Ana Claudia Fiorini, PhD

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Occupational hearing loss in Brazil state of
art

• Ana Claudia Fiorini, PhD
• Catholic University of São Paulo
• PUC-SP
• Brazil

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BRAZIL

• 26 states and Brasília (DC)
• 170 million habitants
• Occupational Activities mining, manufacturing,
  industrial services, construction, trade,
  service, public administration and farming.
• 2008 40 million formal employees

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BRAZILMajor Occupational Disease

• Repetitive Strain Injury (RSI)
• Occupational Hearing Loss

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BRAZILIAN POLICIES
Departments
Health
Benefits
Work OSH

• 2002 The National Network of Total Workers
  Health Care
• 2004 Ordinance to regulate compulsory
  notification of work
• related accidents and diseases

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Brazilian Occupational Safety and Health
Organization
NR-15 exposure limits
NR-6 individual protectors
NR-9 safety program
NR-7 health program
Portaria 19 audiometric test
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Brazilian Occupational Safety and Health
Organization
Ordinance 19 audiometric test

• Rules to perform and follow-up audiometric test
  (PTA from 500- 8kHz, air and bone conduction)
• Pre-employment, after six months and, after that,
  Annual PTA
• Baseline audiogram
• STS follow-up

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Lav
85 dB(A) ------ 8 h 86 dB(A) ------ 7 h 87
dB(A) ------ 6 h 88 dB(A) ------ 5 h 89
dB(A) ------ 4 h 30 min 90 dB(A) ------ 4
h 91 dB(A) ------ 3 h 30 min 92 dB(A) ------
3 h 93 dB(A) ------ 2 h 30 min 94 dB(A)
------ 2 h 15 min 95 dB(A) ------ 2 h 96
dB(A) ------ 1 h 45 min 98 dB(A) ------ 1 h
15 min 100 dB(A) ------ 1 h 102 dB(A) ------
45 min 104 dB(A) ------ 35 min 105 dB(A)
------ 30 min 106 dB(A) ------ 25 min 108
dB(A) ------ 20 min 110 dB(A) ------ 15
min 115 dB(A) ------ 7 min
NR - 15
5 dB
Maximum Level continuous or intermittent noise
Impact noise 130 dB (linear).
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NHO 01 Fundacentro (2001)
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PREVALENCE OF HL

• Until 1990
• ? Textile 37
• ? Metallurgy 40
• ? Cellulose 36
• ? Glass 39
• ? Stones/mining 32
• Plastic 42
• Farmer drivers 56

Andrade e Schochat, 1988 Costa et al., 1989
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PREVALENCE OF HL

• Now
• ? Hearing Loss in Industry 18-40
• ?Cross-sectional household survey was conducted
  with 2427 persons in Southern Brazil, using WHO
  Ear and Hearing Disorders Survey moderate
  (5.4), severe (1.2) and profound (0.2) HL
  6,8

Béria et al., 2007 Pan Am J Public Health.
200721(6)381-7
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Hearing Loss Prevention Program
TextilesGeneral guidelines

• Implemented in 1997
• 5 plants in Brazil (manufacture denim)
• Main occupational hazards cotton dust, noise and
  vibration (2000 workers)
• Associated to the companys environmental
  manegment
• There is a safety engineer, a safety technician,
  na occupational phisician and na audiologist

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Hearing Loss Prevention Program
TextilesGeneral guidelines
Non-occupational activities
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Workplace
Specific program for selection, recommendation,
fitting and follow-up of hearing protectors
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Hearing ProtectionProgram's stages
It determines the HP that may be used in the
workplace, taking scientific research and
new technologies (NIOSHs rules and field survey)
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Hearing Protector Approval

• Ear muffs (three types, NRRsf gt 18 dB)
• Sample 20 subjects (normal hearing)
• Noise measurement 3 dose/3 days (average bellow
  80 dBA to be accepted)
• Questionnaire (protector's use, comfort and
  attenuation) after one month (score above 80)
• Three types are always approved

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HP TEST (dBA)

• HP DOSE DOSE DOSE
• Right WP Left
• 1 78.4 93.3 78.7
• 2 79.6 92.7 81.1
• 3 78.0 93.7 75.7

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Evaluation of Hearing Protector

• Individual training
• Group training
• Guide
• User satisfaction survey (questionnaire)
• Maintenance program
• Regular replacement of HP

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Guide on how to protect your ears
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Guide on how to protect your ears
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Example OAE test
Before exposure
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Example OAE test
After exposure
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Hearing Loss Prevention Program
Non-occupational Activities identifying
workersleasure (personal music players, shows
and others)
Epidemiological Surveillance the performance and
analysis of audiometric testing is standardized
(longitudinal studies to check onset and
worsening of HL)
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Results

• Normal group remains around 80
• Maximum STS 0.27

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Thank you!! acfiorini_at_pucsp.br