WORKSHOP THEME Preventing Hearing loss viz Preventing Compensating

WORKSHOP THEME Preventing Hearing loss viz Preventing Compensating for hearing loss Dr. Anita Edwards - CSIR CHAMBER OF MINES OF SOUTH AFRICA Working together for a sustainable future since 1889

2013 Industry Milestones • December 2008 - No deterioration in hearing greater than 10%PLH shift • December 2013 – Total noise emitted by all equipment in any workplace<110 d. BA Leading the change to zero harm

Need For Paradigm Shift Rands (millions) Prevent Hearing Loss not Compensation for NIHL 100 000 90 000 80 000 70 000 60 000 50 000 40 000 30 000 20 000 10 000 COAL OPENCAST COAL UNDERGROUND/MIXED DIAMONDS GOLD PLATINUM MINERAL MINES SHAFT SINKING 1998 193 206 1 986 753 425 818 66 013 380 37 586 797 693 176 3 870 573 1999 577 623 2 389 042 1 098 751 37 363 965 38 938 335 875 814 2 994 070 2000 543 587 2 436 636 515 843 21 721 472 46 306 795 574 371 3 112 409 2001 721 502 2 192 371 870 179 27 972 900 41 628 991 751 174 2 815 290 2002 1 388 294 2 806 369 941 572 32 147 036 31 449 581 606 407 4 118 758 2003 961 432 1 056 322 1 391 844 29 548 065 26 183 423 771 367 2 056 055 2004 949 875 1 114 459 2 419 865 38 860 654 49 821 153 3 900 348 4 029 768 1998 to 2008 = R 890 million in NIHL compensation claims Leading the change to zero harm 2005 2 235 102 1 672 145 1 120 150 42 980 468 86 852 705 2 927 401 5 316 248 2006 1 944 756 2 453 315 2 743 072 17 086 000 47 419 729 1 112 546 5 188 111 2007 1 906 988 1 298 746 801 168 20 868 763 25 228 727 1 563 173 4 375 532

Need For Paradigm Shift Despite efforts towards NIHL reduction - In 2011 - 948 NIHL cases were reported to DMR NIHL cases reported to DMR Numbner of reported cases 1400 1200 1000 800 600 400 200 0 NIHL cases reported to DMR 2009 1280 2010 1212 Leading the change to zero harm 2011 948

Paradigm Shift is needed • Prevent Hearing Loss not Compensation for NIHL Leading the change to zero harm

Preventing Compensation for NIHL • • Focus on compliance only Only achieve minimum standard Focus needs to be on best practice Focus needs to be on Zero Harm Leading the change to zero harm

Preventing Compensation for NIHL • Report on 5%PLH shift Report on 10%PLH shift Permanent hearing loss Failed systems- not continual improvement Annual hearing test = “Documenting the path to deafness” Leading the change to zero harm

Preventing Compensation for NIHL • All have a “COP for Noise” • If we are honest that is a COP for noise measurement It has very little to say about preventing hearing loss • Revised version is in the pipeline that is much more specific about preventing hearing loss… but where is it? ? ? Leading the change to zero harm

Preventing NIHL • If we really want to prevent hearing loss we have to use Hearing levels as the measure of our success Leading the change to zero harm

Preventing NIHL • Hearing and the development of hearing loss is: individual influenced by many factors Leading the change to zero harm

Preventing NIHL • Therefore prevention of NIHL requires systems that: o Take individual differences into account o Have processes that manage prevention on individual basis o Have systems that manage large numbers of workers Leading the change to zero harm

Noise Induced Hearing Loss Leading the change to zero harm

Noise Induced Hearing Loss Leading the change to zero harm

Noise Induced Hearing Loss Leading the change to zero harm

Noise Induced Hearing Loss Mean Pure Tone thresholds of South African Gold Miners Right Ear Left -10 Ear 250 Hz 28 28 500 Hz 30 30 1000 Hz 36 35 2000 Hz 42 43 3000 Hz 51 53 4000 Hz 55 57 Hearing thresholds in Decibels 0 10 20 30 40 50 60 70 80 90 100 110 120 Leading the change to zero harm 6000 Hz 57 58 8000 Hz 57 57

Noise Induced Hearing Loss Mean binaural hearing threshold levels for years of service -10 Decibles (HL) 1 -10 years 0 11 -20 years 21 -30 10 years 31 -40 years 20 41 -50 years 250 Hz 26 26 28 28 40 500 Hz 28 29 31 32 43 1000 Hz 30 34 37 38 53 2000 Hz 34 38 44 48 70 3000 Hz 42 48 54 58 78 4000 Hz 47 52 58 61 81 6000 Hz 51 54 60 63 76 30 40 50 60 70 80 90 100 110 120 Leading the change to zero harm 8000 Hz 49 54 59 63 75

Noise Induced Hearing Loss With all thresholds at 20 d. B = 3% PLH With all thresholds <15 d. B =1. 1% PLH=9. 4% Leading the change to zero harm

Quality of life Hearing Handicap Inventory for Adults (HHI-A) Category of Hearing handicap Situational hearing Handicap Number of questions 12 questions Emotional hearing handicap 13 questions Area probed by questions Investigates hearing handicap in different everyday life situations Examples of questions Group discussions, use of telephone, complex listening situations Investigates hearing Impact on selfhandicap with image, frustrations reference to experienced, emotional well being limitations on of the affected person lifestyle as a result of hearing loss Leading the change to zero harm

Quality of life Hearing Handicap Inventory for Adults (HHI-A) PLH categories Degree of hearing handicap <4% None 4 -10% 40 -50% 10 -40% 50 -60% >40% >60% Leading the change to zero harm

Preventing NIHL • Emphasis must be based on individual fitting of HPDs: o o o Personal noise exposure History of ear problems Shape of ear canal Hearing levels Effective fitting Leading the change to zero harm

Preventing NIHL • Emphasis must be based on early identification of NIHL development: o High risk employees e. g. exposure, smoking, awareness training, history of ear problems o 10 d. B shift in 2 -3 frequencies o Otoacoustic emission shift Leading the change to zero harm

Preventing NIHL • Emphasis must be on leading indicators: o o o Temporary threshold shift Presence of tinnitus Awareness training results HPD compliance for use HPD fit testing Otoacoustic emission shift Leading the change to zero harm

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