Occupational hearing loss: an interdisciplinary challenge.

Hearing loss caused by occupational noise exposure has been recognized since the industrial revolution. Today, there are still millions of employees with occupational hearing loss (OHL), making it our most prevalent industrial disorder. Even though cost-effective means to prevent nearly all cases of OHL have been available for many years, it continues to occur. The social and economic consequences of hearing loss affect nearly every household in industrialized nations. Nevertheless, great progress has been made in bringing the problem to public attention and in preventing OHL in millions of workers.

Since the late 1940s and early 1950s, a growing number of people have shown their concern for OHL by dedicating their careers to understanding and preventing this form of hearing loss. Occupational physicians, otologists, audiologists, engineers, basic research scientists, occupational nurses, industrial hygienists, health and safety personnel, corporate executives, labor leaders, attorneys, legislators, equipment manufacturers, environmentalists, and others are involved actively in various aspects of the problem. Much has been learned through the efforts of pioneers in many disciplines, and millions of cases of OHL have been prevented, especially since the implementation of the Occupational Safety and Health Act (OSHA) and its hearing conservation amendment in the United States in 1983. Nevertheless, much remains to be accomplished.

Many facets of hearing loss (occupational and otherwise) require research and clarification. Genetic and other factors that may predispose individuals to sustain more or less hearing loss in the same environment remain obscure. Techniques for advancing and implementing technology to control environmental noise require greater research and development. Implementation of currently available safety precautions in noisy industries worldwide should be possible, but such protection has not yet been accomplished fully and consistently, even in the United States. Implementation of reasonable and consistent legislation across jurisdictions is needed to provide just compensation for workers who sustain OHL, to help assure compliance with safety guidelines, and to eliminate many inequities and inconsistencies that exist under current laws.

Addressing these and many other issues is a daunting but exciting challenge. The otolaryngology community should guard against becoming complacent with regard to this important problem. The fact that we have been hearing about it for 50 years does not mean that the scientific, social, or political problems have all been solved. We believe that finding solutions to the problems of OHL will be facilitated in the coming decades by coordinated interdisciplinary research. Otolaryngologists should continue to serve as advocates for prevention of hearing loss from OHL (and other preventable causes) and should continue to collaborate with basic scientists, engineers, geneticists, audiologists, occupational physicians, and the many other professionals whose insights and actions should eventually eliminate occupational noise as a cause of hearing impairment.

ROBERT T. SATALOFF, MD, DMA 

Editor-in-Chief

EAR, NOSE & THROAT JOURNAL

JOSEPH SATALOFF, MD, DSc

Professor of Otology 

Jefferson Medical College

Thomas Jefferson University 

Philadelphia