20 Feb 2017
It is often said that the U.S. and the U.K. are two nations divided by a common language. But where noise is concerned, we definitely have agreement on the causal relationship between exposure and hearing loss, which has been observed anecdotally for centuries.
What
is now referred to in an occupational context as noise induced hearing
loss (NIHL) was observed in the early 1700s among copper workers in
Italy. Later, towards the end of the 19th century, around the time of the first Industrial Revolution, Thomas Barr, a Scottish MD, coined the term Boilermaker’s ear
after the first patients he observed (shipbuilders located on the River
Clyde) who demonstrated the peculiar symptoms of impaired hearing. It’s
easy to imagine the din caused by the impact of metal-on-metal when
riveting.
So it’s frustrating, to say the least, that in the 21st
century, 22 million U.S. workers according to the Centres for Disease
Control (CDC) are still exposed to hazardous noise levels and a further 9
million are exposed to ototoxic chemicals. Hearing loss has become one
of the most common work-related illnesses in the U.S. and globally, with
16 percent of hearing loss attributed to occupational exposure. NIOSH
estimates that $242 million is spent annually on workers’ compensation
for hearing loss disability; in 2015, $1.5 million in penalties was
levied on employers. Doesn’t that seem small change for what is a wholly
preventable disease?
It’s
said that if your ears literally bled then wider society may have a
different attitude toward (occupational) deafness. Perhaps the public
would then view hearing loss as equal to the more obvious loss of a limb
or precious eyesight. The latter are examples of acute safety issues,
whereas hearing loss is chronic in nature—that is, it can take years
before the effects become obvious, by which time the damage is done and
can’t be reversed. Surprisingly, more people have hearing loss than
diabetes, cancer, or vision trouble in the U.S.
The Impact of NIHL
Quoting directly from a CDC blog by Elizabeth Masterson:
Hearing
loss can have a profound impact on the quality of life. The effects
begin small and progress as hearing loss worsens. For most individuals,
it starts with others sounding like they are mumbling because some
sounds cannot be heard well. The individual often has to ask others to
repeat themselves, and this becomes frustrating for both parties. Both
begin limiting the length and depth of conversations. As hearing loss
progresses, it becomes increasingly difficult to hear others in the
presence of background noise. Social gatherings and even dinner at a
restaurant become isolating activities because of the inability to
understand what people are saying and individuals can’t contribute to
the conversation.
There
are other effects, such as loss of enjoyment. Even a person with mild
hearing loss has trouble hearing softer sounds, has difficulty
differentiating between the softest sounds and the loudest sounds, and
has more listening fatigue. To compensate for this loss of hearing
sensitivity, people with hearing loss will need to “turn it up” whenever
possible.
Safety
can also be compromised. The sounds of a tea kettle, the warning beep
as a fork lift backs up, and the engine of an oncoming car may be
missed. There can be a general loss of situational awareness.
Not
surprisingly, all of these challenges can affect a person’s mental
health. Hearing loss is strongly associated with depression. Depressed
people are also less likely to participate in activities with others, so
the effects of hearing loss and depression compound and intensify
isolation. Hearing loss is also associated with cognitive decline, which
includes loss of memory and thinking skills. As people lose their
ability to hear, they don’t use the hearing-related parts of their
brains as much, and these parts start to break down. It is a case of
“use it or lose it.”
The Cost
NIHL
is just one consequence of occupational exposure that the industrial
hygienist has to consider among a plethora of potential hazards such as
toxic dusts and vapours, radiation, and vibration. Long-term exposure
can lead to debilitating illnesses such as hand-arm syndrome in the case
of vibration and occupational asthma and lung cancers from breathing
“contaminated” air in the workplace, which could ultimately lead to
premature death. Construction is very prone to multiple exposure types,
and the rate of deaths from respiratory diseases significantly exceeds
the rate of accidental deaths (by a factor of 100 in the U.K.).
Apart
from the emotive human costs, the National Academy of Social Insurance
(NASI) reported that, for 2009, employers spent $74 billion on workers’
compensation. This figure rose to $88 billion in 2013. In that same
year, the U.S. Bureau of Labour Statistics reported that more than 3
million workers had a non-fatal occupational injury or illness.
Worldwide, according to the International Labour Organization (ILO),
Annually, 160 million people are affected by occupational injuries and
illnesses, and 2 million people die, with costs that equate to nearly 4
percent of world GDP. That’s over $3 trillion U.S. dollars!
Further
delving back into history, during the building of the Panama Canal
nearly six thousand deaths were recorded from disease and accidents,
which today you would think unacceptable. However, it is said that 7,000
construction workers will have died in Qatar by the time the first ball
is kicked in the soccer World Cup in 2022. How many more will have had
preventable exposures? By contrast, the building of the London 2012
Olympic Park was a significant landmark in infrastructure development
since there were no deaths during construction and the provision of
occupational hygiene (and health) services demonstrated a 7:1 return on
investment. This project has become the benchmark for U.K. construction,
and a similar approach has been implemented on other major
infrastructure developments such as London’s Crossrail rail project and
regeneration of the iconic Battersea Power Station on the banks of the
River Thames.
Clearly,
ill health and injury are bad for business, which is at last waking up
to the fact that good health and safety is an investment, not a
“blocker” to productivity. But while health and safety are referred to
in the same breath, we have actually been shouting safety and whispering
health, and this must change.
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