Today, hearing loss is the United States’ leading occupational injury in both prevalence and potential cost. This problem has been recognized since the Industrial Revolution. There are millions of past and present employees with occupational hearing loss in American industry. Neglect of hearing loss, especially occupational hearing loss, has resulted in human and economic consequences that affect virtually every American household. This is especially regrettable since noise-induced hearing loss (NIHL) is almost always preventable at relatively little cost.

Prevention of NIHL (by noise level reduction, exposure reduction, and use of personal hearing protective devices) would probably do more to reduce the societal burden of hearing loss than medical and surgical treatment of all other ear diseases combined.

Although the importance of good hearing can hardly be overestimated, it has not been appreciated by the public, or even by the medical community. Some 40 million Americans have hearing loss.

Most hearing losses are associated with aging, excessive noise exposure, or both, without any other detectable ear disease. Age-related hearing loss is neither preventable nor treatable. However, noise-induced hearing loss (NIHL), whether caused by occupational or recreational exposure, is by definition preventable but is not medically treatable. About 18 percent of hearing loss cases received a diagnosis of NIHL alone or with some other diagnosis. Therefore, about 8 million Americans suffer from NIHL severe enough for them to report hearing difficulties.

Somewhat surprisingly, NIHL doesn’t seem to be going away. Perhaps this is because NIHL develops slowly and insidiously or because the problems of the hearing-impaired are not adequately appreciated by most people. An estimated 10 million Americans now work in noise environments that have been classified as potentially hazardous by the Occupational Safety and Health Administration (OSHA) of the United States Government.

Although the existence of NIHL was widely known in occupational medicine circles by about 1950, hearing conservation programs (HCPs) only began appearing in industry during the 1950s and 1960s. However, fewer than half of American workers with hazardous noise exposures were covered by HCPs as late as 1975 or 1980. Although occupational noise exposure has been extensively regulated at the national level since 1971, some industries are exempt, and the Occupational Safety and Health Administration (OSHA) has not aggressively enforced existing regulations (detailed specifications for HCPs were not promulgated by OSHA until 1983). HCPs can be expensive, and there has been little financial incentive for industry to prevent NIHL other than the desire to avoid compensation costs, which until recently have been modest.

DAMAGES DUE TO NIHL

Hearing loss is still seen as an embarrassing infirmity or a sign of aging and senility. Too often people do not seek medical attention on their own. Many deny and tolerate hearing loss for a considerable period of time before being coerced by a family member to seek medical care. Although people accept eyeglasses easily, it is unusual to tell someone he or she needs a hearing aid without causing distress.

Most people with age-induced or noise-induced hearing loss lose hearing in the high frequencies first, making it difficult for them to distinguish consonants, especially s, f, t and z. This makes a person strain to understand what is being said in everyday conversation. He or she knows that there is speech because he or she can hear the vowels, but cannot distinguish, for example, the difference between “yes” and “get”. This makes talking to a spouse, going to the movies, going to church, and other pleasures that most of us take for granted stressful chores. It is also an often unrecognized source of considerable marital discord. For example, a man who has worked hard for many years in an industrial setting, like a boilermaker, may have a substantial hearing loss, especially if he has not worn ear protectors. At the end of a workday, he may have a temporary hearing loss superimposed on his permanent hearing loss. When he comes home and sits down to read a newspaper, if his wife starts talking to him from another room (especially if there is competing noise such as running water or air conditioners), he will be able to hear her talking but not understand her words. Before long, it becomes so difficult to say, “What?” all the time that he stops listening. Soon she thinks he doesn’t pay any attention to her or love her any more, and neither of them realizes that he has a hearing loss underlying their friction. Considering all of these problems, it is especially tragic to allow millions of people to suffer the consequences of noise-induced hearing loss when it is avoidable.

LEGISLATION AND COMPENSATION

Even though recent legislative and legal developments have catapulted the problem of occupational hearing loss to national prominence, elimination of this occupational injury has been technologically possible for many years. The delay in addressing the issue effectively has been caused by legislative, economic, and political resistance as well as by a lack of scientific information adequate to formulate reasonable standards for hearing conservation and noise control programs.

The federal government showed its concern for this problem by establishing the Occupational Safety and Health Act Noise Regulation. This Act mandated some hearing conservation measures in every plant in the United States that produces over 85 dBA* of noise for 8 hours daily. (*dBA is a measure of sound pressure weighted to ignore intense noise at lower frequencies, which are less damaging to hearing, but to focus on higher-frequency, potentially damaging noise.)

The financial risks faced by companies with noise-exposed workers are rising. More workers are filing for and receiving awards as awareness of NIHL spreads within the general population. Workers in industries not covered by workers’ compensation systems, like many in Louisiana, are suing their employers in court and receiving some very large judgments.

A conservative estimate of the potential cost of compensation for hearing loss in workers exceeds 20 billion dollars. This makes it the number one environmental and medico-legal problem in the United States. At least one company has had a hearing conservation program (HCP) for 40 years, established voluntary hearing safety programs and has virtually no occupational hearing loss in their employees.

PREVENTIVE MEASURES

Despite advances in our understanding of hearing loss and in hearing aid technology, which makes it possible to improve the lives of almost every person with deafness, prevention is still the best cure. No widespread injury lends itself better to preventive medicine than noise-induced hearing loss.

Prevention of noise-induced hearing loss is relatively simple and inexpensive. The obvious and most desirable solution is to quiet machinery and the environment to intensities below damaging levels. Although this is often costly, it should be done. At the very least, however, properly worn personal hearing protection in association with audiometric monitoring is extremely effective in preventing hearing loss and is inexpensive.

Ear protectors should also be worn to protect against loud noises such as chainsaws, motorcycles, bandsaws, and firearms. With persistent diligence, it is possible to eradicate noise-induced hearing loss in American industrial operations. The cost will be minimal and the savings for those at risk are immeasurable.

HEARING LOSS EVALUATION

An evaluation for monetary compensation of NIHL encompasses the following: (1) careful histories of the hearing loss, prior noise exposures, and any otologic complaints, (2) past medical history with emphasis on trauma, diseases, drugs, and inherited disorders that could contribute to hearing loss, (3) physical examination with emphasis on the ears and nasopharynx, and (4) audiometric testing. This evaluation does not take much time and it is painless.

LeBlanc & Waddell has established a comprehensive hearing loss evaluation program. As designated occupational disease counsel for the AFL-CIO, we are dedicated to providing hearing evaluations for those workers who qualify for testing and have been exposed to high levels of occupational noise for many years.

If your group is interested in having your membership tested or if you are interested in personally being tested for possible noise induced hearing loss, please contact LeBlanc & Waddell. These services, as always, will be provided at “no out-of-pocket” cost to you and your members.

Please remember, if you have been diagnosed with noise induced hearing loss from your work environment, under Louisiana law you only have one year to file suit to protect your legal rights.

If you would like to speak with someone concerning Occupational Hearing Loss, you may discuss your particular situation with an experienced attorney at the law offices of LeBlanc & Waddell by telephone at 800-988-3514 or fax at 225-768-7999 or you may contact us online.