#171 Hearing Loss - An Occupational Hazard in Dentistry

Did you know that the noises encountered in a dental practice can make dental team members susceptible to the development of permanent hearing loss?  Learn which devices and equipment produce the highest levels of sound, and what does OSHA say about exposure to high levels of sound in the workplace.  The Divas also discuss methods of protecting against hearing loss.

Resources

• CDC/NIOSH - About Occupational Hearing Loss  https://bit.ly/3SMCrMe
• CDC/NIOSH - Noise and Hearing Loss  https://bit.ly/3SK1Ia1
• SoundEar A/S - About Decibels  https://bit.ly/46I7u1y
• CDC/NIOSH - About Noise https://bit.ly/3SK1Ia1
• American Dental Association - Safety Tips to Prevent Hearing Loss  https://bit.ly/4diHX1j
• Today's RDH - Hearing Loss in Dentistry: A Silent Topic  https://bit.ly/4cpoqeH
• Dental Economics - The Deafening Silence in Dentistry  https://bit.ly/4dj1jUh

                                                 https://www.thecompliancedivas.com

Transcript

Copy Transcript Copied

SPEAKER_02 0:04

Welcome.

SPEAKER_03 0:05

I'm Leslie Cannon. I'm Mary Gavoni.

SPEAKER_02 0:09

I'm Linda Harvey. I'm Olivia Wan. And together we are the Compliance Divas.

SPEAKER_00 0:20

Hello, my name is Leslie Cannon, and I'm your moderator for this podcast of the Compliance Divas. Our episode today is going to focus on hearing loss, which can be an occupational hazard in dentistry. The compliance divas bring clarity and simplicity to compliance by navigating regulatory compliance to keep you on course. We welcome you to subscribe to the Compliance Divas podcast through your favorite podcast channel or on our website, thecompliancedivas.com. The resources that we mentioned during this podcast today can be found on our website, thecompliancedivas.com, and we welcome questions, send them to support at thecompliancedivas.com. So this is a very important subject. And when we think about hearing loss in an occupational setting, if certain conditions are present, noise levels and noise levels in a dental office can contribute to occupational hearing loss. Now, this kind of loss is permanent, but it's totally preventable. I'm going to call on our diva, Linda, to tell us a little bit about causes and risk factors, as well as what noise-induced hearing loss is.

SPEAKER_01 1:39

Sure, Leslie. When you think about hearing loss, everyday sounds typically do not damage your hearing. It's repeated exposure to loud sounds that can cause hearing loss. And loud sounds or noise can lead to noise-induced hearing loss. So think about these kinds of things as far as noise-induced hearing loss. This can be caused from a single loud sound, like firecrackers near the ear, or just think of some kind of explosion at your near, or repeated exposures to loud sounds over time. And of course, the louder the sound, Leslie, the shorter the amount of time it takes for the hearing loss to occur. And the longer the exposure, the greater the list. The longer the exposure, the greater the risk for hearing loss. Now here's a few examples for noisy exposures. Let's see if any of us can identify with these. Watching fireworks over the 4th of July or New Year's Eve, especially when we're close to the source. Lawn mowing. Using power tools, watching a sports game and cheering on your favorite team. Think about how loud that can be when you're inside of an arena. And of course, attending a concert. We all know, depending on where you're seated in the concert, if you're next to the speakers, you may walk out of there and feel like you can't hear for a number of hours after an event. There's a few risk factors I'd like to go over, Leslie. And those can also increase your risk for noise-induced hearing loss. This can be things like a family history of hearing loss that's not exposed, not associated with noise exposure. It could be long-standing, say, chronic conditions such as diabetes and high blood pressure that it can impact hearing, injuries to the ear or another situation, exposure to organic liquid chemicals such as toluene. And I want to say a few words about that in just a moment. And even taking certain medications can cause risk factors for hearing loss. It's a good idea for our listeners to be sure they have their hearing checked during the regular checkups, especially if you're at risk for noise-induced hearing loss. And when you think about some of the signs to be mindful of, if you're having difficulty with hearing, maybe you don't even realize it. But sometimes we have difficulty hearing when there's background noise. For example, you're sitting in a restaurant and you're having trouble hearing someone sitting two seats down from you. And we all we've all been in restaurants where the noise level is extremely high, depending on the types of ceiling and the size of the restaurant and everything. If we frequently think that people are mumbling when they're talking to us, that could be a sign of hearing loss. And if we're constantly needing others to repeat themselves, that's another sign of hearing loss. So research on hearing loss is associated with cognitive decline and heart problems as well. So it's very important that we maintain good hearing. And hearing loss as well as tinnitus can impact your mental health. But Leslie, before we go into some of the other areas that you want to talk about today, I'd like to mention something interesting about the toluene. And I mentioned that just a second ago, talking about that being a risk factor. And although we don't have toluene in dental products, it is in paint enters, lacquer, car exhaust, and even nail polish. And as I was preparing for this podcast, I was surprised to realize that if you look at an SDS sheet with that chemical on it, that the target organ is hearing or ears, rather. So I think it's really interesting to be mindful of that because there is a trend to abuse this solvent with folks huffing this abuse this with individuals. Sorry, I'm sorry, having a rough when you think about toyulene, I'd like you to think about the fact that it is an abused substance for inhaling or huffing, particularly for the fact that it can release dopamine in the brain, and that produces that feeling of euphoria. And that again reinforces using the drug or huffing it longer or again. So it's something to be mindful of because it is a product that does have a target organ effect on our ears, and it's also a dangerous product if it's used for huffing. But that being aside, all the other things we talked about are things that we should all be mindful of for good hearing, Leslie.

SPEAKER_00 5:58

Well, Linda, thanks for that great explanation of what noise-induced hearing loss is, risk factors and signs of hearing loss. I'd like to move on to Olivia to tell us a little bit more about decibels, when noise is hazardous, NIOSH recommended exposure limits, and let us know what it is we need to keep track of.

SPEAKER_02 6:20

Well, Leslie, the important foundation for this topic is to understand that loud noise can damage your hearing. And noise is considered hazardous based on how long the sound is, how long the exposure lasts, how often the exposure is repeated. So keep in mind that's part of our hazard assessments, if you will. But we do need to take precautions when noise is 85A weighted decibels, referred to as DBA average over an eight-hour workday. So it's not just an incoming loud noise in itself, it's when that noise continues over that eight-hour period. And when that happens, when workers are exposed to noise at or above the NIOSH uh limit, then there's that risk of developing significant hearing loss over their working lifetime. And so even though this limit is based on exposure for eight hours, we still have to look at the individual aspect of it, Leslie, because everyone differs in their susceptibility to noise and the type of damage that it can cause. And so it would be wise to assess how much noise is in the workplace. And they can actually look into these different types of monitors that Mary's going to talk about.

SPEAKER_00 8:02

Thanks, Olivia. And I think when we call on Mary, I just want to give a definition of decibels before we go forward. So we have a little uh idea of what that means. And a decibel is a unit of measurement used to describe the amount of sound power present. And standard measurements like pounds or feet have linear requirement relationships. Decibels have logramyths. Thanks, Olivia. And I think our listeners would want to know what a decibel is. It's actually a unit of measurement that's used to describe the amount of sound power present. For example, a sound that is 10 decibels louder than another is 10 times more intense. And Mary's going to give us an idea of what kinds of items or machinery might cause a high level of decibel that we should be careful about, including dental devices. Mary?

SPEAKER_03 8:56

Thanks, Leslie. And Linda gave us a couple of examples when she was talking earlier about going to a concert. The decibel level at concerts is measured at 120 decibels. So that's considerably above what Nyosh says can cause or trigger hearing loss. Normal conversation is usually around 60 decibels. So that is probably not going to cross that threshold unless somebody's very angry and yelling at you. Going into a library is about 45 decibels because you're supposed to be a little quieter in the library. City traffic, 85 decibels. So that's right on the threshold. So for anyone who is going out and walking or riding a bike or jogging where their near city traffic is exposed to that, a baby crying, 110 decibels. That one, of course, is probably by design to get your attention that that little baby needs some help. Using your MP3 player, listening to your music on your phone, 105 decibels. And I know most phones now have a warning level. If you've got your volume up too high, they tell you that this could cause hearing loss. A balloon popping, which is a very loud, startling sound. 157 decibels. Linda, I think you mentioned being in a noisy restaurant and trying to hear conversations that are going on. It's about 90 decibels in some restaurants. And some are designed to just be very open and not really have any noise dampering types of things. And one of my personal interests, because like the rest of the Divas, I fly a fair amount. A jet engine is about 120 decibels. So I measured on a recent flight from the NIOSH sound app that you can download for free and measure the sound level inside of an airplane when we were taking off and then just in flight. And it was way above 90. It was around 100 to 110 decibels inside the plane. So you think about a three or a four-hour flight listening to all that noise. So I am a big fan of noise canceling headphones when exposed to that kind of noise. So let's focus on what is in the dental office. I've noticed over the years that many of the doctors I've known for a very long time who are right-handed and many times have their left ear closer to where the handpiece is, have significant hearing loss in that left ear. And their assistant, the same thing because on their side of the chair, that's just sort of anecdotal information. But we look at what are we using in our treatment rooms that may be above that threshold. Of course, we have slow speed handpieces, which are below, they're about 70 to 74 decibels. We have high-speed handpieces, which are 88 to 102, so definitely above the threshold level. Ultrasonic scalers, 107. They are said to be the highest, loudest decibel level of any of the types of instrumentation that we use. And of course, from an infection control standpoint, they also produce the most aerosol, but yet we want to use them. So our ultrasonic cleaning units in the laboratory, we may have model trimmers, lathes for trimming. And then if you go into the utility room in the dental office, you've got a compressor and you've got the vacuum system also producing noise at or above the decibel level. So we have a noisy place and the cumulative exposure to those noises, maybe it's not eight hours straight, but it's 45 minutes here and 45 minutes there, and that accumulates, and the damage can certainly occur and cause issues for us.

SPEAKER_00 12:58

Thanks so much for that, Mary. It gives us a better perspective of what noise decibel level are, and then also what we experience in a typical dental office. And if we look back on our OSHA training, where OSHA tells us that we should have administrative controls, we also have CDC recommending that we employ administrative controls. For example, how close are we to the noise source? Can we reduce the duration of the exposure? And uh are employees' behaviors increasing noise exposure. So sometimes coworkers being loud, loud speaking. A way to remedy some of the issues that we would develop from exposure to noise is to wear hearing protection. And when you can't eliminate or lessen the noise, then we go into PPE as our last resort. Hearing protection can also be very effective when it's chosen properly and it fits well and it's used consistently. There are many different devices that you can get to reduce the level of hearing, not in dentistry, but in general, if you were out and about, earmuffs can work for you. They have also ear canal caps and earplugs that have three principal types of devices. They have earplugs, the devices that fit snugly into the ear, and they're also made of foam, so they expand to the contour of your ear canal. Then there's also, again, the earmuffs, as I mentioned, and then the canal caps, which devices that cover the entrance to the ear and are held in place by a lightweight band. So probably our best option would be to try something like an ear canal cap or an ear plug. And there are some manufacturers out that do make specified earplugs for industry individuals who experience loud noise. One of the things we can do to monitor our level of hearing loss is to have a baseline hearing test and then to have annual hearing tests, because in dentistry we may be exposed to noise that might cause us to lose our hearing a bit. So if you just put um sound meter, that's the NIOSH sound level meter in your Google search or on your app store. And then for other types of phones, Androids, there are also sound meters that you can uh install on your phone. And it might be interesting to walk around your practice and see what the noise level is, the various different devices that we work with each day.

SPEAKER_03 15:36

Leslie, you made such a good point about the necessity, perhaps, for dental professionals to wear hearing protection to prevent that long-term damage to their own hearing. But I know that many doctors in particular are concerned that they may not be able to hear what their patients are saying. They may not be able to communicate either with patients or with their team members. So we would recommend that you number one, get a hearing test to see where you're at and get some recommendations from a hearing professional and see what would work for you that would still allow you to hear your patients while protecting your hearing.

SPEAKER_00 16:24

With that, we're going to close our program today. And we want to remind you that we bring clarity and simplicity to compliance by navigating regulatory compliance to keep you on course. We hope you'll submit your questions to support at the compliancedevas.com, that you'll take advantage of the many resources we have on the topic that we discussed today. And when you're on your podcast channel, if you would kindly leave us a review, we would certainly appreciate that.