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Hearing damage

Loosveldt Wannes
SAE-Bruxelles
AEPS906
10-07-2008
Introduction
I' ve chosen this subject because the link between loud music and hearing loss remains
unclear. Although, for me, it is indisputably clear that high sound pressures can
damage the hearing apparatus, several governments stagnate in insignificant debates
and vague information campaigns. But has the government already come to a point of
legislating rules concerning hearing loss? Are there any laws already to protect
workers and if they exist, do they apply for all workers in all branches or are they
specified for one or several jobs? How cornes festivals and clubs can play such loud
music that the sound pressure becomes violent to listeners and is there a maximum
limit for MP3-player?
In the first part of my work l'Il explain the human hearing apparatus. In the second
part l ' Il discuss noise-induced hearing loss. There l'Il try to find out what' s legally
determined, what are the maximum output levels of MP3-players, what influence
have different headphones on their output level and how do companies such as Apple
and Creative to protect their clients. Afterwards I'll expose sorne other domains where
hearing loss appears such as orchestras, musicians, etc. It was hard to write a lot about
these specifie, last mentioned, subjects because the main issue has been illustrated in
the preceding chapters.
I hope to extend a sharp-witted summary from what has been written already about
this subject. I have read much information written by and about the Belgian
government, European Council and many, many hearing loss researches. Almost
every text linked different values to similar researches and sometimes even, basic
information was missing which made it impossible to interpret these values on
professional basis. The amount of information is reflected by the amount of pages in
the appendix, which counts almost twice as much page as the case study itself. I have
been filtering information and I tried to create a respectable file concerning damage to
the hearing system. I hope to have succeeded in my wish to bundle the most important
information about this subject.
2
The human hearing system
Introduction
When we examine hearing loss it is important to know the different parts of the
human hearing apparatus and the ir functions. Damaging one of the different parts can
result in diminished functioning; its specifie goal can't be fully obtained any longer.
This can lead to hearing loss. Not only to know the reasons ofhearing loss but also to
do research to find solutions it is good to get to know how the human hearing works.
It is most important to know that the auditory system converts pressure divergences
into nervous-impulses what leads to the possibility ofhearing these pressure
divergences (sound/noise). The auditory system can be split into three different parts.
Every part has its specifie takes in the process of capturing, converting and
experiencing sound.
semi circvlar canals
elliptical window
lnCUS
1
circu r window
vesbbular
" nerve
mal lous
auditory
canal
eympamc membrane
(eardrum)
stap s
nerve
eustachan tube
3
The outer ear (Auris Externa)
The most visible part of the hearing system is called the pinna, this is a cartilage fold
surrounding the auditory canal. The auditory canal is actually divided into two parts,
the meatus acousticus externus is part of the outer ear, this is the auditory canal at the
outside of the tympanic membrane or eardrum. The pinna is responsible for capting
the vibrating air and contacts the caped vibrations to the middle ear through the
auditory canal. The form and dimensions of the pinna and the angle of the in co ming
sound take part in the way we shall experience sound.
The pinna as low-pass fil ter
When low tones (low frequencies have larger wavelengths) arrive at the backside of
the ear, their waves shall bend around the pinna and reach the auditory canal without
any problem. When the frequency increases, the wavelength becomes shorter and the
waves encounter more and more problems to bend around the pinna. In this case we
can talk about a so-called 'shadow effect'. The sound waves not able to bend around
the pinna won't be captured as clear as those possible to bend around the pinna, this is
called the 'shadow zone' , this is the zone where we cannot perceive waves in the
concerning frequency ranges (high frequencies). High tones are muffled and the
overall perception of the in co ming sound becomes duller.
The pinna as comb-filter
Not every sound shall directly reach the auditory canal. Sorne of them will first be
reflected on the pinna before they enter the canal. It is clear that there will be a certain
delay between sounds directly attaining the canal and sounds that are first reflected
before being pointed at the entrance of the canal. This can result in dephased waves
when they are sending to the tympanic membrane. The frequencies being in opposite
phase will be attenuated, others, being in phase will be amplified. This is a typical
characteristic of comb filters. The intensity of the filtering depends on the frequency
and the angle of the incoming sound.
The auditory canal as resonance fil ter
When sound waves propagate in a (semi-) closed tube, such as the auditory canal,
certain frequencies will resonate more than others. The frequencies that resonates
most are tho se of which V4 of the ir wavelength is similar to the length of the tube
(auditory canal). We know that the auditory canal measures approximately 3
centimeter. When we calculate the length of the wave ( 4 * 3 cm), we get to know that
we are looking for a frequency with 12 cm wavelength. The formula to calculate
frequencies, only knowing their golf length is f = C ..;.. length; with f = frequency in
Hertz and C = celerity (340m/s in 20C). Thus we can state that the auditory canal
will resonate at approximately 2800Hz. These frequencies will encounter a slight
boost comparing to the others. The sizes used in the example are average values for
adults.
4
The middle ear (Auris Media)
The middle ear consists out of the tympanic membrane (membrana tympani), 3
delicate bones (ossicles) which are the harnmer (malleus), anvil (incus) and stirrup
(stapes). The base plate of the stirrup is attached to the elliptical window (fenestra
vestibuli).
When vibrations reach out for the eardrum, the membrane moves along. The harnmer
is connected to the eardrum and this connection ( called the umbo) transmits the
vibrations to the ossicles. Finally the stirrup carries the waves via its base plate onto
the elliptical window, which is connected with the inner ear. The functioning of this
part of the auditory system will be described later on.
Just like the outer ear, the middle ear influences the way we percept sound. These are
sorne of the main interferences of the middle ear in the perception:
The middle ear - or stapius reflex
When the stirrup moves the base plate in the elliptical window, the base plate will not
move parallel re garding to the surface of the elliptical window. The plate will react
like a door and tum inwards. In case the sound pressure gets to high (>80dB(SPL))
the middle ear muscles, M. Stapedius and M. Tensor, will contract. A contracted M.
Stapedius will change the axe of the base plate from the si de to the middle of the
plate. The movement of the plate receiving pressure divergences is now comparable
to the movement of a revolving door.
The main function of the base plate is to transfer the vibration into the liquid behind
the elliptical window. When the axe of the plate is positioned in the middle of the
plate, the liquid will be pushed inwards at one side and at the other side there' s a
suction that prevents the liquid of being pushed inwards too heavily. This function
will attenuate the pressure with maximum 20dB and is most effective for the lower
frequencies.
The impedance transformator
When sound propagates through a substance, the sound waves experience an acoustic
resistance, this is the impedance (Z = density * celerity). The amount of sound that is
let pass from one to another substance is called the transmission, calculated T = 4 r --;-
(r + 1)
2
. In the formula, r stands for the relation between both impedances sor = Zliquid
--;- Zair The impedance of air by 20C is 415 Rayl and the impedance of the inner ear
liquid is more or less 1 610 000 Rayl; which makes r = 3880. When we fill in r in the
transmission formula, we get to know that the transmission between air and liquid in
our inner ear is 0,0013 or T = approximately 111000. Imagine the human ear was not
accommodated to this situation, only 0, 1% of the incoming sound would be
transferred in mechanical energies. In dB, the transmission T = 10log (0,001) = -30,
an attenuation of -30dB would have been made in case the hearing system was not
adapted to this. This loss is compensated by the middle ear in different ways:
1. The middle ear functions as transformation of pression. This means that little
pression variations will be converted into larger variations, these larger
variations are easier to perceive. The conversion follows the formula (Piiquid --;-
p sound = eardrum
7
Obaseplate), this means that the pression in the inn er ear liquid
5
responds to the pression of sound in the same way like the surface of the
eardrum res ponds to the surface of the base plate. We know that the surfaces
of the eardrum and base plate are approximately 60mm
2
and 3mm
2
. The
difference in surface leads to an increase of pressure with factor 20.
2. The ossicles function similar to a lever. A lever's main characteristic is to
deliver the energy taken on the long arm to a short arm. It is this characteristic
that intensifies the energy which passes through the ossicles to the elliptical
window. In case of the middle ear, the long arm is the distance between the
eardrum and the ossicles and the short arm is the distance between the ossicles
and the elliptical window. In the formula for levers, the force multiplied by the
length of the arm must be constant, F earct rum * L1ong arm = F baseplate * L short arm
Bec a use of the difference in length there will be a difference in force to
main tain the equal results. In the middle ear the long arm is 1 ,5 times longer
than the short arm, th us the force measured at the end of the short arm is 1 ,5
times stronger than the original force measured at the beginning of the long
arm, the eardrum.
If we combine both compensations, the pressure given to the elliptical window won' t
be 20 or 1,5 times as big but (20 * 1 ,5) 30 times as big as the pressure captured at the
tympanic membrane. Expressed dB, 20 log 30, the middle ear is responsible for a gain
of29,54dB. This, more or less, corresponds to the loss of energies caused by the
transmission.
Note: In reality the ratio between the short and long arm is not 1,5 but 1,3. The
conicalform ofthe tympanic membrane assures the other 0,2 ratios, which make the
compensation approximately 30dB anyway.
Resonance in the middle ear
The frequency of resonance of the ossicles is not determined for a small band of
frequencies; it occupies almost the whole range of audible frequencies. This results in
a broadband filter. Though, due to research but without any prove, we can state that
the ossicles resonate a little more on approximately 1500Hz. Also the cavity, filled
with air, where the ossicles are positioned has a resonance frequency, which is more
or less 2000Hz.
The combination of the resonance frequencies of the extem auditive canal, the
ossicles and the middle ear cavity result in a filter accentuating frequencies between
1OOOHz and 5000Hz.
6
The inner ear
The inner ear is a cavity in the skull bone which is filled with liquid. The composition
of this liquid is comparable to sea water. This liquid is locked up in two concentric
bags. The extemal bag is filled with perilymphe, the internai bag, situated in the
extemal bag, is filled with endolymphe. The inner ear has two functions: it regulates
the balance- and hearing system. I'll explain only the hearing system, because it's
more important in this case.
The cochlea is situated in the cavity of the middle ear. It is separated into three
different parts, three parallel canals with approximately 3,5 cm length. These canals
are wounded up around a central ax (mediolus). The extemal two canals (scala
vestibuli and scala tympani) are filled with perylymphe and at the inner extreme they
are connected through the helicotrema. Between both canals, is situated the scala
media, this canal is filled with endolymphe. The scala media is separated from the
other two by the basilar membrane.
The cochlea has two holes leading to the middle ear. The first one is situated at the
root of the scala vestibularis and leads to the elliptical window; this opening is shut by
the base plate of the stirrup. The second ho le is located at the beginning of the scala
tympani and leads to the round window; it is shut by a membrane.
Organ of Cor ti
The actual hearing organ is situated on the basilar membrane and is called the organ
of Corti. This organ includes four rows of hair cells stretched out over the length of
the basilar membrane. The row at the inside counts more or less 3500 cells, every cell
holds 20 nerve fi bers, these cells are separated of the others by the tunnel of Corti.
The other rows count more or less 25 000 cells of which each 10 cells share 1 nerve
fi ber. It is clear that, because of this, the connection between those cells and the
central nerve system is less intense than the connection between the central nerve
system and the inner hair cells.
The tectorial membrane is placed on top of the organ of Corti. The hair cells rest in
small sockets at the bottom of this membrane and they will bow wh en the membrane
moves in order to the organ of Corti. This is how the cells deliver a so-called action
potential, a signal to the central nerve system.
Electrical f eatures of the inner ear
When we consider the perilymphe, situated in the scala vestibuli, as the electric
neutral (OV), we can measure a potential in the scala media similar to +80V. This is
caused by the stria vascularis (where the endolymph is not devided from the bone by
the perilymph) which donates positive salt-ions to the endolymph.
All cells in our body are enclosed by interstitialliquid. This liquid contains Kalium-
and NatriumChloride, together they are salt. Cells belonging to the nerve system
contain an intracellular liquid. This liquid covers up to 50 times more KaliumChloride
as NatriumChloride. Both liquids (interstitial and intracellular) are separated by a cell
membrane with a width of2 * 10
2
. This membrane is semi-permeable, what means
that the solved salts can pass easier from one side to the other then the other way.
Because of this characteristic, there' s an electric potential at the inside of the hair cells
of -60 rn V comparing to the outside. Whenever the hair cells bend over, the cell
7
membrane becomes permeable and the +80m V potential discharges in the hair cell.
The cell it's negative potential (-60mV) becomes positive for an instance and this
' disorder' propagates through the nerve system. This phenomenon is called ' action
potential ', it means the re is a signal for the nerve system that one of the hair cells
bowed over. These action potentials are transported by neuritis or axons (shoots of the
cell bodies).
After being positively charged, the nerve cells repair their self and the electrical
balance cornes back to its normal point, this is called the refraction period.
8
Noise-induced hearing loss
Introduction
Hearing loss can be caused by several factors such as diseases, too much/loud noise,
malformation from birth, etc. The most occurrent diseases are discussed in appendix
1. As you will see in the appendix, there are plenty of diseases able to jeopardize the
human hearing system. Although it is interesting for people working with and creating
sound to know as much as possible about this, in this memoire I will, more or less,
on1y talk about noise-induced hearing loss.
What is Noise-induced hearing /oss (NIHL)?
Every day we get in touch with sounds in our environment such as traffic sounds,
telephones, airplanes or helicopters, etc. Normally, in these situations, such sounds
are heard at levels harmless to our hearing apparatus. However, when we are exposed
to harmful noise, which means noise that' s too loud or last too long, hair cells can be
damaged, causing noise-induced hearing loss (NIHL). Once hair cells are damaged
they cannot regenerate like most of marnmalian cells.
NIHL can find its origin in exposure to intense short sounds (impulses), such as a
gunshot, or it can be caused by exposure to loud sounds over an extended period of
time. Long or repeated exposure to sounds at or above 80 or 85 decibels can cause
hearing loss. The louder the sound, the shorter the time period before NIHL can
occur. Sounds less than approxirnately 75/80 decibels are un1ikely to cause hearing
loss.
Although being aware of decibellevels is an important factor in protecting one' s
hearing, distance from the source of the sound and duration of ex po sure to the sound
are equally important.
Exposure to harmful sounds causes damage to the hair cells as well as the auditory
nerve. Impulsive sounds can result in immediate hearing loss that may be permanent.
This kind of hearing loss may be accompanied by tinnitus, a ringing, buzzing, or
roaring in the ears or head, which may subside over time. Continuous exposure to
loud noise can also damage the structure of hair cells, resulting in hearing loss and
tinnitus, although the process occurs more gradually than for impulse noise.
Exposure to impulse and continuous noise may also cause only a temporary hearing
loss. If a person regains hearing within a certain time, the temporary hearing loss is
called a temporary threshold shift (TTS). The temporary threshold shift largely
disappears 16 to 48 hours after exposure to loud noise. Y ou can prevent NIHL from
both impulse and continuous noise by regularly using hearing protectors, discussed
later on.
9
What's too /oud according to Belgian authorities
In their directive on the minimum health and safety requirements regarding the
exposure ofworkers to the risks arisingfrom physical agents (noise}', the European
Parliament and Council assumes 80dB(A/ to be the lower exposure action value,
85dB(A) to be the upper exposure action value, and 87dB(A) to be the exposure limit.
The lower exposure action value beholds the employer, when attained, to put hearing
protection at disposai of his workers, inform them about the possible danger and let
them undergo a hearing test; the upper exposure action value beholds workers to use
the disposed protection, inform them about the possible danger and let them undergo
a hearing test; the exposure limit, when attained, forces the employer to take measures
and lower the exposure level. These values are measured for a 5 days week, 8 hours
of work each day.
In the Royal Decree
3
of J anuary 16th, 2006, maximum values have be en registered in
the Belgian law in conformance with the directive on the minimum health and safety
requirements re garding the ex po sure of workers to the risks arising from physical
agents (noise) by the European Parliament and Council. Just like Belgium, The
Netherlands adapt their law in accordance to the European directives. This means that
employees can no longer work in workplaces where there's more then 87dB (A), this
for eight hours a day, five days a week.
When the hearing system encounters extremely high sound levels, the threshold of
hearing will automatically be heightened. After certain time, the threshold will restore
itself, but only when the ears get time to rest, which means when they are no longer
exposed to high sound levels. If they do not get enough time to restore, the threshold
won't come back toits normallevel, in this case we can talk about noise-induced
hearing loss. It is said that you can listen eight hours to 80dB (A) without any risk and
for each rise of 3dB, the listening time most be halved. This means that it is not safe
to listen more than four hours to 83dB(A) and for lOldB(A) it is safe to listen no
longer then 3 minutes and 45 seconds. Certain sources state that listeners will directly
encounter damage when listening to sound levels of 100- 120dB (A). When we
don' t take these levels into account, the threshold of hearing will increase which
results into less intense reaction on received signais of the human hearing apparatus.
Due to this less intense reaction, sound will come across less clearly to the hearing
system, that' s wh y sorne people tend to heighten the sound lev el of music, telephone,
television, etc. systematically after listening for a while. It is important to know that
the only way to enjoy sound in a healthy manner is to rest often and give your ears
enough time to resto re the ir threshold of hearing.
The directives of the European Parliament and Co une il have been effectuated to
protect employs in their working environment. Theoretically taken, music-studio is
also submissive to this law. Practically, it is clear that studio engineers will encounter
levels much more intense then 87dB (A) without the possibility to lower these levels.
Nevertheless it is these people who have interest in not attaining any hearing damage.
Therefore it is important for musicians, engineers and other people in musical
environments to look for the best ways to protect their selves. Wearing earplugs or
earmuffs while placing mies and instruments or lowering the level while mixing
might be just sorne of possible solutions.
Beside these specifie examples there are also concerts, parties, festivals and many
other situations where it is difficult not to exceed laid limits. Another Royal Decree
10
(1977) disallows public institutions to produce electric empowered sound increasing
90dB (A). On the other hand it is possible to request an exception for open air events
such as festivals. In 2006, Prof. Bart Vinck did research on the produced dB levels of
severa! festivals. The results partly affirmed why more and more people suffer
hearing loss. Most of the festivals exceeded 90dB, sometimes the research team
measured dB levels of 110, even 120dB. According to the instigated enquiry, 25% of
the visitors caught permanent hearing damage, besides, 60% said to suffer tinnitus,
which means that they hear one or more frequencies, even in the absence of a sound
producing source. Likewise, on bashes, jamborees or parties, the organizations rarely
restrains their selves or dj's not to exceed the allowed 90dB (A). To apply a sound
control, competent authorities mostly wait for complaints of neighbors concerning
noise nuisance. When complaints are sending to the authorities it rarely happens that
they measure the sound in dB's on a professional way. This makes people don't really
thrust their statements and orders concerning high sound levels and the forth coming
risks. Every city has it's laws concerning nuisance, but when a club or hall is
acoustically threaded and isolated, no complaints will be made by neighbors which
makes it possible for dj 's and club owners to increase the volume, the impact ofthis
increasing is already correct now.
In the center of Bruges for instance there's a strict limit on 90dB (A) and sometimes
even playing not louder than this level, authorities don't stop complaining and forcing
us to lower the amplifier. On the other hand there's a youth center (Het Entrepot)
outside the center where we have already measured 114dB and peaks up to 120dB. In
the past 4 years I have been active as dj , the only audit to measure the sound levels
ever done by a police officer I know about has been accomplished with a cell phone at
1 meter distance of the speakers. 95dB he said, 5dB too much. I did never know it is
possible to measure sound intensity with a cell phone. When the officer left the club it
only took us 5 minutes to be at 95dB and even more, just because people are sick of
those unprofessional actions which makes police officers look unfair, not telling the
truth. People didn't think about their ears, only about partying the way they wanted to,
with loud music. This is because it is important for party people not only to hear
music but also to feel the bass, without hearing people chitchat next to you.
The government has taken already sorne steps to improve working circumstances, but
until now there is no solution for the entertainment and music business. Even in the
directives of the European Parliament and Council there's only a short indication that
member states should establish a code of conduct conform to the national laws and in
dialogue with the social partners conceming the music business. It is clear that it's up
to us, listeners of music, to decide how we treat our ears. But, it is important to know
about the possible risks that come along with the music. For that reason it is important
that people get informed about how the hearing system works and how it should be
treated and protected.
1
Appendix 2
2
dB stands for decibel, made to express the difference between two values. (A) Stands for the type
of weighting curve used to me as ure the decibels. A-weighting is the most commonly used of a
family of curves defmed in the International standard IEC61672:2003 and various national
standards relating to the measurement of sound levet , as opposed to actual sound intensity. It
anticipates on sound similar to the hu man perception of sound.
3
Appendixes 3
11
Consequences of NI HL
1 ntrod uction
The way how sound damages the hearing apparatus is not completely known.
However we do know that the damage is caused to the hair cells in the cochlea. For
sorne of the cells are more sensitive than others, NIHL will begin to affect hearing of
certain frequencies. This results in a dip manifested in an audiogram. High noise
levels damage the hair cells of the organ of Corti, affecting first tho se in the basal part
of the cochlea concemed with reception of the higher frequency sounds and
progressing through to those receiving lower frequencies. This is reflected in
audiometrie changes which show loss of sound perception first in the 4-5 kilohertz
(kHz) range, progressing both in severity and into lower frequency ranges.
Har cells
Being mentioned already, we know that sound is captured by the pinna and let to the
eardrum passing the auditory canal. Via the ossicles, the change in air pressure is let
to the cochlea, which makes the hair cells move. The louder the sound gets, the more
intense the movement of liquid in the cochlea is, which means the basilar membrane
moves more and so the organ of Corty. Finally the hair cells will bow more and more
when the sound level increases. Whenever these cells bow too much, they can snap,
an example of healthy and unhealthy har cells is put in appendix 9. Damaged har
cells do not regenerate like most of our cells, nevertheless research is done to find out
ways to repair or regenerate damaged har cells. Following next, I've made a brief
summary of sorne researches:
Fruit flies use the so called chordotonal
1
organs to detect sound. Flies that missed a
gene called Atonal, lack these organs. Scientists searched for a similar gene
responsible for marnmalian ear development. Mathl and Atohl are genes able to
restore chord tonal organs in flies missing the atonal gene. When scientists removed
the Mathl gene, flies suffered deafness and balance problems. In 2002 another group
of scientists reported that the fruit fly gene can resolve the defects of mi ce lacking
Mathl. This demonstrates a great similarity between the hearing structures of both
animal s.
In 2005 a USA research lab identified a gene responsible for the ageing of hair cells.
The gene (RBl) forces cells to exit the so-called cell-cycle and they begin to mature.
Ifwe want to make more har cells we need to activate the har cell ' on' genes such as
Mathl and inactivate the har cell 'off genes such as RBl.
How to get the genes into the har cells?
The only method used until today is the gene therapy by virus. Scientists treated
deafened pigs with a virus carrying the gene Math li Atohl and found evidence that
new hair cells were generated. The animais showed functional evidence of restoration
of hearing. The only problem with this virus is that it affects only a small number of
cells. To resolve this problem, a cow virus has been modified. It was used to repair
the har cells of rats. It gave sufficient results and almost all hair cells were affected.
Now it's all about finding a way to implement this therapy to the human race.
1
denoting sense organs (in insects), responsive to mechanical and sound
vibrations.
12
Tinnitus
Tinnitus is the perception of a non existing sound. It can be perceived in one or both
ears or in the head. Possible causes are ear infections, foreign objects or wax in the
ear, nose allergies that prevent fluid drain of the wax, injury from loud noises and it
can also be a side effect of ototoxic medications described in the last chapter. There
are two main categories of tinnitus: pulsating and non pulsating tinnitus. Pulsating
tinnitus has nothing to do with hearing loss; it's caused by a resonance effect in the
occipital bone due to vascular deviation. This form of tinnitus can be divided into two
groups: Synchrony to the heart pulse and non-synchrony to the heart pulse, more
synchrony with the rhythm of breathing. Non-pulsating tinnitus can be interpreted as
phantom sounds, induced by deviations of the hearing apparatus. In a minority of
cases, a clinician can perceive an actual sound coming from the patient' s ears,
objective tinnitus. It is mostly caused by muscle spasms that create clicks or crackling
around the middle ear. Subjective tinnitus may not always be correlated with ear
malfunction or hearing loss. Even people with near-perfect hearing may still complain
ofit.
Hyperacusis
Hyperacusis is over-sensitivity to certain frequencies of sound. Somebody who
suffers hyperacusis has problems with tolerating everyday sounds which don' t seem
to be unpleasant to other people.
It can be the result of damage sustained to the hearing apparatus or inner ear, damage
to the brain or the neurological system and in rare cases hyperacusis may be caused
by a vestibular disorder. The last type of hyperacusis, called vestibular hyperacusis, is
caused by the brain perceiving certain sounds as motion input as well as auditory
input. A lesser form of hyperacusis affects musicians, making it difficult for them to
play in the very loud environment of a band or orchestra which previously gave them
no problems. It also makes attendance at loud discos or live events difficult for a
proportion of the population.
1
fibers that ori ginate in the brain which serve to regulate sounds
Diplacusis
According to the medical-dictionary.com, diplacusis is the perception of a single
auditory stimulus as two separate sounds. There are severa! forms of diplacusis:
binaural diplacusis: different perception by the two ears of a single auditory
stimulus.
disharmonie diplacusis: binaural diplacusis in which a pure tone is heard
differently in the two ears.
echo diplacusis: binaural diplacusis in which a sound of brief duration is heard
at different times in the two ears.
monaural diplacusis: diplacusis in which a pure tone is heard in the same ear
as a split tone of two frequencies.
13
MP3-players
lntro
I' ll pay most attention to MP3-players in my case. The increase of complaints about
hearing loss in the 21st century is more and more assigned to MP3-players, a pointing
finger to the 'iPod-generation' .
In case of the MP3-player as harmful weapon against our hearing system, what has
been done already to diminish or better, avoid these problems? Are the authorities
aware of these problems and are they elaborating any laws or restrictions?
Maybe more important then any step taken by any govemment, are factories such as
Apple and Creative aware of the risks and are they cooperating to decrease hearing
loss in this and forthcomming generations?
Legal provision
Februari the 7th, 2007; The HGR
1
publishes an advise concerning the use of portable
digital music players (MP 3) and the risk of hearing los s. In this report, the HGR
states that, enough arguments can be found to reckon that new MP3-players are more
dangerous than their analog equivalents of former generations. This can, according
the text, be assigned to their smaller sizes, longer lasting batteries and bigger intem
memory. It is also a fact that because of digital reproduction and representation of
music and acclimatization of listener' s ears to sound, it is possible for the listener to
enjoy music for more extended periods without experiencing disturbing side-effects,
such as distortion or pain. According to the HGR, noise-intensity is determined by the
maximum output level of the concemed player, and the type ofheadphone used to
listen the music. They state that an in-ear type of headphone can amplify the signal up
to 9dB.
The advice given by the HGR is that all deviees appearing on the Belgian and even
European market must be controlled to decrease the excessive exposure to sound in
present-day recreation. Because of lack of epidemiologica/
2
data and dated
audiometrie screening techniques it is important to execute such epidemiological
studies, concerning the state of health of the hearing system of the Belgian population,
based on tone audiometr/ and O A ~ . They also instigate to check the listening
behavior of the population by examining audits.
Steps that should be taken according to the HGR are, to consider the noise-intensity
levels above which there exists chance to accrue hearing loss, as limits for portable
music players. These levels are the same as stated in the European guidelines
mentioned later on in this case study. They also beckon there should be put
information graphs on the packaging, and 90dB (A), not hack able, limitation plus a
dB-scale reprentation of the volume control on the deviees. HGR also claims it is
important to pay special attention to MP3-players for kids. They want to set up
information campaigns to make people be aware of the existing danger of using
portable music players
In general, the HGR made its point with estimable statements and researches.
Nevertheless, there are sorne points about which I doubt if they contain any truth. In
14
the first paragraph of this chapter you can read that the HGR believes smaller sizes of
MP3-players to be one of the reasons wh y users can listen longer periods without
being disturbed by affecting sound. Although smaller deviees are easier to carry
along, I believe this is no reason for people to use their MP3-players for longer
periods. In times when portable players were taller, bag packs where made specially
to carry these players without much hassle. Just to give one example it has never been
the size of players manipulating the listening time.
They do also seem to believe it is possible to create limitations which are not hack
able to protect users. I can not disprove this statement on scientific basis, but history
has proved that certain specialists are ahead of time and they seem to be able to hack
any software whenever they want it. Therefore I think it is more important to mobilise
the population and spread information concerning hearing loss and if possible, any
changes must be made to the hardware because certain humans will always be smarter
than software.
Last but not least, HGR says that in-ear headphones can boost the sound level up to
9dB. In several researches, discussed later on, in-ear headphones appeared to be able
to amplify music up to approximately 5dB. lt is possible that the HGR research team,
if this do es exist, found specifie head phones with the ability to boost up to 9dB but in
this case it would have been interesting to mention the type of head phones talked
about in their advice.
These are just small points of inaccuracy but nevertheless they testify certain inability
and impreciseness of one of most of the Belgian authorities concerning the
population's hearing health.
1
Hoge Gezondheidsraad; a Belgian authority for health consolation
2
it's the study of factors affecting the health and illness of populations, and serves as the
foundation and logic of interventions made in the interest of public health and preventive
medicine. (Source: en. wikipedia. org)
3
This is a subjective, behavioural measurement of hearing threshold, as it relies on patient response
to pure tone stimuli.
4
OAE or Otoacoustic Emission is a sound which is generated from within the inner ear. Numerous
studies have shown that OAEs disappear after the inner ear has been damaged, so OAEs are often
used in the laboratory and the clinic as a measure of inner ear health.
Broadly speaking, there are two types of otoacoustic emissions: Spontaneous Otoacoustic
Emissions (SOAEs), which can occur without extemal stimulation, and Evoked Otoacoustic
Emissions (EOAEs), which require an evoking stimulus. (Source: en. wikipedia.org)
What about the companies?
ft has not been easy in the last severa! years for MP 3-player designing and creating
companies. In the United States of America, a citizen has already accused Apple for
being responsible for damage to his hearing system after being exposed to extreme
and intense music levels on his iPod. His advocate states that his client bought an
unsafe deviee; he paidfor something that 's not reliable the way it is sold right now. ft
is, according to the advocate, Apple 's responsibility to corrugate their products and
relieve this problem. The American court hasn 't sentenced Apple until now, the case
will be adjudicated later on.
Apple's counter action was to release software to restrict iPod's maximum output
level and protect these limits with a self chosen code. This can be used to protect your
children from listening to irresponsible sound levels. To get to know more about this
15
limitation surfto www.apple.com and take a look at iPod classic or iPod Nano. There
you can select 'Volume Limit' beneath the 'Audio' chapter of the iPod's
specification. For models different from these two there exists no volume limitation
created by Apple such as this one. Ail though, for instance, this software ailows
parents to inhibit their children to exceed a certain volume level, it is not possible to
know at which point 80dB (A) is attained. Besicles, they provide information on
www.apple.com/sound to inform iPod-users about sound and hearing. There is a short
but clear briefing about how the hearing system works and the possible impacts of
listening to extreme levels of loud music. Nevertheless sorne things are not as clear as
possible. To express sound levels they use decibels without any reference. In
assumption they've used dB (A), like widely used when talking about sound and
hearing, 1 continue reading the information with this state of mind. They state that
increasing sound with 1 OdB is similar to a doubling of experienced sound. Though,
when we use the formula to calculate differences between two values in dB,
20log*(X/X
2
), with X1 as 2011Pa (lowest sound pressure a human can hear) and X
2
as
it's double ( 40!-LPa) to find the difference in dB between two values, is clear that a
doubling of sound pressure is similar to increscent of 6dB. This means that Apple has
put wrong information on its website. If this information would be right though, we
can assume that the information is not reaily clear for those who read it. The basics
are clear, though it's not perfect and important information, such as dB references, are
neglected.
Together with Apple, Creative is one of the most important producers worldwide of
MP3-players. Creative also contributes in the gestation of hearing problems due to
excessive sound levels, to protect its users. On the Creative website, choose in ' micro
sites': MP3-players. There you can choose 'Creative cares about your hearing '
1
. On
the first page they wam readers for the possible dangers of intense and long listening
to loud music. Creative cooperates with HEi to protect their users' hearing system.
The information on Creative's website conceming hearing and hearing loss is briefly
and clear. They advise users not to listen to levels higher then 85dB and to regularly
pause 15 minutes when listening to 85dB or more. How often it's recommended to
take a rest is not mentioned. Very interesting is a list, given on the website, with the
volume percentage of ail Creative MP3-players similar to an output level of 85dB.
This list is registered in appendix 4. lt is rarely seen that a company notes such
measurements on the ir website. 1 think this is one of the most important things a
company like this can do. Listeners can know at which level they are no longer safe to
listen long periods. lt would even be more effective if they would put this info on the
packaging op MP3-players.
1
www.creative.com; Micro sites; MP3-players; How-To; Creative cares about your hearing.
2
House Ear lnstitute; www.hei .org.
16
Limitations are hack able
According to the article 'hearing damage caused by mp3-players: Health Supreme
Court asks to send out immediate measures' on www.gezondheid.be, certain MP3-
players are able togo from 90 up to 120dB. There would be, once again according to
the article, software on the internet that could even 'boost' the volume of your iPod
up to 130dB.
After reading this, I immediately went searching on the internet for information that
would either confirm or deny the facts stated above. Several sites are listed when you
do a Google search on 'IPod volume hack'. The following site, the fust to be listed,
' http: //www.tech-recipes.com/rx/2289/ increase_ipod_volume' explains how you can
use iTunes (Apple's Media player) to have the songs you selected play louder than
initially possible. When you go to the song's 'properties' it's possible to raise the
volume up to 100%. Also being mentioned is the possibility to hack the 'lirnits' of the
iPod, meaning you can raise the volume capacity without directly changing the
properties of the song. Therefore I explored the link, leading to http://gopod.free-
go.net/. On the intro page of the site you can read 'Release the sound ofyour iPod' .
When you click 'go' the software starts to download. Once finished I open the
documents and begin reading about the fun etions of the software. I noticed if the
creators of the gopod software do not consider themselves professionals, you can read
this in the 'about gopod' section, able to select in the menu-bar. Together with the
software, a ' read me' text is automatically downloaded, it states that 'gopod' can
remove sound limitations of European iPods, though it is mentioned that the user
hirn/herself is responsible for his/her actions and also not unimportant is that
removing limits has been prohibited in France. It is also stated that gopod has
absolutely nothing to do with Apple computers, Inc.
An interesting piece of information is put in the F AQs. The gopod should adapt the
iPod's 'firmware'. The Firmware prevents the iPod from going to loud by introducing
2 bits in the pro gram code. These bits show if the IPod is 'capped' (protected) or not.
Gopod changes these bits, so the iPod won't be able to take the limits into account.
Also according to the F AQ, when modifying the volume of the iPod by changing the
properties of the songs, it will cause the songs to be deformed and distorted. When
you use gopod, such things will not happen.
Comparison between severa/ MP3-players
On www.hearingconservation.org you can consulta study into the maximum output
level of several MP3-players and the use several head phones. The results of the study
are put into a graphie which can be found in appendix 5. As resulted in this research,
in-ear headphones seem to be able to reinforce the maximum output level of the MP3-
players up to 5,5dB more then headphone types to put on the ear- In their directive
on the minimum health and safety requirements re garding the exposure of workers to
the risks arisingfrom physical agents (noise), the European Parliament and Council
state that in-ear headphones can higher the output leveZ with 9dB. These tests have
been accomplished in use of several music genres, which are Rock, R' n' B, Country,
Dance and Top 40 hits. The research staff reckons not having seen any differences of
result between the genres. Finally, a time-table has been made to express for how long
it is safe to listen to your MP3-player on certain percentages of the volume control,
different types of headphones are interpreted in the list. Also these values can be seen
17
in appendix 5. It is important to know that this table doesn't take different types of
MP3-players into account. Only the iPod, in the last colurnn, has been approached
specifically, the remaining figures apply on all other MP3-players. This has as result,
according to me, that these figures are more difficult to interpret, because such values
are different for all MP3-players. Another difficulty of the table is the way of
expressing the chosen volume controllevel, it isn't always easy to know when you' ve
achieved for example 60% of the MP3-players' maximum possible volume level.
Interesting conceming headphone types is that the isolator headphones (they isolate
the auditory canal from surroundings) can cause most damage according to this
research, followed by the standard delivered headphones for iPod. The supra-aurai
types of head phones are least detrimental.
There have been similar researches, such as the AMC/LUMC/National hoorstichting
research in order ofthe ministry of public health, welfare and sports (The
Netherlands). The measurements have been done with different gemes, MP3-players,
volume controllers and maximum output levels. Appendix 6 shows the results of this
research; everything has been put into apparent graphs. The first graph expresses the
maximum values in dB (FS)
1
for several gemes, stretched over a frequency range
from 20Hz unto 20kHz. Here also, there's no real big difference between the
examined genres, though the maximum values for classical music and R'n'B are a
little lower then for other music styles. The second graph exemplifies the maximum
intensity of several MP3-players for the same, audible, frequency range. The Sweex
Blueba/ results as deviee able to produce most output level, it can go up to OdB(FS),
followed by Samsung K3 and iPod Shuffle. For Samsung, there is no info about this
subject on their website. Beneath these ' toppers', there are several Creative models
together with Packard Bell MP3-players and iPod Nano. Sony A1200 is the lowest
one represented on the graph. Sony has put no information about sound and hearing,
hearing loss or any similar subjects on their website. It is even hard to find a Sony
A1200 model on the internet, I've only found Sony NW-A1200 which is, according to
me, the model discussed about in this research. The third graph tells us about the
influence of the different types of volume controllers, it expresses how much dBV
3
a
deviee produces for several percentages of used volume control. The rising in dB V is
qui te linear comparing to the percentages of the volume controller. There are no
eminent differences between several volume controllers. At last there' s a list with
maximum output levels for different MP3-players compared for several music gemes,
results are expressed in dB(A). The table tells us that all players can rise above 90dB
(A) and sorne can even exceed 1 OOdB (A). Sweex Bluebay is the only deviee with the
ability of passing, for seven of the nine examined gemes, 11 OdB (A).
1
It is an abbreviation for decibel amplitude levels in digital systems which have a maximum
available leve! ; 0 dBFS is assigned to the maximum possible leve!. FS means Full Scale
2
A cheap type of MP3-player, available for approximately 35. No official website has been found
for this deviee.
3
OdBV is similar to 0,775V; it can also be expressed in dBu, which has the same reference voltage.
18
Conclusion and persona/ opinion
Sorne matters are certainly unarguable, such as the fact that extended listening to
MP3-players on high level is harmful to the ears. Factors determine the attained
output level is the choice of head phones, the type of deviee and to a lesser degree the
chosen genre. All though many results and values have been spread all over, it is hard
to determine which behold truth, and so it is hard to draw any conclusions.
We can assume that sorne users are in search ofMP3-players with the highest
maximum output level, only to raise their music above any disturbing environmental
noise. Considering this, it can be taken logically that manufacturers of portable
players will not like to diminish the maximum output lev el of the ir deviees.
Nevertheless I think steps in the right direction have been taken already by the most
important companies such as Apple and Creative, and this might affect the way of
working of smaller concurrent companies. Still there hasn' t been done enough, this
has been shawn by cases held already, a reaction on the irresponsibility of companies
in the run for the highest selling rates. Also, the information isn't always correct, such
as the dB references and information I've found on Apple' s website, explained in the
foregoing chapter, and there is no dB (A) level expressed on iPod' s safety limiter
software, which makes it inefficient according to hearing loss protection. Besides,
Apple' s incorporated limiter is hacking able with easy to find software such as, for
example, gopod. On Creative's website, the impression is made that they are more
concemed about the hearing problems created by the increasing use and abuse of
MP3-players. Though, I sometimes doubt the credibility oftheir plans because, as
seen in appendix 6, both of Creative' s MP3-players' output level discussed in the
researched ri se above 95dB (A). At the other hand Creative is one of the only
comparues expressing volume controls values equal to 80dB(A) on their website, this
makes it possible for their users to know at which level it is more or less safe for the
hearing system to listen to music.
19
Musicians
Orchestras
Since the European Parliament and Council have published their directives
concerning safety of workers with eye on noise and noise-induced hearing loss,
Orchestras are, just like other companies, liable to these standards. Nevertheless it is
not evident for such organizations to decrease the produced volumes in or der to
protect their musicians. Many solutions have been proposed but only few make
chance to become reality.
In orchestras the produced sound can increase 11 OdB and even more. There have been
executed several measurements conceming the produced levels on different positions
of the musicians. One of su ch measurements has been do ne by the makers of
www.drurnkruk.nl. They have done research for approached sound pressure levels
produced by a youth orchestra when every instrument played inforte
1
, results are put
in appendix 7. It is clear, according to these results, wind-instruments and tambours
face highest sound pressures. Also the position of the harpist and pianist are exposed
to high pressures, which also makes these musicians more vulnerable for hearing loss.
Because wind-instruments are positioned on a platform in this orchestra, violinists
don' t catch the direct sound of these instruments. This is no standard, in case this is
not done, also violinists are in a more dangerous position. Apart from the fact that
several musicians encounter lower sound pressure levels, it is clear that all musicians
are exposed to sound levels higher then the maximum limit, as stated in the European
directive.
From its offspring, orchestras have been approached on artistic level, thus it is
comprehensible that no one was thinking about the fact that, since the publication of
the European directive, they are liable to the Belgian law adapted to these directives.
Nevertheless an orchestra hasan employer, musicians are employees and the
locations of concerts and repetitions are place of work. In this case, theoretically
speaking, employers are responsible for the state-of-health of their employees, which
means ifthe average level exceeds 87dB (A), the employer is obliged to adapt this
value to the Belgian law, 85dB (A) maximum. If it would be possible to lower the
volume to 85dB (A), employees are still obliged to use ear protection. In orchestras, it
is not easy to obtain such requirements. Darnping the produced sound has negative
consequences on the total sound of the orchestra, the use of ear protection makes it
more complex for musicians to maintain their way ofplaying and for many it's not an
option to replace total groups of instruments. This situation makes it difficult for
orchestra chefs to work in a legal way without reducing the quality of sound.
Several cases are no already wherein musicians accuse former orchestras for being
responsible for incurred hearing loss. On March 18th, 2008, a court in Arnhem (The
Netherlands) treated a case in which a former musician wanted to put the orchestra
(HGO) responsible for the contracted hearing damage. The court found HGO capable
of knowing about the risks of dangerous sound levels in orchestras. In 1991, there has
been an extensive research in The Netherlands that proved sound pressure levels of
orchestras being dangerous to the human hearing system, HGO is supposed to know
about the results of this research. After recei ving the se results of the 1991 research,
20
HGO found measures to protect their musicians. No it is up to them to prove they
have done enough to protect these people and overcome the possible danger of
hearing damage due to playing in the orchestra. Until the day ofwriting the court has
not given a verdict. (Source: www.meernieuws.be)
1
for forte, meaning "loud" or "strong" in musical terms.
Popular music and sound engineers
For popular music it is not as easy as for orchestras to blame another for caught
hearing loss. While, in orchestras musicians are employees, in pop bands musicians
often work freelance and play for several groups or recording studios. More than
other branches working with music, in this case, state of health of the hearing
apparatus depends on the persona! choice of musicians, engineers or other people
working in this sector. Most of the time, tho se people do not work for a boss, and
therefore they are obliged to take possible hearing damage into account without
waiting for someone else to say dangerous sound levels have been exceeded.
The same persons doing the research about the sound pressure level on severa!
positions of musicians in an orchestra have do ne measurements on a random pop
concert. Sorne ofthe results were: 119dB at the ear ofthe drummer, 120dB nearby a
monitor in front of stage, 11 OdB was reaching the P .A. and in the back of the venue
11 OdB was still achieved.
When visiting a pop concert it's no superfluous luxury to have sorne ear protection at
hand. Also in studios this can be handy, while placing microphones and tuning
instruments high levels of sound can be produced and might be dangerous. Knowing
that these people are in need of good ears to succeed making music, for them it is very
important to care about - and protect the hearing system.
Other situations
Hearing loss doesn't only occur to musicians or people listening MP3-players, but
also other professions face similar problems. A research done by Prof. Bart Vinck
states that more than half of the recruits of the Belgian army between eight-teen and
twenty-five years old, suffer hearing loss. Used machine guns are mostly charged for
being responsible for these problems. One shot can easily release 170dB of sound
pressure, knowing that such machine guns are possible to fire 600 bullets in one
minute; it is not unrealistic to state that recruits' ears are being damaged whenever
using this type of gun. Appendix 8 exemplifies a discussion between senators and the
authorized ministers about this subject.
Also motorcyclists are exposed to high sound levels. Not really the motorcycle itself
is possibly causing hearing damage, but the wind noise due to the turbulence is taking
much more part in the damaging of the hearing system. This wind noise is often
called the ' silent killer' . I've been searching, with success, for information about this
specifie subject, and once more much information spread seems to be incorrect.
www.freehearingtests.com states, in a text concerning motorcycles and hearing loss,
'when the sound levels exceed 1 OOdB, your exposure ti me is reduced to two hours.
21
When sound levels exceed 115dB, your exposure time is drastically reduced to 15
minutes.' We have seen before that, according to the European and Belgian
authorities, it's safe to be exposed to 80dB (A) no longer than 8 hours, for every time
there is 3dB of extra sound level, listening time must be halved. Unfortunately, this
website states that it is no problem to listen to 115dB sound for up to 15 minutes.
Noise might be one of the most frequent reasons of hearing loss, there exist other
reasons of hearing loss such as use of ototoxic drugs. Ototoxic medications are those
medications that have potential to cause damage to the inner ear structures which may
result in temporary or permanent loss of hearing or an aggravation of an existing
sensorineural hearing loss. There are severa! signs of ototoxicity, listed here in order
of frequency: development of tinnitus, intensification of existing tinnitus or the
appearance of a new frequency, pressure in your ear, the development of vertigo
1
or a
spinning sensation usually aggravated by motion and may or may not be accompanied
by nausea
2
. It is important to know which medicines are ototoxic drugs. I've made a
simplified list of ototoxic medications representing the most commonly used:
- Aspirin and aspirin-containing drugs, the toxic effects appear after using more than
6 pills a day. These effects are always reversible once the medications are
discontinued.
- Here also, toxic effects appear after using more than 6 pills a day. The
effect is usual reversible.
- Antibiotics: Aminoglycosides, Erythromycin, Vancomycin. Aminoglycosides are
ototoxic when used intravenousl/, ear drops containing these antibiotics have not
been demonstrated to be ototoxic in humans. Erythromycin is proven to be
ototoxic when used intravenously, no ototoxic effects have been found for the
usual oral Vancomycin is potential ototoxic when used intravenously.
- Loop Diuretics such as Lasix, Edecrin and Bumex are ototoxic when used
intravenously. It has rare causes of ototoxicity when this drug is taken orally in
high doses.
- Chemotherapeutic Agents (Cisplatin, Nitrogen, Mustard, Vincristine ). These
medications are ototoxic when given for cancer treatment. The ototoxic effects are
enhanced in patients who are already taking other ototoxic drugs.
- Quinine (Aral en, Atabrine Legatrin, Q-V el Muscle Relaxant). The effects of these
drugs are very similar to aspirin. The ototoxicity is usually reversible once the
medication is discontinued.
1
a sensation ofwhirling and Joss of balance, associated particularly with looking down from a great
height, or caused by disease affecting the inner ear or the vestibular nerve.
2
the sensation of unease and discomfort in the stomach with an urge to vomit.
3
Nonsteroidal Anti-Inflammatory Drugs (Advil, Aleve, Anaprox, Clinoril , Feldene, lndocin, Lodine,
Motrin, Nalfon, Naprosyn, Nuprin, Poradol , Voltarin).
4
The medication is given directly into the veins.
5
Diuretics cause increased passing of urine.
22
Protection of the hearing system
Earplugs
Introduction
Earplugs used to protect the hearing system are plugs made to put into the auditory
canal to reduce the sound pressure reaching the eardrums. On the internet you can
find earplugs in all col ours and measures and for all kinds of use. There exist earplugs
for musicians, party people, kids and even dogs. Sorne people use cotton or other stuff
to lock the auditory canal away from surrounding noise, though such materials are not
considered as appropriate ear protection.
Here we' ll discuss only the most commonly used and appropriate types of earplugs.
Foam earplugs
Foam earplugs are the widest spread type of earplugs and most used by consumers.
These earplugs are given away often by companies as advertisement on festivals, in
study halls, etc. They must be pressed and put into the auditory canal, and then they
start swelling and isolate the canal from surrounding noise. Mostly, these types of
earplugs are made to use just once or several times.
Natural sound -or musicians earplugs
Musicians Earplugs are custom made for each user. They can be purchased only from
licensed audiologists and hearing instrument specialists. Musician's earplugs are
designed to replicate the natural response of the open ear. Sound, heard with these
earplugs, has the same quality as the original sound, only more quiet. This sound
reduction is achieved by combining a patented fil ter with the specifie acoustics of a
custom ear mold. The combination of the two produces a resonance at approximately
2700Hz (more or less as in the normal ear) resulting in a smooth, flat attenuation.
Three types ofattenuators are available: ER9, ER15 and ER25. The indicated number
corresponds with the amount of sound reduction provided in dB.
Motorcycle earplugs
There exist many types of motorcycle earplugs but none is as popular as Alpine' s
MotoSafe plugs. MotoSafe works by reducing volume evenly across all audible
frequencies. The reduced sound is not as linear as the sound obtained with musicians
earplugs, but it's linear enough though not to hinder hearing oftraffic noise.
23
Earmuffs
Introduction
Earrnuffs are made not to put into the auditory canal but to cover one' s ears to protect
it from noise. Most commonly they consist of a plastic or metallic band that must be
put on top of the head. At each end of the head-band there' s a pad to cover the ears.
There exist earrnuffs to protect ears against cold, though in this case only those who
protect against noise are important and will be highlighted.
Active earmuffs
For active earmuffs it is possible to adjust the reduction level. For sorne types there is
even possibility to select a threshold, when the sound level exceeds this threshold, the
earrnuffs will be activated. There even exist active earmuffs with an extem input. This
can be used to listen to walkie-talkies, radio, portable music player, etc.
Passive earmuffs
For passive earrnuffs the amount of reduction is fixed. There exist different models
with different reduction levels, these levels are not able to be adjusted.
To be even more protected, it is possible to combine both earmuffs and earplugs.
24
Personal opinion
It can be taken as truth that excessive exposure t9 high sound levels is dangerous for our
hearing system. Nevertheless sorne authorities still argue about the reality ofhearing loss
and the possibilities of protecting the hearing system against this danger, only because
sorne people are still not convinced about the possible consequences of extreme sound
levels. These discussions often prevent possible solutions. Also minding the fact that sorne
people don't want to be protected, it is clear that it will never be possible to protect
everybody. For example, users ofMP3-players want to be able to rise the output level of
their deviees above surrounding noise and party heads want to feel the music which makes
90dB(A) not loud enough to enjoy their selves. To be honest, 1 can understand people
claiming such things. 1 love to feel music and sometimes raise the level higher than being
healthy for my ears. Though since 1 know all about the consequences of doing such things,
1 bought myselfhearing protection and 1 almost never raise my MP3's volume above 50%
of the maximum level.
I think the lack of knowledge and the inaccuracy of the authorities do take part in the
reason why so many people seem not to care about their hearing system. There is no real
bond between citizens and authorities which is based on confidence. For example, most of
the laws conceming maximum levels in clubs, festivals, etc. are made from point of view
ofneighbors, never police officers or similar authorities talk about people themselves when
they demand to lower the music level. Therefore 1 think it is important for the govemment
to set up information campaigns talking about people listening to music, not only people
who are disturbed by this music. Employees working in situations where environrnental
noise increases 80dB (A) are supposed to know about the possible consequences ofhigh
levels of noise. Just like these employees, people facing extreme sound levels of for
example music need to be informed. For musicians and engineers similar information is
necessary, although many of them know already about the risks associated with loud
ffiUSlC.
As final conclusion 1 can only say that 1 do not believe in solutions by creating any laws.
Besides, every software will al ways hack able and never the authorities will be able to
control musicians and engineers, heavily isolated clubs will always be able to play at levels
decreasing 90dB(A) and so on .. .. Therefore 1 think it is important to let people make
choices their selves. Allow clubs to play at higher volumes, if possible for the
neighborhood, but obligate, for example, owners to put ear protection at guest's disposai.
Let people know about the risks, give them the chance to protect their selves, but don't
force them when it cornes to making choices.
25
Appendix
1. Ear diseases
Outer ear diseases
Frostbite
The exposed position of the outer ear makes it the part of the body most
frequently affected by freezing, or frostbite. Humidity, duration of exposure,
and, most of ali , wind, in addition to degrees of temperature below freezing ,
predispose to the occurrence of frostbite. The frozen a rea begins along the
upper and outer edge of the ear, which becomes yellow-white and waxy in
appearance, cold and hard to the touch, and numb with loss of skin sensation.
Hem a toma
lnjury to the outer ear can cause bleeding between the cartilage and the skin,
producing a smooth, rounded, nontender purplish swelling called hematoma.
The accumulation of clotted blood is removed by a surgeon because, if it is
left, it will become transformed into scar tissue and cause a permanent,
irregular thickening of the outer ear commonly called cauliflower ear and seen
in boxers and wrestlers whose ears receive much abuse.
Perichondritis
Infection of the cartilage of the outer ear, ca lied perichondritis, is unusual but
may occur from in jury or from swimming in polluted water. lt is due to a
particular microorganism, Pseudomonas aeruginosa. There is a greenish or
brownish, musty or foul-smelling discharge from the outer-ear canal , wh ile the
affected outer ear becomes tender, dusky red , and two to three times its
normal thickness. Prompt antibiotic treatment is necessary to prevent
permanent deformity of the outer ear.
Outer ear Infections and injuries External otitis
Infection of the outer-ear canal by molds or various microorganisms occurs
especially in warm, humid climates and among swimmers. The ear canal
itches and becomes tender; a small amou nt of thin, often foul-smelling
material drains from it. If the canal becomes clogged by the swelling and
drainage, hearing will be impaired. Careful and thorough cleaning of the outer-
ear canal by a physician, application of antiseptic or antibiotic eardrops, and
avoidance of swimming are indicated to clear up the infection.
Boil in the ear (furuncle)
Infection of a har follicle anywhere on the body is known as a boil , or furuncle.
This can occur in a har follicle in the outer-ear canal , especially when there is
infection of the skin of the canal. lt always occurs because of a particular type
of germ known as staphylococcus. Because the skin of the ear canal is
closely attached to the underlying cartilage, a boil in the ear canal is
especially painful , with swelling, red ness, and tenderness but generally
without fever. Heat applied to the outer ear by a hot-water bottle or electric
pad helps the infection to come to a head and begin to drain. Treatment with a
systemic and local antibiotic is required to prevent other har follicles from
becoming infected.
Erysipelas of the outer ear
Erysipelas is an infection in the skin caused by a particular type of
streptococcus and characterized by a slowly advancing red, slightly tender
thickening of the skin. lt may begin at the ear and spread to the face and
neck. Centuries ago erysipelas epidemies caused severe and often fatal
infections. ln ad 1089 one of the most severe erysipelas epidemies occurred.
The disease was referred to as St. Anthony's fire because those who prayed
toSt. Anthony were said to recover; others, who did not, died. Today
erysipelas is usually a mild and comparatively rare infection that clears up
rapidly when treated with an antibiotic.
Le pros y
Leprosy, seen rarely outside the tropics today, was another scourge of
ancient times that sometimes affected the outer ear. lt is caused by the
leprosy bacillus, Mycobacterium leprae, which causes a painless, slowly
progressing thickening and distortion of the affected tissues. The diagnosis is
made by examining a bit of the infected tissue und er a microscope and finding
the leprosy bacilli, which in appearance are not unlike the bacilli that cause
tuberculosis. Fortunately, the antibiotics effective against tuberculosis are
effective today in arresting the progression of the disease.
Osteoma of the bony ear canal
Osteoma of the bony ear canal is a bony knob that grows close to the
tympanic membrane, especially in those who swim a great deal in cold water.
lt is not dangerous and does not need to be removed unless the bony
overgrowth becomes large enough to block the ear canal.
Cyst of the ear
A cyst is a sac filled with liquid or semisolid material. A cyst of the ear is most
often caused by a gland that lubricates the skin behind the earlobe, less often
at the entra nee of the ear canal. If the du ct of this gland becomes stopped, the
lubricating fatty material accumulates as a soft, rounded nodule in the skin.
Infection of the cyst causes a tender abscess to form and drain. The cyst will
re-form unless removed completely by surgery.
Another type of cyst occurs above the ear canal , just in front of the outer ear
or, ra rely, in the neck behind and below the ear. This is a remnant of the
primitive gill of the early embryo, a reminder of our ancient fishy ancestors. lt
may appear as a tiny pitlike depression that discharges a little moisture from
time to time, or a cystic swelling may develop when the opening of the pit is
closed, requiring surgical removal.
Absence of the outer ear
Congenital deformity or absence of the outer ear, usually on one side,
sometimes on both, is often accompanied by absence of the outer-ear canal.
This failure of the primitive gill structures to become properly transformed into
the normal outer and middle ear is, in rare instances, hereditary. More often it
occurs for no known reason. ln sorne cases it can be traced to the damaging
effects on the embryo of rubella in the mother du ring the first three months of
her pregnancy. Since the inner ear and nerves of equilibrium and hearing
come from the otic vesicle, separate from the gill structure, in most cases of
deformed or absent outer ear the hearing nerve is normal. Surgical
construction of a new ear canal and tympanic membrane can often improve
the hearing, which has been impaired by the failure of sound conduction to
reach the hearing nerve in the inner ear.
Lop ear
Lop ear, excessive protrusion of the ear from the side of the head, is a more
frequent but less serious deformity of the outer ear. Surgery may be
performed to bring the ears back to a more normal and less conspicuous
position.
Outer ear Other ailments Eczema
Eczema of the skin of the outer ear, like eczema elsewhere, is an itching,
scaling red ness, sometimes with weeping of the affected skin. lt is often the
result of an allergy to a food or substance such as hair spray that comes in
contact with the skin. The best treatment is discovery and avoidance of the
allergen. Cortisone ointment applied topically may temporarily relieve
symptoms.
lmpacted earwax
The waxy substance produced by glands in the skin of the outer-ear canal
normally is carried outward by slow migration to the outer layers of skin. When
wax is produced too rapidly, it can accumulate, completely filling the outer-ear
canal and blocking the passage of sound to the tympanic membrane, causing
a painless impairment of hearing. Large plugs of earwax need to be removed
by a physician. Smaller amounts may be softened by a a few drops of baby oil
left in the ear overnight, then syringed out with warm water and a soft-rubber
infant ear syringe.
Middle ear diseases
Acute middle-ear infection
Fortunately, acute middle-ear infections, called acute otitis media, are nearly
always due to microorganisms that respond quickly to antibiotics. As a result,
acute infection of the mastoid air cells resulting in a dangerous mastoid
abscess with the possibility of meningitis, brain abscess, septicemia, infection
of the labyrinth, or facial nerve paralysis, complicating an acute infection of
the middle-ear cavity, has become rare. Abscess of the mastoid and the other
complications of acute middle-ear infection are seen chiefly in remote regions
and countries where the population lacks proper nutrition and adequate
medical care.
While serious and life-threatening acute infections of the middle ear and
mastoid air cells have become rare, chronic infections, mentioned below,
continue to occur, and another type of middle-ear disease, secretory otitis
media, is frequent.
Acute middle-ear infection Secretory otitis media
ln secretory otitis media the middle-ear cavity becomes filled with a clear, pale
yellowish, noninfected fluid . The disorder is the result of inadequate ventilation
of the middle ear through the eustachian tube. The air in the middle ear, when
it is no longer replenished through this tube, is gradually absorbed by the
mucous membrane, and fluid takes its place. Eventually, the middle-ear cavity
is completely filled with fluid instead of air. The fluid impedes the vibratory
movements of the tympanic membrane and the ossicular chain, causing a
painless impairment of hearing.
The usual causes for secretory otitis media are an acute head cold with
swelling of the membranes of the eustachian tube, an allergie reaction of the
membranes in the eustachian tube, and an enlarged adenoid (nodule of
lymphoid tissue) blocking the entrance to the eustachian tube. The condition
is cu red by finding and removing the cause and then removing the fluid from
the middle-ear cavity, if it does not disappear by itself within a week or two.
Removal of the fluid requires puncturing the tympanic membrane and forcing
air through the eustachian tube to blow out the fluid. ln the absence of fever
and infection of the middle ear, antibiotics, which may impede the normal
immune protection of the middle ear, are not necessary. ln cases in which an
allergie reaction is not the underlying cause of the condition, it may be
necessary to insert a tiny plastic tube through the membrane to aid in
reestablishing normal ventilation of the middle-ear cavity. After a time, when
the middle ear and hearing have returned to normal , this plastic tube is
removed. The small hole left in the tympanic membrane quickly heals.
Acute middle-ear infection Aero-otitis media
Aero-otitis media is a painful type of hearing loss that can result from an
inability to equalize the air pressure in the middle-ear cavity when a sudden
change in altitude occurs, as may happen in a rapid descent in a poorly
pressurized aircraft. Allergies or a preexisting head cold may inhibit an
individual 's ability to equalize, which is accomplished by yawning or
swallowing to open the eustachian tube. The tympanic membrane becomes
sharply retracted when the air pressure becomes less within than without,
wh ile the opening of the tube into the upper part of the throat becomes
pressed tightly together by the increased air pressure in the throat, so that the
tube cannot be opened by swallowing. A severe sense of pressure in the ear
is accompanied by pain and a decrease in hearing. Sometimes the tympanic
membrane ruptures because of the difference in pressure on its two sides.
More often, the pain continues until the middle ear fills with fluid or the
membrane is surgically punctured. Usually aero-otitis media produced during
a fl ight is of a temporary nature and disappears of its own accord.
Chronic middle-ear infection
Chronic infection of the middle ear occurs when there is a permanent
perforation of the tympanic membrane that allows dust, water, and germs
from the outer air to gain access to the middle-ear cavity. This results in a
chronic drainage from the middle ear through the outer-ear canal. There are
two distinct types of chronic middle-ear infection, one relatively harmless, the
other caused by a dangerous bone-invading process that leads, when
neglected, to serious complications.
The harmless type of chronic middle-ear disease is recognized by a stringy,
odourless, mucoid discharge th at cornes from the surface of the mucous
membrane that li nes the middle ear. Medical treatment with applications of
borie acid powder will dry up the chronic drainage. The perforation in the
membrane may then be closed, restoring the normal structure and function of
the ear with recovery of heari ng.
The dangerous type of chronic middle-ear drainage is recognized by its foul-
smelling discharge, often scanty in amount, coming from a bone-invading
process beneath the mucous membrane. Such cases are usually caused by a
condition known as cholesteatoma of the middle ear. This is an ingrowth of
skin from the outer-ear canal that forms a cyst within the middle ear. An
infected cholesteatoma cyst enlarges slowly but progressively, gradually
eroding the bane until the cyst reaches the brain cavity, the nerve that
supplies the muscles of the face, or a semicircular canal of the inner ear. The
infected material within the cyst then produces a serious complication:
meningitis or brain abscess, paralysis of the facial nerve, or infection of the
labyrinth of the inner ear with vertigo, ali of which may lead to total deafness.
Fortunately, cholesteatoma of the middle ear is now rarely so neglected asto
permit development of a serious complication. By careful examination of the
tympanic membrane perforation and by X-ray studies, the bone-eroding cyst
can be diagnosed; it can then be removed surgically before it has caused
serious harm. This operation is known as a radical mastoid or a modified
radical mastoid operation. If during the same procedure the perforation in the
tympanic membrane is closed and the ossicular chain repaired, the operation
is known as a tympanoplasty, or plastic reconstruction of the middle-ear
cavity.
Ossicu/ar interruption
The ossicular chain of three tiny bones needed to carry sound vibrations from
the tympanic membrane to the fluid that fills the inner ear may be disrupted by
infection or by a jarring blow on the head. Most often the separation occurs at
its weakest point , where the incus joins the stapes. If the separation is partial ,
there is a mild impairment of hearing; if it is complete, there is a severe
hearing loss. ln such a case, a hearing test demonstrates that the nerve of
hearing in the inner ear is functioning normally but that sound fa ils to be
conducted from the tympanic membrane to the inner ear. The defective
ossicular chain can be surgically corrected through tympanoplasty, which
allows sound to be conducted to the inner ear once again.
Otosc/erosis
The commonest cause for progressive hearing loss in early and middle adult
life is a disease of the hard shell of bane that surrounds the labyrinth of the
inner ear. This disease of bane is known as otosclerosis, a name that is
misleading, for in its early and actively expanding stage the nodule of
diseased bane is softer than the ivory-hard bane that it replaces. The more
appropriate name otospongiosis is sometimes used, but such is the tenacity
of tradition that the older name, applied before the process was weil
understood, has persisted and is the term generally used.
The cause for the occurrence of the nodule of softened otosclerotic bane is
unknown. There is a certain familial tendency, half the cases occurring in
famil ies in which one or several relatives have the same condition. lt is one-
tenth as common among blacks as among whites and twice as common in
women as in men. The nodule of softened otosclerotic bane first appears in
late childhood or in early adult life. Fortunately, in most cases it remains quite
small and harmless, producing no symptoms, and is discoverable only if the
ear bones are removed after death and examined under a microscope. Such
evidence indicates that approximately 1 in 10 white adult men and 1 in 5 white
adult women will be found to have such a nodule of otosclerotic bane by
middle adult life.
ln about 12 percent of otosclerosis cases the nodule of softened bane
becomes large enough to reach the aval window containing the footplate of
the stapes (stirrup). lncreasing pressure caused by the expanding nodule
begins to impede its vibratory movements in response to sound striking the
tympanic membrane. Gradually and insidiously, affected persans begin to
lose their sharpness of hearing. First they begin to lose the ability to hear faint
sounds of law pitch, next they begin to have difficulty hearing the whispered
voice, then they have difficulty in hearing conversation from a distance, and
finally they can hear and understand the spoken voice only when it is quite
laud or close to the ear. One of the characteristics of impaired hearing due to
stirrup fixation by otosclerosis is retained ability to hear a telephone
conversation by pressing the receiver against the head so that the sound is
carried to the inner ear by bane conduction. Another characteristic of this type
of impaired hearing is that hearing seems to improve while one is riding in an
automobile, in a plane, or on a train. This is because the low-pitched roar of
motors causes persans with normal hearing to unconsciously raise their
voices, wh ile the individual with stirrup fixation fails to hear the low-pitched
roar and thus hears better and enjoys the raised voices around him.
The diagnosis of stirrup fixation by otosclerosis is made on the basis of a
history of a gradually increasing impairment of hearing with absence of any
chronic infection of the middle ear or of perforation of the tympanic membrane
and with hearing tests showing that the auditory nerve in the inner ear is
functioning but that sound fails to be conducted properly to it. Hearing tests
carried out with either a tuning fork or an audiometer demonstrate that the
hearing by bane conduction is better than by air conduction.
The final and conclusive diagnosis of otosclerosis is a finding made through
surgical exploration-namely, that the stapes is fixed and unable to be moved
because of a nodule of bane that has grown against it. An X ray of the ear
using computed tomography may be made to demonstrate that the footplate
of the stapes has been invaded by otosclerosis.
Fixation of the stapes can be corrected surgically. ln 1956 it was found that
the fixed stapes cou Id be removed and replaced by a plastic or wire substitute
in cases in which it could not be mobilized. Today this operation, known as
stapedectomy, is the one most often used to correct fixation of the stapes by
otosclerosis.
The otosclerotic bane disease in sorne cases expands as far as the cochlea
of the inner ear, causing a graduai deterioration of the auditory nerve. This
progressive nerve deafness may precede, accompany, or follow fixation of the
stapes. ln sorne cases it may occur without fixation of the stapes.
While the exact cause of otosclerosis is not known, it may be associated in
sorne cases with lack of fluoride in drinking water. There is evidence that
increasing the intake of fluoride may promote hardening of the softened
nodule of otosclerotic bane, thus arresting or retarding its expansion. ln this
way the graduai impairment of auditory nerve function that often occurs with
fixation of the stapes may be retarded. Fluoridation of water supplies, which is
carried out in many countries, has reduced the incidence of otosclerosis.
lnner ear diseases
Congenital nerve deafness
Congenital nerve deafness, a defect of the auditory nerve in the cochlea, may
be present at birth or acquired during or soon after birth. Usually both inner
ears are affected to a similar degree, and as a rule there is a severe
impairment of hearing, although in sorne cases of congenital nerve loss the
impairment is moderate. Many cases of congenital nerve deafness have been
caused by the rubella (German measles) virus in the mother during the first
three months of her pregnancy, causing arrest of development of the vesicle
of the embryo. This can happen du ring a rubella epidemie, even when the
mother has no symptoms of the infection. ln most cases the vestibular nerve
is not affected oris affected to a lesser degree, and in most (but not ali) cases
the outer- and middle-ear structures are not affected. A vaccine against the
rubella virus made available in 1969 has reduced the number of cases of
congenital nerve deafness in developed countries.
Congenital nerve deafness acquired at or soon after birth may result from
insufficient oxygen (anoxia) du ring a difficult and prolonged delivery or from
the condition known as kernicterus, in which the baby becomes jaundiced
because of incompatibility between its blood and that of the mother. ln a few
cases congenital nerve deafness is an inherited failure of the cochlea to
develop properly. When the hearing loss is severe, speech cannat be
acquired without special training. Children so afflicted must attend special
classes or schools for the severely deaf, where they can be taught lipreading,
speech, and sign language. Electrical hearing aids can be helpful , especially
during classes, to use the remnants of hearing usually present in such cases.
Another alternative, although controversial within the deaf community, is a
cochlear implant, which is sometimes useful in cases of profound hearing loss
or total absence of hearing when the nerve itself is present. ln this operation
an electrode is surgically implanted to directly stimulate the auditory nerve
between the brain and the ear.
lnner ear Nerve deafness Viral nerve deafness
Viral infections can cause severe degrees of sensorineural hearing loss in one
ear, and sometimes in both, at any age. The mumps virus is one of the
commonest causes of severe sensorineural hearing loss in one ear. The
measles and influenza viruses are less-common causes. There is no effective
medical or surgical treatment to restore hearing impaired by a virus.
Ototoxic drugs
Ototoxic (harmful to the ear) drugs can cause temporary and sometimes
permanent impairment of auditory nerve function. Salicylates such as aspirin
in large enough doses may cause ringing in the ears and then a temporary
decrease in hearing that ceases when the persan stops taking the drug.
Quinine can have a similar effect but with a permanent impairment of auditory
nerve function in sorne cases. Certain antibiotics, such as streptomycin,
dihydrostreptomycin, neomycin, and kanamycin, may cause permanent
damage to auditory nerve function. Susceptibility to auditory nerve damage
from ototoxic drugs varies greatly among individuals. ln most cases, except
when streptomycin is the drug taken, the more durable and less easily
damaged vestibular nerve is not affected. Streptomycin affects the vestibular
nerve more than it affects the auditory nerve.
Sku/1 fracture and concussion
Skull fracture and concussion from a severe blow on the head can impair the
functioning of the auditory and vestibular nerves in varying degrees. The
greatest hearing loss arises when a fracture of the skull passes through the
labyrinth of the inner ear, totally destroying its function.
Exposure to noise
The effects of noise exposure on hearing depend on the intensity and duration
of the noise. The effects may be temporary or permanent. A single exposure
to an extremely intense sound, such as an explosion, may produce a severe
and permanent loss of hearing. Repeated exposures to sounds in excess of
80 to 90 decibels may cause graduai deterioration of hearing by destroying
the ha ir ce lis of the inner ear, with possible subsequent degeneration of nerve
fibres (see Figure ?Figure 7: (Top) Portion of a healthy organ of Corti from a
guinea pig shows the characteristic ... [Credits : Robert Preston and Joseph
E. Hawkins, Kresge Hearing Research lnstitute, University of Michigan, Ann
Arbor, Mich.] from the article ear, human ). The levels of noise produced by
rock music bands frequently exceed 110 decibels. The noise generated by
farm tractors, power mowers, and snowmobiles may rea ch 100 decibels. ln
the United States, legislation requires that workers exposed to sound levels
greater than 90 decibels for an eight-hour day be provided some form of
protection, such as earplugs or earmuffs.
lndividuals differ in their susceptibility to hearing loss from noise exposure.
Because hearing loss typically begins at the higher frequencies of 4,000 to
6,000 hertz, the effects of noise exposure may go unnoticed until the hearing
loss spreads to the lower frequencies of 1,000 to 2,000 hertz.
Inhalation of carbogen, a mixture of 5 percent carbon dioxide and 95 percent
oxygen, for 20 minutes will accelerate recovery of hearing if administered
within a few hours after excessive noise exposure.
lnner ear Inflammation and tumour Labyrinthitis
Labyrinthitis, an inflammation of the labyrinth of the inner ear, happens when
infection occurs as a result of meningitis, syphilis, acute otitis media and
mastoiditis, or chronic otitis media and cholesteatoma. Loss of both
equilibrium and hearing occurs in the affected ear. Prompt antibiotic treatment
sometimes arrests the damage and allows for the possibility of partial
recovery of the function of the inner ear.
lnner ear Inflammation and tumour Acoustic neuroma
An acoustic neuroma is a benign tumour that grows on the auditory nerve
near the point where it enters the labyrinth of the inner ear. The tumour
causes graduai and progressive loss of auditory and vestibular nerve function
on one side. Eventually the tumour grows out into the brain cavity, causing
headaches and paralysis. If it is not removed, blindness and death may result.
Fortunately, acoustic neuroma usually can be diagnosed early by magnetic
resonance imaging (MRI) and removed before it has serious consequences.
Mnire's disease
Mnire's disease, also called endolymphatic hydrops, is a fairly common
disorder of the labyrinth of the inner ear that affects both the vestibular nerve,
with resultant attacks of vertigo, and the auditory nerve, with impairment of
hearing. lt was first described in 1861 by a French physician, Prosper
Mnire. lt is now known that the symptoms are caused by an excess of
endolymphatic fluid in the inner ear. The diagnosis is made from the recurring
attacks of vertigo, often with nausea and vomiting, impairment of hearing with
a distortion of sound in the affected ear that fluctuates in degree, and a sense
of full ness or pressure in the ear. The cause of the excess of endolymphatic
fluid is not always known, although in many cases it results from defective
functioning of the endolymphatic du ct and sac, the structures that normally
resorb endolymphatic fluid from the inner ear. Allergie reactions to certain
foods may also cause the disease. The treatment of Mnire's disease is
directed toward finding the cause of the excess of endolymphatic fluid in arder
to control it. If medical treatment does not relieve the repeated attacks of
vertigo, surgery may be necessary.
Presbycusis
Presbycusis is the graduai decline of hearing function that results from aging.
lt is similar to other aging processes because it occurs at different ages and at
different rates among the population. As a persan ages, there is a graduai
loss of cochlear hair cells, beginning at the basal end of the organ of Corti ,
with the result that hearing is gradually reduced and eventually lost, first for
the highest audible frequencies (around 20,000 hertz) and then progressively
for sounds of lower frequency. Usually the slow diminishing of hearing does in
hearing sounds of high pitch and in understanding conversation. Correction of
a nutritional deficiency of zinc, coenzyme Q10, or possibly vitamin A may
stabilize the progressive hearing loss. The physician must make certain that
the individual does not have a correctable impairment, such as accumulated
earwax, secretory otitis media, or stirrup fixation by otosclerosis, as part of the
difficulty. An electrical hearing aid is of limited help to some, while others find
that a hearing aid makes voices louder but less clear and therefore is of little
hel p.
2. Directive 2003/1 0/EC of the European Parliament
and of the Council of 6 February 2003 on the minimum
health and safety requirements regarding the
exposure of workers to the risks arising from physical
agents (noise) (Seventeenth individual Directive within
the meaning of Article 16(1) of Directive 89/391/EEC)
Directive 2003/1 0/EC of the European Parliament and of the Cou neil of 6
February 2003 on the minimum health and safety requirements regarding the
exposure of workers to the risks arising from physical agents (noise)
(Seventeenth individual Directive within the meaning of Article 16(1) of
Directive 89/391/EEC)
THE EUROPEAN PARLIAMENT AND THE COUNCIL OF THE EUROPEAN
UNION,
Having regard to the Treaty establishing the European Community, and in
particular Article 137(2) thereof,
Having regard to the proposai from the Commission(1 ), submitted after
consultation with the Advisory Committee on Safety, Hygiene and Health
Protection at Work,
Having regard to the opinion of the Economie and Social Committee(2) ,
Having consulted the Committee of the Regions,
Acting in accordance with the procedure laid down in Article 251 of the
Treaty(3) , in the light of the joint text approved by the Conciliation Committee
on 8 November 2002,
Whereas:
(1) Under the Treaty, the Cou neil may adopt, by means of directives,
minimum requirements for encouraging improvements, especially in the
working environment, to guarantee a better level of protection of the health
and safety of workers. Such directives are to avoid imposing administrative,
financial and legal constraints in a way which would hold back the creation
and development of small and medium-sized undertakings.
(2) While, in accordance with the Treaty, this Directive does not prevent any
Member State from maintaining or introducing more stringent protective
measures, its implementation should not serve to justify any regression in
relation to the situation which already prevails in each Member State.
(3) Cou neil Directive 86/188/EEC of 12 May 1986 on the protection of workers
from the risks related to exposure to noise at work(4) made provision for its
re-examination by the Council on a proposai from the Commission and with a
view to reducing the risks concerned, taking into account in particular
progress made in scientific knowledge and technology.
(4) The communication from the Commission on its programme concerning
safety, hygiene and health at work(5) provides for the adoption of measures to
promote safety at work, particularly with a view to extending the scope of
Directive 86/188/EEC and the re-evaluation of the threshold values. The
Council , in its resolution of 21 December 1987 on safety, hygiene and health
at work(6) , took note of this.
(5) The communication from the Commission concerning its action
programme relating to the implementation of the Community Charter of the
Fundamental Social Rights of Workers provides for the introduction of
minimum health and safety requirements regarding the exposure of workers
to the risks caused by physical agents. ln September 1990 the European
Parliament adopted a resolution concerning this action programme(?) , inviting
the Commission in particular to draw up a specifie directive on the risks
caused by noise and vibration and by any other physical agent at the
workplace.
(6) As a first step, the European Parliament and the Council adopted on 25
June 2002 Directive 2002/44/EC on the minimum health and safety
requirements regarding the exposure of workers to the risks arising from
physical agents (vibration) (sixteenth individual Directive within the meaning of
Article 16(1) of Directive 89/391/EEC)(8) .
(7) As a second step, it is considered appropriate to introduce measures
protecting workers from the risks arising from noise owing toits effects on the
health and safety of workers, in particular damage to hearing. These
measures are intended not only to ensure the health and safety of each
worker on an individual basis, but also to create a minimum basis of
protection for ali Community workers in order to avoid possible distortions of
competition.
(8) Current scientific knowledge of the effects which exposure to noise may
have on health and safety is not sufficient to enable precise exposure levels
covering ali risks to health and safety, especially as regards the effects of
noise other than those of an auditory nature, to be set.
(9) A system of protection against noise must limit itself to a definition, free of
excessive detail , of the objectives to be attained, the principles to be observed
and the fundamental values to be used, in order to enable Member States to
apply the minimum requirements in an equivalent manner.
(1 0) The level of exposure to noise can be more effectively reduced by
incorporating preventive measures into the design of work stations and places
of work and by selecting work equipment, procedures and methods so asto
give priority to reducing the risks at source. Provisions relating to work
equipment and methods th us contribute to the protection of the workers
involved. ln accordance with the general principles of prevention as laid down
in Article 6(2) of Council Directive 89/391/EEC of 12 June 1989 on the
introduction of measures to encourage improvements in the safety and health
of workers at work(9), collective protection measures have priority over
individual protection measures.
(11) The Code on noise levels on board ships of the International Maritime
Organisation Resolution A 468(12) provides guidance for achieving a
reduction of noise at source on board ships. Member States should be entitled
to provide for a transitional period with regard to the personnel on board
seagoing vessels.
(12) ln arder to correctly assess the exposure of workers to noise it is useful
to apply an objective measuring method, and thus references to the generally
recognised standard ISO 1999:1990 are made. The assessed or objectively
measured values should be decisive for initiating the actions envisaged at the
lower and upper exposure action values. Exposure limit values are needed to
avoid irreversible damage to workers' hearing; the noise reaching the ear
should be kept below the exposure limit values.
(13) The particular characteristics of the music and entertainment sectors
require practical guidance to allow for an effective application of the provisions
laid dawn by this Directive. Member States should be entitled to make use of
a transitional period for the development of a code of conduct providing for
practical guidelines which would help workers and employers in those sectors
to attain the levels of protection established in this Directive.
(14) Employers should make adjustments in the light of technical progress
and scientific knowledge regarding risks related to exposure to noise, with a
view to improving the health and safety protection of workers.
(15) Since this Directive is an individual Directive within the meaning of Article
16(1) of Directive 89/391/EEC, that Directive applies to the exposure of
workers to noise, without prejudice to more stringent and/or specifie
provisions contained in this Directive.
(16) This Directive constitutes a practical step towards creating the social
dimension of the internai market.
(17) The measures necessary for the implementation of this Directive should
be adopted in accordance with Council Decision 1999/468/EC of 28 June
1999 laying dawn the procedures for the exercise of implementing powers
conferred on the Commission(1 0) ,
HAVE ADOPTED THIS DI RECTIVE:
SECTION 1
GENERAL PROVISIONS
Article 1
Aim and scope
1. This Directive, which is the 17th individual Directive within the meaning of
Article 16(1) of Directive 89/391/EEC, lays dawn minimum requirements for
the protection of workers from risks to the ir health and safety arising or likely
to arise from exposure to noise and in particular the risk to hearing.
2. The requirements of this Directive shall apply to activities in which workers
are or are likely to be exposed to risks from noise as a result of their work.
3. Directive 89/391/EEC shall apply tully to the whole area referred to in
paragraph 1, without prejudice to more stringent and/or specifie provisions
contained in this Directive.
Article 2
Definitions
For the purposes of this Directive, the physical parameters used as risk
predictors are defined as follows:
(a) peak sound pressure (ppeak) : maximum value of the "C"-frequency
weighted instantaneous noise pressure;
(b) daily noise exposure level (LEX,8h) (dB(A) re. 20 ~ P a ) : time-weighted
average of the noise exposure levels for a nominal eight-hour working day as
defined by international standard ISO 1999: 1990, point 3.6. lt covers ali
noises present at work, including impulsive noise;
(c) weekly noise exposure level (LEX,8h ): time-weighted average of the daily
noise exposure levels for a nominal week of five eight-hour working days as
defined by international standard ISO 1999:1990, point 3.6 (note 2) .
Article 3
Exposure limit values and exposure action values
1. For the purposes of this Directive the exposure limit values and exposure
action values in respect of the daily noise exposure levels and peak sound
pressure are fixed at:
(a) exposure limit values: LEX,8h = 87 dB(A) and ppeak = 200 Pa(11)
respectively;
(b) upper exposure action values: LEX,8h 85 dB(A) and ppeak = 140 Pa(12)
respectively;
(c) lower exposure action values: LEX,8h = 80 dB(A) and ppeak = 112 Pa(13)
respectively.
2. When applying the exposure li mit values, the determination of the worker's
effective exposure shall take account of the attenuation provided by the
individual hearing protectors worn by the worker. The exposure action values
shall not take account of the effect of any such protectors.
3. ln duly justified circumstances, for activities where daily noise exposure
varies markedly from one working day to the next, Member States may, for
the purposes of applying the exposure limit values and the exposure action
values, use the weekly noise exposure level in place of the daily noise
exposure level to assess the levels of noise to which workers are exposed, on
condition that:
(a) the weekly noise exposure level as shawn by adequate monitoring does
not exceed the exposure limit value of 87 dB(A); and
(b) appropriate measures are taken in arder to reduce the risk associated with
these activities to a minimum.
SECTION Il
OBLIGATIONS OF EMPLOYERS
Article 4
Determination and assessment of risks
1. ln carrying out the obligations laid dawn in Articles 6(3) and 9(1) of
Directive 89/391/EEC, the employer shall assess and, if necessary, measure
the levels of noise to which workers are exposed.
2. The methods and apparatus used shall be adapted to the prevailing
conditions particularly in the light of the characteristics of the noise to be
measured, the length of exposure, ambient factors and the characteristics of
the measuring apparatus.
These methods and this apparatus shall make it possible to determine the
parameters defined in Article 2 and to decide whether, in a given case, the
values fixed in Article 3 have been exceeded.
3. The methods used may include sampling, which shall be representative of
the persona! exposure of a worker.
4. The assessment and measurement referred to in paragraph 1 shall be
planned and carried out by competent services at suitable intervals, taking
particular account of the provisions of Article 7 of Directive 89/391/EEC
concerning the necessary competent services or persans. The data obtained
from the assessment and/or measurement of the level of exposure to noise
shall be preserved in a suitable form so as to permit consultation at a later
stage.
5. When applying this Article, the assessment of the measurement results
shall take into account the measurement inaccuracies determined in
accordance with metrological practice.
6. Pursuant to Article 6(3) of Directive 89/391/EEC, the employer shall give
particular attention, when carrying out the risk assessment, to the following:
(a) the level, type and duration of exposure, including any exposure to
impulsive noise;
(b) the exposure limit values and the exposure action values laid dawn in
Article 3 of this Directive;
(c) any effects concerning the health and safety of workers belonging to
particularly sensitive risk groups;
(d) as far as technically achievable, any effects on workers' health and safety
resulting from interactions between noise and work-related ototoxic
substances, and between noise and vibrations;
(e) any indirect effects on workers' health and safety resulting from
interactions between noise and warning signais or other sounds that need to
be observed in arder to reduce the risk of accidents;
(f) information on noise emission provided by manufacturers of work
equipment in accordance with the relevant Community directives;
(g) the existence of alternative work equipment designed to reduce the noise
emission;
(h) the extension of exposure to noise beyond normal working hours under
the employer's responsibility;
(i) appropriate information obtained following health surveillance, including
published information, as far as possible;
G) the availability of hearing protectors with adequate attenuation
characteristics.
7. The employer shall be in possession of an assessment of the risk in
accord ance with Article 9(1 )(a) of Directive 89/391 /EEC, and shall identify
which measures must be taken in accordance with Articles 5, 6, 7 and 8 of
this Directive. The risk assessment shall be recorded on a suitable medium,
according to national law and practice. The risk assessment shall be kept up
to date on a regular basis, particularly if there have been significant changes
which could render it out of date, or when the results of health surveillance
show it to be necessary.
Article 5
Provisions aimed at avoiding or reducing exposure
1. Taking account of technical progress and of the availability of measures to
control the risk at source, the risks arising from exposure to noise shall be
el iminated at their source or reduced to a minimum.
The reduction of such risks shall be based on the general principles of
prevention set out in Article 6(2) of Directive 89/391/EEC, and take into
account in particular:
(a) other working methods that require less exposure to noise;
(b) the choice of appropriate work equipment, taking account of the work to be
done, emitting the least possible noise, including the possibility of making
available to workers work equipment subject to Community provisions with the
aim or effect of limiting exposure to noise;
(c) the design and layout of workplaces and work stations;
(d) adequate information and training to instruct workers to use work
equipment correctly in order to reduce their exposure to noise to a minimum;
(e) noise reduction by technical means:
(i) reducing airborne noise, e.g. by shields, enclosures, sound-absorbent
coverings;
(ii) reducing structure-borne noise, e.g. by damping or isolation;
(f) appropriate maintenance programmes for work equipment, the workplace
and workplace systems;
(g) organisation of work to redu ce noise:
(i) limitation of the du ration and intensity of the exposure;
(i i) appropriate work schedules with adequate rest periods.
2. On the basis of the risk assessment referred to in Article 4, if the upper
exposure action values are exceeded, the employer shall establish and
implement a programme of technical and/or organisational measures intended
to reduce the exposure to noise, taking into account in particular the
measures referred to in paragraph 1.
3. On the basis of the risk assessment referred to in Article 4, workplaces
where workers are likely to be exposed to noise exceeding the upper
exposure action values shall be marked with appropriate signs. The areas in
question shall also be delimited and access to them restricted where this is
technically feasible and the risk of exposure so justifies.
4. Where, owing to the nature of the activity, a worker benefits from the use of
rest facil ities under the responsibility of the employer, noise in these facilities
shall be reduced to a level compatible with their purpose and the conditions of
use.
5. Pursuant to Article 15 of Directive 89/391/EEC, the employer shall adapt
the measures referred to in this Article to the requirements of workers
belonging to particularly sensitive risk groups.
Article 6
Persona! protection
1. If the risks arising from exposure to noise cannat be prevented by other
means, appropriate, properly fitting individual hearing protectors shall be
made available to workers and used by them in accordance with the
provisions of Council Directive 89/656/EEC of 30 November 1989 on the
minimum health and safety requirements for the use by workers of persona!
protective equipment at the workplace (third individual Directive within the
meaning of Article 16(1) of Directive 89/391/EEC)(14) and Article 13(2) of
Directive 89/391/EEC and under the conditions set out below:
(a) where noise exposure exceeds the lower exposure action values, the
employer shall make individual hearing protectors available to workers;
(b) where noise exposure matches or exceeds the upper exposure action
values, individual hearing protectors shall be used;
(c) the individual hearing protectors shall be so selected asto eliminate the
ri sk to hearing orto reduce the risk to a minimum.
2. The employer shall make every effort to ensure the wearing of hearing
protectors and shall be responsible for checking the effectiveness of the
measures taken in compliance with this Article.
Article 7
Li mitation of exposure
1. Under no circumstances shall the exposure of the worker as determined in
accordance with Article 3(2) exceed the exposure limit values.
2. If, despite the measures taken to implement this Directive, exposures
above the exposure li mit values are detected, the employer shall :
(a) take immediate action to reduce the exposure to below the exposure limit
values;
(b) identify the reasons why overexposure has occurred; and
(c) amend the protection and prevention measures in order to avoid any
recurrence.
Article 8
Worker information and training
Without prejudice to Articles 10 and 12 of Directive 89/391/EEC the employer
shall ensure that workers who are exposed to noise at work at or above the
lower exposure action values, and/or their representatives, receive
information and training relating to risks resulting from exposure to noise
concerning, in particular:
(a) the nature of such risks;
(b) the measures taken to implement this Directive in order to eliminate or
reduce to a minimum the risks from noise, including the circumstances in
which the measures apply;
(c) the exposure limit values and the exposure action values laid down in
Article 3 of this Directive;
(d) the results of the assessment and measurement of the noise carried out in
accord ance with Article 4 of this Directive together with an explanation of their
significance and potential risks;
(e) the correct use of hearing protectors;
(f) why and how to detect and report signs of hearing damage;
(g) the circumstances in which workers are entitled to health surveillance and
the purpose of health surveillance, in accordance with Article 10 of this
Directive;
(h) safe working practices to minimise exposure to noise.
Article 9
Consultation and participation of workers
Consultation and participation of workers and/or of the ir representatives shall
take place in accordance with Article 11 of Directive 89/391/EEC on the
matters covered by this Directive, in particular:
-the assessment of risks and identification of measures to be taken, referred
to in Article 4,
- the actions aimed at eliminating or reducing risks arising from exposure to
noise, referred to in Article 5,
- the choice of individual hearing protectors referred to in Article 6(1)(c).
SECTION Ill
MISCELLANEOUS PROVISIONS
Article 10
Health surveillance
1. Without prejudice to Article 14 of Directive 89/391/EEC, Member States
shall adopt provisions to en sure the appropriate health surveillance of workers
where the results of the assessment and measurement provided for in Article
4(1) of this Directive indicate a risk to the ir health. Those provisions, including
the requirements specified for health records and their availability, shall be
introduced in accordance with national law and/or practice.
2. A worker whose exposure exceeds the upper exposure action values shall
have the right to have his/her hearing checked by a doctor or by another
suitably qualified person under the responsibility of a doctor, in accorda nee
with national law and/or practice. Preventive audiometrie testing shall also be
available for workers whose exposure exceeds the lower exposure action
values, where the assessment and measurement provided for in Article 4( 1)
indicate a risk to health.
The objectives of these checks are to provide early diagnosis of any loss of
hearing due to noise, and to preserve the hearing function.
3. Member States shall establish arrangements to ensure that , for each
worker who undergoes surveillance in accordance with paragraphs 1 and 2,
individual health records are made and kept up to date. Health records shall
conta in a summary of the results of the health surveillance carried out. They
shall be kept in a suitable form so asto permit any consultation at a later date,
taking into account any confidentiality.
Copies of the appropriate records shall be su pp lied to the competent authority
on request. The individual worker shall , at his or her request, have access to
the health records relating to him or her personally.
4. Where, as a result of surveillance of the hearing function, a worker is fou nd
to have identifiable hearing damage, a doctor, or a specialist if the doctor
considers it necessary, shall assess whether the damage is likely to be the
result of exposure to noise at work. If this is the case:
(a) the worker shall be informed by the doctor or ether suitably qualified
persan of the result which relates to him or her personally;
(b) the employer shall:
(i) review the risk assessment carried out pursuant to Article 4;
(ii) review the measures provided for to eliminate or reduce risks pursuant to
Articles 5 and 6;
(iii) take into account the advice of the occupational healthcare professional or
other suitably qualified persan or the competent authority in implementing any
measures required to eliminate or reduce risk in accordance with Articles 5
and 6, including the possibility of assigning the worker to alternative work
where the re is no risk of further exposure; and
(iv) arrange systematic health surveillance and provide for a review of the
health status of any other worker who has been similarly exposed.
Article 11
Derogations
1. ln exceptional situations where, because of the nature of the work, the full
and proper use of individual hearing protectors would be likely to cause
greater risk to health or safety than not using such protectors, Member States
may grant derogations from the provisions of Articles 6(1)(a) and (b) and 7.
2. The derogations referred to in paragraph 1 shall be granted by Member
States following consultation with both sides of industry and, where
appropriate, with the medical authorities responsible, in accordance with
national laws and/or practice. Such derogations must be accompanied by
conditions which guarantee, taking into account the special circumstances,
that the resulting risks are reduced to a minimum and that the workers
concerned are subject to increased health surveillance. Such derogations
shall be reviewed every four years and withdrawn as soon as the justifying
circumstances no longer obtain.
3. Every four years Member States shall forward to the Commission a list of
derogations referred to in paragraph 1, indicating the exact reasons and
circumstances which made them decide to grant the derogations.
Article 12
Technical amendments
Amendments of a strictly technical nature shall be adopted in accordance with
the regulatory procedure laid down in Article 13(2) and in line with:
(a) the adoption of directives in the field of technical harmonisation and
standardisation with regard to the design, building, manufacture or
construction of work equipment and/or workplaces; and
(b) technical progress, changes in the most appropriate harmonised European
standards or specifications and new findings concerning noise.
Article 13
Committee
1. The Commission shall be assisted by the Committee referred to in Article
17 of Directive 89/391/EEC.
2. Where reference is made to this paragraph, Articles 5 and 7 of Council
Decision 1999/468/EC shall apply, having regard to the provisions of Article 8
thereof.
The period laid dawn in Article 5(6) of Decision 1999/468/EC shall be set at
three months.
3. The Committee shall adopt its Rules of Procedure.
Article 14
Code of conduct
ln the context of the application of this directive Member States shall draw up
in consultation with the social partners, in accordance with national law and
practice, a code of conduct providing for practical guidelines to help workers
and employers in the music and entertainment sectors to meet their legal
obligations as laid dawn in this Directive.
Article 15
Repeal
Directive 86/188/EEC is hereby repealed with effect from the date set out in
the first subparagraph of Article 17(1 ).
SECTION IV
FINAL PROVISIONS
Article 16
Reports
Every five years Member States shall provide a report to the Commission on
the practical implementation of this Directive, indicating the points of view of
bath sides of industry. lt shall contain a description of best practice for
preventing noise with a harmful effect on health and of other forms of work
organisation, together with the action taken by the Member States to impart
knowledge of such best practice.
On the basis of those reports, the Commission shall carry out an overall
assessment of the implementation of this Directive, including implementation
in the light of research and scientific information, and, inter alia, taking into
account the implications of this Directive for the music and entertainment
sectors. The Commission shall inform the European Parliament, the Council ,
the European Economie and Social Committee and the Advisory Committee
on Safety, Hygiene and Health Protection at Work thereof and, if necessary,
propose amendments.
Article 17
Transposition
1. The Member States shall bring into force the laws, regulations and
administrative provisions necessary to comply with this Directive before 15
February 2006. They shall forthwith inform the Commission thereof.
When Member States adopt these measures, they shall contain a reference to
this Directive or shall be accompanied by such reference on the occasion of
their official publication. The methods of making such reference shall be laid
dawn by the Member States.
2. ln arder to take account of particular conditions, Member States may, if
necessary, have an additional period of five years from 15 February 2006,
that is to say a total of eight years, to implement the provisions of Article 7
with regard to the personnel on board seagoing vessels.
ln arder to allow for the drawing up of a code of conduct providing for practical
guidelines for the implementation of the provisions of this Directive, Member
States shall be entitled to make use of a maximum transitional period of two
years from 15 February 2006, th at is to say a total of five years from the entry
into force of this Directive, to comply with this Directive, with regard to the
music and entertainment sectors on the condition that during this period the
levels of protection already achieved in individual Member States, with regard
to the personnel in these sectors, are maintained.
3. The Member States shall communicate to the Commission the text of the
provisions of national law which they adopt or have already adopted in the
field covered by this Directive.
Article 18
Entry into force
This Directive shall enter into force on the day of its publication in the Official
Journal of the European Union.
3.Arrt royal du 16.01.2006 relatif la
protection de la sant et de la scurit
des travailleurs contre les risques lis au
bruit sur le lieu de travail (transposition
en droit belge de la directive europenne
2003/10/CE)
Article 1. Le prsent arrt est la transposition en droit belge de la directive
2003/1 0/CE du Parlement europen et du Conseil du 6 fvrier 2003
concernant les prescriptions minimales de scurit et de sant relatives
l'exposition des travailleurs aux risques dus aux agents physiques (bruit) (dix-
septime directive particulire au sens de l'article 16, alina 1er de la directive
89/391/CEE) .
Art. 2. Le prsent arrt s'applique aux employeurs et aux travailleurs ainsi
qu'aux personnes y assimiles, vises l'article 2 de la loi du 4 aot 1996
relative au bien-tre des travailleurs lors de l'excution de leur travail.
Art. 3. Le prsent arrt s'applique aux activits dans l'exercice desquelles
les travailleurs sont ou risquent d'tre exposs, du fait de leur travail , des
risques dus au bruit.
Art. 4. Pour l'application du prsent arrt, on entend par :
1 o la loi : la loi du 4 aot 1996 relative au bien-tre des travailleurs lors de
l'excution de leur travail;
2danger : la proprit intrinsque du bruit susceptible d'avoir un effet
nuisible;
3risque : la probabilit de dvelopper, dans les conditions d'exposition au
bruit, une situation potentiellement dommageable;
4 o exposition : la mesure dans laquelle le bruit a un effet sur le corps
humain;
5mesurage : le mesurage proprement dit, l'analyse et le calcul du rsultat ;
6l'arrt royal relatif la politique du bien-tre : l'arrt royal du 27 mars
1998 relatif la politique du bien-tre des travailleurs lors de l'excution de
leur travail ;
r Comit : le Comit pour la Prvention et la Protection au travail , ou,
dfaut, la dlgation syndicale ou, dfaut, les travailleurs eux-mmes,
conformment aux dispositions de l'article 53 de la loi.
Art. 5. Aux fins du prsent arrt, les paramtres physiques suivants sont
utiliss comme indicateurs du risque et sont dfinis de la faon suivante :
1 o pression acoustique de crte (Pcrte) : valeur maximale de la pression
acoustique instantane mesure avec la pondration frquentielle C;
2niveau d'exposition quotidienne au bruit (LEX, 8h) (dB(A) re. 20 'mu'Pa) :
moyenne pondre dans le temps des niveaux d'exposition au bruit pour une
journe de travail nominale de huit heures, dfinie par la norme NBN ISO
1999 : 1992, au point 3.6. Cette notion couvre tous les bruits prsents au
travail, y compris le bruit impulsif;
3niveau d'exposition hebdomadaire au bruit (LEX, 8h) : moyenne pondre
dans le temps des niveaux d'exposition quotidienne au bruit pour une
semaine nominale de cinq journes de travail de huit heures, dfinie par la
norme NBN ISO 1999 : 1992, au point 3.6 (note 2).
Section Il. -Valeurs limites d'exposition et valeurs d'exposition dclenchant
l'action.
Art. 6. Aux fins du prsent arrt, les valeurs limites d'exposition et les
valeurs d'exposition dclenchant l'action par rapport aux niveaux d'exposition
quotidiens au bruit et la pression acoustique de crte sont fixes :
1 o valeurs limites d'exposition : LEX, 8h = 87 dB(A) et Pcrte = 200 Pa
respectivement (140 dB(C) par rapport 20 'mu'Pa) ;
2valeurs d'exposition suprieures dclenchant l'action : LEX, 8h = 85 dB(A)
et Pcrte = 140 Pa respectivement (137 dB(C) par rapport 20 'mu'Pa) ;
3valeurs d'exposition infrieures dclenchant l'action : LEX, 8h = 80 dB(A)
et Pcrte = 112 Pa respectivement (135 dB(C) par rapport 20 'mu'Pa) .
Art. 7. Pour l'application des valeurs limites d'exposition, la dtermination de
l'exposition effective du travailleur au bruit tient compte de l'attnuation
assure par les protecteurs auditifs individuels ports par le travailleur. Les
valeurs d'exposition dclenchant l'action ne prennent pas en compte l'effet de
l'utilisation de ces protecteurs.
Section Ill. - Dtermination et valuation des risques.
Art. 8. Dans le cadre de l'analyse des risques et des mesures de prvention
bases sur l'analyse des risques conformment aux dispositions de l'arrt
royal relatif la politique du bien-tre, l'employeur value si les travailleurs
sont ou peuvent tre exposs des risques lis au bruit lors de l'excution de
leur travail.
Dans le cas o il ressort de l'valuation mentionne dans l'alina 1er que les
travailleurs sont ou peuvent tre exposs des risques lis au bruit lors de
l'excution de leur travail , l'employeur value et si ncessaire mesure le
niveau de l'exposition des travailleurs au bruit.
Art. 9. Les mthodes et appareillages utiliss pour l'valuation et le
mesurage viss l'article 8 sont adapts aux conditions existantes, compte
tenu notamment des caractristiques du bruit mesurer, de la dure
d'exposition, des facteurs ambiants et des caractristiques de l'appareil de
mesurage.
Les mthodes et les appareillages viss l'alina 1er permettent de
dterminer les paramtres dfinis l'article 5 et de dcider si , dans une
situation donne, les valeurs fixes l'article 6 sont dpasses.
Les mthodes vises l'alina 1er peuvent consister en des
chantillonnages qui sont reprsentatifs de l'exposition individuelle du
travailleur.
Art. 1 O. L'employeur fait appel, selon le cas, son service interne ou externe
pour la prvention et la protection au travail pour l'valuation et le mesurage
viss l'article 8, alina 2, qui doivent tre effectus de faon comptente et
des intervalles appropris.
Au cas o le service interne ou externe pour la prvention et la protection au
travail ne possde pas de comptence pour l'valuation et le mesurage viss
l'alina 1er, l'employeur fait appel un laboratoire agr dont l'agrment se
rapporte au mesurage du bruit.
Art. 11 . Les donnes issues de l'valuation eUou du mesurage du niveau
d'exposition au bruit sont conserves sous une forme susceptible d'en
permettre la consultation une date ultrieure.
Art. 12. Pour l'valuation des rsultats des mesurages, on prend en compte
l'incertitude de mesurage qui est dtermine conformment aux pratiques de
la mtrologie.
Art. 13. Dans le cadre de l'valuation des risques et des mesures de
prvention qui en dcoulent conformment aux dispositions de l'arrt royal
relatif la politique du bien-tre, l'employeur prte une attention particulire
aux lments suivants :
1 o le niveau, le type et la dure d'exposition, y compris toute exposition au
bruit impulsif;
2les valeurs limites d'exposition et les valeurs d'exposition dclenchant
l'action fixes l'article 6;
3toute incidence sur la sant et la scurit des travailleurs appartenant
des groupes risques particulirement sensibles;
4 o dans la mesure o cela est ralisable sur le plan technique, toute
incidence sur la sant et la scurit des travailleurs rsultant d'interactions
entre le bruit et des substances ototoxiques d'origine professionnelle et entre
le bruit et les vibrations;
5toute incidence indirecte sur la sant et la scurit des travailleurs
rsultant d'interactions entre le bruit et les signaux d'alarme ou d'autres sons
qu'il importe d'observer afin de rduire le risque d'accidents;
6les renseignements sur les missions sonores fournis par les fabricants
des quipements de travail conformment l'arrt royal du 5 mai 1995
portant excution de la directive du Conseil des Communauts europennes
concernant le rapprochement des lgislations des Etats membres relatives
aux machines;
r l'existence d'quipements de travail de remplacement conus pour
rduire les missions sonores;
8la prolongation de l'exposition au bruit au-del des heures de travail , sous
la responsabilit de l'employeur;
go une information approprie recueillie lors de la surveillance de la sant, y
compris l'information publie, dans la mesure du possible;
1 oo la mise disposition de protecteurs auditifs ayant des caractristiques
adquates d'attnuation.
Art. 14. L'employeur value les risques conformment aux dispositions de
l'arrt royal relatif la politique du bien-tre et mentionne les mesures qui
sont prises conformment aux articles 15 20 afin d'viter ou de diminuer
l'exposition.
L'valuation des risques est accompagne de documents sous une forme
adapte et est rgulirement mise jour, notamment lorsque des
changements importants, susceptibles de la rendre caduque, sont intervenus
ou lorsque les rsultats de la surveillance de la sant en dmontrent la
ncessit.
Section IV. -Dispositions visant viter ou rduire l'exposition.
Art. 15. En tenant compte du progrs technique et de la disponibilit de
mesures de matrise du risque la source, les risques rsultant de
l'exposition au bruit sont supprims leur source ou rduits au minimum.
La rduction de ces risques se base sur les principes gnraux de
prvention figurant l'article 5, 1er de la loi, et prend en considration,
notamment :
1 o d'autres mthodes de travail ncessitant une exposition moindre au bruit ;
2le choix d'quipements de travail appropris mettant, compte tenu du
travail effectuer, le moins de bruit possible, y compris la possibilit de mettre
la disposition des travailleurs des quipements soumis aux dispositions de
l'arrt royal du 5 mai 1995 portant excution de la directive du Conseil des
Communauts europennes concernant le rapprochement des lgislations
des Etats membres relatives aux machines, et dont l'objectif ou l'effet est de
limiter l'exposition au bruit;
3la conception et l'agencement des lieux et postes de travail;
4 o l'information et la formation adquates des travailleurs afin qu'ils utilisent
correctement les quipements de travail en vue de rduire au minimum leur
exposition au bruit;
5des moyens techniques pour rduire :
a) le bruit arien, notamment par crans, capotages, revtements l'aide de
matriaux absorption acoustique;
b) le bruit de structure, notamment en amortissant le bruit ou par l'isolation;
6des programmes appropris de maintenance des quipements de travail ,
du lieu de travail et des systmes sur le lieu de travail ;
r la rduction du bruit par une meilleure organisation du travail :
a) limitation de la dure et de l'intensit de l'exposition;
b) des horaires de travail adapts, ainsi que suffisamment de priodes de
repos.
Art. 16. Sur la base de l'valuation des risques vise l'article 8, lorsque les
valeurs d'exposition suprieures dclenchant l'action vises l'article 6, 2,
sont dpasses, l'employeur tablit et met en oeuvre un programme de
mesures techniques et/ou organisationnelles visant rduire au minimum
l'exposition au bruit, en prenant en considration, notamment, les mesures
vises l'article 15.
Art. 17. Sur la base de l'valuation des risques vise l'article 8, les lieux de
travail o les travailleurs sont susceptibles d'tre exposs un bruit
dpassant les valeurs d'exposition suprieures dclenchant l'action, vises
l'article 6, 2, font l'objet d'une signalisation approprie. Ces lieux sont en
outre dlimits et font l'objet d'une limitation d'accs lorsque cela est
techniquement faisable et que le risque d'exposition le justifie.
Art. 18. L'exposition du travailleur, telle que dtermine conformment aux
dispositions de l'article 7, ne peut en aucun cas dpasser les valeurs limites
d'exposition vises l'article 6, 1 o .
Si , en dpit des mesures prises pour mettre en oeuvre le prsent arrt, des
expositions dpassant les valeurs limites d'exposition sont constates,
l'employeur :
1 o prend immdiatement des mesures pour rduire l'exposition un niveau
infrieur aux valeurs limites d'exposition,
2dtermine les causes de l'exposition excessive, et
3adapte les mesures de protection et de prvention en vue d'viter toute
rcurrence.
Art. 19. Lorsque la nature de l'activit amne un travailleur bnficier de
l'usage de locaux de repos sous la responsabilit de l'employeur, le bruit dans
ces locaux est rduit un niveau compatible avec leur fonction et leurs
conditions d'utilisation.
Art. 20. En vue de pouvoir protger des groupes risques particulirement
sensibles contre les risques qui leur sont spcifiques, l'employeur adapte les
mesures prvues aux articles 15 17 et l'article 19 aux exigences des
travailleurs appartenant ces groupes.
Section V. -Protection individuelle.
Art. 21 . Si d'autres moyens ne permettent pas d'viter les risques dus
l'exposition au bruit, des protecteurs auditifs individuels, appropris et
correctement adapts, sont mis la disposition des travailleurs et utiliss par
ceux-ci conformment aux dispositions de l'arrt royal du 13 juin 2005 relatif
l'utilisation des quipements de protection individuelle et de l'article 6 de la
loi et dans les conditions suivantes :
1 o lorsque l'exposition au bruit dpasse les valeurs d'exposition infrieures
dclenchant l'action, vises l'article 6, 3, l'employeur met des protecteurs
auditifs individuels la disposition des travailleurs;
2o lorsque l'exposition au bruit gale ou dpasse les valeurs d'exposition
suprieures dclenchant l'action, vises l'article 6, 2, les travailleurs
utilisent des protecteurs auditifs individuels;
3les protecteurs auditifs individuels sont choisis de faon liminer le
risque pour l'oue ou le rduire le plus possible.
L'employeur est tenu de vrifier l'efficacit des mesures prises en application
du prsent article et veille ce que les travailleurs portent des protecteurs
auditifs.
Section VI. - Information et formation des travailleurs.
Art. 22. Sans prjudice des articles 17 21 de l'arrt royal relatif la
politique du bien-tre des travailleurs, l'employeur veille ce que les
travailleurs qui sont exposs sur leur lieu de travail un niveau sonore gal
ou suprieur aux valeurs d'exposition infrieures dclenchant l'action, vises
l'article 6, 3, et le comit reoivent des informations et une formation en
rapport avec les risques dcoulant de l'exposition au bruit, notamment en ce
qui concerne :
1 o la nature de ce type de risques;
2les mesures prises en application du prsent arrt en vue de supprimer
ou de rduire au minimum les risques rsultant du bruit, y compris les
circonstances dans lesquelles les mesures s'appliquent;
3les valeurs limites d'exposition et les valeurs d'exposition dclenchant
l'action fixes l'article 6;
4 o les rsultats des valuations et des mesurages du bruit effectues en
application de l'article 8 accompagns d'une explication relative leur
signification et aux risques potentiels;
5o l'utilisation correcte de protecteurs auditifs;
6l'utilit et la faon de dpister et de signaler des symptmes d'altration
de l'oue;
r les conditions dans lesquelles les travailleurs ont droit une surveillance
de leur sant et le but de cette surveillance de la sant, conformment aux
articles 24 28;
8les pratiques professionnelles sres, afin de rduire au minimum
l'exposition au bruit.
Section VIl. -Consultation et participation des travailleurs.
Art. 23. La consultation et la participation des travailleurs eUou de leurs
reprsentants ont lieu conformment aux dispositions de l'arrt royal du 3
mai 1999 relatif aux missions et au fonctionnement des Comits pour la
prvention et la protection au travail , en ce qui concerne les matires
couvertes par le prsent arrt.
Le Comit est consult et participe notamment:
1 o l'valuation des risques et la dtermination des mesures prendre,
vises aux articles 8 14;
2aux mesures visant supprimer ou rduire les risques rsultant de
l'exposition au bruit, vises aux articles 15 17 et aux articles 19 et 20;
3au choix de protecteurs auditifs individuels viss l'article 21 , 3.
Section VIII. -Surveillance de la sant.
Art. 24. Les travailleurs occups une activit risque d au bruit, dont
l'exposition dpasse les valeurs d'exposition infrieures dclenchant l'action
vises l'article 6, 3, sont soumis une surveillance de la sant approprie,
selon les dispositions de l'arrt royal du 28 mai 2003 relatif la surveillance
de la sant des travailleurs.
Art. 25. Pour chaque travailleur soumis une surveillance de la sant
conformment aux exigences de l'article 24, des dossiers de sant sont
tablis et tenus jour conformment aux dispositions de l'arrt royal du 28
mai 2003 relatif la surveillance de la sant des travailleurs.
Art. 26. Pralablement l'affectation d'un travailleur une activit telle que
vise l'article 24, celui-ci est soumis une valuation de la sant pralable.
Cette valuation pralable comprend le contrle de l'audition par un examen
audiomtrique prventif effectu selon les prescriptions de la norme ISO
6189.
Art . 27. Le travailleur concern est soumis une valuation de sant
priodique incluant un examen audiomtrique dans les 12 mois qui suivent la
premire valuation.
La priodicit de l'valuation de sant priodique est fixe comme suit :
1 o tous les ans pour les travailleurs qui sont exposs une exposition
quotidienne moyenne gale ou suprieure 87 dB(A) ou une pression
acoustique de crte de 140 dB;
2tous les trois ans pour les travailleurs qui sont exposs une exposition
quotidienne moyenne gale ou suprieure 85 dB(A) ou une pression
acoustique de crte de 137 dB;
3tous les cinq ans pour les travailleurs qui sont exposs une exposition
quotidienne moyenne gale ou suprieure 80 dB(A) ou une pression
acoustique de crte de 135 dB.
Art. 28. Lorsque les rsultats de l'valuation de sant priodique font
apparatre qu'un travailleur est atteint d'une altration identifiable de l'audition
1 o le conseiller en prvention-mdecin du travail informe le travailleur du
rsultat qui le concerne;
2l'employeur :
a) revoit l'analyse des risques vise l'article 8;
b) revoit les mesures de prvention prises pour supprimer ou rduire les
risques, telles que vises aux articles 15 17 et aux articles 19 21 ;
c) tient compte de l'avis du conseiller en prvention-mdecin du travail ou de
tout autre conseiller en prvention comptent ou du fonctionnaire charg de la
surveillance pour la mise en oeuvre de toute mesure juge ncessaire pour
supprimer ou rduire les risques conformment aux articles 15 17 et 19
21 , y compris l'ventuelle affectation du travailleur un autre poste ne
comportant plus de risques d'exposition;
d) veille ce que tous les travailleurs ayant subi une exposition analogue
soient soumis une valuation de sant.
Section IX. - Drogations.
Art . 29. Dans des cas exceptionnels o, en raison de la nature du travail ,
l'utilisation complte et approprie des protecteurs auditifs individuels serait
susceptible d'entraner un risque plus grand pour la sant ou la scurit que
leur non-utilisation, une drogation aux dispositions des articles 18 et 21 , 1 o
et 2peut tre accorde.
Art. 30. Aux fins de l'application des valeurs limites d'exposition et des
valeurs d'exposition dclenchant l'action, le niveau d'exposition quotidien au
bruit peut tre remplac par le niveau hebdomadaire, si les conditions
suivantes sont runies :
1 o il s'agit d'activits pour lesquelles l'exposition quotidienne au bruit varie
notablement selon la journe de travail;
2les circonstances sont dment motives;
3le niveau d'exposition hebdomadaire au bruit indiqu par un contrle
appropri ne dpasse pas la valeur limite d'exposition de 87 dB(A);
4des mesures appropries sont prises afin de rduire au minimum les
risques associs ces activits.
Art. 31. Les drogations vises l'article 29 et les drogations vises
l'article 30 sont accordes par le Ministre qui a le Bien-tre au travail dans ses
attributions ou par le fonctionnaire qui il a donn dlgation cet effet.
Les drogations vises l'alina 1er sont accordes aprs examen et avis
du fonctionnaire charg de la surveillance.
A dfaut d'un avis dans les deux mois qui suivent la demande de drogation
de l'employeur, celui -ci est considr comme favorable.
Art. 32. La demande de drogation est adresse par crit la Direction
gnrale Humanisation du Travail du Service public fdral Emploi , Travail et
Concertation sociale. Elle est accompagne du procs-verbal de la runion
du comit pendant laquelle l'avis des membres du comit sur la demande a
t recueilli et de l'avis du service comptent pour la Prvention et la
Protection au travail.
La demande contient galement la mention des circonstances et causes
particulires qui ont amen l'employeur demander cette drogation ainsi
que les mesures qu'il envisage de prendre afin de garantir, compte tenu de
ces circonstances, que les risques qui en rsultent soient rduits au minimum.
Art. 33. L'autorisation de droger contient :
1 o les conditions garantissant que les risques rsultant du fait de droger
soient, compte tenu des circonstances particulires, rduits au minimum;
2l'obligation de soumettre les travailleurs concerns une surveillance
renforce de leur sant.
Art. 34. L'autorisation de droger est valable pendant quatre ans. Une
nouvelle demande est introduite au plus tard un mois avant l'expiration de la
dure de validit en cours. L'autorisation de droger devient caduque
l'expiration de la dure de validit si la demande n'est pas introduite dans le
dlai prcit.
Art. 35. Lorsque soit l'employeur, soit le fonctionnaire charg de la
surveillance constate pendant la dure de validit de la drogation que les
circonstances qui ont justifi la drogation n'existent plus, ils en informent
immdiatement par crit le directeur gnral de la Direction gnrale
Humanisation du travail du Service public fdral Emploi , Travail et
Concertation sociale.
Le cas chant, aprs que l'employeur ait t entendu, l'autorisation de
drogation accorde est abroge.
L'employeur est tenu inform de la dcision motive d'abroger la drogation.
Section X. - Modifications et clauses finales.
Art . 36. Sont abroges dans le Rglement gnral pour la protection du
travail , approuv par les arrts du Rgent du 11 fvrier 1946 et du 27
septembre 1947, les dispositions suivantes :
1 o le point 4sexies "Dispositions particulires concernant les travailleurs
exposs au bruit" de la sous-section Il "Surveillance de la sant des
travailleurs" de la Section Ire du chapitre Ill du Titre Il, comprenant l'article
135sexies, insr par l'arrt royal du 26 septembre 1991;
2le point a) " Lutte contre le bruit " de l'article 148decies 2. 1. a) modifi par
les arrts royaux du 26 septembre 1991 et du 7 aot 1995;
3le point 2.3 "Bruit" du Groupe Il de l'annexe Il "Surveillance mdicale des
travailleurs exposs au risque de maladies professionnelles" , de la sous-
section Il , Section Ire, Chapitre Ill du Titre Il;
4 o L'annexe XV " Dfinitions des critres d'valuation du risque d au bruit
viss l'article 148decies 2. 1. a) 2 "de la Section Ire, chapitre Ill , Titre Il ,
insr par l'arrt royal du 26 septembre 1991 ;
5o L'annexe V "Indications pour les mesures du bruit vises l'article
148decies 2. 1. a) 3.1" de la Section Il, chapitre Ill , Titre Il , insr par l'arrt
royal du 26 septembre 1991.
Art. 37. A l'annexe Il de l'arrt royal du 13 juin 2005 relatif l'utilisation des
quipements de protection individuelle, le point 11 est remplac comme suit:
" 11 . Equipements de protection de l'oue :
Les travailleurs exposs au bruit disposent des quipements de protection
individuelle de l'oue et les utilisent selon les dispositions des articles 21 et 29
de l'arrt royal du 16 janvier 2006 relatif la protection de la sant et de la
scurit des travailleurs contre les risques lis au bruit sur le lieu de travail. "
Art. 38. Les dispositions des articles 2 35 du prsent arrt constituent le
chapitre Ill du titre IV du Code sur le bien-tre au travail , avec les intituls
suivants :
1 o " Titre IV : facteurs d'environnement et agents physiques ";
2" Chapitre Ill : Ambiances sonores ".
Art. 39. Notre Ministre de l'Emploi est charg de l'excution du prsent
arrt.
Donn Bruxelles, le 16 janvier 2006.
ALBERT
Par le Roi:
Le Ministre de l'Emploi,
P. VANVEL THOVEN.
(source: http:llwww.juridat.be/cgi_loilloi_N.pl?cn=2006011645)
4. Recommended volume for Creative MP3-players
Model Volume Level
Zen Vision W 19
Zen Vision M 19
Zen MicroPhoto 19
Zen V series 20
Zen Neeon 2 19
MuVo V100 20
The volume levels correspond to less than 85d8 as recommended by House
Ear lnstitute.
(source: http://www. creative. comlproductslmp3/howtolwelcome. asp ?c=6&t=4)
5. Output Levels from different types of MP3-players
and earphones, 1 st research
1 0
100
00
~
~
sv
i
>
70

.....
:J
a.
6()
:;
0
50
music
~
iP"Jd
------
IF'()(! N 00
- - -
.
---

10 20 30 0 60 70 80 00 100
Perntage or Vo me Control
F"gure 1. Free- ek:l equivalent output l:eveJs or 5 P3 players, usi ng
sto ea p ones. as .a unction or volu ile oontol setti ,gs.
Gra Ave age is t e mean of al i music genres across ali players.
Er or baros rapresent 1 standard evjali on round 1 e Gra Average.
Ou pu Levels of usic
, ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~
<
ctJ
:E..
;
l
'5
0
H)O
8()
70
60
~
'10
30
0
0 iF"od' in-Erar
s
- -il - Supra-aur
ER6i
10 20 30 60 70
Percentage of Volume Con roi
80 00
Fi ure 2. F ee-- i qu iv le t ou t r el ro ali m of m
functio o vol me control setting or 5 models o earp o es.
levels are avera ed across ali 3 players
00
Supra-aurai earphones are earphones that sit on top of the ears. The other
models are earbud-style earphones.
%of
Volume
Control
10-50%
60%
70%
80%
90%
100%
Earbud
No limit
No limit
6 hours
1.5 hours
22 minutes
5 minutes
Maximum listening time per day
lsolator Supra-Aurai iPod, stock earphones
No limit No limit No limit
14 hours No limit 18 hours
3.4 hours 20 hours 4.6 hours
50 minutes 4.9 hours 1.2 hours
12 minutes 1.2 hours 18 minutes
3 minutes 18 minutes 5 minutes
Table 1. Maximum listening time per day using NIOSH damage-risk criteria. "Earbud"
includes stock earphones and iPod ln-ear earphones. "lsolator" includes Bymotic ER6i
earphones and Shure E4c earphones. "Supra-Aurai" includes Koss headphones that
rest on top of the ear.
The isolator style refers to earphones that have been reported to black out
back round noise.
(source:http: / / www. hearingconserv a ti on . org/ docs /virt ual Pr e s
s Room/ portnuff.htm)
6. Output Levels from different types of MP3-players
and earphones, 2nd research
Different music styles
0
10, Hz
-10
100,0 Hz 1000,0 Hz 10000,0 Hz 1000 0,0 Hz
-20
-30
-40
-50
-60
-70
-80
-+- normruis
- dance
folk
hiphop
-*- jazz
-+- klassiek
-+- latin
- pop
- r&b
rock
-90 ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~
Horizontal ax = frequency in Hertz
Vertical ax =dB (Fs)
Different types of MP3 players
-4
-6
-8
-10
-12
-14
-16
-18


-20 .____ ______________________________ _____,
Horizontal ax = frequency in Hertz
Vertical ax = dB(Fs)
-+- iPod Nana
---Creatiw Mu\0
Crea iw Zen
-+- Sweex Bluebay
----.-. iPod S huflle
-+- Packard Bell Pulse
-+-- Philips SA3125
- Samsung K3
- Sandisk Sansa
Sony A1200
Different types of volume controllers
1
1 0 33% 66%
Horizontal ax = Volume control in %
Vertical ax = Output voltage in dBV
1 o h ~
-10
-20
iii
-30 "C
Cil
Cl
"'
-40 ~
>
'5
-50 &
::::J
0
-60
-70
-80
- iPod a no
- Creative M \0
Creative Zen
Sweex BI ebay
-iPodShuffle
- Packard Bell Pulse
- Phi lips SA3125
- Samsung K3
Sandis Sansa
Sony A1200
iPod a no
Creative Mu\0
Creative Zen
Sweex BI ebay
iPod Shuffle
Packard Bell Pulse
- Philips SA3125
Samsu g K3
Sandis Sansa
Maximum Output level for different music genres and different
types of MP3-players, messured in dB(A)
iPod Nano
Creative Muvo
Creative Zen
Sweex Bluebay
iPod Shuffle
Packard Bell
Pulse
Philips SA3125
Samsung K3
Sandisk Sansa
Sony A1200
~
2

0
c:
96
102,4
102 5
11 3,3
102,2
99,7
97,1
106 5
95,4
97,8
0
Gl
Gi
94,6
100,6
100 9
11 1 4
100, 5
98
95 7
104 5
93,7
96
.::
93,7
100,3
100 2
111,5
99,8
97,3
99,1
104 3
93,3
95,8
a.
0
.r:.
a.
:E
95,3
101, 6
101 7
112,4
101, 5
98,8
96 5
105 7
94,6
96,9
Cil
93,7
100,5
100 4
111 ,9
99,7
98,2
94,7
104 2
93,9
96,2
:iii!
88,6
95,4
95 3
106,4
94,9
92,3
89,8
99 6
88,2
90,8
c:
;
ca
94,5
101,2
101 2
112,4
100, 6
98,8
95,6
105 1
94,5
96,8
c.
8.
93,6
100,2
100 2
11 1,3
99,7
97,7
94,7
104
93,4
95,7
iS
""
0
...
89,4 92,7
96,1 99,2
962 99 2
107,1 110,2
95,7 98,8
93,2 96,6
906 93 8
100 4 103 1
88,9 92,3
91 ,5 94,6
7. Geluidsniveaus op verschillende plaatsen in het
orkest
Opstelling GSO 13-03-07
llOdB

98dB
108dB
98dB

96dB 104dB 112dB llOdB 108dB
verhoging +- aocm

96dB 96dB


98dB
96dB
98dB .

94dB
94dB

86dB
84dB

dirigent

dwarsfl uiten

trompet

viol en

piccolo

piano
ce llo

klarinet

harp
contrabas

saxofoon

drums

pau ken
8. Hearing loss in the Belgian army
Questions et Rponses
SNAT DE BELGIQUE
Bulletin 3-60
Questions poses par les Snateurs et rponses donnes par les Ministres
(Art. 70 du rglement du Snat)
(Fr.): Question pose en franais- (N.): Question pose en nerlandais
Ministre de la Dfense
Question n3-4010 de M. Vandenberghe H. du 29 dcembre 2005 (N.):
Soldats belges. - Lsions auditives.
Il ressort d'une tude ralise par l'universit de Gand la demande du
ministre de la Dfense que plus de la moiti des jeunes soldats prsentent
de srieuses lsions auditives ou deviennent sourds. Ces lsions sont
souvent dues aux bruits auxquels sont confronts les soldats dans l'exercice
de leur profession. Ainsi, l'exposition des bruits d'explosion, mme de
courte dure, est beaucoup plus nuisible pour l'audition qu'un bruit constant.
De plus, les hommes sont par nature plus sujets aux lsions auditives que les
femmes.
J'aimerais une rponse aux questions suivantes :
1. Combien de cas de lsions auditives ont-ils t constats chez les soldats
belges au cours des cinq dernires annes ? Quel est le nombre de soldats
masculins et fminins concerns?
2. Dans combien de cas les lsions taient-elles irrversibles?
3. Dans quelles divisions les formes les plus graves de lsions auditives sont-
elles constates?
4. Quelles mesures le gouvernement prendra-t-il pour limiter les risques de
lsions auditives pour les soldats ? A-t-il l'intention de leur procurer des
protge-oreilles ? Comment compte-t-il attirer l'attention des soldats sur les
dangers que comporte leur profession pour l'audition ?
Rponse : L'honorable membre est pri de trouver ci-aprs les rponses
ses questions.
Avant-propos
Il faut mentionner que non seulement la Dfense belge mais aussi TOUTES
les forces armes sont confrontes avec ce risque important concernant le
dommage auditif.
1. Selon la fonction du militaire, un audiogramme tonal est ralis par
diffrents acteurs : pour les fonctions spcifiques au Centre d'expertise
mdicale et pour la majorit des militaires chez le mdecin du travail.
Jusqu' ce jour, une analyse statistique de cette information n'a pas t
ralise.
Dans le nouveau logiciel informatique Total Health qui contiendra toutes
les donnes mdicales relatives chaque militaire, cette possibilit est
prvue.
En bref, la Dfense n'a ce jour aucune information sur le nombre de cas o
un dommage auditif a t constat au cours des cinq dernires annes.
2. Si des dommages sont constats lors d'un examen de routine, leurs
consquences (pertes auditives) sont toujours irrversibles. Nanmoins, les
membres du personnel sont toujours sensibiliss sur les risques.
3. Les pertes auditives les plus srieuses se manifestent chez les militaires
qui sont exposs professionnellement au bruit des armements et qui n'ont pas
port de protection auditive.
On constate galement des pertes auditives srieuses chez les militaires
exposs au bruit des moteurs des vhicules de transport (vhicules bl inds,
etc.).
4. La Dfense mne depuis des annes une politique de prvention contre la
surdit. Celle-ci est focalise sur trois axes : la sensibilisation, la mise
disposition de protection auditive adquate et l'examen de l'exposition au
bruit. En excution de cette politique, le plan global de prvention de la
Dfense comprend un item traitant de la Prvention de la surdit
professionnelle.
1) Sensibilisation du personnel
Des conseillers en prvention du Service Interne de Prvention et de
Protection au Travail et un mdecin du service ORL du Centre d'Expertise
Mdicale (CME) donnent rgulirement des exposs dans les coles de
futurs cadres (sous-officiers, officiers) ainsi que dans les units des
composantes Air et Terre.
L'Agence Europenne pour la Prvention et la Protection au travail a men
une campagne de sensibilisation contre le bruit au travail. Dans ce cadre, la
Dfense a pris les initiatives suivantes : organisation de journes
d'i nformation, ralisation d'un reportage Televox diffus par les postes
rgionaux, ralisation d'une affiche au profit des travailleurs des units,
rdaction d'une brochure d'information diffuse tous les membres du
personnel via DIRECT, ralisation d'un film d'information.
2) Mise la disposition de protections auditives adquates
La Dfense met la disposition de son personnel les protections auditives
suivantes : le bouchon d'oreille non linaire, pour chaque militaire ds son
instruction de base - le serre-tte lectronique, pour des groupes risques
spcifiques (ex: instructeurs de tir)- le Communication Ear Plug pour les
casques des pilotes et de l'quipage des avions et des hlicoptres (consulter
Direct 1 0/2005) -des serre-ttes spcifiques pour salle de machines pour le
personnel de la composante Mer- des protections auditives spcifiques
pour les musiciens militaires - des protections spcifiques selon les rsultats
de l'analyse des risques au poste de travail.
3) L'examen de l'exposition au bruit
La directive europenne 2003/1 0/CE impose une valuation du risque de
l'exposition au bruit. Dans ce cadre l'efficacit de la protection auditive utilise
est contrle de faon thorique et pratique. C'est dans ce cadre que le
Service Interne de Prvention et de Protection au Travail a demand
l'expertise de l'universit de Gand.
1 O. Common sources of noise
Sound Loudness measured dB (A)
Gunshot (peak level) 140 to 170
Jet takeoff 140
Rock concert, chain saw, 110 to 120
diesel Locomotive, stereo
headphones
Motorcycle, lawnmower 90
OSHA* level for hearing 80 to 85
Conversation 60
Quiet room 50
Whisper 30 to 40
* OSHA= Occupational
Safety and Health
Administration
(source: www.aafp.org)