Can You Hear Me An Introduction to Hearing

Can You Hear Me? An Introduction to Hearing Loss Prevention In Agriculture Janet Ehlers, R. N. , M. S. N. Occupational Health Nurse Pamela S. Graydon, M. S. , COHC Electronics Engineer The results reported in this workshop represent the opinions of the authors and do not necessarily represent the policies of the National Institute for Occupational Safety and Health.

Janet Ehlers, R. N. , MSN Occupational Health Nurse jehlers@cdc. gov Pamela S. Graydon, M. S. , COHC Electronics Engineer pgraydon@cdc. gov

WHAT WE WILL TALK ABOUT? Damage to Hearing including: Hearing Loss Tinnitus How to Prevent the Damage Hints and Resources

Disclosure: There is no commercial support for this activity. CDC, our planners, and our presenters wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Presentations will not include any discussion of the unlabeled use of a product or a product under investigational use.

For Continuing Nursing Education for Nurses (CNE): 1. 2 The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center's Commission on Accreditation. This activity provides 1. 2 contact hours. Continuing Education Contact Hours in Health Education (CECH): 1. 5 Sponsored by the Centers for Disease Control and Prevention, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designed for Certified Health Education Specialists (CHES) to receive up to 1. 5 Category I CECH in health education. CDC provider number GA 0082. IACET Continuing Education Units (CEU): 0. 1 The CDC has been approved as an Authorized Provider by the International Association for Continuing Education and Training (IACET), 1760 Old Meadow Road, Suite 500, Mc. Lean, VA 22102. The CDC is authorized by IACET to offer 0. 1 ANSI/IACET CEU's for this program.

To receive continuing education – Can You Hear Me? … Hearing Loss Prevention In Agriculture Course number: ECEV 1726 • Go to the CDC Training and Continuing Education Online at http: //www. cdc. gov/tceonline • Complete and submit your evaluation and posttest • Your CE certificate will be located at the Transcript and Certificate section of your record • Complete application for CE within 30 days • For more detailed instructions, e-mail me at farm. noise@cdc. gov

Occupational Safety and Health Act Of 1970 • To ensure safe and healthful working conditions for working men and women.

Occupational Safety and Health Act Of 1970 • OSHA - U. S. Department of Labor – Develop and enforce workplace safety and health regulations. • NIOSH - U. S. Department of Health and Human Services – Provide research, information, education, and training in the field of occupational safety and health.

Noise-Induced Hearing Loss • An acquired hearing loss • Begins at the higher frequencies (3, 000 to 6, 000 Hz) • Develops gradually as a result of chronic exposure to continuous noise – Generator Running, Engine Noise, etc. • Develops suddenly as a result of a single impulsive noise exposure. – Gunfire, Nail Guns, Fireworks, etc.

Who is at Risk? 33% of all people who are exposed to hazardous noise at work will develop Noise-Induced Hearing Loss. Even young people are at risk: 12 -15% of people between 6 and 19 years old show signs of Hearing Loss.

Bilateral Noise-Induced Hearing Loss in 872 Wisconsin High School Students Live and Work on Farm Little or no Farm Exposure

Noise-induced hearing loss is: • PAINLESS • PROGRESSIVE • PERMANENT. . . but it is also PREVENTABLE

How Does Noise Damage Hearing?

Healthy Cochlea Damaged Cochlea National Hearing Conservation Association

Healthy Hair Cells Damaged Hair Cells

You Have Killed the Hair Cells Associated With the Nerve Fibers They Have Died. NOW WHAT? ? ?

How Do We Measure Sound? Decibels (d. B) = How loud it is Frequency = High pitch vs. low pitch

Hearing Level (decibels) Frequency (Hz) 500 0 10 20 30 40 50 60 70 80 90 1000 200 0 3000 4000 6000

By age 25, the average carpenter or millwright has 50 -year old ears! Hearing Level (decibels) Frequency (Hz) 500 0 1000 2000 3000 4000 6000 10 20 30 40 50 Carpenter, age 25 60 70 Healthy age 50 nonnoise exposed male 80 Carpenter, age 55 90 You do not have to lose your hearing as you

Tinnitus • One form of damage results in tinnitus • A ringing, buzzing, whistling, clicking, hissing, chirping or other noise, – heard in the ear in the absence of environmental noise.

Tinnitus: What does it mean when you have it?

Percent of People With Tinnitus Non-Noise Exposed Workers American Tinnitus Association

Hearing Loss Does Not Mean Everything Is Just Quiet “I thought if I lost my hearing, it would be quiet. But that constant ringing keeps me awake at night and I can’t hear my friends very well on my cell phone. ”

Hearing Loss Impacts All Aspects of Life “My little girl doesn’t understand why I can’t hear what she is whispering in my ear. she says. . . Mommy hears me when I whisper. ”

How Can You Protect Yourself, Students, & Others From Damaging Hearing?

What You Should Do To Prevent Hearing Damage Hierarchy of Controls: Remove the Noise (Engineering controls) Remove the Worker (Administrative controls) Protect the Worker (Hearing Protection Devices)

Warning Signs of Too Much Noise • • Raise your voice to be heard at arms length Feeling of “fullness” in ears Ringing in ears Huh? What? Blasting radio/TV Raised Blood Pressure Tired, Stressed

Task/Tool Mortising Orb. Sand. Table Saw Planer Belt Sander Router Metal Shear Hand Drill Circular Saw Tile Saw Impact Wrench Miter Saw Chop Saw Chain Saw Hammer Drill Noise Levels for Common Tools 75 80 85 90 95 100 105 110 115

Key Factors for Selecting Hearing Protection Devices – Type – Intermittent or continuous noise – Comfort – RIGHT SIZE – Environment – grease, dirt – Communication - co-workers and equipment NIOSH Hearing Protector Device Compendium

The Best choice…The one that is -worn correctly when needed --best suited for the job Over 400 available

Formable Earplugs Roll down slowly. Make sure you don’t get creases. Reach over you head to straighten the ear canal. Insert and hold for about 10 seconds. Perform the hands over the ears test to determine if you have a good fit.

The plug is best rolled between the fingertips

Premolded Earplugs Hold the stem of the plug. Reach over you head to straighten the ear canal. Insert so that all flanges are inside the ear canal. Perform the tug test to determine if you have a good fit.

Bands - Can be labeled with student’s name Teachers can see if they are wearing Hang around neck when not needed and put on quickly Have replaceable tips, no need to replace whole band

Why do people say they do not wear hearing protection?

Cost NO EXCUSE – Disposable plugs available for $0. 18 – Custom plugs can cost hundreds of dollars but last for years and are tailored to different exposures

Communication and Hearing Equipment NO EXCUSE – Electronic devices can make communication easier – Hearing can be temporarily impaired during a day if noise is excessive. Therefore, you may be less able to hear your equipment due to hearing loss later in the same work day than earlier.

Convenience NO EXCUSE – Easily removed and hung around the neck until needed – Kept on belt or hard hat – Left in the workers’ toolbox – Available at each machine that is excessively noisy

Culture – Peer Pressure NO EXCUSE Especially for teachers and supervisors – Teachers can eliminate this aspect by requiring hearing protection use in labs and modeling the appropriate use of hearing protection yourself.

Maintain hearing protection • Keep them clean • Store them appropriately • Replace them when needed • When plugs or seals feel different • When plugs or seals appear dirty • Do not alter them • By cutting flanges • By putting holes in them • By adding your own string

Other Sources Of Hearing Damage • Pesticides • Organic solvents • Carbon Monoxide • Medications • Smoking • Leisure activities

How loud are you listening? Nick tells you Instructions available at dangerousdecibels. org

Personal Music Players

Jo Farmer Dave and Shari Kuther - PAF Clinic Nurse Specialist St. Mary’s Hospital & Clinics, ID Carlie Amy Rademaker - PAF Farm Safety Specialist Carle Foundation Hospital, IL

Hints and Resources Dangerous Decibels Teacher Kit Handout of our slides Posters List of Resources (Websites) Brochures (Hard copy or electronically) Your Local Community

Free Brochures NIOSH Publication No. 2007 -175 NIOSH Publication No. 2007 -176

Free NIOSH Companion Brochures • They’re Your Ears – Protect Them (Pub. #2007 -175; red) • Have You Heard? (Pub. #2007 -176; blue) • Access online at: www. cdc. gov/niosh/topics/noise/pubs/ no pubs. html • Order in bulk via farm. noise@cdc. gov Provide complete mailing address and phone number

Community Resources Volunteers ? • Local large company – Certified Occupational Hearing Conservationist (20 hour course) – Occupational Health Nurse – Safety director • School Speech Pathologist • School nurse – with additional education • Audiologist – volunteer? ?

NAAE Communities of Practice Classroom ready resource Sound Advice Through the Years A narrative interactive activity Deborah Reed, RN, Ph. D; University of KY FFA New Horizons December 2009 Turn That Down! Before you pop in those EARBUDS

www. cdc. gov/niosh/topics/noise www. cdc. gov/niosh/topics/youth www. cdc. gov/nasd Janet Ehlers, RN, MSN: jehlers@cdc. gov

WHAT WE TALKED ABOUT! Hearing Loss and Tinnitus Noise Hearing Protection Hints and Resources.

It’s Really Pretty Simple. . . Wear This Now. . . Or Wear This Later! Per Pair Each Ear Standard issue $0. 18 -$7 Standard issue ~$300 -$600 Newest Technology ~$250 Newest Technology ~$3500 -$5000

This is your ear. This is your ear on noise. Any questions?

To receive continuing education – Can You Hear Me? … Hearing Loss Prevention In Agriculture Course number: ECEV 1726 • Go to the CDC Training and Continuing Education Online at http: //www. cdc. gov/tceonline • Complete and submit your evaluation and posttest • Your CE certificate will be located at the Transcript and Certificate section of your record • Complete application for CE within 30 days • For more detailed instructions, e-mail me at farm. noise@cdc. gov

Thank You

Take Home Message Wear correctly Wear in loud noise - always Select appropriately Have an assortment for students