How does fit checking minimize the risk of hearing loss claims and help workers properly use hearing protection products?
Traditionally, the verification of how well an ear protector (muff or plugs) attenuates has been conducted under laboratory standards that resulted in reporting a noise reduction rating. The resulting NRR score simply implied the expected attenuation when the product was properly installed at the time of use. Eventually, it was recognized that numerous end users weren’t achieving these values for a number of reasons, such as poor fit, improper insertion or lack of comfort. As a result, employees with significant threshold shifts were identified through audiometric evaluations and advised about better options and procedures to minimize the risk of further hearing loss or workers’ compensation.
For those who were concerned about how to improve the selection and use of hearing protectors, in addition to verification of real ear attenuation at the time of fit, a new science known as fit checking was introduced. Test results were reported with a personal attenuation rating, and, as with NRR, scores with higher PAR value had greater attenuation. However, in this case, the value was a real onsite score for the employee, not a score achieved in a laboratory.
Reprinted from Trap and Field Magazine
Some joke that it’s easy to spot a trapshooter by how often he or she says “huh?” during a conversation, but hearing loss is no laughing matter. Many healthcare professionals believe that over a period of time, sounds louder than 90 decibels can permanently damage hearing. The average gun blast exceeds 140 decibels.
Many vendors at the Grand addressed the importance of ear protection for shooters. “Once your hearing is gone, it’s gone. You can’t bring it back,” John Romanko of Shooter’s Safety Products said. Andrew Gordon of E.A.R. Inc. echoed that sentiment, stating, “It’s a one-way trip.”
A survey conducted at the Grand American by Garry Gordon, president of E.A.R. Inc., showed that nearly 30% of respondents said they have some hearing loss, and almost 24% experience ringing or buzzing sounds, known as tinnitus, in their ears.
Since June 1, all participants, referees and trap personnel of ATA events have been required to wear ear protection. Competitors at the Grand American were reminded of this rule by an announcement morning after the national anthem.
There are many kinds of ear protection on the market, and choosing which is best can he difficult. Ear plugs should block harmful sound, such as the gunshot, but still allow the shooter to hear voices. Many select molded ear plugs. which provide a good fit by duplicating every contour and crevice of the ear.
Following are some tips and suggestions Gordon recommends for shooters when looking for molded ear protection, which can be made in minutes and is available at many shoots. He recommends shooters do sonic research. Safety is a concern when purchasing molded ear plugs because regulations differ from state to state, and there is often little monitoring.
- The manufacturer’s name should be labeled and clearly visible on the jars.
- The dealer should be able to provide and explain the noise reduction numbers.
- How is the mold inserted’? Gordon says injection is recommended.
- The dealer should check the ears at the beginning of the process to make sure no swelling or infection is present.
- Ear dams should be inserted to provide protection and better fit.
- Does the dealer carry liability insurance’?
- Are Product Safety Sheets available?
- What type of silicone is used? It should be water repellant.
- Does the silicone have a seal coating on the outside to overcome dirt? Silicones are porous. The coating helps keep the ear plugs clean and dry. Another benefit of the seal coating is that extra coats can be added for a tighter fit if necessary. This • is particularly beneficial for children’s growing ears and allows them to keep a set of ear plugs longer.
- Who trained the person to fit! Ray Mack of Earmoid Australia urges shooters to look for someone with experience. Mack, who has been fitting ear plugs for 25 years, chooses not to measure his experience in length of time, instead saying he has “thousands of ears of experience.”
Molded ear plugs can last for many years, but audiologists recommend having the fit checked every two years.
Children of any age can get molded ear plugs, however, it can be difficult to get very young children to sit still for the process. Also, children will have to replace their plugs more often than adults to keep them fitted properly. Keith Baker of W. K. Baker Co. recommends that children who don’t shoot but watch their parents from the sidelines get an inexpensive pair of earmuffs to protect their hearing.
E.A.R. also has a product called ‘Insta-Putty’, which works well for children. It is made of a high-grade silicone and effectively seals the ear for protection from noise. Foam ear plugs do not work for young children because they are too big and slowly work their way out of the ear. David McGee of Texas Plugs said young shooters adapt to wearing ear protection more easily than older shooters, who have not always had to use it.
Options for molded ear plugs include filters that allow sounds below 80 decibels to pass through unaffected. Monitors are also available that allow shooters to listen to music while on the line. When purchasing this type of plug, customers should make sure they are made properly, so gunfire does not come through the transducer. Handles and cords can be added to the plugs, and they can be made in a variety of colors.
McKissick Combo Earplugs provides a different kind of molded ear plug that is hard on the outside but soft inside. They are made with the same material used in protheses. Company representative Ken Foster said their customers like this kind of plug because they are comfortable and clean and allow the shooter to still hear voices.
E.A.R. recommends shooters get an audiogram every year to make sure their hearing protection choice is working. Shooters who would like to test their hearing can also go to www.freehearingtest.com.
Most importantly, shooters should look for someone who will take the time to answer their questions.
People don’t have to accept hearing loss as a part of trapshooting. “We as a sport have the best hearing protection in the world,” McGee said.
(Photos by Terry Ewing)
Good hearing is essential to enjoying the shooting sports for both safety and situational awareness. Clinical hearing loss is increasing and occurring at younger ages according to Garry G. Gordon, Audiologist with over 35 years of experience and CEO of E.A.R., Inc.
New Food and Drug Administration (FDA) regulations have defined a new class of product, the Personal Sound Amplification Product (PSAP). While hearing aids are defined as medical devices and require a visit to a licensed dispensing audiologist, hearing aid dispenser, or ENT doctor, the PSAP doesn’t. The PSAP is ideal for those seeking additional sound amplification and who don’t require a medical diagnosis. High quality digital hearing aids can cost upwards of $6,000 per set while PSAP’s can be purchased for $299-$599 per ear.
Some PSAP’s even allow for Bluetooth connections. Many in the shooting sports may try to use their electronic hearing protection as an amplification device with less than ideal results due to circuitry designed primarily for protection.
New guidelines are also forthcoming from the FDA regarding Over The Counter (OTC) hearing aids that should allow for lower cost options that will be available from non-traditional sources such as big box retailers. Everyone should have their hearing professionally tested and evaluated with options for protection and/or augmentation discussed.
Article credit: TrapShootingUSA.
What is “acoustical confusion,” and what are some solutions to this problem?
Responding is Garry G. Gordon, audiologist, and CEO, E.A.R. Inc., Boulder, CO.
I’m sure most people have experienced environmental situations in which their ability to communicate was hindered. Such places include restaurants, concerts, movies, meetings, work assignments and even home environments.
Should one have mild, moderate or severe hearing loss, life predictably becomes more complicated and usually begins with denial, followed by withdrawal.
Have you ever had your spouse or a friend say, “Turn down the TV,” “Your turn signal is still on” or “You need a hearing aid”?
How about a plant manager who said, “I told you to meet at 7 a.m., not 11 a.m.”? If such exposures continue without adequate hearing devices, the risk of a recordable threshold shift or an error stemming from a communication breakdown rises.
A common response is, “I hear you but I don’t understand!” The same scenario applies to equipment failures because the mechanic or engineer could not hear critical sounds coming from machines. As a result, it’s common for employees to alter their ear protection to hear better.
So what’s the problem? Some call it acoustical confusion. We are witnessing noise-induced hearing loss at an all-time high. This includes young and old. The current ramifications of excessive noise exposure could not be more apparent, and when an employee has hearing issues at home, similar issues should be expected at work.
With more than 35 years of professional experience in the industrial and recreational hearing healthcare markets, we decided to review many of the responses our clients fill out to questions regarding their hearing acuity. Of particular note were the clients who said they don’t hear well at home, work or play, and when they are required to wear hearing protection, their situational awareness diminishes. As a result, many alter their protection or don’t install it properly.
We also spoke with several of the audiometric teams that provide services to industrial accounts and asked how they review their results. In most cases, they said all audiograms are reviewed to identify an employee’s current hearing status, as well as identify recordable threshold shifts that could result in a claim or need to see a doctor. There was no evidence, for the most part, that audiograms were reviewed to identify those with the untreated hearing loss, which could contribute to communication breakdowns or poor situational awareness on the job.
So, a big question to pose to the market is: How many errors or safety issues are a result of inadequate hearing acuity or poorly selected hearing protection devices?
A review of current and forthcoming products suggests numerous options may provide improved situational awareness and better communications. The same goes for those needing amplification when away from work. According to the Food and Drug Administration, a new classification of over-the-counter hearing aids and personal sound amplification products are emerging quickly at affordable prices. Not being able to hear well – on or off the job – can be considered a serious safety concern, and the options available to minimize acoustical confusion are being made available at affordable prices. After all, hearing loss often is more noticeable than the products that can assist.
‘We don’t realize we have hearing loss until it is too late’
- About 22 million people are exposed to potentially damaging noise at work every year, according to OSHA.
“Loud noise can create physical and psychological stress, reduce productivity, interfere with communication and concentration, and contribute to workplace accidents and injuries by making it difficult to hear warning signals,” the agency states, adding that noise-induced hearing loss can impair a person’s ability to understand speech and communicate.
Here, hearing protection industry insiders discuss what’s new and offer helpful advice.
Advances in technology allow employers to provide workers with hearing protection that doesn’t disrupt situational awareness, according to Garry G. Gordon, an audiologist at Boulder, CO-based E.A.R. Inc. “This includes both filterings in addition to digital electronics that help with communications,” Gordon said.
Chris O’Donnell, hearing and eyewear product manager for Memphis, TN-based Radians Inc., touted the benefits of communication devices that also provide hearing protection. “They allow workers to communicate without having to remove their hearing protection,” O’Donnell said. “This not only helps the employees protect against hearing loss, but they are less likely to make mistakes that cause injury because of miscommunication.”
If hearing protection isn’t worn the way it’s designed to be worn, workers are more vulnerable to injury. This may seem straightforward, yet, according to O’Donnell, “a large percentage of users don’t take the time to wear hearing protection properly.”
He notes that another common problem is overprotection when workers use hearing protection with too high of a noise reduction rating. “This could cause difficulty communicating with co-workers and lead to injury,” he said.
“Fit checking surveys continue to imply numerous employees are not wearing their options properly,” Gordon said, adding that educating workers about wearing hearing protection and understanding their expectations is critical.
When asked to describe the most important principle workers should know about hearing protection, Gordon said, “Basically, it would be: Use a product that works, and use it religiously at work, home or play. And take advantage of having an annual audiometric test that includes an explanation.”
Ultimately, don’t take your hearing for granted. “Hearing damage … occurs slowly over a period of time,” O’Donnell said, “and most of the time we don’t realize we have hearing loss until it is too late.”
Compiled with the assistance of the International Safety Equipment Association
Can you tell me more about hearing protection products that help provide situational awareness at work?
Responding is Garry G. Gordon, CEO, audiologist, E.A.R. Inc., Boulder, CO.
With my more than 35 years’ experience working with industrial, recreational, law enforcement, music, and military accounts, it has been interesting to witness how hearing protection often is selected and assigned.
We all know the ramifications of excessive noise exposure, but in many cases, the selection of hearing protection is not always given the attention it deserves. After reviewing numerous audiograms, in addition to hearing surveys and fit check reports, we had many indications that end users were not installing their protection properly or were intentionally wearing them incorrectly.
Some said full insertions are uncomfortable, while others implied they already had mild or moderate hearing loss and needed a product that would assist with situational awareness. In other words, they were in need of being acoustically aware of their surroundings before circumstances resulted in negative consequences.
Lack of attention to such matters has proven to be expensive. For example, it has been estimated that in the United States we pay more than $1.6 billion annually for hearing-loss claims from the military. Communication breakdowns or not hearing critical sounds with machinery or moving vehicles also contribute to undesirable expenses for industrial accounts.
It also should be understood that employees with unidentified or untreated hearing loss who work in areas that are not noisy also contribute to expensive mistakes that are costly to industry. New legislation has opened a door for employees to buy over-the-counter hearing aids or personal sound amplification products at an affordable price.
What options can be considered for an employee to hear better while working in a hazardous noise environment?
Filtered ear protection is a common choice made available to workers who need to tamp down the intensity while minimizing this risk of overexposure. One of the most recent items has been a dual-filtered product that provides variable attenuation and also works for impact sounds such as gunfire. As the noise level goes up, so does the attenuation. Most, but not all, filtered protection is available in a generic form with different size options or custom fit. These can be worn under a muff when dual protection is required. Another version is available in foam.
Generic and custom molded products that connect with communication devices such as radios, Bluetooth, and smartphones are available.
Electronic earplugs and muffs are another options, and they too can integrate communications into their circuitry. These options are considerably more expensive but extremely valuable where there is a need to hear accurately while engaged in a noisy environment.
Situational awareness can coexist with hearing protection. Proper selection of such devices will minimize the risk of noise-induced hearing loss and allow an employee to perform better and not feel so isolated.
Technology constantly is changing, and it’s critical to understand the options that are available and how they work.
Editor’s note: This article represents the independent views of the author and should not be construed as a National Safety Council endorsement.
We have read with interest the diverse articles in The Hearing Review that have looked at a range of issues and viewpoints concerning over-the-counter (OTC) and direct-to-consumer (DTC) hearing aids.1-10 After enjoying the holidays, the first author (GG) recalled an interesting conversation at a social event. We think this may sound familiar to you.
One of the guests knew Garry was an audiologist and told him that he had recently been investigating the purchase of hearing aids. He also mentioned that he had been doing his homework by visiting an independent clinic in addition to Costco, Sam’s Club, and even Cabela’s, as well as the Internet. Near the end of the conversation, he said, “You know, I am beginning the think the market for hearing aids is much like the wine industry!” Of course, Garry asked, “How so?”
“Well let me tell you,” the man explained. “Consumers see numerous vintages and flavors ranging in price from $10 per bottle to several thousand of dollars per bottle. In most (not all) cases, the marketing hype behind the more-expensive bottles suggests notable differences in taste and quality between the expensive and less-expensive bottles.
“For example,” he said, “I took an empty bottle from an expensive vintage (over $500) and refilled it with a much less-expensive wine, and nobody really knew the difference while believing it was ‘the best.’ The result was the less-expensive wine provided the same outcome as the more-expensive wine.
“When I visit the different options for purchasing hearing aids, I see a similar situation,” he continued. “Their message is ‘Buy from me; I am a professionally trained and certified provider. My costs may be higher, but I provide better service in addition to proper fit.’ The big-box store basically said the same, but their prices were far more competitive, and you also get a substantial rebate at the end of the year for using their credit card services. And finally, with the Internet, I see numerous advertisements for new OTC hearing aids or Personal Sound Amplification Products (PSAPs) at a fraction of the cost. And with many of the Internet promotions, they declare their devices are backed by MDs or audiologists and often claim that it is the product of new advanced technology. Really? Why would you want to pay $2,000 or more when you can get quality hearing benefits for less than $200-$300 per ear?
“Also read the online testimonies,” he added. “There are hundreds of people saying these hearing aids sound better than my previously purchased hearing aids which cost a bundle. And if a customer is not happy with the final results there are no issues getting a full refund within 30-60 days.”
Bottom line: Many of the apparent differences this person cited were basically surrounded by marketing dialog, while the final outcome was a happy customer with a product that works and was more affordable. Need we say more? It worked and the customer was happy.
Does this conversation ring a bell? We have spoken to many friends, relatives, and colleagues who report the same or similar discussions. Our conclusion is that we are witnessing the need for our industry and professions to focus more on marketing and pricing efforts, and finally realize that there are changes going on that permit consumers to purchase quality products at different price points.
When it comes to hearing aids, many potential customers will choose the product that works well—or at least “okay”—for the least amount of expense.8 Like one of our clients said, “I know you’re an audiologist, but I feel I have done my homework and I don’t hear a $2,000 difference.” Another went to a dispenser in a chain office and was quoted a discounted price of $4,500. He was told there are no miracles when it comes to hearing loss and this manufacturing company was a well-known, successful, well-established hearing aid developer. The client’s response was, “You are incorrect. If I spend $4,500 on these units that will be a miracle.”
Current marketing conditions are changing, and not everyone will need a Rolls Royce if a Ford or Chevrolet will do. Both hearing aid manufacturers and the various professional delivery channels need to recognize and acknowledge these changes. Additionally, new federal regulations will be opening doors for consumers to get access to better hearing at more affordable prices.
Manufacturing companies and/or provider networks with staff or officers who don’t understand these conditions risk the chance of losing out on a fantastic opportunity. Our belief is if the Internet companies, in addition to the big-box stores, are selling well over 10,000+ units per month to their clients who are happy, then these clients will not be easily persuaded to enter into the traditional professional dispensing channel.
For the past five years, during our attendance at numerous consumer trade shows, we have begun to see a lot more companies build hearing-related products, and these companies are seeking new customers and new delivery systems for marketing these products. It’s up to us—as an industry, as business managers, and as professionals—to respond appropriately and proactively.
— Garry Gordon, MS, Del Hawk, AuD, and Michael J. Metz, PhD
Used with permission of The Hearing Review. All rights reserved. Original citation: Gordon G, Hawk D, Metz MJ. Hearing aids and wines. Hearing Review. 2018;25(3):42.
References 1. Kochkin S. A comparison of consumer satisfaction, subjective benefit, and quality of life changes associated with traditional and direct-mail hearing aid use. Hearing Review. 2014;21(1):16-26. 2. Smith C, Wilber LA, Cavitt K. PSAPs vs hearing aids: An electroacoustic analysis of performance and fitting capabilities. Hearing Review. 2016;23(7):18. 3. Humes LE, Herring C, Kinney DL, Main AK, Quigley TM, Rogers SE. The effectiveness of two service-delivery models in older adults: A randomized double-blind, placebo-controlled clinical trial. Hearing Review. 2017;24(5);12-19. 4. Tecca JE. A perspective on the Indiana University OTC outcome study. Hearing Review. 2017;24(7):18-24. 5. Tedeschi TJ, Kihm J. Implications of an over-the-counter approach to hearing health care: A consumer study. Hearing Review. 2017;24(3);14-22. 6. Amlani AM, Hosford-Dunn H. How do we increase hearing aid adoption rates? Hearing Review. 2016;23(10):10-11. 7. Amlani A, Taylor B, Levy C, Robbins R. Utility of smartphone-based hearing aid applications as a substitute to traditional hearing aids. Hearing Review. 2013;12:16-23. 8. Taylor B. The ‘good enough’ era and hearing healthcare. Hearing Review. 2015;22(5):10. 9. Killion MC. Myths about hearing aid benefit and satisfaction. Hearing Review. 2004;11(9):14-66. 10. Godinho L. What Is the most efficient reimbursement system in Europe? Hearing Review. 2016;23(1):16.
Full Article from – The Hearing Review
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Boulder, CO (July 24th, 2015)
Excess moisture has long been the number one cause of damage to the electronic hearing protection and/or hearing aids.
E.A.R. Inc.’s new WATERPROOF/RESILIENT series of custom-fit electronic earplugs have been specifically designed to meet or exceed the acoustical needs of both hunters and shooters.
All earplugs are 100% DIGITAL and automatically reduce damaging sounds that exceed 85 dB such as gunfire while amplifying quiet sounds and ensuring 360-degree situational awareness.
There are 12 color choices of faceplates and multiple color choices for shells including swirls and glow-in-the-dark. The earplugs come with a removable lanyard for those who want to minimize the risk of loss when hunting or shooting.
Available in one or two channel variations.
For more information contact E.A.R., Inc. at firstname.lastname@example.org or 1-800.525.2690 (Toll-Free Canada/US), 1-303.447.2619 (International/US).
When activated, SHOTHUNT™ electronic earplugs provide two different functions at the same time:
- The digital protective function will automatically and drastically suppress all noises and sounds above an 85dB safety threshold – either sharp and brief, like a gunshot, or very long, like the noise of working heavy machinery.
- The corrective function will enhance all noises and sounds under the safety threshold, providing a +20dB level without altering natural hearing.
SHOTHUNT™ electronic earplugs will easily adapt to the shape of the user’s auricle, thanks to the ergonomically-shaped “Half-Shell” design that also grants excellent retention within the natural shape of your ear. The interchangeable memory-foam tips will also adapt to the user’s ear canals, and ensure comfort and efficiency.
The electronic “heart” of SHOTHUNT™ technology consists in a 100% digital, multi-channel processor that will eliminate all dangerous noises, leaving all others intact such as sound directionality, vocal tones, and proximity sounds, allowing the user to retain a full 360° environmental awareness.
SHOTHUNT™ electronic earplugs are totally waterproof, both on the outside and inside: the P2i Aridion nanotechnology provides total protection for the electronic components against water, moisture, sweat and other corrosive elements.
SHOTHUNT™ electronic earplugs are sold in a full deluxe package including spare batteries and foam tips.
SHOTHUNT™ electronic earplugs are perfectly suited for all shooting-related purposes – hunting, all shooting sports and other civilian shooting disciplines, and military and police tactical/professional/operational deployments – and will show all their excellent potential particularly in some fields, like IPSC or professional training, where the shooter must remain focused while at the same time always be aware to the orders given by the trainers or the Range Masters, and follow them.