Academic journal article Scandinavian Journal of Work, Environment & Health

Association between Ambient Noise Exposure, Hearing Acuity, and Risk of Acute Occupational Injury

Academic journal article Scandinavian Journal of Work, Environment & Health

Association between Ambient Noise Exposure, Hearing Acuity, and Risk of Acute Occupational Injury

Article excerpt

Noise exposure is ubiquitous in many occupational and non-occupational settings, with an estimated 22.4 million workers in the United States (US) exposed to hazardous noise on the job (1) and >100 million more exposed to potentially harmful ambient noise from traffic, personal listening devices, and other sources (2). Average noise exposures >85 dBA have been linked to a variety of adverse auditory and extra-auditory effects (3). Adverse auditory effects include temporary and permanent noise-induced hearing loss (NIHL) (4-6), which may interfere with on the job communication and impair workers' ability to hear warning signals or monitor workplace equipment (7). Current evidence suggests that 16% of adult-onset hearing loss globally is related to occupational noise exposure (8) and that hearing loss accounts for 4.2 million disability-adjusted life years (9). In the US, an estimated 10 million workers have NIHL resulting in hearing thresholds >25dB (10), and such workers with hearing loss may work in environments where noise and hearing loss interact to impair ability to hear communications and other important safety signals (7, 11, 12).

While NIHL is the classically-recognized health effect of noise exposure, mounting evidence links noise exposure to extra-auditory effects including increased stress (13), performance decrements (14, 15), reduced temporal processing skills (16), sleeping disorders (17), hypertension (18), and heart disease (19, 20). Some evidence suggests that adverse effects of occupational noise exposure can occur with exposures in the 80-84 dBA range (21, 22) - substantially lower than many current occupational noise exposure limits.

Occupational injuries also represent a significant burden globally, with an estimated 100 million occupational injuries occurring worldwide each year and evidence of under-reporting suggesting the actual number may be substantially higher (23, 24). During 2007 in the US alone, approximately 8 559 000 nonfatal occupational injuries occurred with associated costs totaling $186 billion (24).

A number of studies have suggested an association between occupational noise and increased accident and injury risk (6, 25-28) and have proposed several possible mechanisms for such a link. Noise may cause distraction or impede concentration (26, 29), increase fatigue and prolong reaction time (30), and reduce ability to hear warnings signals or other critical auditory messages (7), each of which may contribute to accidents and injuries. Some have postulated that highfrequency noise exposure may disrupt the vestibular system increasing postural sway and position variability of center of pressure, which may increase risk for slips and falls particularly for those working at heights (31).

Noise exposure could also increase injury risk by causing hearing loss, which by itself could lead to increased accident risk (25, 26). Hearing difficulty resulting from overprotection due to use of hearing protection devices (HPD) in the workplace has also been suggested as a pathway for increased injury risk among HPD wearers (32). Workers wearing inappropriately protective HPD may experience decreased ability to hear, heed, or accurately interpret messages and workplace warning signals, and reduced ability to distinguish between sounds required to adequately monitor machines and other workplace equipment (7).

Other reports suggest that noise exposure may impair performance by interfering with information processing or influencing strategies for task completion (33), degrading working memory (34), or increasing the mental workload thus reducing cognitive resources available for task performance (35).

Although reports suggest that occupational noise exposure and hearing loss increase work-related accident and injury risk when considered independently (36, 37), relatively few reports have examined the combined effects of noise exposure and hearing loss on injury risk (6, 27, 28). …

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