University of Michigan
  • Implementation of noise controls – Trends in managing industrial worker noise exposure, Jim Barnes, Acentech, Inc.
  • What can be done from a legal and/or regulatory sense? Robert Aldrich, Department of Labor
  • The Global Regulatory Landscape of Hearing Protector Fit Testing: Path towards employer mandates? Laurie Wells, 3M
  • Nicotinamide riboside for potential prevention of hearing loss, Charles Brenner, City of Hope

Participating in this workshop, I gained a much broader perspective on occupational noise and the problems faced in protecting American workers. Finally, I would like to share my conclusions and recommendations based on what I learned at this workshop.

Conclusions

  1. Approximately 22 million workers are overexposed to noise each year in the US.
  2. There is almost no industry in which workers are safe from overexposure to noise. The assumption that this is a unique problem for workers in manufacturing factories or heavy industry is wrong.
  3. Current OSHA and Mine Safety and Health Administration (MSHA) regulations are obsolete. They are at least two decades behind current knowledge and technology.
  4. Occupational noise has been shown to lead to:
    • Stress
    • Tinnitus
    • Increased injury risk
    • Cardiovascular disease (high blood pressure, heart attacks, strokes)
    • Cognitive impacts and decreased work performance.
    • Vestibular impacts
    • Dementia in old age
  5. There is clear evidence that hearing loss is a major contributor to dementia. The Lancet recently noted “A clear link between dementia and hearing loss is established for older adults.”
  6. US employers depend too much on hearing protection devices (HPDs) to protect workers. Numerous studies have shown these devices to have limited effectiveness in “real world” usage and they isolate workers from communication and alarms.
  7. There are multiple studies that show fit testing and training to substantially increase the “as worn” performance of HPDs. There are several fit testing systems available in the commercial marketplace.
  8. Current audiometric tests do not provide sufficient precision in determining those with hearing issues. There is a need to include hearing in noise components in audiometric protocols as well.
  9. Multiple drugs and supplements have shown promise in reducing the impact of noise overexposure and/or in reversing damage. Nicotinamide Riboside has shown promise.
  10. Public and worker understanding of noise exposure and impact is poor. This leads to unnecessary exposure and failure to use HPDs properly.
  11. OSHA and the MSHA inspect only a small percentage of workplaces for noise. Noise issues are not a top priority.
  12. Small firms, including farms, are not protected by OSHA and noise overexposure is prevalent in such cases.

Recommendations

  1. The number of US workers overexposed to noise is too high. Priority must be given to reducing this number, not only to protect hearing, but to prevent injuries, cardiovascular disease, and dementia.
  2. The National Occupational Research Agenda (NORA) or a new interagency taskforce should be formed to recommend changes to the OSHA and MSHA regulations to bring them in line with current knowledge and technology. Members of this taskforce should include EPA, OSHA, MSHA, and NIOSH. In addition, volunteers from this workshop could serve on this taskforce.
  3. A standard protocol for fit testing should be developed and recommended by NIOSH.
  4. Fit testing should be required as part of hearing conservation programs to ensure proper usage and an understanding of the protection provided. Each worker should know the noise levels in their work area and their Personal Attenuation Rating (PAR).
  5. NIOSH with the Council for Accreditation in Occupational Hearing Conservation (CAOHC) and others should develop a new audiometric test protocol to better identify hearing difficulties including hearing-in-noise. This should be incorporated in both the OSHA and MSHA regulations.
  6. Hearing testing should be a recommended part of cognitive decline testing.
  7. There should be funds earmarked for the evaluation and trial of drugs and supplements to prevent, reduce, and reverse hearing damage due to noise overexposure. Potential sources for such funding would include NIH, NIOSH, and FDA.
  8. The federal government (NIOSH and other agencies) should have an active messaging program aimed at specific occupations and industries to inform workers about noise overexposure and the effects, not limited to hearing loss.
  9. NIOSH and other agencies should develop outreach programs to school age children to help them to understand noise and the impact of overexposure to noise.

While I do not expect all these recommendations to be implemented, I hope they do help to promote conversation and thoughts about this important issue. It would be good if they helped to motivate improvements in worker protection.