America’s most common workplace injury is hearing loss

Eight years ago, Jeff Ammon, now 55, began noticing a feeling of pressure in his ears every day after work.

Over the next months, when his symptoms progressed into a slight loss of hearing and sensitivity to noise, he became worried. Ammon, a construction worker for 32 years, eventually started wearing ear protection hoping this would address these complaints – but it was too late.

From that point on, sounds ranging from the hum of a lawnmower to normal tones of conversation caused a piercing, jabbing pain in his inner ear. He stopped working in 2011, when the pain became unbearable. He also hears ringing in his ears and experiences dizziness, both side effects of the auditory damage.

“It’s debilitating … completely,” he said.

Ammon spent almost all of his working life surrounded by the loud noises of jackhammers, saws and air compressors. Now he avoids going outdoors, choosing instead to stay in his soundproof basement in Lebanon, Pa., and communicate with his doctor mostly through an online patient portal.

“The medication to address pain has not been very successful at all. … I’m also on some medication for stress, anxiety and depression,” he said. “It has isolated me from society.”

Ammon is not alone in suffering from workplace-related hearing loss.

In fact, according to the Centers for Disease Control and Prevention, it is the most common work-related injury with approximately 22 million workers exposed annually to hazardous levels of occupational noise. Workers in the mining sector, followed by those in construction and manufacturing, are most likely to suffer from hearing impairment. An estimated $242 million is spent on worker’s compensation annually for hearing loss disability, according to the Department of Labor.

In an effort to reduce these numbers, the Labor Department launched a challenge earlier this summer called “Hear and Now,” in which it is soliciting pitches for innovative ideas and technology to better alert workers of hazardous noise levels.

But critics say that while these efforts might help, technology to reduce hearing injuries already exists. They contend that the maximum level of noise exposure allowed before employers are required to provide sound-protection equipment is too low, and the regulations developed by the Occupational Safety and Health Administration are outdated. For example, those regulations use sound level limits that don’t factor in the noise exposures that occur beyond the workplace – at restaurants, concerts and sporting venues, for instance –  that can add to workers’ cumulative risks of harm.

According to OSHA officials, the agency will issue a request for information later this year about current regulations at construction sites to figure out if more stringent protections are needed and how companies are complying. (The construction industry has often been held to separate noise-related rules and requirements than those in place for other industries.) The review may lead to an update to these rules, most of which date back to the 1970s. A similar call for information was issued in 2002, but no changes resulted from the action.

Employers may also have to shoulder the responsibility of instilling more awareness and education among their workers. For example, workers sometimes choose not to wear hearing protection at work sites because they are not aware of their risks – especially when they are not operating loud equipment.

Mark Cullen, a professor at Stanford University who explores workplace hazards,found in a study that the employees who suffer most from hearing loss were those who were working in jobs involving moderate noise levels instead of high-noise environments.

“At very high noise exposures, people very faithfully wear hearing protection and at low noise situations, people don’t,” he said.

For general industry workers who are exposed to noise for eight hours a day at or above a time-weighted average of 85 decibels, OSHA requires employers to provide notification, audiometric testing and free hearing protectors. Employers also have to offer training programs for affected workers. The limit is 90 decibels for an eight-hour exposure for construction industry workers.

Cullen said employers could build noise barriers or eliminate noisy equipment, but old factories often choose to just offer hearing protection gear.

“But the problem with hearing protections is it is way too easy, unsupervised, to take it off,” he said. “What would really make a difference is to train employers.”

He said there is also existing technology that will measure noise exposure in real time in each worker’s hearing protection gear, with lights that will flash when the level becomes hazardous. The data can be downloaded each day to monitor daily exposures.

Ammon worked for several small construction companies building houses.

He said he was never told to wear ear protection. His colleagues didn’t wear it either. No one talked about it and, even when he worked with loud equipment, he wasn’t aware of the need for it.

“It costs money. That’s my opinion on why it’s gotten as bad as it has, at least for small construction companies,”

Ammon said, and the rules are “just not enforced.”

Some of the steps taken by the federal government to move toward tightening regulations and increasing awareness suggest this might be changing. But in the meantime, people like Ammon, who feel disabled by their condition, might face difficulties in getting recognition for their symptoms and financial support.

He applied for Social Security disability benefits but was rejected because his condition was not on the Social Security Administration’s list of medical diseases considered disabling. When he first experienced his symptoms, he visited dozens of audiologists who only told him he had slight hearing loss. Research linking hyperacusis – unusual tolerance toward ordinary sounds – and pain was only at its infancy.  Specific treatments still are not available for people with this type of hearing damage.

These days, he experiments with new medications or therapies, hoping for more awareness about the illness – and about protecting hearing at the workplace. He is waiting for the third appeal for Social Security disability benefits.

“I’m hearing a little more about it, but not nearly enough,” he said. “And it needs to start at the workplace.”

Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation