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Death, Taxes and NIHL
What’s the idiom about the only two certainties in life being death and taxes? Well, let’s add a third, that you risk noise induced hearing loss (NIHL) if you are exposed to too much noise!
Repeatedly exposing your unprotected hearing to high noise over a long enough period of time poses a risk to your hearing acuity, which can be detected as a classic notch at 4Khz in a health surveillance audiogram. The damage has already been done by this time though and the notch will widen and deepen meaning even poorer hearing over time if unmitigated exposure continues. Indeed, the higher the level, the shorter the time before that potential damage occurs with the risk doubling for every 3dB increase. Typically, legislative limits say that 85dBA over eight hours is considered ‘safe’ which equates to 88dBA over four hours, 91 over two and so on, which will result in the same noise dose. There is also an instantaneous risk of damage from high impulsive (peak) sources.
But of course, all high noise sources are potentially damaging which means that listening to loud music directly or through headphones, or taking part in sporting activity such as clay pigeon shooting or motorsports can add to one’s accumulated noise dose. And worse still, hearing loss has been associated with the onset of dementia as well as other health issues such as high blood pressure and heart disease which can be life shortening. Tinnitus is another significant risk which is a distressing condition that may include the perception of ringing, whistling, buzzing, hissing, or humming, often leading to difficulty concentrating, sleep disturbances and stress.
Paradoxically, NIHL is the world’s most common occupational disease according to ILO/WHO reports[1], despite the cause and effects being well documented over many decades and yet is wholly avoidable. Once your hearing has gone, it has gone!
It is the 50th anniversary of the introduction in the UK of the Health & Safety at Work Act this year and 20 years since the EU introduced specific noise related legislation known in the UK as the Control of Noise at Work Regulations (2005).
More recently, the personal protective equipment (PPE) regulation (EU) 2016/425, which came into effect in 2018, recognised harmful noise as an irreversible health risk. As such, hearing protection, often a first line of defence, moved from category II (intermediate PPE) to category III (complex PPE).
But based on Labour Force Survey data, it is estimated that around 11,000 workers in Britain had work-related hearing problems in the period from 2020/21 to 2022/23. The Industrial Injuries Disablement Benefit scheme, meanwhile, recorded 85 new cases of deafness in 2022. This is based on a measured loss of more than 50 dB of hearing in both ears which is pretty severe.
In May 2024, the UK Health & Safety Executive (HSE) commenced a campaign of up to 5000 targeted inspections, with a focus on hearing protection, in known noisy sectors for the first time since the Control of Noise at Work Regulations legislation was enacted.
The HSE have coined the acronym CUFF relating to hearing protector condition, use, fit and fit for purpose. The fit for purpose ‘requirement’ relates to adequate levels of hearing protection which can be calculated using the SNR, HML or octave band data stated on the PPE packaging together with the relevant measured noise level data – the HSE have a useful resource to help with the calculations.
A month earlier in April 2024, the British Safety Industry Federation (BSIF) released a new hearing protection campaign Just because it fits. The BSIF campaign[2] focuses on hearing protection and making sure that the selected PPE fits and is effective when incorporating other elements of PPE such as safety helmets, applicable to many construction and infrastructure sectors. The pressure group UKHCA, made up of industry professionals, has also promoted fit testing and routine health surveillance.
However, there have been repeated calls from leading experts[3] that NIHL prevention is broken. Indeed, HSE’s own research[4] published in 2009, showed that the use of hearing protection was largely ineffective. In summary, three of the twelve companies that allowed on site observation of hearing protector use during normal working, and one out of four groups of outdoor workers seen had problems with ensuring correct use such that the hearing protection use was ineffective (nil protection) for all or the majority of workers. In addition, in premises where the majority of workers were seen making effective use of hearing protection one in seven workers were still seen to be not using hearing protection when and where its use was required. This proportion suggests that possibly only 60% of workers supposedly using hearing protection are in fact protected.
Having adequate quantitative data on which to make risk assessment is often lacking, certainly the case in high noise sectors like the military. And while an objective measurement of noise exposure is not a mandatory requirement it often adds weight to a risk assessment, although when prescribing ‘fit for purpose’ hearing protection it is a necessity.
Instrumentation for noise dose measurement dates to the early 1970s. These analogue electronics-based instruments were cigarette packet sized devices, with a microphone on a cable, displaying a single number dose often in percentage terms i.e. 100% equating to (at the time) 90 dBA for 8 hours.
Fast forward several decades and modern digital noise dosimeters have as much processing power as their full function sound level meter cousins, now offering, data logging, octave band analysis and even audio recording. Download to PC software for analysis and reporting is a given but connectivity has extended to mobile apps, which offer the user the ability to monitor their workforce remotely without having to disturb them.
But noise measurement (and acoustics in general) has always been seen as something of a black art and sometimes less is more, particularly for the H&S generalist who may not have the scientific skill set of their fellow Industrial Hygiene specialists, which is why we are at the threshold of a new era in low cost, noise dosimetry ‘for the masses’. Being able to measure more of the people more of the time is a significant step closer to ubiquitous wearable technology which offers a paradigm shift in hearing safety and productivity.
Keep an ear open for more information on this game changing technology development, pun intended!
Repeatedly exposing your unprotected hearing to high noise over a long enough period of time poses a risk to your hearing acuity, which can be detected as a classic notch at 4Khz in a health surveillance audiogram. The damage has already been done by this time though and the notch will widen and deepen meaning even poorer hearing over time if unmitigated exposure continues. Indeed, the higher the level, the shorter the time before that potential damage occurs with the risk doubling for every 3dB increase. Typically, legislative limits say that 85dBA over eight hours is considered ‘safe’ which equates to 88dBA over four hours, 91 over two and so on, which will result in the same noise dose. There is also an instantaneous risk of damage from high impulsive (peak) sources.
But of course, all high noise sources are potentially damaging which means that listening to loud music directly or through headphones, or taking part in sporting activity such as clay pigeon shooting or motorsports can add to one’s accumulated noise dose. And worse still, hearing loss has been associated with the onset of dementia as well as other health issues such as high blood pressure and heart disease which can be life shortening. Tinnitus is another significant risk which is a distressing condition that may include the perception of ringing, whistling, buzzing, hissing, or humming, often leading to difficulty concentrating, sleep disturbances and stress.
Paradoxically, NIHL is the world’s most common occupational disease according to ILO/WHO reports[1], despite the cause and effects being well documented over many decades and yet is wholly avoidable. Once your hearing has gone, it has gone!
Legislation and enforcement
It is the 50th anniversary of the introduction in the UK of the Health & Safety at Work Act this year and 20 years since the EU introduced specific noise related legislation known in the UK as the Control of Noise at Work Regulations (2005).More recently, the personal protective equipment (PPE) regulation (EU) 2016/425, which came into effect in 2018, recognised harmful noise as an irreversible health risk. As such, hearing protection, often a first line of defence, moved from category II (intermediate PPE) to category III (complex PPE).
But based on Labour Force Survey data, it is estimated that around 11,000 workers in Britain had work-related hearing problems in the period from 2020/21 to 2022/23. The Industrial Injuries Disablement Benefit scheme, meanwhile, recorded 85 new cases of deafness in 2022. This is based on a measured loss of more than 50 dB of hearing in both ears which is pretty severe.
In May 2024, the UK Health & Safety Executive (HSE) commenced a campaign of up to 5000 targeted inspections, with a focus on hearing protection, in known noisy sectors for the first time since the Control of Noise at Work Regulations legislation was enacted.
The HSE have coined the acronym CUFF relating to hearing protector condition, use, fit and fit for purpose. The fit for purpose ‘requirement’ relates to adequate levels of hearing protection which can be calculated using the SNR, HML or octave band data stated on the PPE packaging together with the relevant measured noise level data – the HSE have a useful resource to help with the calculations.
A month earlier in April 2024, the British Safety Industry Federation (BSIF) released a new hearing protection campaign Just because it fits. The BSIF campaign[2] focuses on hearing protection and making sure that the selected PPE fits and is effective when incorporating other elements of PPE such as safety helmets, applicable to many construction and infrastructure sectors. The pressure group UKHCA, made up of industry professionals, has also promoted fit testing and routine health surveillance.
However, there have been repeated calls from leading experts[3] that NIHL prevention is broken. Indeed, HSE’s own research[4] published in 2009, showed that the use of hearing protection was largely ineffective. In summary, three of the twelve companies that allowed on site observation of hearing protector use during normal working, and one out of four groups of outdoor workers seen had problems with ensuring correct use such that the hearing protection use was ineffective (nil protection) for all or the majority of workers. In addition, in premises where the majority of workers were seen making effective use of hearing protection one in seven workers were still seen to be not using hearing protection when and where its use was required. This proportion suggests that possibly only 60% of workers supposedly using hearing protection are in fact protected.
Game changer
Having adequate quantitative data on which to make risk assessment is often lacking, certainly the case in high noise sectors like the military. And while an objective measurement of noise exposure is not a mandatory requirement it often adds weight to a risk assessment, although when prescribing ‘fit for purpose’ hearing protection it is a necessity.Instrumentation for noise dose measurement dates to the early 1970s. These analogue electronics-based instruments were cigarette packet sized devices, with a microphone on a cable, displaying a single number dose often in percentage terms i.e. 100% equating to (at the time) 90 dBA for 8 hours.
Fast forward several decades and modern digital noise dosimeters have as much processing power as their full function sound level meter cousins, now offering, data logging, octave band analysis and even audio recording. Download to PC software for analysis and reporting is a given but connectivity has extended to mobile apps, which offer the user the ability to monitor their workforce remotely without having to disturb them.
But noise measurement (and acoustics in general) has always been seen as something of a black art and sometimes less is more, particularly for the H&S generalist who may not have the scientific skill set of their fellow Industrial Hygiene specialists, which is why we are at the threshold of a new era in low cost, noise dosimetry ‘for the masses’. Being able to measure more of the people more of the time is a significant step closer to ubiquitous wearable technology which offers a paradigm shift in hearing safety and productivity.
Keep an ear open for more information on this game changing technology development, pun intended!
References
- Health Effects of Occupational Noise (springer.com)
- HSM - Cut through the noise (hsmsearch.com)
- Noise risk reduction has failed - it's time to update best practice for Nil NIHL - Industrial Noise & Vibration Centre (invc.com)
- Real world use and performance of hearing protection (hse.gov.uk)