Tales from DC: OSHA Stakeholders Meeting on Preventing Occupational Hearing Loss

On November 3, Tom Cecich, VP for CoPA, represented ASSE at OSHA’s “Conversation with Stakeholders:  Preventing Hearing Loss” held in response to the Agency’s withdrawal of its economic feasibility interpretation concerning employers’ responsibility to provide engineering controls.  The four questions below about hearing protections in general provided the structure for the moderator-led discussion.

In general, the meeting was not as contentious as, for example, the infectious disease stakeholder meeting held in August, where for and against comments played like a ping pong match between the participants.  In general, there was wide agreement that hearing loss is a problem.  How to address the problem, as the individual comments below reflect, swung between what more employers, OSHA and NIOSH could be doing to what more employees could be doing.    

Other organizations represented at the meeting included the Academy of Audiology, NASA, AIHA, International Safety Equipment Association, Edison Electric Institute, AFL-CIO, Hearing Association, Mercer ORC, National Association of Home Builders, National Ready Mixed Concrete Association, National Hearing Conservation Association, Association of Equipment Manufacturers, United Food and Commercial Workers, Coalition for Workplace Safety, Laborers’ Health and Safety Fund, United Auto Workers, NIOSH, United Steelworkers, Non-Ferrous Founders’ Society and the Scranton Army Ammunition Plant. 

OSHA staff opened the meeting.  Beth Perry, Deputy Director, Standards and Guidance introduced the topic.  Debbie Berkowitz, Chief of Staff, thanked the participants and observers for coming to the meeting, pointed out that since 2004 BLS has reported that nearly 125,000 workers have suffered significant, permanent hearing loss and brought attention to OSHA’s topic page on the issue at http://www.osha.gov/SLTC/noisehearingconservation/. 

Rich Fairfax, Deputy Assistant Secretary, explained in some detail how OSHA does a noise survey.  He said that, contrary to widespread thoughts to the contrary, OSHA does not require and is not moving toward requiring noise reductions below its current PEL of 90 dBA for all workers for an 8 hour day and a 5 dBA exchange rate while the rest of the world uses a 3 dBA, demonstrating OSHA’s leniency.  He said that, when working with employers, OSHA looked for incremental improvement in the noise levels versus the expectation that noise exposures had to be reduced to below the legal limit. As long as an employer demonstrated it had made improvements, it would not be cited.   He went on to say that, for most surveys, OSHA gives employers 6-9 months to comply, has always allowed more time when employers need it to the point that, in one case, 10 years was allowed.  OSHA has always been “very cooperative,” he said.

The following represents many of the various comments participants made in response to each of the four questions posed by OSHA.

What are the best practices regarding hearing conservation programs?

• Make sure background noise when testing is low enough not to interfere with testing.
• The current OSHA requirement does not apply to construction.  Just having a hearing conservation program (HCP) is a best practice.  Good faith hearing protection efforts by employers encourages workers.
• Do baseline hearing tests sooner than later.  Conducting one within one year is current practice but that is not a best practice.
• Everyone conducting testing should be certified by NCHA.  A best practice is high quality training that encourages employees to consider off-work risks. 
• There are model programs, as the Safe in Sound Awards (http://www.safeinsound.us/)  show.  Find ways to recognize good programs.  Programs under VPP should be shared.  Fit testing of ear plugs is needed. 
• OSHA should look at monitoring HCPs.
• Really what we are talking about are time-weighted averages, not certain levels.  HCPs will encourage workers to participate so HCPs should be #1 best practice.  Safe in Sound winners all have HCP elements and workers are involved.  Audiology testing doesn’t save hearing.
• Longshoremen are concerned that if they use hearing protection they won’t be able to communicate on wharfs.  They need education, training and outreach.  Participants should ask themselves how often we who even understand the issue use hearing protection in our real lives?
• Washington State requires HCPs (http://www.lni.wa.gov/Safety/Topics/AtoZ/NoiseHearing/default.asp).  Noise control is the best practice.  ANSI/ASSE10.46 is the voluntary consensus standard.  Enforcement is a best practice.
• Joint employee/management committee is a best practice.  Doing simple things like using foam or hanging acoustical cloth often works and is cheap.  Employee rotation is not a best practice.
• Language issues are important with workers with varieties of languages.  Time to train people is getting smaller and smaller.  In meat packing training used to be 5 days but no longer.  Longer work days and working 6 days a week is not uncommon in food industry.  Food industry has turn-over issues so tracking workers is difficult.  There should be 14 hours of quiet before testing.
• The use of 2 threshold averages by OSHA is confusing.  Eliminate the high threshold.  Old technology needed a high range.  Modern technology does not. 
• ASSE brought free copies of the A10.46 standard.  In the field for 40 years, all companies worked for used the 85 dBA.  US operators are using the lower threshold for consistency with their foreign worksites. OSHA’s higher level still leaves people unprotected.  The younger population is showing up with hearing loss so an HCP can also identify loss from outside the environment.
• OSHA is asking the wrong question.  Getting people to use hearing protection is the significant problem.  How to change personal behavior will solve all the problems with hearing protection. 
• NIOSH should be taken to task for not doing anything on the issue for 15 years.  The hearing feasibility interpretation should go through rulemaking.  Companies committed to hearing protection say what is needed is (1) committed leadership in the company, (2) 85 dBA and 3 dBA exchange rate, (3) 80 dBA threshold (4) audits, (5) incident investigations, (6) use of real time monitors to alert workers and (7) retraining on a regular basis.
• NIOSH in 2010 instituted a study to see what was working in hearing protection.
• Exposure to toxins needs to be considered. 
• Under Washington State workers compensation, company doctors say loss isn’t from work but considerable workers comp payments are made to older workers retiring.  Baseline testing is needed to address that problem.
• Difficult to change personal behavior, demonstrating the need for HCPs.  Bystander protections are also needed. 
• Be careful about mandatory hearing protection.  Studies show that hearing protections does inhibit communications and put people in danger.
• To address workforce mobility challenges, a credential should be created for workers to carry with them.
• Addressing lack of knowledge about how two protect workers, one study demonstrated that the only thing that worked was a feedback device showing hearing loss effect.  Another study showed that, for the vast majority of homebuilding workers studied, what they did off the job had little effect on hearing. 

What are the best practices for, as well as concerns with, using personal protective equipment for noise control?

• New study has documented that hearing loss occurs at 85 dBA or even less.  Workers are no accurate on reporting their own use of hearing protection.
• OSHA should ban all punitive measures on workers concerning hearing protection.  Barriers to achieving hearing protection should be studied.
• New guidance from OSHA on use of fit-testing is needed.  Companies should use personal attenuation rating (PAR) (http://www.e-a-r.com/pdf/hearingcons/par.pdf) to demonstrate compliance.  Companies that are using fit testing are succeeding.
• Companies’ low rates of hearing loss are because of discipline.
• Need to measure variable exposure day to day.  Time weighted average exposures are not helpful.
• Two NIOSH HHEs demonstrate that flight attendants have noise exposure.  FAA has jurisdiction and has done nothing.
• Labeling of PPE should be standardized for small employers.
• EPA may change the way hearing PPE is labeled so it may be getting tougher for small businesses.  OSHA should create visual documents with simple protections provided as it did for the heat stress program.  Technology is quickly changing and will help, such as noise cancellation protections that are already used outside workplaces.  Next year OSHA will be seeing new technologies.
• #1 illness recorded in manufacturing is hearing loss.
• As to fit testing, one study says 60% of workers do fine and no more training is needed; 15-20% are not doing fine and a small amount of training – 5 minutes – is needed; and less than 5% of workers could not use plugs. 
• Overlooked in OSHA Act is that employer must demonstrate PPE is adequate.  Fit-testing, ocular/nonocular audiograms and education is critical.
• OSHA should adopt the new labeling of PPE that EPA is considering.
• Guidelines for recording hearing loss should be on OSHA forms.  Companies just offer a box of PPE, not a variety.  More guidance for small businesses is needed.
• Best practice is playing a tape that shows what happens when a worker loses hearing.
• A problem is workplaces where multiple layers of protections, perhaps a helmet and hearing protection, are required, pointing to the need for engineering controls.  In workplaces such as meat packing, there is no opportunity to adjust PPE.  Employers consider it a cost for workers to insert plugs.
• The EPA rulemaking on labeling PPE is not moving forward.
• NASA has a CD to demonstrate what hearing loss sounds like and it is very effective.  Most hearing loss among longshoreman is occurring at retirement when workers think of entitlement.

What are the best practices for using engineering controls?

• Need a data base of best practices.  Buy Quiet, which NIOSH is involved with, shows best practices. 
• MSHA in the 1980s put out guidelines for machines.  NASA buys quiet, so the rest of the federal agencies could adopt the practice.
• Hard concrete facts are needed to determine if engineering controls are needed.  Data is needed to see if engineering controls work.  Money for engineering controls comes out of the same pot so employees will also pay for it.
• Quantifying cost of exposure verses the cost of buying quiet is a best practice.  Encourage product noise labeling with noise emission labels. 
• Keep over-exposure in perspective.  According to this CIH, less than 10% of workers were over-exposed in companies he’s dealt with.  The percentage used to be 19% but many of those companies are now off shore.  There is a 5-15% additional cost related to Buy Quiet.  Research shows an HCP costs $300-350 a worker versus engineering, a problem out.
• Participation of employees in purchasing new equipment, which the Big 3 automakers do.
• As to claim that there is no data that engineering controls work,  Cochrane reports that traditional HCP without engineering controls is not effective.  MSHA enforced engineering controls and exposures are way down.  Cost is $300-350 per worker.  For smaller employers it will cost more — $700-800 for companies with up to 20 workers.  Small companies need help, which OSHA should provide.
• Safety and health professionals are on the front line to protect workers so look to risk reduction.  It’s hard to argue not to use engineering controls but there are issues of basic physics involved.  Improvement with engineering controls is incremental.  OSHA should be encouraged to continue identifying hierarchy of controls, but Rich Fairfax’s explanation is a realistic approach to helping solve the problem.  Engineering controls should be a given when purchasing new equipment, but what to do with existing machinery is difficult.  Has anyone heard OSHA say what Rich Fairfax did?  OSHA could do a lot on the soft side to help companies address engineering controls.  But it’s not going to happen overnight.  There needs to be a concerted effort of OSHA doing a better job of encouraging employers to deal with engineering controls because there are going to be some very challenging issues are involved in lowering standard from 90 dBA to 85 dBA.
• The need for the hierarchy of controls should be challenged.  That there needs to be documentation of its effectiveness remains true.
• Engineering controls can be pretty simple.  Noise levels in workplaces changes from day to day so PPE is appropriate.  In construction, contractors buy only a few nail guns a year, for example, so Buy Quiet doesn’t work.
• Hearing loss is on the decline. 
• It takes three years to get investment back in engineering controls but there is an enormous cost to the employee, the cost of which is not being calculated.
• There are limits to HCPs and PPE.  OSHA and NIOSH need to assess what we know about protections so we can know those limitations.
• 15 countries have assessed return on investment of safety and health programs.  There is a ratio of 1 to 2.2 in dollars invested to dollars saved.  OSHA Act requires employers to provide safety and health compliance.

What are examples of companies that have effective noise control programs and what are the key elements of their programs? 

• For NASA, there is a general requirement that there be site-specific implementation.  NASA sites are very different.  A point of contact for a site is an industrial hygienist with stakeholders from all areas including procurement.  Buy Quiet principles are used.  Surveys of employers help in evaluating Buy Quiet equipment.
• See Safe in Sound awards winners.  The Army Hearing Program (http://phc.amedd.army.mil/organization/institute/doem/Pages/ArmyHearingProgram(AHP).aspx) ensures combat effectiveness and is based on protect and communicate.  Alcoa has a good program.  VPP in OSHA Region V has a good program for compliance officers.   
• What works is clear identification of individual source of noise and what makes up exposure, but the challenge is sustaining the effort.  Equipment sold in Europe are Buy Quiet, so why not here?
• GM and Ford achieve annual reductions due to employee/management committees.  Employees are involved in upstream purchase of equipment.
• Auto manufacturers turn over cars more often so they buy equipment more often and are able to see benefits of Buy Quiet.
• OSHA doesn’t keep companies from achieving hearing protection below 90 dBA.
• OSHA needs to use all its tools.  It needs to share examples of effective programs.  125,000 workers a year are losing their hearing.
• 125,000 figure is from BLS and is very under-estimated.  Companies are often not reporting hearing loss any more.  Reducing noise through engineering controls also has positive effect on safety, an issue that is seriously under-studied in the US.  Lots of other accidents would be avoided, as studies in other nations indicate. 
• Culture of commitment to safety is needed.  Success will follow in hearing and all programs.
• There is a 1 in 4 lifetime risk of hearing loss if a worker is exposed to OSHA’s current level.
• Companies already are working at the 85/3 levels.  Science says that OSHA should move towards that standard also.  Culture and leadership commitment is needed.
• There is an impression that all responsibility for safety is on the employer under the OSH Act.  That’s not true.  The Act places responsibility on the employee also.  We need a change in the paradigm of command and control.  A better job must be done of figuring out how to fix the problem. 
• Getting Rich Fairfax’s discussion about how OSHA approaches hearing with companies needs to be shared. 
• Small companies need help. 
• As to penalizing employee, if the employee is not protecting himself and engineering controls are not done, the onus is on the employee to correct the situation.
• 85/3 is a best practice.
• For solutions, look into specific industries.  Solutions should be industry-specific.

Dorothy Dougherty thanked the participants and stated notes for the meeting will be posted in 3-4 weeks.