NHCA 2010 HEARING LOSS PREVENTION TRAINING NOISE MEASUREMENTS

NHCA 2010 HEARING LOSS PREVENTION TRAINING, NOISE MEASUREMENTS AND AUDIOLOGICAL EXAMS IMPROVES WORK CONDITIONS AMONG INDUSTRIAL FISHERMEN IN THE SOUTH OF BRAZIL Evelyn Albizu Fundacentro/Ministry of Labor Curitiba, Paraná, Brazil

NHCA 2010 This presentation reports: partial findings from Aqua. Forum, a Brazilian Government National Program which included hearing loss prevention training and education, noise measurements and audiological testing and Ø how it contributed to change occupational health practice among fishermen in Brazil. Ø

INTRODUCTION Fishing is: Ø one of the humankind oldest productive activities; Ø one of the most important global economical sectors (1% of global workforce); Ø one of the most dangerous working activities; responsible for 75% of the all global mortality among workers; Ø ~15 million fishermen are employed aboard fishing vessels operating in the marine capture fisheries, mostly on vessels less than 24 meters in length. Ø SOURCE: ILO 2009

COMMERCIAL FISHING: 1. Vessels > than 24 meters in length: Industrial Fishing 2. Vessels < than 24 meters in length: Small-scale and Artisanal fishing Ø Small-scale - use most advanced fishing technology and electronics on board, small fishing craft (high level of income and standard of living) Ø Artisanal fishing - mostly poor fisherfolk, operate low-investment boats and fishing equipment. Most live in remote, coastal communities where living standards and quality of life keep them at the bottom of the socio-economic pyramid (developing countries) Source: ILO 2009

BRAZIL Ø artisanal fishermen (work > than 8 hours/ day, with ( less than 16 hours of rest and often > than 5 days/week, but they go home everyday): ~ 1. 2 million (family based economic regime and small vessels); Ø industrial fishermen work embarked from 20 -30 days/trip, exposed to motorboats noise, hardly any acoustical rest due (1 hour sleep – 4 hours work): 45, 000 (employees of industrial fishing companies). Source: SEAP/PR, 2009

METHODS Ø Participants were interviewed on medical and work history, type of vessel used, occupational and nonoccupational noise exposure. Ø Noise measurements were conducted during representative fishing trips. Ø Audiological tests were conducted after acoustical rest (14 hours). Ø Lectures were given to the fishermen showing them the results (Training and Education).

Sound Level Measurements Equipments used: Ø Integrating Sound Level Meter Ø Noise Dosimeters The standard used is based on TWA of 8 hours, 40 hours/week and a PEL of 85 d. B (A) for 8 hours of exposure, with both 3 d. B and 5 d. B exchange rates.

Sound level measurements

Audiological Testing Pure-tone audiometry (air- 500 Hz- 8 k. Hz range- and bone conduction) & immitance audiometry ARTISANAL FISHERMEN

Audiological Testing INDUSTRIAL FISHERMEN

RESULTS Fishermen, artisanal and industrial are exposed to high sound levels – 85 to 114 d. B(A) - from motorboats In both categories: The working conditions expose them to other unfavorable work factors such as climatic variations, humidity, vibration, sleep deprivation and night work.

2004: NUMBER AND % OF THE AUDIOMETRIC CLASSIFICATIONS OF THE STUDIED GROUPS 141 male artisanal fishermen GROUP 1: Exposed to high SPL / motorboats, no previous noise exposure; GROUP 2: Exposed to high SPL / motorboats, with previous noise exposure; GROUP 3: Not exposed / boats without engines, no previous noise exposure; GROUP 4: boats without engines and previous noise exposure. AUDIOMETRIC CLASSIFICATION GROUP 1 Nº % GROUP 2 Nº % GROUP 3 Nº % GROUP 4 Nº % CONTROL Nº % Normal Bilateral thresholds < 25 d. B HL 10 13. 5 1 3. 3 12 63. 2 5 27. 8 67 90. 7 High frequency loss 61 82. 5 27 90 5 26. 3 12 66. 7 7 9. 3 Other 3 4 Total 74 2 6. 7 2 10. 5 1 5. 5 0 0 100 30 100 9 100 18 100 73 100 Paini, Morata, Corteletti, Albizu et al. , 2009

RESULTS Industrial Fishermen 2007 N= 172 2008 N= 106 2009 N=84 % % % Normal hearing 8 36 33 High frequency HL 58 41 64 Other configurations 34 23 3 Percentage of cases

TRAINING & EDUCATION Hearing Loss Prevention Ø Artisanal fishermen (Paraná): 402 participants (2007 & 2008) Ø Industrial fishermen (Santa Catarina): 193 participants (2008 & 2009)

LEGISLATION C 188 Work in Fishing Convention, 2007 (revision of Convention 113 - Medical Examination, 1959) Article 11: Each Member shall adopt laws, regulations or other measures providing for: (a) the nature of medical examinations; (b) the form and content of medical certificates; Article 12: On a fishing vessel of 24 meters in length and over, or on a vessel which normally remains at sea for more than three days: 1. The medical certificate of a fisher shall state, at a minimum, that: (a) the hearing and sight of the fisher concerned are satisfactory for the fisher's duties on the vessel;

IN BRAZIL In 2009, due to our findings the Port Authority in Itajaí, a coastal city in Santa Catarina State, began requiring audiometric testing prior to issuing or renewing a fishing license.

TEAM INDUSTRIAL HYGIENE Evelyn Albizu Fundacentro/Ministry of Labor, Curitiba, PR, 80030 -320 Brazil Mario Sergio dos Santos Fundacentro/Ministry of Labor, Florianopolis, SC, 88020 -200 Brazil AUDIOLOGY Adriana B. Lacerda; Claudia G. O. Gonçalves; Adriana Betes Heupa; Department of Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, PR, 80710 -250, Brazil

SPECIAL THANKS AUDIOLOGISTS 2004 Michele Paini & Lorayne Santos - Universidade Tuiuti do Paraná 2007 Simone Roggia – Universidade Vale do Itajaí Sandie Poulin and Julie Baril – University of Montreal Karlin Klagenberg – Universidade Tuiuti do Paraná 2009 Fabiane Paulin, Milena Raquel Iantas, Patricia Schiniski, Rebecca Torquato – Universidade Tuiuti do Paraná

SPECIAL THANKS SANTA CATARINA STATE FISHERMEN UNION SITRAPESCA - Sindicato do Trabalhadores das Empresas de Pesca de Santa Catarina ARTISANAL FISHERMEN ASSOCIATION OF PARANÁ Colônias de Pescadores do Litoral do Paraná MEDICAL EXAMS: Deborah Cristina Farchadi – Geneva- Switzerland Patricia Piaskowy – Universidade Positivo/Paraná

SPECIAL THANKS Thais C. Morata NIOSH/ Cincinnati, Ohio, USA

REFERENCES Ø International Labour Office. Conditions of work in the fishing sector. Report V. 2004; 92 nd Session. Geneva: International Labour Office. Ø ILO http: //www. ilo. org/public/english/dialogue/sector/techmeet/tmfi 99/tmfir 1. htm#E mployment access in 02/04/2010 Ø ILO http: //www. ilo. org/public/english/dialogue/sector/techmeet/tmfi 99/tmfir 1. htm#S mall-scale and artisanal fisherfolk access in 02/04/2010 Ø Paini MC, Morata TC, Corteletti LJ, Albizu E, Marques JM, Santos L. Audiological findings among workers from Brazilian small scale fisheries. Ear and Hearing. 2009 Feb; 30 (1): 8 -15.

QUESTIONS ? Photo by Nicky Albizu evelyn. albizu@fundacentro. gov. br