Working in Noise with a Hearing Loss: Perceptions from Workers, Supervisors, and Hearing Conservation Program Managers

Objective: Workers with hearing loss face special problems, especially when working in noise. How­ever, conventional hearing conservation practices do not distinguish between workers with normal hearing versus impaired hearing. This study col­lected information from workers with self-reported noise exposure and hearing loss, supervisors of such workers, and hearing conservation program managers through focus groups and in-depth inter­views to evaluate their perspectives on the impact of hearing loss on safety and job performance, the use of hearing protection, and information needed to appropriately manage hearing-impaired workers who work in noisy environments. Results: Concerns about working in noise with a hearing loss could be grouped into the following 10 categories: impact on job performance, impact on job safety, impaired ability to hear warning signals, impaired ability to monitor equipment, interfer­ence with communication, stress and/or fatigue, impaired communication caused by hearing protec­tor use, reduced ability to monitor the environment as the result of hearing protector use, concerns about future quality of life, and concerns about future employability. Mostly, there was an agree­ment between the perceptions of workers, supervi­sors, and hearing conservation program managers regarding difficulties associated with hearing loss and consequent needs. These findings suggest that noise-exposed workers with hearing loss face many of the same problems reported in the literature by noise-exposed workers with normal hearing, with additional concerns primarily about job safety as the result of a reduced ability to hear environmental sounds, warning signals, and so forth. Conclusions: The study outlines potential chal­lenges regarding job safety and hearing conserva­tion practices for noise-exposed, hearing-impaired workers. Awareness of these issues is a necessary first step toward providing appropriate protective measures for noise-exposed, hearing-impaired workers. Of the 19 million adults in the United States with some degree of hearing trouble, nearly half are currently employed in the workforce (NCHS, 1994). More than 30 million US workers are exposed to hazardous noise levels, and noise-induced hearing loss is the most common occupational disease in the United States (NIOSH, 1996). Many workers incur their hearing losses during the first 5 to 10 yrs of employment (Rosler, 1994; Ward et al., 2000) and subsequently work the rest of their careers in an environment where noise and hearing loss interact to impair their ability to hear communication and other important signals. Workers with hearing loss who are exposed to hazardous noise levels present a dilemma to hearing loss preventionists. On the one hand, it is of great importance to ensure that their residual hearing is protected from the damaging effects of the noise to which they are exposed. On the other hand, how­ever, traditional hearing protectors serve to further “deafen” such workers, making communication more difficult and impairing the detection of environmen­tal sounds and warning signals. These workers have special needs that must be addressed. However, conventional hearing conservation practices do not distinguish between workers with normal versus impaired hearing; and, to date, no governmental or professional organization has developed specific guidelines or policies concerning the accommodation of noise-exposed, hearing-impaired workers. Some research regarding noise-exposed, hearing-impaired workers has been completed. These studies have primarily focused on three areas: (a) speech intelligibility in noise versus quiet, with and without various types of hearing protection devices (Abel et al., 1982; Abel et al., 1993; Abel & Spencer, 1997; Rink, 1979; Suter, 1989); (b) signal detection and localization under similar conditions (Abel et al., 1993; Abel et al., 1985; Abel & Hay, 1996); and (c) the use of hearing aids as hearing protectors (Berger, 1986; Dolan & Maurer, 1996; Hétu et al., 1992; Hétu et al., 1993). Research in these three areas has provided an initial framework for development of a management para­digm for these workers. However, each of these studies addressed a very specific research question, examining