Protecting Your Team: How to Navigate the HSE's Workplace Noise Intervention with Confidence
Image source: https://careers.hse.gov.uk/professions/health-and-safety-inspectors/
From the Institution of Occupational Safety and Health (IOSH) :
Britain’s national regulator for workplace health and safety has kicked off a new workplace noise intervention – we found out more about what inspectors will be looking for.
During the first year of the HSE’s workplace noise intervention, inspectors will be targeting high noise industries and assessing duty holders’ management of hearing protection using the acronym ‘CUFF’:
C = CONDITION
Is the hearing protection in good order and well maintained?
U = USE
Are the employees using the hearing protection when needed?
F = FIT THE EAR
Have the employees fitted their hearing protection properly?
F = FIT FOR PURPOSE
Is the hearing protection correctly specified? Is it over attenuating and causing a safety risk or under attenuating and exposing workers to noise?
'Hearing protection will be the focus in the first instance as it is used across a broad range of industries and creates significant management challenges,' Dr Rachel van Besouw, a specialist inspector in noise and vibration at the HSE, told IOSH magazine.
'As the workplace noise intervention progresses the focus will shift from individual protection to collective technical and organisational protective measures that eliminate or reduce exposure to noise in the workplace,' she added.
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How Eave can support you during the HSE’s new Workplace Noise Intervention
The Health and Safety Executive’s Noise & Vibration Specialist Paul Delderfield‘s update on HSE‘s Workplace Noise Intervention at The Health & Safety Event, NEC Birmingham.
The Eave system offers a comprehensive solution for safeguarding your team and navigating the HSE's Workplace Noise Intervention with confidence. At its core, the Eave solution features the FocusLite smart ear defenders, which not only provide essential hearing protection but also offer situational awareness. These ear defenders are equipped to collect crucial noise and hearing protection use data, enabling near real-time insights and analysis through the Peak online platform.
Let's break down how the Eave solution can specifically support duty holders during the HSE’s new Workplace Noise Intervention starting with the specifics of CUFF:
Condition: the complete Eave solution can ensure that your team's hearing protection is in optimal condition with reminders to use hygiene kits for ear cushion replacements every 6-12 months, and prompts to inspect the ear defenders, ear cushions and connectors if there's a decline in Personal Attenuation Rate or an increase in personal noise dose level as shown on Peak. Additionally, you are able to ensure that helmet clips and c-clips are securely attached, along with the usage of the USB grit cover on the charging port to ensure good condition. With its modular and easy to maintain design, the FocusLite hearing protection can be kept in optimal condition for multiple years, even when used in harsh industrial environments, ensuring the effectiveness of the hearing protection you have provided to your team. Each registered FocusLite comes with a 12 month warranty and the highest standards of customer support to ensure the condition of the hearing protection remains optimal, ensuring the necessary protection is provided throughout the product lifetime.
Use: The complete Eave solution ensures that the FocusLite hearing protection are consistently utilised during shifts. Monitoring Peak overexposures and unprotected events, you can track trends to ensure that your team's exposure to noise is minimised. By aligning hearing protection usage with shift patterns and maintaining a trend towards a 100% wear rate as tracked on Peak, Eave can help you to ensure that your team is adequately protected at all times.
Fit The Ear: Proper fitting of ear defenders is crucial for effective protection. Eave provides training on how to wear the ear muff correctly and guides users to adjust the bracket so that the cups properly cover the ears. By monitoring Peak personal dose levels and ensuring they remain below 100%, Eave can help you to ensure that the hearing of every member of your team is safeguarded.
Fit For Purpose: Eave goes beyond basic protection by enabling level-dependent HearThrough via theFocusLite. This technology allows users to maintain situational awareness while still benefiting from hearing protection. By ensuring that Peak personal dose levels remain below 100%, Eave can help you to ensure that the hearing protection is not just worn but also optimised for maximum effectiveness. This means that you will be able to ensure that your team are neither under nor over-protected (receiving excessive attenuation/over-attenuated). The level-dependent Focuslite hearing protection ensures the right level of protection is being provided even when the environment noise level fluctuates over time.
Eave can empower duty holders and site managers with the tools and insights needed to proactively address the CUFF expectations of the HSE's Workplace Noise Intervention requirements. By seamlessly integrating hearing protection with data collection and analysis, Eave streamlines compliance efforts, helping you to ensure the safety and well-being of your team when in noise.
But it doesn’t end there. The HSE inspections will go beyond CUFF as outlined below. Eave is ready to support you in addressing these additional crucial aspects.
What the Inspections Will Look Like: The inspections under HSE's Workplace Noise Intervention will scrutinise various facets of noise management in the workplace. From the adequacy of hearing protection to the implementation of control measures, inspectors will conduct thorough assessments to ensure compliance with regulations and standards.
Training on the use of hearing protection: One key area of focus will be whether adequate training on the proper fitting of hearing protection has been provided to workers. Eave can support this by offering training modules and guidance on how to correctly wear and adjust ear defenders for optimal protection.
Maintaining Wear Rates: Inspectors will also examine whether wear rates of hearing protection are being maintained at acceptable levels. Eave's data collection capabilities can track usage patterns, alerting managers if there are deviations from recommended wear rates, thereby facilitating proactive intervention.
Correct Specification of Hearing Protection: Concerns regarding over or under protection/attenuation will be addressed during inspections. Eave's technology ensures that the hearing protection provided is correctly specified for the noise levels encountered in specific work environments, mitigating the risk of either over-protection/attenuation leading to communication issues or under-protection causing exposure to harmful noise levels.
Maintenance of Hearing Protection: Regular maintenance of hearing protection is crucial for ensuring its effectiveness. Eave can assist in this aspect by providing reminders for maintenance tasks such as cleaning and replacing components, thereby prolonging the lifespan of protective equipment and maintaining compliance with regulations.
Recommended Controls: Inspectors will assess whether appropriate control measures are in place to minimise noise exposure. Eave can help by offering insights into the effectiveness of existing controls and recommending additional measures based on near real-time noise data collected from the workplace.
Buy Quiet Scheme: The implementation of a Buy Quiet scheme, which prioritises the procurement of quieter equipment and machinery, will be evaluated. Eave can support duty holders in implementing and monitoring such schemes, ensuring that noise levels are minimised at the source.
Control Action List: Duty holders will be expected to have a comprehensive control action list in place to address identified noise hazards. Eave can assist in developing and managing this list, ensuring that all necessary actions are documented and tracked for implementation.
CUFF Approach: As detailed above, the CUFF approach, focusing on Condition, Use, Fit the Ear, and Fit for Purpose of hearing protection, will guide inspectors' assessments. Eave aligns with this approach by providing tools and insights to ensure that each aspect is addressed effectively, thus demonstrating compliance with regulatory requirements.
Noise report quality: The HSE will also be collecting and assessing third party workplace noise survey reports for the quality of the advice provided.
HSE's Objective: It's essential to note that the HSE's objective is not to catch duty holders out but rather to promote awareness and adherence to regulations. Eave can support you with this objective by empowering duty holders with the tools and information needed to proactively manage noise risks in the workplace, fostering a culture of safety and compliance.
As the HSE's Workplace Noise Intervention unfolds, ensuring the safety and well-being of your team amidst heightened scrutiny is paramount. The team at Eave stands ready to support duty holders and site managers through this process. Our comprehensive solution offers not just hearing protection but a proactive approach to compliance. By addressing the CUFF expectations and beyond, Eave empowers you with tools and insights to navigate inspections with confidence. Together, we can foster a culture of safety, compliance, and proactive risk management in the face of evolving regulatory requirements.
Contact us today to learn more about how Eave can safeguard your team during the HSE's Workplace Noise Intervention.
HEARING PROTECTION FOR RAILWAY WORKERS
Are passive ear defenders enough?
Tens of thousands of British Rail workers use passive ear defenders every day whilst working in noise. But, passive ear defenders have been shown to inadequately protect workers from noise in the workplace. In fact, they are known to increase the risk of injury and death through accidents on the tracks. Not only that but they can even lead to an increase in the number of rail workers who lose their hearing through noise exposure as the protection is unknowingly not worn correctly.
Should they be banned?
In modern Britain, this is not acceptable. Today, there should be a ban on the use of these dangerous, passive ear defenders. Rail workers need a change in the equipment they are provided, moving from passive to level-dependant hearing protection. These allow rail workers to hear what’s going on around them, whilst still protecting their hearing. Further, without integrated fit-testing it is not feasible to know if the protection is being worn correctly, or at all throughout a shift
You may be aware of the recent tragic case of two railway workers who were killed by a train whilst working on a track on the Port Talbot line. It is believed that these two men could not hear the train approaching because they were wearing passive ear defenders that blocked out sound.
British rail workers should not have to choose between losing their hearing and losing their lives. Technological advances have provided alternatives to these dangerous passive ear defenders, which means they no longer need to make that choice.
Occupational deafness is preventable
This is the most commonly-reported workplace disease, yet it is entirely preventable. In British workplaces, noise is known to be the single largest contributor to deafness.
My own grandmother made equipment in the tunnels of the London Underground network during World War II. She lost her hearing because of this vital work, and for all the time I knew her she was frustrated by the two hearing aids she had to wear. Her hearing loss isolated her from those around her, especially when she was in situations where there was background noise, like a family get-together. This was tremendously sad. It isolated her and ultimately led to a diagnosis of dementia - the worst of it being that it could have been prevented had she been provided with the equipment that Eave now supplies to thousands of people across the UK who work in noise.
What can we do about it?
By working together and banning the use of passive hearing protection we can prevent the devastating impact of tinnitus and hearing loss on other British workers, especially rail workers who are particularly susceptible to the risks of noise exposure and reduced situational awareness.
THE CONTROL OF NOISE AT WORK REGULATIONS
In this comprehensive guide, we’ll highlight the crucial requirements from The Control of Noise at Work Regulations and the implementation guidance, recently updated in 2021.
According to UK Research and Innovation, the true cost of hearing loss in the UK is £30bn a year – attributed to life-long treatment, mental health issues and lost economic productivity. Therefore, it’s extremely important to follow all regulations to protect against hearing loss.
Complying with noise at work regulations is vital for preserving staff’s hearing health. Regular exposure to high decibel (dB) sounds can cause tinnitus and noise-induced hearing loss (NIHL).
Specific noise regulations in the UK have evolved over the years since the first ones were written in 1989; therefore, it’s crucial for employers to stay up-to-date with the latest guidance.
Read on to learn about the history of The Control of Noise at Work Regulations and the changes made over time to better protect against hearing loss.
The Noise at Work Regulations 1989
The first HSE Noise at Work Regulations were published in 1989 and came into force a year later.
Key points from this original legislation included requirements for employers to:
Conduct a “noise assessment” if employees are likely to be exposed to 85 dB or more
Give “adequate information, instruction and training” about the risk of hearing damage to employees and how they can minimise this
Provide “suitable ear protectors” to reduce “the risk of damage to that employee’s hearing”
Make sure that hearing protection equipment is “fully and properly used” as well as being “maintained in an efficient state, in efficient working order and in good repair”
A key citation at the heart of the legislation was:
“Every employer shall reduce the risk of damage to the hearing of his employees from exposure to noise to the lowest level reasonably practicable.”
Every employee also had a responsibility to “fully and properly use personal ear protectors when they are provided by his employer”.
The Noise at Work Regulations 1989 were revoked in 2006 following the introduction of the Control of Noise at Work Regulations 2005.
The Control of Noise at Work Regulations 2005
A crucial change made in the HSE Control of Noise at Work Regulations 2005 was the lowering of the exposure limits.
In this current legislation, the noise exposure limits were reduced from the 85 dB and 90 dB action levels in the Noise at Work Regulations 1989 to:
The regulations also introduced:
Restrictions on permitted “weekly personal noise exposure levels”
Requirements for employee “health surveillance, which shall include testing of their hearing”
Research informing these new regulations included the report Occupational exposure to noise and hearing difficulties in Great Britain, prepared for the HSE by the University of Southampton in 2001.
Its conclusions were concerning, reporting that:
“Significant hearing difficulty and tinnitus are quite common, especially in men in the older working age range. Both are strongly associated with years of exposure in a noisy occupation, and these exposures arise largely in men. The burden of hearing difficulties attributable to occupational noise exposure in Great Britain is substantial.”
Controlling noise at work: supplementary guidance
To help employers understand their duties under The Control of Noise at Work Regulations, the HSE has provided an easy-to-read short leaflet outlining:
The harm that noise can cause
The legal duties of employers
How to identify if there is a problem with noise in the workplace
How to control noise and prevent harm
For staff, there is also a separate leaflet which runs through employees’ responsibilities according to The Control of Noise at Work Regulations 2005, stressing their legal duties to:
Cooperate with employers to protect their hearing
Wear any hearing protection provided
Look after their hearing protection
Attend hearing checks
Report any problems
The instructions also list the different types of personal hearing protection that staff can use.
After all, while The Control of Noise at Work Regulations place a legal duty on employers to protect their employees’ hearing, employees themselves also have a part to play.
We now know that deafness is the largest modifiable risk factor for dementia, so it’s incredibly important for staff to also take responsibility for looking after their hearing.
Controlling Noise at Work Guidance: Third edition (2021)
To assist employers with the implementation of The Control of Noise at Work Regulations, accompanying guidance is available.
The third and latest edition, released in October 2021, can be found here. It was updated to leverage experience and take into account technical advances since 2005.
The third edition is divided into six parts:
Legal duties of employers concerning noise at work
Management and control of risks from noise
Practical examples of noise control
Hearing protection
Health surveillance for hearing damage
Selecting quieter tools and machinery
There is no fundamental change to HSE policy on the noise regulations of 2005 in the guidance but there is a clear emphasis on the control and management of risk or exposure.
It stresses the importance of suitable, sufficient risk assessments to identify everywhere with a risk of noise and everyone it is likely to affect.
Due diligence is essential to estimate likely noise exposure levels and evaluate the measures needed to control or manage them.
Summary: The Control of Noise at Work Regulations
In short, The Control of Noise at Work Regulations establish legal requirements around:
Exposure limit values
Health and safety risk assessments
Eliminating or controlling noise exposure
Hearing protection
Maintaining and using equipment
Health surveillance
Informing, instructing and training the workforce
Guidance is also freely available to employers – providing thorough advice on how to assess risks, control noise, select and use hearing protection, choose appropriate equipment and develop health surveillance procedures.
Noise exposure is the single largest contributor to deafness, so it’s crucial to control as well as reduce workers’ exposure to harmful levels and rates.
Protect your workforce from hearing loss with EAVE
At EAVE, we believe that NIHL has been far too common in the UK for far too long. As a starting point, it’s vital for employers to adhere to The Control of Noise at Work Regulations.
In particular, if you’re responsible for other people’s hearing, you should make sure staff are aware of the risks and have access to suitable protective equipment. It’s also essential for staff themselves to use this equipment consistently and correctly.
To see how EAVE’s noise management and intelligent hearing protection solutions support compliance with The Control of Noise at Work Regulations, please contact us or book a demo today.
TYPES OF HEARING LOSS
Hearing loss is a very serious issue, with RNID reporting that one in five adults – 12 million people – have at least mild hearing loss in the UK. This article describes in detail the three main types of hearing loss and some of the key differences between them.
We’ll also explain what causes hearing loss in one ear only and sudden hearing loss.
The three main types of hearing loss are:
Sensorineural hearing loss
Conductive hearing loss
Mixed hearing loss
For each of these types of hearing loss, we’ll also outline the different treatment options.
Please note that if you want to take a hearing loss test, they are available for free on the NHS. However, it may take weeks to see a specialist.
Alternatively, several charities such as The Royal National Institute for Deaf People (RNID), or pharmacies such as Boots, offer a quick and free hearing loss test online.
Though it is a fairly prevalent condition, hearing loss can often be prevented or managed. Therefore, it’s important to be aware of its causes and how to reduce the risk of developing it.
Hearing loss: a growing problem
By 2035, RNID estimates that hearing loss will affect 14.2 million adults. Worryingly, it also reports that people wait 10 years on average before seeking help for their condition.
Having mild hearing loss means you can’t hear sounds of 25-40 decibels (dB) and would struggle to hear speech in noisy situations.
The other levels of hearing loss – as defined by the British Society of Audiology – are:
Moderate hearing loss: unable to hear sounds between 41-70dB and finding it difficult to follow speech in general
Severe hearing loss: unable to hear sounds between 71-95dB and struggling to follow speech without a hearing aid
Profound hearing loss: unable to hear sounds of more than 95dB and in need of a hearing aid, cochlear implant, sign language and/or lip-reading.
Moreover, research has shown that there is a link between deafness, dementia and a decline in brain cognitive abilities. For hearing loss, prevention is better than cure, and there are ways of minimising your chances of developing it, or managing the condition.
Here are the differences between the three main types of hearing loss, as well as how they can be managed or treated:
#1 Sensorineural hearing loss
Out of the different types of hearing loss, the most common form is sensorineural hearing loss and it is usually permanent. It is caused by damage to auditory nerves or stereocilia cells in the inner ear.
The most frequent causes are noise-induced hearing loss, often from work, or age-related hearing loss.
Sensorineural hearing loss cannot normally be cured medically or surgically, but it can be treated and managed with a hearing aid or a cochlear implant. If you think you may need a hearing aid or an implant, the NHS provides further information.
Both the loudness and clarity of sounds are affected by sensorineural hearing loss, meaning that you may be able to hear people speaking, just not very clearly.
Tinnitus, which is typically when you perceive some form of ringing noise in the ears, is also a symptom of sensorineural hearing loss.
As well as noise-induced hearing loss, deafness can be inherited or caused by rare genetic syndromes. Auditory neuropathy spectrum disorder, for example, is a rare form of sensorineural hearing loss.
In order to reduce the likelihood of developing sensorineural hearing loss, it’s important to take precautions to manage and limit exposure to loud noise. By adopting measures to monitor noise exposure, for example in a loud work environment, you can be proactive in protecting yourself and other employees from noise-induced hearing loss.
#2 Conductive hearing loss
Out of these first two types of hearing loss, this one is less common.
Conductive hearing loss is usually due to an obstruction or damage to the middle or outer ear, such as the ear canal or drum.
The specific causes of conductive hearing loss are wide-ranging; they can include earwax, fluid, infections, or tumours preventing sound from reaching the inner ear. In some cases, it could be due to the ear’s formation.
In contrast to sensorineural hearing loss, this condition primarily impacts the loudness of sounds, rather than the clarity. Other symptoms can include feeling pain or pressure in the ear.
Conductive hearing loss can sometimes be treated medically or surgically, or otherwise managed by a hearing aid if it is permanent. The NHS provides further information on hearing aids, how they can help, and how to get the necessary support.
#3 Mixed hearing loss
This is a combination of the above two types of hearing loss. With sensorineural hearing loss and conductive hearing loss, one can lead to the other.
For example, someone with conductive hearing loss could begin to experience age-related hearing loss too.
Alternatively, someone with sensorineural hearing loss could then also have their hearing affected by earwax or an infection.
Mixed hearing loss typically occurs when the ear sustains some form of trauma.
Symptoms are a mix of those associated with sensorineural hearing loss and conductive hearing loss.
Similarly, the most suitable form of treatment will depend on whether the cause is more associated with sensorineural hearing loss or conductive hearing loss.
Hearing loss in one ear
These three types of hearing loss can also take place in just one ear rather than both.
This is also known as unilateral hearing loss, as opposed to bilateral hearing loss.
Hearing loss in one ear can alternatively be referred to as single-sided deafness, usually when the damage is profound.
Once again, the best form of treatment depends on whether the symptoms are more related to those of sensorineural hearing loss or conductive hearing loss.
Symptoms which are particular to hearing loss in one ear include:
Muffling of higher-pitched sounds: also known as the ‘head shadow’ effect
Struggling to locate sounds: this is due to the impact on your sound localisation
Feeling disoriented in a crowd: this is due to the effect on your selective listening
Detecting sounds off-kilter: the brain senses sounds louder than normal
Hearing loss in one ear can build gradually over time, but in more serious cases it develops very quickly. This is why it’s important to monitor and limit your exposure to noise, particularly if you work in an industry where loud environments are common.
Sudden hearing loss
If you experience sudden hearing loss in one ear, this is an emergency and it needs urgent medical attention.
The NHS’ advice, if this happens, is to ask for a GP appointment immediately or use its 111 phone and online service.
There are a range of potential causes for this; these include head trauma, physical damage to the ear, infections, or Ménière’s disease – which can also cause feelings of dizziness and vertigo.
With sudden hearing loss, you may also experience ‘double hearing’ or diplacusis. This is the often troubling perception of the same sounds at two different pitches.
If you ever think you’re experiencing sudden hearing loss, it’s crucial to get treated as soon as possible in order to prevent further damage or maintain your hearing.
Summary: types of hearing loss
There are three main types of hearing loss:
Sensorineural hearing loss is the most common and is often age-related or caused by noise-induced hearing loss
Conductive hearing loss is less common and is usually caused by an obstruction or damage to the ear
Mixed hearing loss is a combination of these and one can cause the other
There are also different severities which affect how many dB you can hear; these range from mild hearing loss to profound hearing loss.
Hearing loss in one ear only is also possible and if this happens suddenly, urgent medical attention is required. Partial deafness can be managed by wearing a hearing aid, or a cochlear implant can be fitted to manage profound hearing loss.
It is possible to treat conductive hearing loss medically or via surgical procedures. However, sensorineural hearing loss is usually permanent, which is why it’s important to take precautions to mitigate the risk of developing it in the first place.
If you’re experiencing hearing loss, we recommend that you seek advice from a medical professional.
Protect your hearing with EAVE
In many cases, hearing loss can be prevented, so it’s vital for employers to follow important measures. These include adhering to The Control of Noise at Work Regulations 2005 and ensuring employees wear effective protective equipment for hearing.
With noise-induced hearing loss such a common cause of partial and total deafness, it’s vital to take steps to control environmental noise and reduce exposure to it. At EAVE, we believe that prevention is always better than cure.
To find out more about how EAVE’s noise management and intelligent hearing protection solutions can help you to reduce the risk of hearing loss in your workplace, contact us or book a demo today.
WHAT IS TINNITUS?
You may think you’re familiar with it, but what is tinnitus exactly and what causes it?
Before getting into the details, for any employer with responsibility for noise management under The Control of Noise at Work Regulations 2005, it’s important to know about tinnitus.
It can be a symptom of hearing loss, which is a growing problem – by 2050, one in four will live with some degree of hearing loss, according to the World Health Organization.
So, what is tinnitus? And what is it caused by? Moreover, is there such a thing as a tinnitus cure?
Here is our comprehensive guide, with answers to these questions and many more.
What is tinnitus?
In most cases, having tinnitus means that you perceive noises when no matching external sounds are present.
While there is some evidence that it can be genetic, much more often there are underlying causes, meaning that it is an overall symptom rather than a disease.
How common is tinnitus? According to the British Tinnitus Association (BTA), it’s very prevalent, with approximately 30% of people experiencing it at least once in their life.
However, persistent tinnitus is something which about 13% – more than one in eight people – have to live with.
What causes tinnitus?
The primary causes of tinnitus are mental or physical changes in the amount of information sent to the brain.
When this happens, the brain responds by attempting to receive more information from the ear – this creates the perception of sounds.
What is tinnitus caused by? Well-established reasons for these mental or physical changes include:
Hearing damage
Presbycusis, or age-related hearing loss
Ear infections
Head injuries
Emotional stress
Side effects of certain medications
Tinnitus sounds aren’t always experienced in the head or both ears. Sometimes, it only occurs in one ear – this is unilateral tinnitus.
One of the most common causes of tinnitus in one ear only is the build-up of too much earwax, which can be straightforward to remove.
However, other causes of tinnitus in one ear only include:
Eardrum perforation
Ménière’s disease
Multiple Sclerosis (MS)
Infections
Regarding COVID-19 and tinnitus, recently ‘long COVID’ has been recognised by the NHS as a cause of tinnitus and earaches.
Tinnitus symptoms
What does tinnitus sound like? It varies, but often it’s the following types of noises:
Ringing
Humming
Buzzing
Hissing
Throbbing
Whooshing
These sounds can be continuous, or more intermittent.
If you think you may be hearing a noise like this regularly or constantly, you should see a GP. They may refer you to a specialist or audiologist who will conduct a tinnitus test.
Long-term, the frustration of experiencing tinnitus can lead to disturbed sleep, anxiety and depression.
What are the different types of tinnitus?
The two main types of tinnitus are typically classed as:
Subjective:The sounds which the individual hears, either in their head or ears, are not audible to anyone else
Objective:These sounds may also be heard by others
Objective tinnitus – sounds produced by functions in the blood flow and musculo-skeleteal movement systems – is much rarer, representing under 1% of total casesaccording to the American Tinnitus Association.
While most cases are subjective, there are other sub-categorisations:
Neurological tinnitus:
Caused by disorders affecting the brain’s auditory functions
Somatic tinnitus:
Caused by changes in sensory information from the cervical spine or jaw
Pulsatile tinnitus:
Caused by a change in blood flow; the sounds produced are rhythmic, matching the heartbeat
One other subtype is musical tinnitus, which is the experience of hearing a melody with no external source. Also known as musical hallucinations or musical ear syndrome, it tends to occur amongst those who have had hearing loss or tinnitus for a long period of time.
Is there a cure?
Does tinnitus go away by itself? For most minor cases, it often disappears naturally. In some persistent cases, it may become much less noticeable over time. However, is tinnitus curable?
Sadly, the answer is no – there is no scientifically proven tinnitus cure. That’s why it’s so important to take preventative measures, to stop it from becoming something you may have to live with permanently.
For anyone wanting to know how to get rid of tinnitus, while that may not always be possible, there are several management and treatment options to alleviate the experience.
You can read about these in detail on NHS Inform and to summarise, they are:
Treating the underlying health condition:
For example, when it’s a build-up of earwax. However, in many cases, the cause is not detectable
Correcting even minor hearing loss:
To avoid straining to listen and worsening the tinnitus – in some cases, this could mean having a hearing aid fitted
Self-help:
Hobbies, relaxing with deep breathing or yoga, listening to music, avoiding caffeine or alcohol and attending support groups can all help manage the condition
Sound therapy:
Also known as sound enrichment, this is the act of filling silence with background noise – that could mean leaving the window open or TV on, or alternatively using a specially-designed noise generator
Cognitive behavioural therapy (CBT):
This treatment aims to retrain your way of thinking, with the goal of reducing any anxiety and depression associated with this condition
Counselling:
A healthcare professional, such as a hearing therapist or audiologist, can work with the patient to help understand and find ways of coping
Tinnitus retraining therapy (TRT):
A more specific version of CBT, featuring more intensive sound therapy and counselling
The BTA also has several helpful resources, including its online Take on Tinnitus initiative.
Conclusion: what is tinnitus?
Common symptoms include hearing ringing, humming or buzzing noises. What is tinnitus exactly? Technically it’s the brain attempting to receive more information from the ear, producing sounds in the process.
However, for those who have to live with it persistently, it can be more than the noise; it can be an anxious and depressing experience – unfortunately there is no proven cure, but there are several ways of treating or managing the effects.
One of the most common causes is noise-induced hearing loss (NIHL), which has been linked to a decline in brain function and dementia.
Protect yourself from hearing loss with EAVE
Here at EAVE, our CEO David Greenberg has experience in tinnitus research and we believe in fighting NIHL via preventative measures.
Our research is based on information from the British Tinnitus Association and World Health Organization. If you are experiencing any symptoms, we recommend that you seek medical attention.
For more information about how to prevent tinnitus using EAVE’s workplace noise management solution, please get in touch with us.
NHS TO ENTREPRENEUR
The journey from tolerating hearing loss to preventing it
The journey from tolerating hearing loss to preventing it
Dr David Greenberg, CEO and founder of Eave, an Internet of Things startup which has designed the world’s first smart ear defenders with integrated noise monitoring, tells the story of leaving the NHS to set up his own company as an entrepreneur.
When I left my career as an audiologist to be an entrepreneur and start Eave, people would often look askance at me, as if it was somehow unworthy moving from healthcare to business. And I can understand that. But to survive in a highly stressful environment you have to feel like you’re achieving something, and what they hadn’t realised at the time was that I would be able to help more people outside of the NHS than in.
For me, as an audiologist, clinical work became frustrating. Not through any political, financial or hierarchical concerns. But because the work was so limiting. The truth was that there was little I could do to help my patients within the field. The research simply wasn’t – isn’t – there. So, I left the NHS to start Eave in an attempt to counter that. Being an entrepreneur is not how I saw my career panning out. But it’s been a fascinating and rewarding learning curve so far.
The trouble with clinical audiology
Imagine you have a patient who is beginning to lose their hearing. They’re in denial because, well – who wants to face up to that? It’s isolating, frustrating, frightening, life-limiting. And for a huge number of people, it’s also sadly embarrassing. Eventually, they give in and admit they need help. As a clinician, the main solution you can offer is a hearing aid. And it takes some persuasion. In the quiet environment of the consultation room your patient feels restored. But when they step out into the real world, their ability to listen and communicate drops away because the tech can only do so much. Thus, your patient is disappointed and feels let down. You are frustrated because you’ve spent time, effort and money to produce a result that is little more than a half measure.
This is the trouble with clinical audiology. And that is why, after practising clinical audiology I embarked on a PhD in auditory neuroscience – this was the first step towards Eave.
The path to entrepreneurialism
Studying auditory neuroscience showed me why the existing tech simply can’t cut it in the real world. But university life opened other, unexpected avenues. I was encouraged to engage with business development and entrepreneurship programmes. As my academic and scientific understanding increased, so too did my commercial knowledge, and I began to think that what patients needed didn’t exist, so maybe I could create other solutions.
The progression from the NHS to Eave
While, on paper, clinical audiologist and CEO seem like disparate roles, my progression from the NHS to Eave felt very natural to me. The NHS provided me with a strong foundation of skills, knowledge, methodology and ethics upon which to build my business. Eave will return that investment with equipment that will help the NHS, reducing the drain on resources by reducing the occurrence of unnecessary hearing loss.
The NHS taught me many things, but there are two that have really been pivotal. Firstly, the importance of evidence-based best practice. All of Eave’s work is built around evidence. It doesn’t matter what people think or what people’s opinions are. It’s the hard facts that really matter. And it’s the ethos of the NHS that has instilled that in me.
Secondly, the importance of communication and teamwork. In the megastructure that is the NHS these things aren’t always possible. And that’s where frustration begins. When you’re working in a far smaller team, as with Eave, communication is critical. You have to build cohesion, motivate and instil best-practice. Open communication and teamwork are necessary to success.
The development and future of Eave
Since 2015, Eave has been in a constant cycle of development and production. We’ve moved from our minimum viable product, an IoT hearing conservation system using ear defenders and noise monitoring software that prevents Noise Induced Hearing Loss, to a revised and upgraded product enhanced through end-user testing and feedback.
This year we’ve focused on the Construction Industry, where the need to protect workers from noise is paramount. Our second generation product, the Eave FocusLite has proved successful on construction sites, and is now being rolled out across the industry. In fact in the last month two major Construction firms, Galliford Try Highways and CSjv, mandated our unique form of hearing protection with integrated noise monitoring across their supply chains. This is a game changer for Health & Safety in the industry and one I’m incredibly proud to be a part of.
In the future, we have new product ranges and new features planned for different demographics and industries. While our primary concern has been – and will remain – the prevention of hearing loss, we’ve discovered other things that our tech could assist with: augmented hearing; pre-existing hearing loss; and a full range of products that we can take to the industrial, medical and consumer sectors.
The years since I made the decision to leave the NHS have been a period of intense learning for me. Both about what it takes to be an entrepreneur and about the rich value of the NHS as an institution. I could not have founded Eave without the foundation of knowledge and evidence-based approach that I accrued in clinical practise. But equally, it’s my belief that the NHS cannot be sustainable without the work of organisations like Eave. It’s totally symbiotic and positive because of that, and an example of how business and government can work together.
CONSTRUCTION COMPANIES TO MANDATE ACTIVE HEARING PROTECTION WITH NOISE MONITORING
By Dr David Greenberg, Eave Founder and CEO
Noise induced hearing loss is the number one occupational disease in Europe because traditional solutions are failing. So why are we still largely silent on the issue?
Over 46 million people in Europe work in harmful levels of noise. Occupations most at risk of harmful levels of noise exposure include construction, metal, electrical and textile processing. The higher the level of noise, and the longer individuals are exposed to it, the greater the risk they have of suffering harm from it. According to the European Agency for Safety and Health at Work, Noise-Induced Hearing Loss (NIHL) is the most common occupational disease in Europe and the Health and Safety Executive estimates that over 2 million people in the UK are exposed to harmful noise levels at work.
The number of people in the UK suffering from hearing damage as a result of exposure to noise at work was estimated at 509,000 in a Medical Research Council survey. NIHL is permanent and incurable and has been recognised as an occupational disease since the 18th century, among copper workers hammering metal, blacksmiths, and shipbuilders. We can’t stay silent about noise induced hearing loss and the failure of traditional solutions any longer.
Why is the adoption of Active hearing protection with noise exposure monitoring so critical?
We already know what harmful levels of noise exposure can mean for an individual. The dangers of conventional solutions are perhaps less well understood as the alternatives have until now been limited. The 2018/19 RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations) statistics show that of the 147 reported fatal injuries to workers in Great Britain, the largest percentage came from the construction industry (30 people) and 48.3% (71 people) of all fatal injuries are linked to a failure in situational awareness. It is not known how many of those killed were wearing conventional passive hearing protection at the time of the fatal accident.
Aside from the immediate, physical danger of working on a construction site with compromised auditory sensing and perceptual abilities, exposure to harmful levels of noise can have long-term, “silent” implications that include stress, fatigue, isolation, elevated blood pressure, dementia, hearing loss and tinnitus. Hearing damage gradually increases with exposure to noise and it can take a number of years of damage from noise for a person to realise they have become deaf. What is the current legal requirement? ‘Passive hearing protection’.
The protection and preservation of operatives hearing against noise exposure is already a legal requirement and therefore, the use of hearing protection is required whenever there is a risk of noise exposure. However, this mandate means there is widespread adoption of conventional passive hearing protection such as:
foam ear-plugs
custom moulded ear-plugs
passive ear-muffs
While well-meaning, these approaches to hearing protection actually degrade auditory aspects of task performance while not providing the necessary or expected levels of protection. Any impairment, impediment, or distortion of normal hearing raises the risk of the operative not detecting, identifying, recognising or localising a hazard. He or she might not hear a hazard warning signal or approaching vehicle, or not adequately understand communications from other personnel.
What is the solution? ‘Active hearing protection’.
Those required to operate in noisy environments should rely on Active hearing protection if the source of noise cannot be managed in another way.
Active hearing protection uses an electronic sound transmission circuit to provide a dynamic level-dependant degree of sound to the wearer, using a battery-powered series of integrated speakers and microphones. By controlling the level of noise exposure, it resolves the issues presented by conventional passive hearing protection.
The benefits of active hearing protection, compared to conventional passive hearing protection, include:
more natural hearing for the user
improved speech communications
improved signal detection
reduced noise-induced annoyance
protection from loud noise
Active hearing protection applies the correct level of protection automatically. Level-dependent, electronic hearing protection is specifically designed to maintain or even enhance one’s auditory capabilities as compared to conventional passive hearing protection. It is important to remember that noise exposure and the occupational diseases that can result are preventable if employers are able to apply effective noise control measures.
Can occupational deafness be prevented?
The harm caused by noise exposure at work is entirely preventable if:
employers take action to reduce exposure to noise and provide personal hearing protection
manufacturers design tools and machinery to operate more quietly
employees make use of the personal hearing protection and other control measures supplied
The UK Construction sector is already beginning to shift away from using passive hearing protection and towards active hearing protection with integrated noise monitoring as an effective tool to prevent occupational deafness. Galliford Try Highways for example has made the decision to no longer carry the risk of conventional passive hearing protection and has implemented a policy mandating the use of Active hearing protection with noise monitoring on its work sites. It is no longer a question of if the shift to Active hearing protection will take place, only how fast will it happen.
NOISE CONTROL FOR HIGHWAYS WORKERS – MEASURING AND REPORTING THE BENEFITS
By Dr David Greenberg, Eave Founder and CEO
In life and at work we use our eyes and ears to communicate and to stay safe. This is especially true for highway workers who are always operating with the risk posed by the unpredictability of civilian drivers. The standard approach to protecting our eyes when they are at risk at work is to wear see-through protective glasses. However, the modern approach to protecting our ears at work is to block them with pieces of plastic that we can’t hear-through – this is completely illogical.
When working on the highways, operatives are often forced into choosing to protect their hearing or protect their lives, removing their hearing protection in order to maintain awareness of their environment. This is untenable because, not only do employers have a legal duty to protect the hearing of operatives (under the Control of Noise at Work Regulations 2005), noise exposure can be devastatingly harmful to both our hearing and overall health. It is the most common preventable cause of hearing loss deafness, which we now know is the number one preventable risk factor for dementia. £360 million was spent by insurance companies on occupational deafness claims in 2014 and it is still the most commonly reported occupational disease in the EU.
Despite advancements in our understanding of the life-long negative health consequences of noise exposure, there are cross-sector failings in our ability to manage noise at work effectively. A key reason for this is that measuring and reporting the benefit of noise control interventions has traditionally been the domain of experts in acoustics or simply deemed to be too difficult. My background as an NHS Audiologist left me appalled at the state of the UK’s hearing health and its impact on relationships and safety at work, suggesting that something more needed to be done to prevent noise exposure at source.
There is no single technique or solution that is appropriate for every noise control requirement on the highway, so a good understanding of operations and work processes is necessary in order to determine the most effective intervention.
The hierarchy of noise control
Occupational safety and health professionals should follow the hierarchy of noise control, a widely accepted model of hazard control promoted by the Health and Safety Executive, when deciding what risk management mechanisms they will use to tackle noise-related issues during highway works:
Elimination of the noise source is the most effective way to prevent risk to workers. Examples include avoiding the use of noisy processes or machinery, elimination of impacts between hard objects or surfaces, outsourcing the noisy work processes and moving the noisy operations away from other work activities.
Substitution by replacing noisy machinery or equipment with quieter alternatives, when elimination is not possible, is often the next-best alternative to protect workers from exposure to noise. Performing a task differently can also protect the workers from noise.
Engineering controls involve making changes to processes, machinery or equipment to reduce exposure to noise. Some engineering measures include separating noisy areas from other workspaces, avoiding metal-to-metal contact by using plastic bumpers, replacing loose parts, worn bearings and gears and undertaking regular maintenance of equipment.
Administrative controls can be applied to the way the work is organised to reduce either the number of workers who are exposed to noise or the length of time they are exposed to noise. Some administrative controls include identifying hearing protection zones and clearly sign-posting noisy areas, organising schedules so that noisy tasks are performed when as few people as possible are present, limiting the time workers must spend in noisy areas and providing sufficient information and training to workers for the proper use of equipment.
Hearing protection is then the final option in the hierarchy of noise controls and should be used as a last resort after all efforts to eliminate or reduce noise levels have been exhausted. While hearing protection is the least effective intervention in reducing the risk of noise exposure, it is the most critical because it is the last line of defence.
The most common reasons that hearing protection fails are cited as: the interference it causes to communication, to hearing speech and warning signals; its effect on job performance was; incorrect use with other safety equipment; deterioration of the protection; and discomfort when wearing.
Hearing protection must be capable of reducing the noise reaching the wearer’s cochlea to a sufficiently safe level. However, it is when workers are over-protected that communication becomes difficult and individuals can find themselves working in isolation. Active or level-dependant hearing protection is therefore required to ensure the right level of protection is provided at all times.
From this point, how do you measure if your interventions have been effective?
Measuring and reporting the benefits of your noise control
To report the effectiveness of your noise control initiatives, you should gather data to answer the questions:
How has the control measure changed the level of noise present?
How has the control measure affected hearing protection wear-rates?
How has the control measure affected an individual’s noise exposure dose? (100% dose is equivalent to 85dBA for 8 hours)?
Historically it would be near impossible to answer these questions with any level of accuracy, which means that managing noise has typically been seen as too difficult to do well. Today however, there are digital technologies that can be used to quickly and simply provide accurate answers, enabling industry wide reduction in exposure to noise. Ear defenders within-built noise monitoring capabilities, such as the FocusLite from Eave, can measure each individual’s dose of noise, taking employers from guessing exposure levels to accurate knowledge of risks.
Being able to pinpoint who is being exposed above a specific dose allows occupational health professionals to focus on those people most at risk, rather than a blanket approach of screening the entire workforce. Combining the personal noise exposure data with noise mapping software, such as Peak from Eave, which visualises and analyses the data based on geographical location, provides the fastest, most accurate and cost effective way to evaluate noise exposure levels. This process makes reporting the benefits of the noise controls you have put in place simple and accurate.
The key here is that accurate knowledge of noise exposure is vital in order to address it and data from the source is critical to measure and report the benefits. Once understood, the necessary controls can be implemented without difficulty and continually improved.
More articles can be found on the Safer Highways Blogs here.
THE PROFOUND COST OF DEAFNESS
Dr David Greenberg, Founder and CEO of Eave, shares his very personal story on the impact of hearing loss.
With over 10 years’ experience practising as a Clinical and Research Audiologist, I have seen first-hand the profound isolation and loneliness caused by hearing loss. I have had patients who have given up careers, developed depression, and who have simply lost the joy of human interaction as a result of their hearing loss.
But my reason for starting Eave was an even more personal one: my grandmother.
Audrey Greenberg worked in a munitions factory in the East End of London during World War II. Her vital work making munitions was also incredibly noisy work, and tragically it caused her to lose her hearing. For the whole of the time I knew her, she wore two hearing aids just to get by.
Grandma Audrey was what you would call a real matriarch – she was always cooking for everyone, one of those people who was full of motivation. And yet, in family situations where there was a lot of noise, she would fade into the background because she simply could not hear what was going on – a retreat from social situations that was completely contrary to her sociable nature.
In the end, her hearing loss led to the development of dementia. We are now learning that this is a condition that is strongly linked to the social isolation caused by hearing loss, which means it is entirely preventable. It was terribly sad for my family and particularly distressing for me in my profession as an audiologist as I felt completely at a loss to help her.
Today, Eave has developed the technology that would have prevented my grandmother from losing her hearing. Yet, across the country, millions of workers just like her – in construction, manufacturing and utilities – are working in high-risk, noisy environments every day.
We also know that some nine million people in the UK are deaf, according to the British Deaf Association, and that occupational deafness is the most commonly reported workplace disease.
THIS was the motivation behind Eave. Our mission is to stem the tide of this debilitating condition, so that people like my grandmother can go on living life to the full.
More than that, at Eave our philosophy is not simply to help workplaces to conform to basic standards and regulations – these should be viewed as a baseline for compliance – but to truly understand and work to solve the basis of the problem the regulations were established to prevent.
We know a lot more about the impact of noise on health now than we did in 1989, when the Noise at Work Regulations were first written, and even since 2005 when they were rewritten. Eave products also bring together many other advancements since that time, in wireless technologies, cloud computing, digital signal processing and materials science.
All this enables our customers to take their responsibility for their workers’ hearing as seriously as it deserves to be. Our hearing is absolutely central to our experience of being alive – let’s work together to protect it.
HEARING LOSS AND DECLINING BRAIN FUNCTION
By Dr David Greenberg, Eave Founder and CEO
Amazingly, the first report on the relationship between hearing loss, dementia, and decline in brain function appeared about 30 years ago (thank you Richard Uhlmann, Eric B Larson et al. – link at the end). Today we know a great deal more about the link between sensory stimulation of the brain and keeping cognitively sharp but, while a full understanding may still be decades away there are things we can do today in order to live healthier for longer.
What we already know.
The first issue to address is that what we already DO know about the link between hearing and cognition simply doesn’t filter through to those people who could already benefit from this knowledge today. From my perspective there are two key groups here, those who are losing their hearing through the process of ageing and those who are losing their hearing through exposure to loud sounds. The evidence appears simple and obvious: for the first group there is typically a 10 year gap between when a person would benefit from a hearing aid and when they eventually get one. This means 10 extra and unnecessary years of reduced brain stimulation. For the second group, there is a systemic lack of care when it comes to protecting hearing from loud sounds as evidenced by the sheer volume of clinical cases presenting for Noise Induced Hearing Loss and Tinnitus in Audiology clinics across the country.
The Baltimore Longitudinal Study of Ageing was started in 1958 by the National Institute on Ageing to track various health factors in thousands of men and women. One of the most compelling findings from this study is that those with hearing loss lose more than an additional cubic centimetre of brain tissue each year compared with those with normal hearing. It goes without saying that losing brain tissue at accelerated rates will lead to a deterioration in a person’s cognitive ability and cognitive decline is bad for everyone. If we then consider the size of our ageing population, we’ve got a serious problem on our hands. (Thank you Frank Lin et al. for your amazing work – link at the end.)
This means the silent epidemic of hearing loss should be a matter of public health urgency.
Imagine if there was a way to prevent hearing loss in the first place.
Slowing or even reversing the ageing process is a lofty goal but that hasn’t stopped Nikolay Kandul repairing ageing cells, Geraldine Gontier switching old blood for new and David Sinclair enhancing cellular ageing regulation, amongst countless others, from trying. Not to forget (could I?) Calico, Human longevity and Elysium who may well between them be trying out every possible method of controlling ageing.
There are plenty of risks to think about when considering the science of controlling ageing and its link to the rest of the world. A great example is the ‘brain-training’ company Lumosity (Lumos Labs). Based in San Francisco, Lumosity has had 70 million people over the past decade play games that the company claimed could “ward off cognitive decline.” These claims resulted in The Federal Trade Commission handing Lumosity a $2 million fine based on their adverts being unsubstantiated.
Hearing loss and dementia prevention go hand-in-hand.
From my experience, I bet it will be the business and commercial world working hand-in-hand with academic institutions adopting an evidence-based approach, governed by market forces, that will bring innovation to those who will benefit most. Of the two groups most in need that I referenced above, I’m focused on the second group: those who are losing their hearing due to noise exposure and within that group, those losing their hearing due to occupational noise exposure.
I’ve spoken with thousands of people in the UK and Europe who work in noisy industries like construction, manufacturing and engineering. Almost all of them will talk about having a ringing in their ears or hearing loss. What’s most distressing is that most of them describe it as if it’s a normal state.
Noise induced hearing loss claims are in the order of £400m per year in the UK alone. A volume like that suggests thousands of people are suffering from hearing damage, most of which could be avoided by changing the way risk is managed, mitigated, educated and by design and distribution of proper noise control measures and protection.
The main reason I’m spending my time on Occupational Noise Induced Hearing Loss is that I believe in the powers of root cause analysis, prevention and taking the shortest road.
Thinking back to Frank Lin’s study, those with hearing loss had accelerated rates of brain atrophy compared to those with normal hearing and significantly more brain shrinkage in particular regions responsible for processing sound and speech (probably due to lack of stimulation). The issue with this is that each region of the brain does not work in isolation.
The connections in the brain are like an unimaginably complex three-dimensional spider web. The brain contains around 100 trillion neural connections between the various regions and are by their very nature not working in isolation, including those responsible for processing sound and language. It’s this interconnectivity that can give rise to fascinating human conditions like Synesthesia and that allows us, through neural plasticity, to develop our expertise both physically (motor skills) and intellectually (learning and experience.) Unfortunately, we also know that this interconnectivity and the decline in areas processing memory and sensory integration are involved in the early stages of mild cognitive impairment and Alzheimer’s disease.
So what to do?
Thankfully, knowing a problem means you are well on your way to solving it. This concluding section could well be multiple articles in itself so if there is interest, I’m willing. Until then and first of all, take care of your own hearing – don’t over-expose yourself to noise and if you or those around you think you might have a hearing loss, get it checked out and addressed as soon as possible.
Second, think of Future-You and live healthily today – exercise, socialise, sleep, be present, eat well and smile often.
Third, if you are responsible for other people’s hearing, perhaps as a health and safety specialist, occupational hygienist or responsible manager in an industry that produces workplace noise over 80dB it, directly address your risks immediately. It is your legal and dare I say moral obligation. The risk-debt that is building up by ignoring or not understanding today’s occupational noise problem will be something we will all pay for later. For all of these, but especially the third, get in contact with me and the team at EAVE to see if we can help.
N.B. I’ve left out a number of references from this article to keep it brief so feel free to contact me if you would like links. Sorry and thank you to everyone working in the space for not covering this as extensively as it deserves. I wish I could include it all as there is plenty more to say. Please reach out if there’s anything further you’d like to discuss.
Sources
Richard Uhlmann, Eric B Larson et al. 1989:
https://jamanetwork.com/journals/jama/article-abstract/376858
Frank Lin et al. 2014: