Miranda Guilbo April 24 th 2018 Background Hearing Loss Presbycusis Noise induced damaged to ear hair cells Other causes Trauma birth defects ototoxic chemicals diabetes kidney disease ID: 999270
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1. Noise Exposure, First Responders and Hearing LossMiranda GuilboApril 24th, 2018
2. BackgroundHearing LossPresbycusisNoise induced: damaged to ear hair cellsOther causesTrauma, birth defects, ototoxic chemicals, diabetes, kidney diseaseTinnitus may be preliminary or co-symptomhttps://thehearinginstitute.org/hidden-hearing-loss-effect/
3. Background (Cont.)BLS estimates 657,690 Police Officers, 327,300 Firefighters in 2016Due to variance and unpredictability in work, first responders may be at higher riskNIOSH HHEOccupational noise sources: firearms, sirens, machinery, explosions, fires, crowdsFirearms produce impulse sound 140-160 dBOSHA PEL: 90 dB 8hr TWA; 140 dB for impulse noise
4. Specific AimsIn different first responder occupations, determine level of association between hearing loss andnoise exposures at worknoise exposure outside of workfirearms useDetermine prevalence on hearing protection use and it’s effectiveness to protecting from hearing loss
5. Initial HypothesisDue to increased use of firearms in and outside of the workplace, law enforcement officers will show a higher prevalence of hearing loss, compared to other first responder occupations and all other occupations.
6. MethodsCDC NHIS 2007 and 2014 Survey data3 study populations: Law Enforcement Officer, Firefighters, Other Protective ServicesReference: All other occupationsMain Outcomes: Hearing Loss, TinnitusConfounders: Diabetes, Kidney Disease, Smoking, AgeOther Covariates: Veteran Status, Working Status
7. Results: DemographicsLaw Enforcement WorkersFirefightersOther Protective ServicesAll Other OccupationsSample %0.69% LEO0.15% FF0.90% OPS98.26%Mean Age44.8147.6644.0148.45RaceWhite (78.48%)White (90.81%)White (68.63%)White (80.67%)SexMale (76.26%)Male (97.01%)Male (68.17%)Female (54.87%)Veteran16.39%20.00%13.91%5.78%US Citizen99.87%100%96%92.55%Annual Income>$75,000 (15.53%)>$75,000 (17.78%)<$15,000 (18.00%)<$15,000 (12.47%)
8. Results: ContinuedLaw Enforcement WorkersFirefightersOther Protective ServicesAll Other OccupationsHearing Less than Good14.81%26.33%16.84%17.23%Tinnitus12.60%17.71%10.68%11.00%Exposed to Noise at Work63.09%43.58%71.67%76.47%Exposed to Noise Outside of Work42.75%61.62%32.46%26.64%Firearms Use87.38%70.38%50.33%32.07%
9. Results: ConfoundersSelf Reported Cause of Hearing LossHearing Loss CauseLaw EnforcementFirefightersOther Protective ServicesAll Other OccupationsBirth0.68%**--0.45%**1.05%Illness or Trauma4.03%3.76%**4.17%3.32%Impulse Noise5.41%11.18%*4.65%3.64%Constant Noise3.03%15.39%4.67%3.85%Noise of Unknown Source0.86%**0.72%**3.78%2.79%Ageing1.73%*0.90%**0.32%*3.87%Other/Unknown2.71%*1.52%*3.34%2.79%For “hearing worse in one ear”, firefighters and other occupations showed equal hearing loss in both ears.Law enforcement showed higher hearing loss in left versus right ear.
10. Results: Hearing Protection UseWhen asked about hearing protection use during firearms use, 52% of FF with hearing loss used HP less than half the time. LE (86% and 95%) and OPS (74% and 87%) had similar rates of with hearing protection use more than half the time in both hearing loss outcomes. When asked about hearing protection use at work90% of FF with hearing loss wore HP less than half the time. In LE and OPS, majority reported wearing HP less than half the time, regardless of hearing loss. 82% and 88% for LE; 88% and 93% for OPS. 89% of AOO with hearing loss wore HP more than half the time.
11. Results: Noise Exposures Outside of WorkExposure to Very Loud Noise Sources Outside of Work in Firefighters Hearing Less than GoodChi Squared P ValueNoise SourceTotalYesNo Lawn Mower43 (77.31%)18 (38.58%)25 (61.32%)0.2308Farm Machinery2 (0.02%) Power Tools38 (62.10%)16 (44.14%)22 (55.86%)0.0462Household Appliances23 (36.03%)14 (66.58%)9 (33.42%)<0.0001Vehicles33 (64.62%)6 (28.85%)12 (71.15%)0.4463Rock Concerts17 (29.44%)5 (30.13%)12 (69.87%)0.0811CD/MP3 Player7 (38.51%)1 (9.59%)6 (90.41%) Other Music3 (25.69%)-3 (100%) Sporting Event2 (2.22%) 2 (100%)-Firearms9 (44.94%)3 (25.88%)6 (74.12%)-Videogames1 (15.27%)-1 (100%)-Other7 (33.34%)2 (20.75%)5 (79.25%)-
12. Results: Multivariable AnalysisAssociation Between Occupation and Hearing Related Issues in Protective ServicesHearing Loss Unadjusted Odds RatioP-valueAdjusted Odds RatioP-valueFirefighters1.720 (1.069, 2.769)0.02542.055(1.255, 3.363)0.0042Law Enforcement 0.835 (0.602, 1.158)0.27901.090 (0.772, 1.540)0.6244Other Protective Services0.972 (0.761,1.240)0.81751.166(0.901, 1.540)0.2416Tinnitus Firefighters1.742(1.016, 2.986)0.04371.822(1.058, 3.138)0.0306Law Enforcement 1.166 (0.813, 1.674)0.40351.294(0.896, 1.869)0.1697Other Protective Services0.967(0.703, 1.332)0.83911.027(0.743, 1.419)0.8730
13. DiscussionAfter adjusting for possible confounders, firefighters were at increased odds for both hearing loss and tinnitus.No significant risk for law enforcement or other protective servicesIncreased odds firefighters possibly due to: Increased noise exposures outside of workPoor use of hearing protectionLack of understanding on hazard of noise exposure
14. LimitationsCross-Sectional DataHearing loss is self reportedNo audiometry measurementsAdjusted for ageExposure variables are self reportedNoise exposure source, cause of hearing lossMissing data and Small Cell SizeVeteran statusSexCitizenship Chemical Exposure
15. ImplicationsFirefighters should be in workplace hearing conservation programsEducation on noise hazards and hearing protection use in and outside of workEncourage use of hearing protection with communication capabilitiesEngineer control for sirenhttps://www.firecom.com/cutting-out-the-noise/
16. Works CitedThe American Speech-Language-Hearing Association (ASHA). Causes of Hearing Loss in Adults. Retrieved from https://www.asha.org/public/hearing/causes-of-hearing-loss-in-adults/Bureau of Labor Statistics. (2014) Police Officers Fact Sheet: Injuries, Illnesses, and Fatalities. Retrieved from https://www.bls.gov/iif/oshwc/cfoi/police-officers-2014.htm. EPA report No. 550/9-1981-101, Noise in America. Le T.N., Straatman L.V., Lea J., Westerberg B. Current insights in noise-induced hearing loss: A literature review of the underlying mechanism, pathophysiology, asymmetry, and management options. J. Otolaryngol. Head Neck. Surg. 2017;46:41. doi: 10.1186/s40463-017-0219-x.Lesage F, Jovenin, N, Deschamps, F, Vincent, S. Noise-induced hearing loss in French police officers. Occup Med (Lond). 2009 Oct;59(7):483-6. doi: 10.1093/occmed/kqp091.Lie, A., Skogstad, M., Johannessen, H. A., Tynes, T., Mehlum, I. S., Nordby, K., . . . Tambs, K. (2015). Occupational noise exposure and hearing: a systematic review. International Archives of Occupational and Environmental Health, 89(3), 351-372. doi:10.1007/s00420-015-1083-5Mantysalo, S and Vuori, J. (1984). Effects of impulse noise and continuous steady state noise on hearing. British Journal of Industrial Medicine. 41: 122-132Masterson, Elizabeth A., et al. “Prevalence of hearing loss in the United States by industry.” American Journal of Industrial Medicine, vol. 56, no. 6, May 2012, pp. 670–681., doi:10.1002/ajim.22082. Nageris BI, Raveh E, Zilberberg M, Attias J. Asymmetry in noise-induced hearing loss: relevance of acoustic reflex and left or right handedness. Otol Neurotol. 2007;28:434–437. doi: 10.1097/mao.0b013e3180430191.National Institute on Deafness and Other Communication Disorders. (June 29, 2017). Age Related Hearing Loss. https://www.nidcd.nih.gov/health/age-related-hearing-lossNational Institute on Deafness and Other Communication Disorders. (February 7, 2017). Noise-Induced Hearing Loss. https://www.nidcd.nih.gov/health/noise-induced-hearing-lossNational Institutes of Health. (2008) Hearing Loss Is Common in People with Diabetes. https://www.nih.gov/news-events/news-releases/hearing-loss-common-people-diabetesPark SK, Elmarsafawy S, Mukherjee B, Spiro A 3rd, Vokonas PS, Nie H., et al. 2010. Cumulative lead exposure and age-related hearing loss: The VA Normative Aging Study. Hear Res 269(1-2):48–55, PMID: 20638461, 10.1016/j.heares.2010.07.004. Sung, Joo Hyun, et al. “Relationship of Cigarette Smoking and Hearing Loss in Workers Exposed to Occupational Noise.” Annals of Occupational and Environmental Medicine. 2013 Jul 3;25(1):8. DOI: 10.1186/2052-4374-25-8.Tak, SangWoo and Calvert, Geoffrey M. Hearing Difficulty Attributable to Employment by Industry and Occupation: An Analysis of the National Health Interview Survey—United States, 1997 to 2003. Journal of Occupational and Environmental Medicine. 2008 Jan; 50(1):46-56. DOI: 10.1097/JOM.0b013e3181579316Tao L, et al. Effect of cigarette smoking on noise-induced hearing loss in workers exposed to occupational noise in China. Noise & health. 2013;15:67–72. doi: 10.4103/1463-1741.107159.Occupational Health and Safety Administration. Occupational Noise Exposure. Retrieved February 22, 2018, Retrieved from https://www.osha.gov/SLTC/noisehearingconservation/index.htmlTexas Department of Insurance: Division of Workers’ Compensation (TDI/DWC). Noise and Hearing Protection FactSheet. Retrieved from http://www.tdi.texas.gov/pubs/videoresource/fsnoise.pdf