Title: Life cycle analysis of noise and hearing handicap in Finland
1Life cycle analysis of noise and hearing handicap
in Finland
- Esko Toppila1, Ilmari Pyykkö2,
- Rauno Pääkkönen1
- 1Finnish Institute of Occupational Health
- 2University of Tampere
2Noise and Work
Military branch
Industry
Services
Schools
Environment
Communication
Hearing loss
Annoyance
3Characteristics of work in 20th century (Ruben
2000)
4Hearing handicap
- Symptoms
- hearing loss
- hyperacusia
- difficulties in sound localisation
- tinnitus
- reduced speach intelligibility especially in
ambient noise - diplacusis
- --.
- Symptoms start typically in age of 45
- First affect in poor acoustical conditions
5Classification of hearing handicaps
- Non-noise induced (gt10 of people under 65)
- Presbyacusis
- Often genetic background
- CNS infection, ear infection
- sociocusis
- Middle ear problems (seldom)
- Noise induced (lt10 of workers in noise over 85
dB) - Acute trauma
- Chronic trauma (The "real" hearing handicap)
- Evaluation based on audiogram
- Tinnitus .. do not affect typically
6Social effects of hearing handicap
- Reduced speech intelligibility
- Do no understand especially in ambient noise
- Social isolation
- Mental problems (. 2x)
- Tendency to believe that others make fun
- Increased accident risk
- Misunderstanding instructions
- Failure to hear warning signals
- Reduced career opportunities
- Training difficult speech
- is not understood
- Increased risk of unemplyoment
- " dumb people do not work here"
- Reduced capability to localize sounds
- Increased accident risk
- if moving machines around
- Reduced speech intelligibility
7Social effects of hearing handicap
- Tinnitus
- Increased annoyance
- may interfere with warning signals
- sleep disturbance
- avoidance of social noisy events
- concerts, public events,.
-
- Hyperacusia
- stress
- avoidance of social noisy events
- concerts, public events,
8Self evaluated hearing
Normal
Mild
Moderate
9Quality of life and self-evaluated hearing
80
70
60
50
EQ-5D thermometer
40
30
20
1
15
161
257
147
N
Deaf
Some difficulties
Normal
almost deaf
Minor problems
Self-evaluated hearing
10Effect of hearing in different populations
0.9
0.9
0.85
0.85
0.8
0.8
Normaali
Normal
0.75
0.75
Liev
ä
Mild
0.7
Kohtalainen
0.7
Moderate
Vakava
Almost deaf
0.65
0.65
0.6
0.6
0.55
0.55
0.5
0.5
Technicians
TAYSlt66
Laminoijat
Puusep
ä
t
Korkea
Users of hearing aids
Physical workers
High comm workers
Kommunikaatio
11Life cycle of noise
(20-30 y)
(0-5 y)
(45-68 y)
-Exercise -Noise limits in discos -Teaching
attitudes
Accumulation of noise effects
Ambient noise Free time noise
- Vaccination - Personal pacifier
Nosocusis Discos and concerts Equipment
Earlier access to hearing aids
Life style Work noise
- Hearing protection
- Healthier life style
-Better hearing protection
Infections
Early retirement dementia
Ambient noise
-Personal hearing solutions - Office noise
Conscript noise
12Estimates of the size of the problem
- Number of conscripts with hearing loss gt20 dB at
any frequency has increased from 13 to 20 - Noise ?
- Life style factors (Young age cholesterol RR7.2,
Pyykkö et al 2007) - Kindergarten infections ?
- Call centers (Toppila et al 2008)
- 15 -25 complaints about hearing
- Demanding job -gt subclinical hearing loss
important - Protection against work noise not efficient
- In elderly people in noisy occupations
overpresented in hearing aids fitting - Factor 2
13Size of problem
- Finland looses 21 B every year because of early
removal from workforce (Ahonen, Vainio 2010) - Hearing impairment seems to be involved in 5-15
of the cases - Annual cost 2.1 B (Extrapolated to US 176 B)
- Mostly from work not done
- Direct costs 200-400 M (Extrapolated to US
2.5B) - These calculations exclude
- Lost career opportunities
- Effect on pensionnaires
- earlier dementia etc.
14Hearing loss, removal from workforce and
statistics (Total workforce 2.2 M)
Ei ty
ö
melua 1600 000
No worknoise 1600 000
2000
2000
Risk group
Unempolyment
for early removal from workforce 250 000
Toistuvat
Repeated
300
-
500
300
-
500
korvatulehdukset
infections
3000
3000
Vapaa
-
ajan
100
-
400
-
100
-
400
Free time
Early retirement
Melu
noise
300
-
500
300
-
500
30
-
40?
30
-
40?
Accident
Asevelvollisuus
Conscript noise
melu
500?
500?
1000
1000
Dementia
Nuoren i
ä
n
Young age
kolesteroli
cholersterol
lt10
lt10
Statistics
Stat
Ototoxic
130
Ototoksinen
130
l
ää
kitys
medication
NIHL
1000
1000
Riskitekij
ä
t
Risk factorsj
50
50
Hearing loss
Worknoise
700
700
0
0
Noise caused accident
70
Combined exposure
A
70
Chemicals, vibration, medication
Work noise 400 0000
15Potential for savings
- Reduction of sociocusis, early age effects 30
- Reduction of Noise Induced Hearing Loss 70
- Not 100 because of overdiagnosis
- Totally in work force 35
- 750M/y (US 62 B)
16Discussion
- Noise is underestimated problem in modern
societies - Affects people with hearing handicap in harsh
communication environments - Cause for underestimation
- Affects several factors
- Never the most important factor but ranked 3-5
(de Hollander et al 1999) - To reduce the adverse effects of noise
- work noise protection
- reduction of nosocusis
- protection of free time noise