Use of historical data and a novel metric in the evaluation of the effectiveness of hearing conservation program components.
OBJECTIVE
To evaluate the effectiveness of hearing conservation programs (HCP) and their specific components in reducing noise-induced hearing loss (NIHL).


METHODS
This retrospective cohort study was conducted at one food-processing plant and two automotive plants. Audiometric and work-history databases were combined with historical noise monitoring data to develop a time-dependent exposure matrix for each plant. Historical changes in production and HCP implementation were collected from company records, employee interviews and focus groups. These data were used to develop time-dependent quality assessments for various HCP components. 5478 male (30,427 observations) and 1005 female (5816 observations) subjects were included in the analysis.


RESULTS
Analyses were conducted separately for males and females. Females tended to have less NIHL at given exposure levels than males. Duration of noise exposure stratified by intensity (dBA) was a better predictor of NIHL than the standard equivalent continuous noise level (L(eq)) based upon a 3-dBA exchange. Within this cohort, efficient dBA strata for males were <95 versus ≥ 95, and for females <90 versus ≥ 90. The reported enforced use of hearing protection devices (HPDs) significantly reduced NIHL. The data did not have sufficient within-plant variation to determine the effectiveness of noise monitoring or worker training. An association between increased audiometric testing and NIHL was believed to be an artifact of increased participation in screening.


CONCLUSIONS
Historical audiometric data combined with noise monitoring data can be used to better understand the effectiveness of HCPs. Regular collection and maintenance of quality data should be encouraged and used to monitor the effectiveness of these interventions.
Battelle CPHRE, 1100 Dexter Ave N, Suite 400, Seattle, WA 98109-3598, USA. heyern@battelle.org
Nicholas
N
Heyer
Thais C
TC
Morata
Lynne E
LE
Pinkerton
Scott E
SE
Brueck
Daniel
D
Stancescu
Mary Prince
MP
Panaccio
Hyoshin
H
Kim
J Stephen
JS
Sinclair
Martha A
MA
Waters
Cherie F
CF
Estill
John R
JR
Franks
D000328:Adult; D001301:Audiometry, Pure-Tone; D001336:Automobiles; D004430:Ear Protective Devices / Q000706:statistics & numerical data; D004784:Environmental Monitoring / Q000379:methods; D004812:Epidemiologic Methods; D062665:Epidemiological Monitoring; D005260:Female; D005511:Food Handling; D006317:Hearing Loss, Noise-Induced / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009623:Noise, Occupational / Q000009:adverse effects / Q000517:prevention & control*; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D009786:Occupational Health Services / Q000379:methods / Q000592:standards; D015397:Program Evaluation; D011785:Quality Assurance, Health Care