National Surveillance for Occupational Hearing Loss

SangWoo Tak, ScD, MPHSangWoo Tak, ScD, MPH

Geoffrey M. Calvert, MD, MPHGeoffrey M. Calvert, MD, MPH

Division of Surveillance, Hazard Division of Surveillance, Hazard Evaluation, and Field StudiesEvaluation, and Field Studies

NIOSHNIOSHCDC/DHHSCDC/DHHS

Chronology

2005 – National Academy of Science 2005 – National Academy of Science (Institute of Medicine) recommends national (Institute of Medicine) recommends national surveillance for OHL and noise exposuresurveillance for OHL and noise exposure

2006 – NIOSH Prioritized OHL surveillance 2006 – NIOSH Prioritized OHL surveillance goalsgoals

2008 – OHL surveillance project proposed2008 – OHL surveillance project proposed

2009 – NORA project awarded funding2009 – NORA project awarded funding

Project goal

To conduct surveillance research to track To conduct surveillance research to track

occupational hearing lossoccupational hearing loss

To develop the first ever national surveillance To develop the first ever national surveillance

system on OHLsystem on OHL

Where are the data?

NHCA – audiometric service providers NHCA – audiometric service providers across the USacross the US

In December 2007, a recruiting letter sent In December 2007, a recruiting letter sent to all audiometric service provider to all audiometric service provider membersmembers

Six providers gave a positive responseSix providers gave a positive response

Received letters of support from five of Received letters of support from five of these audiometric service providers these audiometric service providers

Hearing loss prevention programs

Workers

Audiometric Service

Providers

Employers

NIOSH OHL

Surveillance

AnalysisIncidence &Prevalence

InterpretationBy industry

CollectionNational Data

Repository

DisseminationPreventiveintervention

Audiograms,Noise survey data

Stakeholders Industry

Labor unions State health departments

Practitioners Scientific community

Specific aim 1

Collect audiometric data from audiometric Collect audiometric data from audiometric testing service providers to develop an testing service providers to develop an audiometric data repository audiometric data repository

Tasks Recruit 15 audiometric service providers Recruit 15 audiometric service providers

across the countryacross the country

11stst year: 3 year: 3

22ndnd year: 5 year: 5

33rdrd year: 7 year: 7

Retrieve historical data for those who were Retrieve historical data for those who were tested at lease once from 01/2003 to 12/2008tested at lease once from 01/2003 to 12/2008

Identify a audiometric data repository systemIdentify a audiometric data repository system

Data elementsDemographic characteristics of the workerDemographic characteristics of the worker

1)1) Unique identifier (will be assigned by data provider)Unique identifier (will be assigned by data provider)

2)2) GenderGender

3)3) Date of birthDate of birth

Workplace variablesWorkplace variables

1)1) Workplace stateWorkplace state

2)2) Unique identifierUnique identifier

3)3) Industry code and literals (NAICS 2002)Industry code and literals (NAICS 2002)

Audiometric testing variablesAudiometric testing variables

1)1) Date of testDate of test

2)2) Threshold for each pure tone frequency (500, 1K, 2K, 3K, 4K, Threshold for each pure tone frequency (500, 1K, 2K, 3K, 4K, 6K, and 8K). 6K, and 8K).

Specific aim 2

Estimate the rate of occupational hearing loss Estimate the rate of occupational hearing loss and changes in hearing per year and changes in hearing per year by industry by industry using NAICS codes*using NAICS codes*

North American Industry Classification SystemNorth American Industry Classification System

Tasks

Data management Data management

CleaningCleaning

Quality controlQuality control

Protocol for data managementProtocol for data management

Descriptive data analyses by industryDescriptive data analyses by industry

Report disseminationReport dissemination

Specific aim 3

Identify specific industries associated with a Identify specific industries associated with a high risk of occupational hearing loss in the high risk of occupational hearing loss in the construction and manufacturing industry construction and manufacturing industry sectorssectors

Definitions

OHL -- average hearing threshold of 25 dB or greater at OHL -- average hearing threshold of 25 dB or greater at frequencies of 0.5k, 2k, 3k, and 4k Hz in either earfrequencies of 0.5k, 2k, 3k, and 4k Hz in either ear

Standard threshold shift (STS) -- average increase from Standard threshold shift (STS) -- average increase from baseline of 10 dB or more (pure tone test in the baseline of 10 dB or more (pure tone test in the frequencies of 2k, 3k, and 4k Hz in either ear)frequencies of 2k, 3k, and 4k Hz in either ear)

NIOSH defines STS as shift from baseline of 15 dB or NIOSH defines STS as shift from baseline of 15 dB or more at any test frequency in either ear more at any test frequency in either ear

Tasks

Comprehensive statistical analysisComprehensive statistical analysis

Risk ratios estimated for hearing loss (OHL Risk ratios estimated for hearing loss (OHL and STS)and STS)

Multilevel analysis Multilevel analysis

industry level adjusted for individual factors (age & sex)industry level adjusted for individual factors (age & sex)

Disseminate reports & at least one peer Disseminate reports & at least one peer reviewed paperreviewed paper

Outcome – 1st year (2009-2010)

Initial contacts with 3 providersInitial contacts with 3 providers

Data use agreement (between providers and Data use agreement (between providers and NIOSH)NIOSH)

Industry codingIndustry coding

Established a secure web site for data Established a secure web site for data upload/downloadupload/download

Data retrieval in progressData retrieval in progress

Outcome – 2nd year (2010-2011)

Recruit 5 more audiometric service providersRecruit 5 more audiometric service providers

Design NIOSH OHL data repositoryDesign NIOSH OHL data repository

Continue audiometric data managementContinue audiometric data management

Begin analyzing audiometric dataBegin analyzing audiometric data

Produce reportsProduce reports

Expected outcomes upon project completion

This project is anticipated to:This project is anticipated to:

Measure incidence/prevalance of OHLMeasure incidence/prevalance of OHL

Identify industrial sectors with the highest Identify industrial sectors with the highest rates of OHLrates of OHL

Set research priorities Set research priorities

Guide workplace interventions Guide workplace interventions

Discussion -- Issues

Data confidentiality is assuredData confidentiality is assured

Audiometric data quality assuranceAudiometric data quality assurance

-- work in progress-- work in progress

More participation is neededMore participation is needed

Acknowledgement

Mark StephensonMark Stephenson

Theresa SchulzTheresa Schulz

John SestitoJohn Sestito

Scott HennScott Henn

Christa ThemannChrista Themann

Thais MorataThais Morata

Chandran AchutanChandran Achutan

Kenneth RosenmanKenneth Rosenman

ContactE-mail) STak@cdc.govPhone) 513-458-7117