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Hearing Cons 3
Hearing Cons Exam 3
| Question | Answer |
|---|---|
| How do you determine if your hearing conservation program is working? | Complete and accurate records |
| Why should HCP records be confidential? | Because they should be treated like and considered to be medical records, which are subject to HIPAA rules |
| Who should have access to the hearing records? | Records should be available upon request to current/former employees as well as OSHA agents |
| What are some types of records? | (TEN HANP) Training records Evidence of technician competence Noise exposure measurements HPD information Audiometric records Notification letters Program evaluation information |
| What are the OSHA requirements for how long records should be maintained? | - Maintain noise surveys for at least 2 years - Hearing tests maintained for duration of the employment and transferred to successor if employer goes out of business |
| What are the MSHA requirements for how long records should be maintained? | - Employee noise exposure notices and training records for duration of enrollment in HCP + 6 months - Hearing tests for duration of employment + 6 months (records transfer like OSHA) - Record of miner's training certificate |
| What are the NIOSH requirements for how long records should be maintained? | - Noise surveys for 30 years - Hearing tests for duration of employment + 30 years (records transfer like OSHA) - Calibration records for 5 years - Records of hearing protector utilization for 30 years |
| OSHA regulations mandate that the following information should be included on audiometric test records. | (NEEDDM) Name and job classification of employee Employee's most recent noise exposure ass. Examiner's name Date of audiogram Date of last acoustic or exhaustive calibration of audiometer Measurements of background SPLs in audiometric test rooms |
| According to OSHA, what forms need to be filled out if there is a problem? | OSHA-92 Noise Survey Report (where all the noise in the work area is reported) OSHA 300 Log of Work-Related Injuries and Illnesses (report instances of acoustic trauma or hearing loss) |
| According to MSHA, what forms need to be filled out if there is a problem? | MSHA Form 7000-14 (Change from baseline at 2k, 3k, and 4k Hz that is determined to be work-related or STS of 25dB HL or more that is work-related |
| Warning signs/postings for OSHA, MSHA, and NIOSH | OSHA - hearing cons amendment must be posted and made available to affected workers MSHA - No requirement to post; but when admin controls utilized the procedures are posted NIOSH - Signs must be posted @ entrance to areas w/ TWAs of 85 dBA or more |
| Who is exempt from OSHA record keeping regulations? | (BED 10MM) Bowling centers Entertainers, producers, orchestras Dance studios, schools, and halls <10 employees Motion picture Motorcycle dealers |
| What are some ways to evaluate program effectiveness? | PIOS - Practical survey - Individual effectiveness (shifts over time) - Overall program effectiveness (OSHA checklist or other compliance checklists) - Statistical procedures (NIOSH annual incidence of HL should be no higher than 3% but up to 6%) |
| What has the trend for NIHL in children? | - 1940s - 15% males and 5% females - 2001 - 12.5% of children ages 6-19 yrs old - 2011 - 16.8% of 12-19 yr olds (teenage girls had as much NIHL as teenage boys) |
| What was the warning from the WHO regarding children in North America and noise exposure? | "North American children may receive more noise at school than workers from an 8-hour work day at a factory." - 1997 |
| How does OSHA noise exposure standards relate to children? | There is no correlation. OSHA assumes long-term exposure limits (8-hours/day, 40 hours/week, 50 weeks/year, for 40 years) and we cannot assume that these levels and duration are the same for kids. |
| What is the WHO Guideline for Community Noise regarding children? | The 1999 Guideline recommended: <70 dBA 24-hour Leq = 75 dBA TWA (8-hr) No exposures over 120 dB peak SPL |
| What are the WHO guidelines exposure limits for: 1) Any individual? 2) Impulse limits for adults and children? 3) Schools? 4) Pre-school naps? | 1) 70dBA Leq(24) (Any person) 2) LMAX (impulse limit) 140dB adult and 120 dB for children 3) 35dBA Leq (schools) 4) 30dBA Leq (pre-school nap time) |
| What are the the US EPA recommended exposure limits for: 1) any individual? 2) day/night exposure limits? | 1) 70 dBA Leq(24) (day/night) 2) 55 dBA LDN to prevent any health effects |
| What does the American Conference of Governmental Industrial Hygienist (ACGIH) say regarding noise exposure to pregnant women? | Noise exposure in excess of C-weighted TWA of 115 dBC or peak exposure of 155 dBC to the abdomen of pregnant workers beyond the 5th month of pregnancy, may cause hearing loss in the fetus. |
| What are the noise recommendations for the NICU? | 1) 55-90 dBA ambient sound 2) 70-80 dBA prolonged 3) 105-120 dB peak SPL 4) 45 dBA recommendation by a committee group |
| How can toys be dangerous? | - Some toys are loud. - When held directly to ear, noise can range from 90/120 dBA - Examples include cap guns, musical instruments, toys with cranks |
| What does the American Society of Toy Manufacturers (ATSM) Standard (2011)? | For toys that are "designed to produce noise" - The A-weighted equivalent sound pressure level of continuous sound produced by all toys except close-to-the-ear toys & push/pull toys shall not exceed 85 dB. (does not apply to blow or muscle activated toys) |
| What does the American Society of Testing and Materials say about toys and distances in relation to the child? | Toys shall not exceed 85 dB at 50 cm from the surface of the toy. |
| What does the US Product Safety Commission (2001) say about toys that have caps? | There should be a warning label on caps in the 138-158 dB level. |
| What are some tips for parents regarding them buying toys? | 1) Screen toys first 2) Control the volume (i.e. masking tape over speaker) 3) Adjust toys/play area 4) Measure sound levels of toys 5) Report noisy toys |
| What are the noise standards for day cares? | - There are no standards/recommendations in place. |
| What are the HPD considerations for what type of protection children should use? | 1) Ease of use (age, dexterity, ability to follow directions) 2) Comfort 3) Fit (size and weight) 4) Attenuation 5) Style (earmuffs, plugs, canal caps) |
| What are some safety considerations for children and HPD? | 1) Swallowing or choking 2) Use corded plugs and pin to child's clothing 3) skin allergies 4) Adults should be a positive role model and lead by example |
| Why might children be more susceptible to noise effects? | - children don't know what "loud" is - children's perception of loudness and duration of loudness is not developed - parent may not recognize the loudness - child doesn't know that some sounds are dangerous |
| Who is responsible for hearing conservation in the schools? | Educational audiologist: 1) educating parents, teachers, and students about HL and its prevention 2) inservices 3) Direct instruction to students 4) Presentation to PTA 5) Monitoring noise levels during various |
| What would be good to know about planning a hearing conservation program at a school? | 1) Ongoing programming is crucial 2) Knowledge of school's curriculum 3) Teacher involvement 4) Targeting school environment |
| How can you integrate hearing conservation into school curricula? | Finding the appropriate school standard and applying it to what you want to teach since there is a lot of correlation with hearing conservation and school subjects. |
| What are some considerations for a school-based hearing conservation program? | 1) Documentation and support 2) Funding 3) Students with hearing impairment |
| What are the three ways "Dangerous Decibels" recommends to protect one's ears? | 1) Turn it down 2) Walk away 3) Protect your ears |
| In regards to the military, where can AD and veterans get HAs? | 1) AD through the military audiologists 2) Veterans through the VA |
| If a Soldier is injured during war, where do they go for treatment, initially? Then where? | First to Rammstein Air Base in Germany. Then to Walter Reed or San Antonio. If a service member's kid needs a HA, they will go to San Antonio. |
| For the VA, what are CBOCs? | Community Based Outpatient Clinic - Primary care doctor for a veteran where they can go to if they are too far from a VA Center. CBOC has to be contracted with the VA system. |
| What are the 8 categories of a veteran? | 1/2 - Active Duty 2/3 - Purple Heart/Silver Star recipients 4 - Those who can't afford service on their own 5/6 - Service-connected disability 7/8 - Individuals who pay for service |
| When does a service member need to go into for more comprehensive testing? What's done? | - If there is a change of 15dB or more in an audio. - SPRINT (Speech Recognition In Noise Test) |
| Describe the military SPRINT. | - 200 words from 4 lists (Form C of NU-6 lists) - Pre-recorded in a background of multi-talker babble (4 talker) - +9 dB speech-to-babble ratio at 50 dB - presented binaurally - compared to 50th percentile of random sample of H-3 profiles |
| Is Agriculture industry covered by OSHA? | No - although it is a noisy profession (tractors, grinders, choppers, pigs, shotguns, etc) it is not covered. |
| What are estimates about NIHL from the US Department of Agriculture about farmers? | - ~10% of farmers exposed to noise levels over 85dB - 1/4 of young farmers have NIHL - 50-70% of older farmers have NIHL |
| What is some information regarding the noise levels of tractors? | - Older tractors were ~6dB louder than newer tractors - Cabs reduced noise by 16dB or by 8dB with door open - Radios added 3-5dB to the noise in the cab |
| What are some controls to reduce noise exposure in agriculture? | (CHADE) - Consider noise levels when purchasing equipment - HPD - Alter work schedule - Double distance from sound source (reduces noise by 1/4) - Engineering controls |
| What are some things to keep in mind when working with farmers? | 1) Ask about the farming that they do 2) Environment (to get info about possible type of HPD and HAs) 3) Lifestyle 4) Busy season (i.e. harvest/planting time) |
| How can we go about promoting hearing conservation with farmers? | 1) Outreach during winter 2) Farm shows 3) Having SLM and dosimeter ready for checkout 4) Educate primary care physicians |
| What is the incidence rates for music induced hearing loss? | It varies depending on the type of instrument played and position within orchestra. 1) Classical musicians - 4-58% have milder losses 2) Rock and pop musicians - 13-30% have more severe losses Consumers are at risk too |
| What are some differences between music and noise? | 1) Intensity dynamic range for music 2) temporal characteristics (peak intensity measures and overall shape need to be taken into account) |
| Characteristics of NIHL (when compared against MIHL). | (NNRS - like nurses) 1) Noise is lower in frequency 2) Noise notch b/w 3-6kHz 3) Reverberant environments 4) Symmetrical hearing loss |
| Characteristics of MIHL (when compared against NIHL). | (MAN_P) 1) Mid and high frequency range 2) Asymmetries up to 25dB (an asymmetry >25dB may suggest retrocochlear activity) 3) Non-reverberant environments 4) Position of instrument plays a role |
| What may musicians encounter (problems/complaints) with a hearing loss? | -Probs pitch matching -May lead to very loud playing, esp. at higher freqs) -Loss of color & clarity -Diplacusis (abnormal perception of sound, in pitch or in time; one sound is heard as two - also, an inc. in freq perceived as an inc. in loudness |
| Why use musician hearing protection? | 1) Maintain overall spectral shape so attenuation will be more flat 2) May want to do an open- and closed-jaw impression (w/ high viscosity) for custom products |
| What are some things to keep in mind when working with musicians? | - Educate them on HPD will not effect music perception - Know musical lingo - Have access to DPOAE to monitor sub-clinical changes and evidence of needing to protect and monitor hearing status |
| How can we go about promoting hearing conservation with musicians? | - Adopt-A-Band Program - Having dosimeter available for checkout - Inservice at schools - Pass out ear plugs at sporting events |
| What are the labeling of noise regulations? | - Most voluntary - Mand. for portable air compressors, not mand. for other stationary products - Sears requirements on some appliances - Consumers Union has 5-level pictograph scale - Inst. of Noise Control Engin working to develop better label system |
| How would you advise parents on what is too loud? | If parents has to speak to kid >3' - intensity may be above 85dBA, which is unsafe |
| What principles of hearing conservation should be implemented? | 1) Remove noise 2) Turn down sound 3) Hearing protection (baseline & monitoring audiogram) 4) DPOAEs 5) Counsel about neg. effects of noise & issue HPD 6) Have & maintain records 7) Discuss about degree of risk based on intensity & exposure limit |
| What is "Healthy People 2020?" | - 10-year national objectives to improve health - Healthy People est. benchmarks & monitored programs over time: - encourage collab across sectors - Guide ind. to make informed health discussions - Measure impact of prev. actities |
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