Anil,
Sounds like a good AFOM paper 2 question !
Answer :
Allows identification of other causes of hearing loss (possibly treatable)
Gives opportunity for one to one health education about Personal Protective
Equipment use
Allows sensitive individuals to be identified and further educated
(Temporary Threshold Shift may identify)
Allows inspection of PPE (get them to bring it with them - dirt inside the
muffs = not worn)
Pooled results of audiometry will show overall effectiveness of policy (if
numbers under surveillance increase, or if deterioration in thresholds, then
policy is not effective no matter what the Hygiene measurements on the day
they were done)
None of the above have strict medico-legal uses, but all would form part of
a noise control policy - which does have medico-legal purpose.
Audiometry fulfils the HSE criteria for Health Surveillance :
Is there a disease that can be identified ?
Can it be identified before serious or permanent handicap ?
Is the technique sensitive and specific ?
Is the technique non-invasive and acceptable to employees ?
Geoff Helliwell
(did I pass Anil ?)
-----Original Message-----
From: This list will be of interest to all practitioners of occupational
and envi [mailto:[log in to unmask]]On Behalf Of Anil ADISESH
Sent: 24 April 2001 14:50
To: [log in to unmask]
Subject: Re: Hearing tests
Is there a useful medical (non medicolegal) function for
occupational audiometric surveillance that cannot be achieved by
hygiene measures alone?
Date sent: Wed, 18 Apr 2001 21:54:38 +0100
Send reply to: Geoff Helliwell <[log in to unmask]>
From: Geoff Helliwell <[log in to unmask]>
Subject: Re: Hearing tests
To: [log in to unmask]
Alex,
HSE published methodology in 1995 - they expect a booth meeting appropriate
BS (haven't got chapter and verse on my tongue tonight).
There is only one reference to a legislative requirement for audiometry,
MHSAW Regs 1999 say "would normally be expected" at >105dBa (you will be
nowhere near there).
So if the drive is not HSE compliance, perhaps you are being asked to do it
to measure the effectiveness of their Noise Control programme, or for
Employer's Liability Insurance purposes - I would suggest doing either of
these things without full Quality Control procedures, including calibration
of audiometers, training of staff to British Audiology Society standard, and
assessment of booth - would be a waste, it would certainly not stand up in
court of law as a defence for a civil claim.
As 14% will get 30dB loss in 30 years work at 80dBa (the effect of
Presbycusis)and 16% at 85, and 30% at 90dBa - how will you tell the
difference in this level of handicap if your lack of booth could add 10 to
15dBa to the perceived threshold?
The customer can be king, but be sure they have appropriate advice before
they make their decision to have non-booth audiometry or your NHS trust may
become liable for the eventual civil claim costs that cannot be defended
(how does the NHS handle this type of liability ?).
Why do you not have a booth for use within your own NHS trust ?
Dr. Geoff Helliwell MB ChB CIH FFOM MIOSH
Medical Director
WellWork Ltd. UK
-----Original Message-----
From: This list will be of interest to all practitioners of occupational
and envi [mailto:[log in to unmask]]On Behalf Of [log in to unmask]
Sent: 18 April 2001 19:51
To: [log in to unmask]
Subject: Hearing tests
As a relatively new recruit to the world of occupational medicine b doing
a
couple of sessions for our local NHS trust-I would value the lists advice.
The trust has been looking for some outside contracts and a local
manufacturing company has approached us to provide their occupational health
service. I have not visited the site, as yet, but I understand that there
are
areas within the factory where the First action level is exceeded and ear
protectors are provided.
The company is keen for us to provide preemployment hearing tests b whilst
we
have trained nurses and a pure tone audiometer- we donot have a purpose
built
test booth.
I understand that a noise survey is carried out, on a regular basis, by an
outside contractor.
Under these circumstances does the list feel that it would be appropriate
for
us to be carrying out hearing tests in a quiet but not sound proofed room?
Alex Swan
Occupational Health Department
Northampton General Hospital
Regards
Anil
Dr. Anil Adisesh
Consultant in Occupational Medicine
Cardiff & Vale NHS Trust
University Hospital of Wales
Denbigh House
Heath Park
Cardiff CF14 4XW
Tel. 029 - 20743264
Fax. 029 - 20744411
email [log in to unmask]
|