ana claudia fiorini, phd catholic university of são paulo puc-sp brazil
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Occupational hearing loss in Brazil: state of art. Ana Claudia Fiorini, PhD Catholic University of São Paulo PUC-SP Brazil. BRAZIL. 26 states and Brasília (DC) 170 million habitants - PowerPoint PPT PresentationTRANSCRIPT
Ana Claudia Fiorini, PhDCatholic University of São Paulo
PUC-SPBrazil
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
BRAZIL
Repetitive Strain Injury (RSI) Occupational Hearing Loss
BRAZILMajor Occupational Disease
HealthHealth BenefitsBenefits WorkOSH
WorkOSH
DepartmentsDepartments
BRAZILIAN POLICIES
2002: The National Network of Total Worker´s Health Care2004: Ordinance to regulate compulsory notification of work related accidents and diseases
NR-15: exposure limitsNR-15: exposure limits
Brazilian Occupational Safety and Health Organization
NR-6: individual protectorsNR-6: individual protectors
NR-9: safety programNR-9: safety program
NR-7: health programNR-7: health program
Portaria 19: audiometric testPortaria 19: audiometric test
Brazilian Occupational Safety and Health Organization
Ordinance 19: audiometric test
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
Maximum Level:
continuous or intermittent
noise
Lav
85 dB(A) ------ 8 h86 dB(A) ------ 7 h87 dB(A) ------ 6 h88 dB(A) ------ 5 h89 dB(A) ------ 4 h 30 min90 dB(A) ------ 4 h91 dB(A) ------ 3 h 30 min92 dB(A) ------ 3 h93 dB(A) ------ 2 h 30 min94 dB(A) ------ 2 h 15 min95 dB(A) ------ 2 h96 dB(A) ------ 1 h 45 min98 dB(A) ------ 1 h 15 min100 dB(A) ------ 1 h102 dB(A) ------ 45 min104 dB(A) ------ 35 min105 dB(A) ------ 30 min106 dB(A) ------ 25 min108 dB(A) ------ 20 min110 dB(A) ------ 15 min115 dB(A) ------ 7 min
NR - 15 5 dB:
Impact noise: 130 dB (linear).
Level Maximum/day Dose 8 hours Maximum/day Dose 8 hours Dif (Minutes)dB(A) (Minutes) (%) (Minutos) (%) q= 5dB - q= 3dB
85 480 100 480 100 086 418 115 381 126 3787 364 132 302 159 6188 317 152 240 200 7789 276 174 190 252 8590 240 200 151 317 8991 209 230 120 400 8992 182 264 95 504 8793 158 303 76 635 8394 138 348 60 800 7895 120 400 48 1008 7296 104 459 38 1270 6798 79 606 24 2016 55
100 60 800 15 3200 45102 45 1056 9 5080 36104 34 1393 6 8063 29105 30 1600 5 10159 25106 26 1838 4 12800 22108 20 2425 2 20319 17110 15 3200 1 32254 14112 11 4222 1 51200 10114 9 5572 1 81275 8115 8 6400 0 102400 7
q = 5dB(A) q = 3dB(A)
NHO 01 Fundacentro (2001)
PREVALENCE OF HLUntil 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
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. 2007;21(6):381-7
Hearing Loss Prevention Hearing Loss Prevention Program – TextilesProgram – TextilesGeneral guidelines General guidelines
• Implemented in 1997• 5 plants in Brazil (manufacture denim)• Main occupational hazards: cotton dust,
noise and vibration (2000 workers)• Associated to the company´s
environmental manegment• There is a safety engineer, a safety
technician, na occupational phisician and na audiologist
Hearing Loss Prevention Hearing Loss Prevention Program – TextilesProgram – TextilesGeneral guidelines General guidelines
ManagementManagement
Workplace agentsWorkplace agents Non occupationalactivities
Non occupationalactivities
EpidemiologicalSurveillance
EpidemiologicalSurveillance
Non-occupationalactivities
Non-occupationalactivities
ManagementManagement
AssessmentNoiseDust Vibration
AssessmentNoiseDust Vibration
ControlControlHearing
ProtectionDevices *
Hearing ProtectionDevices *
WorkplaceWorkplace
*Specific program for selection, recommendation, fittingand follow-up of hearing protectors
ManagementManagement
ProtectorApproval*ProtectorApproval* ControlControl QuestionnaireQuestionnaire
Hearing ProtectionHearing ProtectionProgram's stages Program's stages
* It determines the HP that may be used in the workplace, taking scientific research and newtechnologies (NIOSH´s rules and field survey)
Hearing Protector Approval
Ear muffs (three types, NRRsf > 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
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
HP TEST (dBA)HP TEST (dBA)
Evaluation of Hearing Protector
Individual training Group training Guide User satisfaction survey
(questionnaire) Maintenance program Regular replacement of HP
Guide on how to protect your ears
Guide on how to protect your ears
Before exposure
Example: OAE test
Example: OAE test
After exposure
Hearing Loss Prevention Hearing Loss Prevention Program Program
Non-occupational Activities: identifying workers´leasure (personal music players, shows and others)
Non-occupational Activities: identifying workers´leasure (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)
Epidemiological Surveillance: the performance and analysis of audiometric testing is standardized (longitudinal studies to check onset and worsening of HL)
Results
0
20
40
60
80
100
2001 2002 2003 2004 2005 2006 2007 2008
Year
%
Normal
NIHL
Others
STS
•Normal group remains around 80%•Maximum STS: 0.27%
Thank [email protected]