Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Features
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Features  |   March 01, 2018
Ear Care for All, On and Off the Job
Author Notes
  • Kathy E. Gates, AuD, CCC-A, is prevention lead at the U.S. Department of Defense Hearing Center of Excellence. She is associate coordinator of ASHA Special Interest Group (SIG) 8, Audiology and Public Health. kgates@blueearthmarketing.com
    Kathy E. Gates, AuD, CCC-A, is prevention lead at the U.S. Department of Defense Hearing Center of Excellence. She is associate coordinator of ASHA Special Interest Group (SIG) 8, Audiology and Public Health. kgates@blueearthmarketing.com×
  • Vickie L. Tuten, AuD, CCC-A, is director of the Prevention and Surveillance Branch at the U.S. Department of Defense Hearing Center of Excellence. She is coordinator of SIG 8. vickie.l.tuten.civ@mail.mil
    Vickie L. Tuten, AuD, CCC-A, is director of the Prevention and Surveillance Branch at the U.S. Department of Defense Hearing Center of Excellence. She is coordinator of SIG 8. vickie.l.tuten.civ@mail.mil×
Article Information
Hearing Disorders / Regulatory, Legislative & Advocacy / Features
Features   |   March 01, 2018
Ear Care for All, On and Off the Job
The ASHA Leader, March 2018, Vol. 23, 44-51. doi:10.1044/leader.FTR1.23032018.44
The ASHA Leader, March 2018, Vol. 23, 44-51. doi:10.1044/leader.FTR1.23032018.44
Pregame music blasts, and fans scream in the packed arena as they await the start of the basketball game. Among the fans are longtime friends Sue and Jane, who enjoy the excitement—but not the din.
Sue pulls a pair of earplugs from her purse. She tells Jane that her employer gave them to her for free when they recently tested her hearing.
That surprises Jane because Sue works as a receptionist in relative quiet in the front office at a company that produces wooden trusses. Herself an accountant at a company that manufactures automotive tools, Jane notes that her company only tests and gives hearing protection to employees who work in the machine shop.
Handing Jane an extra set of earplugs, Sue, 40, explains, “Even though my office is pretty quiet, my company offers hearing tests to all employees.”
Sue relates how the previous month’s testing revealed she had no hearing loss. But an audiologist gave her earplugs, showed her how to use them, and advised her to use them when around loud noise that could damage her hearing.
Sue’s employer recently launched its occupational audiologist-staffed hearing program as part of its “Total Worker Health” initiative. The company had always emphasized hearing testing and protection for its workers who routinely use large saws when cutting lumber for trusses and are exposed to noise levels of 85 dBA or greater during their eight-hour work day. But with the new program, it expanded the services to all workers, with an emphasis on hearing protection in all settings—not just at work.
While it’s typical for employers to protect employees who are regularly exposed to occupational noise—in accordance with National Institute for Occupational Safety Health (NIOSH) regulations—this narrow focus excludes the hearing health of other employees. Realizing this, some employers are broadening hearing health services to workers whose noise exposure may only be occasional, on or off the job.
This approach aligns with NIOSH’s 2011 launch of the Total Worker Health Program, which encourages employer programs that advance the well-being of workers generally. It also squares with objectives of the World Health Organization (WHO) and Healthy People 2020—the U.S. Department of Health and Human Services’ 10-year agenda to improve the nation’s overall health.

Potentially harmful exposure to noise while not at work—during commuting, target shooting or operating a riding mower, for example—is not regulated.

The push for hearing health
Specifically, Healthy People 2020 objectives recommend hearing testing across the lifespan, and an increase in people’s use of hearing-protection devices. The National Academies of Sciences, Engineering, and Medicine has also weighed in, noting in its 2016 report, “Hearing Health Care for Adults: Priorities for Improving Access and Affordability.” that hearing loss is a public health and societal concern.
The report calls on individuals, employers, the private sector and the community at large to support and manage hearing health and effective communication. It also recommends increasing awareness about the risks of hearing loss due to hazardous noise. It further recommends promoting strategies to reduce the risk for non-occupationally exposed populations.
Last May, WHO delegates approved a resolution to intensify international action to prevent deafness and hearing loss, noting that much hearing loss can be avoided and managed through cost-effective interventions. The new resolution also emphasizes the importance of ensuring universal access to prevention and care.

We might think hearing loss prevention strategies are intuitive, but the incidence of noise-induced hearing loss suggests otherwise.

Prevention beyond the workplace
Why involve employers in efforts to prevent hearing loss, within and outside work hours? Because hearing health is key to total worker wellness. Because the invisible damage noise causes to hearing is often not recognized until it becomes significant. And because potentially harmful exposure to noise while not at work—during commuting, target shooting or operating a riding mower, for example—is not regulated.
In 1974, the U.S. Environmental Protection Agency (EPA) issued a recommendation (but, notably, not a standard, specification or regulation) that noise exposure for the general public not exceed 70 dBA over a 24-hour period and 75 dBA over eight hours. The EPA also suggested a limit of 55 dBA for outdoor activities and 45 dBA for indoor activities to reduce speech interference and annoyance. The recommended limits sought to protect 96 percent of the general population from hearing loss, and to protect “public health and welfare.”
Staying within these limits is achievable by practicing appropriate hearing loss prevention. Simple yet effective strategies include turning down the volume, distancing oneself from sources of noise, and using hearing protection, such as earplugs. We might think these strategies are intuitive, but the incidence of noise-induced hearing loss suggests otherwise. Consider these statistics:
  • 1.1 billion people ages 12–35 are at risk for hearing loss due to noise exposure in recreational settings (WHO).

  • About 26 million Americans ages 20–69 have high-frequency hearing loss from exposure to loud noises at work or through leisure activities (National Institute on Deafness and Other Communication Disorders).

  • People tend to wait an average of seven years before they seek hearing health services. This delay results in higher incidence and severity of hearing loss (Hearing Loss Association of America).

When hearing loss is identified and treated early in all workers, it can support optimal job performance, productivity and overall health.

Companies that care
Through total worker hearing health programs, employers can do much to educate employees on the importance of preventing hearing loss. They can also promote early identification of hearing loss, which provides a chance to prevent additional loss through hearing protection and healthy hearing behavior. When hearing loss is identified and treated early in all workers, it can support optimal job performance, productivity and overall health.
Healthy hearing, as a subset of an employee’s overall health, should translate to improved employee engagement, capability and well-being on the job. It seems reasonable to suggest that employees will feel better about an employer that shows concern for their health and well-being, on and off the job.
A number of employers have embraced total worker hearing health, with some earning Safe-in-Sound Excellence in Hearing Loss Prevention Awards, co-sponsored by NIOSH and the National Hearing Conservation Association. Among the award winners are Northrop Grumman Electronic Systems (Linthicum, Maryland), a 3M manufacturing plant (Hutchinson, Minnesota) and the Domtar Paper Company (Kingsport, Tennessee).
Domtar, for example, is just 300 miles from Nashville, so many of its employees are musicians who play gigs outside of work. Large numbers of them attend concerts regularly. So to help protect them, Domtar provides hearing conservation training on safe exposure to loud music. Its employee-safety newsletter includes family-friendly articles about hearing protection. And Domtar also distributes free hearing protection to the public during local music events.
Meanwhile, at the 3M plant in Hutchinson, a hearing-conservation team promotes “24-hour protection” of hearing by distributing earplugs and educational materials. Many of its employees are hunters regularly exposed to recreational firearm noise, so the company includes information on auditory risks of firearm noise and promotes use of hearing protectors for shooting sports in their annual Occupational Safety and Health Administration hearing conservation training.
When hunting seasons open each fall and spring, the company runs ear-protection awareness campaigns. The plant also stocks small-orifice “combat arms” earplugs in the employee store for a small cost. It emphasizes proper insertion and adequate fitting. Read more about both programs to protect employees’ hearing.
Although we’ve focused here on hearing health at work, we also should emphasize the crucial role of audiologists in educating the community on hearing health. Audiologists can also educate other health care professionals—pediatricians, family practitioners and others—about noise exposure risk and the value of hearing screening. As front-line subject matter experts, audiologists can do much to help prevent hearing damage.
We live in a noisy world, and we all must act to protect our hearing when we can. As Winston Churchill once observed, “There is nothing wrong with change, if it is in the right direction.” Audiologists can be that change, advocating in the right direction to provide hearing health for all.
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March 2018
Volume 23, Issue 3