Review by Dr David Greenberg
In this webinar, we hear from:
Alex Wilson – an introduction to the work of the UKHCA
Clare Forshaw – what the goal of hearing health surveillance is and what the pitfalls are and limitations to be aware of are
Tom Parker – sharing a method for hearing screening tests
Rob Shepheard – the role of Otoacoustic Emissions (OAEs) in hearing health surveillance
Noise and Hearing Damage
Opening with a description of why noise is a problem for our society and how the UKHCA was established to tackle this, we hear from Alex that noise induced hearing loss is one of the most preventable occupational diseases. With a description of the consequences of untreated hearing loss including that those with hearing loss are five times more likely to develop dementia.
Hearing Health Surveillance
Next, we hear from Clare that one of the primary goals of hearing health surveillance is to allow for early identification of ill health allowing for corrective actions to take place. This is in fact a current legal requirement under the control of noise regulations. Hearing health surveillance also offers a great opportunity to advise and talk to a person one- to-one about the risks of noise exposure. Unfortunately, the reality is that hearing health surveillance alone is not enough to prevent hearing loss and tinnitus as it can only identify hearing damage that already exists.
We also hear that in general employers are not as competent in meeting requirements related to hearing health surveillance as with other types of health risks. In addition, we hear that the hearing damage categorisation scale that the regulation depends on for flagging issues is flawed.
Otoacoustic Emissions Testing
Some of the limitations of traditional hearing health surveillance can be overcome by OAE testing; Rob begins with an introduction of the test and how we hear using inner and outer hair cells within the cochlear. Outer hair cells get damaged by noise before we see a reduction in hearing threshold as measured during traditional hearing health surveillance. Measuring OAEs tests for damage of outer hair cells thus providing an early indicator of hearing damage allowing us to take preventative action at an earlier stage.
We also hear that hearing health surveillance tests can be useful in measuring the effectiveness of noise control processes that have been put in place. Unfortunately, we find out that in many cases hearing health surveillance is seen as a box ticking exercise. This is despite the fact that when done properly it can form an important part of a hearing conservation program while recognising that traditional audiometry alone is not sensitive enough to highlight early exposure risks and hearing damage.