In the days of COVID-19 and what we all like to call the new normal, we easily forget that noise has become an everyday contributing factor to several challenges affecting the quality of life. Such challenges include communication loss, where speech intelligibility is affected. It can also impact on our daily lives through fatigue, sleep disturbance, cardiovascular and physiological effects, reduced performance at work and many others. The health significance and implications of noise exposure are quite severe, especially pertaining to safety, quality of work and social life. Conversely, this article is related to specific tools of a hearing conservation program to improve the burden of NIHL in our society.
We understand that apart from noise induced hearing loss (NIHL), the effects of noise exposure are far-reaching, mostly affecting production at work, employees’ safety, and their positions in the job market and quality of social life. Therefore, hearing conservation programs are crucial in the prevention of NIHL.
Hearing conservation programs should aim at empowering and educating the employees, society about health and safety and the prevention of noise induced hearing loss. A golden rule is to have an effective hearing conservation program in the workplace and having the buy in of employees is as important. The employees should also be trained on the methodology of the program and what it aims to achieve. The knowledge and experience gained by effective health behaviour research programs can be applied to the hearing conservation programs to address lack of awareness and concern about the risk of NIHL. This is also true for the community at large, as the exposure of noise is not limited to occupational settings.
Reducing the prevalence of hearing loss necessitates a comprehensive and coherent approach. On the one hand, it requires integrating hearing surveillance into clinical practice and community outreach programs. On the other hand, it calls for occupational hearing loss prevention programs to raise awareness and encourage protective behaviour when employees are exposed to noise at work.
Clinicians can ask their patients about noise exposures and listening habits and provide recommendations to reduce risk. Expanding the test battery for at-risk clients (e.g., OAEs) can be helpful to identify signs of early hearing changes requiring intervention.
Hearing care professionals can help their noise-exposed patients select appropriate hearing protection and provide fit testing for hearing protectors. Furthermore, they can look for outreach opportunities to raise awareness of the importance of preserving good hearing; for example, offer hearing screenings at wellness clinics or visit schools to discuss hearing health and measure output of personal listening devices.
Health & Safety service providers can extend their efforts beyond the workplace and broaden the scope of their hearing conservation program with non-work-related risks; for example, wearing hearing protection during DIY or music festivals.
The challenge of reducing risk can be overcome using effective tools which address all the aspects of prevention of NIHL, and one reason is that noise exposure does not only occur in the workspace. There are a lot of NIHL cases attributed to social and recreational noise exposure; often, these types of exposures are not monitored or prevented. Due to these external factors and other dynamics of noise exposure. The industry faces challenges in preventing NIHL in South Africa and I believe world-wide.
Challenges we have been experiencing in the continent with current hearing conservation programs are probably not unique to Africa only.
- The lack of appropriate, efficiency and effectiveness of ‘Personal Hearing Protectors’(PHP). Issues such as correct fitting of hearing protectors, influence of wearing time, audibility of speech and warning signals and maintenance of hearing protectors.
- The shortcomings of the technique being used for the early detection & follow up of Noise-Induced Hearing Loss. Currently employees’ hearing ability is monitored using a subjective tool which detects the problem when it is already existing. Early detection of NIHL is critical in prevention thereof, so expanding the test battery for at-risk clients example the Oto acoustic emissions test (OAEs) can be helpful to identify signs of early hearing changes requiring intervention.
- The absence of a long-term multidisciplinary approach. Hearing conservation programs need to involve relevant and specialised solutions that address the many aspects of prevention. This helps to bridge the gap between clinical data and occupational health systems which can help identify, manage the risk of NIHL.
- The lack of know-how to put guidelines into everyday practice. Covid-19 has affected the world in an unprecedented manner, it has become apparent that the world is moving towards digital for most health care solutions. We know that due to Covid-19 movement restrictions imposed have affected access to hearing healthcare services and perhaps forced us to adapt to new ways recommended for management of employees at risk of NIHL.
- The absence of collaboration between the many disciplines involved (Health and Safety Managers, Medical dept., Suppliers of PHP’s, Management, and workforce at risk).
The good news is that there are solutions available to tackle and address these challenges we have been facing in the prevention of NIHL. As a preventive audiologist having worked in the industry of NIHL prevention for more than 10 years, I can say that these challenges are probably not unique to our South African market or to the continent Africa. Having said that, I have been involved in implementing a Hearing Conservation program called the HearingCoach program in and around Southern Africa. I would like to share some of the tools we have been using to improve our current hearing conservation program challenges both in the industry and with musicians in our country. This company is called HearingCoach, it has been in the market for many years and has recently launched a business website for professionals and practitioners in the hearing healthcare industry.
In the past the primary goal of HearingCoach was to be a service provider, selling ‘Hearing Conservation Programs’ comprising of service components such as noise measurement, performing risk assessments and evaluations. We also conducted hearing screening using OAE’s as an early indicator of hearing loss. The most important aspect of the program was the individualised coaching that we offered employee/ everyone to change behaviour. These tools were only limited to HearingCoach and could only be conducted by HearingCoach audiologists and trained audiometrists through its service providers like Variphone (in European market) and or Noise Clipper (South Africa). Given such a history, we have conducted OAE screening measurements, did individual and group coaching to over thirty thousand employees/ individuals annually. We quickly came to understand that NIHL is not a problem for Europe or Africa alone, it is a worldwide pandemic, affecting the young and old, on and off the job.
To address this fast-growing market of NIHL, both occupational and non-occupational, the company decided to make its Unique selling propositions (USPs) worldwide available to any professional who, in good faith, wants to use them. To achieve this goal, HearingCoach International launched new software enabling professionals around the globe to use our tools and integrate our reports (USPs) in their own service packages. These tools are now available for professionals to use in their own private practice, occupational setting and even for government institutions for the general population when conducting community outreach programs.
The software package consists of a database management system that easily creates patient data profiles and stores results of hearing tests, online and offline. This software is now accessible anytime and anywhere which allows professionals to create customized reports. The tools also make use of State-of-the-Art assessment & reporting methods to help facilitate the decision-making process and instructional counselling where necessary.
The first tool is called OAE Screening, this tool identifies hearing problems in a pre-clinical phase and helps to raise awareness. The second tool is the OAE Expert, this tool quantifies ‘outer hair cell’ function as a percentage per frequency and objectifies subjective complaints including hearing loss and tinnitus. Thirdly we have the Risk profile which assess the risk of exposure to high noise levels. The fourth tool is the Hearing age, we all can understand age and how it impacts our hearing, now this tool determines how old your ears are in relation to your current age. Final tool, is the Hearing protection compliance which evaluate the ‘protective function’ of custom earplugs in real-world circumstance.
This article highlighted the hurdles experienced to prevent NIHL and reveal new insights, solutions and tools which can contribute to an effective hearing conservation program. The use of innovative diagnostic and screening methods for prevention of hearing loss and methods that enhance the traditional hearing conservation programs are very crucial. Covid-19 has not only added to the burden of hearing loss caused by the virus but to the hearing health system accessibility for patients in need of these services. The use of innovative methods and tools such as HearingCoach digital clinical hearing conservation solutions will be the way forward to tackle these challenges faced by employees and the public in general regarding noise exposure and or noise ototoxicity. For more information on these tools, please visit the HeraingCoach website at www.hearingcoachsoftware.com
Article compiled, by Nolwazi Letsoalo
(HearingCoach audiologist, MS. Audiology, UP)
HearingCoach is a key player in health surveillance programs and leading in the field of OAE-applications for the early detection of hearing damage due to physical (noise), chemical or medical agents.
We have training facilities situated in Belgium (Peer), The Netherlands (Purmerend) and South Africa (Pretoria). We therefore collaborate with preventive audiologists, ENT doctors and other hearing health professionals.
HearingCoach organises training programs for occupational service providers (doctors, nurses, audiologists…) on preventative hearing screening and is involved in training health & safety managers in organizing hearing conservation programs
For research projects HearingCoach works closely together with the University of Ghent, Leuven and Pretoria.