NOISE INDUCED HEARING

LOSS (NIHL)
SISA PRESENTATION
DECEMBER 2007

Based on The Australian Safety and Compensation Council (ASCC)

WORK-RELATED NOISE INDUCED HEARING LOSS IN AUSTRALIA (APRIL
2006)

BY JASON SPARNON, AUDIOLOGIST &

JAN MACHOTKA, AUDIOLOGIST
Introduction to NIHL
NIHL is defined by National Code of Practice (2004) as
hearing impairment arising from exposure to excessive
noise at work, and is also commonly known as industrial
deafness.

NIHL is entirely preventable but once acquired it is

irreversible

Most recent data (2006) suggests that the number of

NIHL represents 19% of all of all disease-related
claims made and 3.2% of the total disease and injury
related claims.
Causes of NIHL
Continuous Noise exposure
The extent of hearing loss increases with time of exposure,
and also increases with increasing the intensity of sound
levels to which an employee is exposed

Greatest amount damage occurs in the first 10-15 years

Most scientific evidence suggests that the hearing loss

does not progress once exposure to noise has discontinued

National Occupational Health and Safety Commission

(NOHSC) standard identifies a continuous exposure level of
85dB(A) over 8 hrs and a maximum peak exposure level 140
dB(C)
Causes of NIHL
Impulsive Noise
Eg Explosions and Gunfire
Very high sound level eg > 140dB (c)
Can result in asymmetrical loss

Ototoxicity
Exposure to chemicals containing ototoxins

Damage usually associated with combination of ototoxins

and noise
Eg butanol, toluene, carbon monoxide, solvent mixtures
and certain types of medications eg cancer therapy drugs
and asprins
Causes of NIHL
Compounding factors
Non-work related

Eg Congenital factors and recreational noise

Role of co-factors remains poorly understood

Eg cardiovascular disease, diabetes, and neurodegenerative

diseases
 Interpreting Audiograms
 Audiograms represent the softest sound a person
can hear.
 Conductive loss–outer or middle ear.
 Sensorineural loss –inner ear or neural pathway.
Permanent. Often age or noise
related.
 Liability usually based upon
sensorineural only

X = left ear. O = Right ear

[ or ] denotes bone conduction
Effect of NIHL
 NIHLs commonly appear as a sloping loss that is
most prominent in the higher frequencies (4k)
 Effects speech perception by reducing perception
of consonant sounds (p,b,k,s,z etc) needed for
speech clarity.
 Vowels usually remain intact as there is often
good residual hearing throughout the lower
frequencies.
 Result = clients report that they can hear people
speaking but not understand them – the vowels
come through clearly but the important
consonants are distorted.
 Progression of NIHL ( 0 – 5 years)

Normal Hearing Mild high frequency loss

= 0% = 4.6% (40yo), 0% (70yo)
 Progression of NIHL (10 – 20 years)

Moderate high Moderate to severe high

frequency loss frequency loss
= 16.8% (40yo), 11.9 (70yo) = 23.8% (40yo), 18.9 (70yo)
Progression of NIHL (25 + years)

Moderate to Profound high

frequency loss
= 67.4% (40yo), 62.5% (70yo)
Calculation of percentage hearing loss (PHL)
Procedure for determine PHL
1. Establish hearing threshold levels at defined frequencies:
500Hz, 1000hz, 1500Hz, 2000Hz, 3000Hz, 4000Hz

2. Go to look up tables (NAL Report No 118) for each of the

frequencies to determine percentage hearing loss (PLH) for
each frequency (PLH500, PLH1000…..);

3. Add up all the percentage hearing losses to give an overall

figure

4. Appropriate deductions (if any) made

5. This % hearing loss (PLH) determined is used for

compensation claims.
Calculation of percentage hearing loss (PHL)
Deductions from PHL
1. Asymmetrical hearing loss

Noise Ordinarily effects both

Ears equally.

? – shooter
- tumor

= 21.2%
= 16.8% (using L levels for R)
Calculation of percentage hearing loss (PHL)
Deductions from PHL (cont’d)
2. Non-sensorineural hearing loss

= 61.7 % = 16.9%
Deductions from PHL (cont’d)
3. Age related hearing loss (presbyacusis)

= 23.8% (40yo),
= 18.9 (70yo)
 Other possible deductions
4. Pre-employment hearing loss and Congenital hearing loss

5. Non-work related medical conditions eg diabetes

6. Recreational noise exposure

7. Evidence suggests that noise exposure alone does

not usually produce a loss greater than 75 dBHL at
high frequencies, and 40 dBHL at lower frequencies.
 Statistics of NHIL claims
Table 1. Comparison of Comparison of Workers’ Compensation
Arrangements.
Jurisdiction Industrial deafness threshold, i.e. when a claim can be made

Comcare 5%.

Seacare 10%
VIC 10%
NSW 6% binaural loss
SA 5%
WA 10% (Above baseline hearing loss previously
assessed)
QLD 5%
TAS 5% binaural loss
NT 5% whole person impairment (percentage of loss of whole body)

ACT A worker is not entitled to compensation if the total

hearing loss is less than 6%
 Statistics of NHIL claims
Table 2. Number of Claims for NIHL

1998-99 1999-2000 2000-2001 2001-2002

Claims for NIHL 5755 5280 5185 4510

Percentage of Total 24 22 21 19
Disease Claims
Percentage of Total 3.8 3.5 3.5 3.2
Disease and Injury
Claims

Claims in SA decreased from 370 in 1999 to 190 in 2002

Although the number of NIHL claims has been reduced, it does
not mean that noise induced deafness in Australia has been
reduced
*most recent data available (2006)
 Number of claims per hundred thousand employees
Statistics of NHIL claims
Figure 1. NIHL Claims per Exposed Employees (2001/2)
1200
1000
800
600
400
200
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The highest number of claims are made by: Labourers and related workers, 33%
Tradespersons and related workers, 30% Intermediate production & transport
workers (plant or machine operators or transport drivers),25%
Statistics of NHIL claims
The average cost of workers compensation claims for NIHL in
2001/2 was calculated to be $6711.

Therefore, for Australia, the direct cost of NIHL claims for

2001/2 is calculated to be $6711 x 4510 claims i.e. just over
$30 million.

This figure does not include Hearing Aid fittings

Prevention NIHL
Noise Control and Hearing Loss Prevention
Program
Actions to reduce noise exposure eg. Noise insulation, ear
protection

Actions to monitor the health of employees eg, annual

hearing screening programs

Establishing a noise control policy and

program
noise control policy and program will enable a systematic
approach to hearing conservation in a company eg purchasing
policy on equipment noise levels, mandatory ear protection,
training programs for employees
Who is Hearing Matters
3 audiologists – Jan, Tara, Jason

Only independent clinic owned by its audiologists

NOT aligned by any hearing aid manufacturer

NOT solely a hearing aid clinic – also diagnostic clinic

Services provided by Hearing Matters

Determination of NIHL percentage and diagnostic reports.

Referrals to ENT specialists when appropriate

Hearing aid fittings and tinnitus treatment when appropriate

Noise protection equipment

Hearing Aids
 CIC: Mild – Moderate

 ITC: Moderate

 BTE: Moderate-Severe

 Open-Fit: Mild – Severe