Functional hearing is critical for many tasks in the military and public safety where performance impacts could have life-threatening consequences. However, many of these occupations also involve frequent exposure to harmful noise. Ideally, our warfighters and public safety officers (PSOs) would have readily accessible Hearing Protection Devices (HPDs) that protect them from high-level noise exposures while preserving auditory situation awareness (SA). The unfortunate reality is that many HPDs degrade auditory SA, so our Service Members (SMs) and PSOs must often make a deliberate choice when engaging in hearing-critical life-threatening tasks between 1) wearing a hearing protector and sacrificing some SA or 2) operating without hearing protection and risking a temporary shift in hearing thresholds, both of which may impact their performance during the mission. The latter choice may also result in permanent hearing damage, which could impact fitness for duty or make them less effective in future operations. Yet, many still choose to operate without hearing protection.

Many forms of HPDs are available to mitigate the risk of both long- and short-term damage to the auditory system, and each have certain advantages and drawbacks in terms of their effect on functional hearing. Historically, this is assessed in laboratory settings at the individual level using highly controlled speech perception, sound detection, and localization experiments. In practice, SMs and PSOs rely on effective communication between individuals in environments with dynamic sources of auditory and visual input that compete for attention. 

Given the complexity and multifaceted nature of combat operations, few studies have evaluated the impact of hearing protection and hearing loss in these environments. In this presentation, we will review the relevant literature and highlight a series of completed and planned studies aimed at measuring the functional impact of hearing loss and various hearing protection conditions on SMs in field operations. The hope is that these studies will help to illustrate and quantify the importance of hearing in combat operations and provide valuable evidence to inform the selection of hearing protection for our Warfighters and PSOs.

Moderator: Kathy Gates

Presenter:

• Benjamin Sheffield holds dual degrees in Electrical and Mechanical Engineering. After a four-year stint working in the defense industry, he got his start in auditory research as a volunteer in a hearing and speech lab while in graduate school at UC Irvine. He now has 16 years of experience working in auditory research, including the last 13 in a dual appointment with the Defense Centers for Public Health – Aberdeen and Walter Reed National Military Medical Center. He has been the principal investigator on several studies examining the relationship between hearing acuity and operational performance and is a project lead on several public health surveillance projects leveraging boothless audiometry.
• Financial Disclosures: None
• Non-Financial Disclosures: None

Program Level: Intermediate

Learning Objectives: 

1. Describe forms of objective and subjective assessment for quantifying combat performance.
2. Discuss the potential drawbacks of forgoing use of HPDs while engaging in combat operations.
3. Describe different types of hearing protection and their impact on communication ability and operational performance.

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In monitoring audiometry, adjustments to threshold changes (often called age corrections) can be used to account for changes in hearing that may be due to non-noise factors.  The OSHA hearing conservation amendment (45 CFR 1910.95) includes an age adjustment table based on a relatively small NIOSH study from the early 1970s. However, if age adjustments are used, the OSHA Technical Manual currently recommends using recently published age adjustment data (Flamme et al., 2019) instead of the tables in the OSHA hearing conservation amendment.  The updated age adjustment tables reveal a population trend toward less age-related change than the original NIOSH tables at younger ages, address differences by race/ethnicity, and extend the age range to account for older workers in today’s workforce.  NIOSH continues to recommend against any age adjustment in threshold shift determination.  This presentation includes the underpinnings of the NIOSH adjustment tables in the noise standard, the validity issues that initiated the update, and the development and validation of the age adjustment tables that are now recommended in the OSHA Technical Manual. 

Moderator: Laura Kauth

Presenters:

• Dr. Kristy Deiters is a research audiologist and consultant with a doctorate in Audiology (Au.D) from Western Michigan University and a Bachelor of Arts degree in Marketing and Economics from Alma College.  Dr. Deiters' research interests range from changes in hearing over time, reliability of hearing thresholds, the dependability of middle ear muscle contractions as hearing protection, and the epidemiology of and risk factors for hearing loss.  In 2021, Dr. Deiters and her co-workers received the NIOSH Alice Hamilton Award for Excellence in Occupational Safety and Health (Epidemiology and Surveillance category) for their leadership through science and publishing their work on population-based age adjustment tables for occupational hearing conservation programs.
• Financial Disclosures: None
• Non-Financial Disclosures: None

• Dr. Gregory Flamme is the Senior Scientist and Chief Operating Officer of Stephenson and Stephenson Research and Consulting (SASRAC), which is a company founded by Dr. Mark Stephenson and Dr. Carol Stephenson. Dr. Flamme has a Ph.D. in Audiology from the University of Memphis, completed post-doctoral work in Epidemiology and Biostatistics at the University of Iowa, and was an Associate Professor in the Department of Speech-Language Pathology and Audiology at Western Michigan University prior to joining SASRAC. Dr. Flamme's research interests include the prevention, treatment, and epidemiological study of hearing impairment.

• Financial Disclosures: None
• Non-Financial Disclosures: None

Program Level: Intermediate

Learning Objectives: 

1. Attendees will critique the empirical basis for the age adjustments (corrections) included in the OSHA Hearing Conservation Amendment.
2. Attendees will recognize the disadvantages of applying age adjustments that do not represent workers today.
3. Attendees will understand how NHANES data can be used to provide validated contemporary age adjustments.
   

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Presenters:

• Laura Kauth, Moderator
• Tim Chismar - 3M

• 3M Personal Safety Division offers comprehensive solutions, influenced by our vast industrial experience, to proactively address growing worker health and safety needs in our rapidly evolving world.  Protecting people, improving lives, and enhancing productivity. 

• Tim Chismar is the North American Product Marketer for the 3M™ PELTOR™ Portfolio of protective communication solutions.  With a background in biomedical engineering and business administration (and a former COHC), Tim has developed and supported numerous auditory solutions over the last 15 years including products under the Littmann® brand of stethoscopes and now with PELTOR protective communication headsets.
• Susan Cooper - CavCom
• CavCom is a privately held company with manufacturing facilities in Walker, MN and staff throughout the United States. CavCom manufactures innovative products designed to prevent hearing loss and improve radio communications in high noise and respirator environments. Our electronics interface with any 2-way radio on the market, and our earsets simultaneously provide safe listening levels and superior hearing protection. CavCom is the original “Talk Through Your Ears®” technology.
• Susan received a bachelor’s degree from Emory University and M.A. and Ph.D. degrees in audiology from the University of Kansas. She is certified as an audiologist (CCC-A) by the American Speech-Language-Hearing Association and has been active in many professional organizations. Susan has served on the noise committee of the American Industrial Hygiene Association (AIHA), as Chair of the Council for Accreditation in Occupational Hearing Conservation, President of the National Hearing Conservation Association (NHCA), and on the board of directors of the NHCA Scholarship Foundation. She is also a recipient of NHCA’s Threadgill Award for Outstanding Service. She has authored numerous articles on hearing conservation regulatory matters and is co-author of “Workers’ Compensation” in AIHA’s Noise Manual. Susan serves as hearing conservation and regulatory specialist for CavCom, editor of the SoundBytes newsletter, and oversees product development and continuous improvement for manufacturing.
• James Schrack – Decibullz 
• Decibullz came about in 2012 as the brainchild of founder Kyle Kirkpatrick, who wanted a way to keep his earphones in his ears while doing all the extreme sports he loved to do while listening to music. Custom earphones existed, but they were expensive and quite a commitment. He got creating and developed a patented thermoplastic molding system that allowed users to shape a material quickly and easily to their individual ear, and remold and reshape as many times as needed at an affordable price point. Quickly the opportunity arose to utilize the same patented thermoplastic molding system to address a gap in the market of hearing protection. Today Decibullz has sold over a million molds into the marketplace providing an affordable, and accessible spin on custom molded earplugs and earpieces. All Decibullz products utilize the same Easy Shape molding system, where the molds are dropped into hot water, left to soften for about 5 minutes and then pressed into the user's ear for a comfortable and snug fit. This simple process can be repeated as many times as needed to achieve the most comfortable and protective fit. The standard NRR31 earplugs come in 6 different colors and have an MSRP of $25.99. They are the number one hunting and shooting earplugs on Amazon for the past several years and are prevalent in the retail sporting goods industry, most big box retailers, and hundreds of independent retailers across the country and abroad. Decibullz has several products within the family that include Acoustic High Fidelity Fillers, Professional High Fidelity filters, Persecutive Shooting filters, and several Acoustic tube radio earpiece adapters. The whole goal of Decibullz is to make custom more accessible to the masses. We want to make it easy to do, affordable, and not such a burdensome process so that more people can experience the benefits of custom.
• James Schrack is a Colorado native and relentless entrepreneur. He joined the Decibullz team in early 2019 and quickly grew the wholesale side of the blossoming business quickly. James thrives in a scrappy environment and loves to achieve things others see as impossible. His background is not in hearing protection, but rather in taking great new innovative products to market and he quickly latched on to the Decibullz team and vision. He continues to love the atmosphere and really believes in the direction and technology Decibullz has to offer and believes it has a unique fit into the marketplace.
• Andy Wetjen – Protective Industrial Products (PIP)
• PIP is a Head to Toe manufacturer of workplace safety PPE specializing in Hand Protection, Above-the-Neck PPE (eye, face, head, hearing), Protective Workwear, and Arc Flash & Electrical Safety. This section of the webinar will provide an overview of the wide-variety of basic hearing protection options discussing: variety and quality vs compliance fit, size options, compatibility with other PPE, and customizations (colors, logos).
  • Andy Wetjen's background is in Industrial Safety Supply products and sales since 1996.

• Program Level: Beginner

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This webinar will address current practices for quantifying workplace noise and how they identify noise-hazardous locations and quantify individual worker noise exposures. The math underlying operation of noise dosimeters is explained with the goal of improving accuracy of automated readings.

Presenters:

• Charles Jokel - Mr. Charles Jokel received an MS degree in engineering from the University of Texas in 1972, complementing his MAT degree in the teaching of science received from Colgate University in 1969.  Mr. Jokel currently works for the U.S. Army Defense Centers for Public Health in Aberdeen Maryland as a noise control engineer, consulting on Army noise problems and providing expertise on noise issues for the Army Health Hazard Assessment Program.  Prior to joining the Army in 2004, he had worked in private industry as a noise control consultant, specializing in industrial and product noise control.  One of Mr. Jokel’s numerous technical papers in the field of noise control, the NIOSH publication“Industrial Noise Control, revised edition” was one of that agency’s most popular publications.
• • Financial Disclosures
  • None
  • Non-Financial Disclosures
  • None
• Christopher J. Smalt is a technical staff member in the Human Health & Performance Systems Group at MIT Lincoln Laboratory. His current work focuses on computational auditory modeling, specifically on mechanisms of hearing damage and the effect of noise exposure on hearing and cognitive performance. As part his research, he has developed a personal noise monitoring system for industrial and tactical environments with combined continuous and impulse noise, as well as taken and analyzed noise data during military training exercises. Dr. Smalt received a BS degree in computer engineering from Clarkson University and earned both MS and PhD degrees in electrical engineering from Purdue University
• • Financial Disclosures
  • None
  • Non-Financial Disclosures
  • None

  Moderator:

• J. Andrew Merkley - Dr. Merkley is an occupational and clinical Audiologist with over 22 years of experience in both national and international workplaces. His experience includes small clinic management to strategic oversight and responsibility for large multi-clinic regions.  His presentation experience includes podium, poster, and full workshop presentations at national and international conferences on topics including hearing health education, process improvement, and management of workplace hearing injuries.  He holds a Master of Science in Communicative Disorders from Utah State University and Doctor of Audiology from Central Michigan University. He holds the Certificate of Clinical Competence in Audiology from the American Speech-Language Hearing Association. He is certified as a Course Director and Professional Supervisor by the Council for Accreditation in Occupational Hearing Conservation and also serves as the Council Chair.

Program Level: Intermediate

Learning Objectives: 

1. Identify procedures for performing workplace noise surveys. 

2. Identify procedures for quantifying workplace noise exposures.

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This session was designed to aid hearing conservationists and educators with the successful application of virtual audiometry and patient simulators during training activities. Several website- and software-based programs have been developed for general diagnostic audiology education, and to date two such website-based tools have been developed specifically to facilitate manual testing technique training for Occupational Hearing Conservationists. The developers of those programs will demonstrate their use, discuss the application of these types of alternative teaching delivery methods, and provide guidance on the development of partial or fully virtual practica in the context of CAOHC training courses.

Presenters:

• Frank Wartinger, Au.D., ABAC, is an active CAOHC Course Director and the founder of Earmark Hearing Conservation, a music audiology clinic in Philadelphia. He serves on the CAOHC (Council for Accreditation in Occupational Hearing Conservation) Course Director Committee, is an adjunct faculty at Wayne State University, and co-authored the AAA 2020 Clinical Consensus Document “Audiological Services for Musicians and Music Industry Personnel”. He is an active member of the NHCA (National Hearing Conservation Association) Music Induced Hearing Disorders Task Force and served as the NHCA Director of Communications from 2017-2019. Additionally, Dr. Wartinger created and hosts “Talking Ears”, a musician-focused hearing health podcast.

• Sarah Mouser, Au.D., CCC-A, CPS/A is the owner of Occupational Sound Solutions and an active CAOHC Course Director. She is based in North Carolina however; she manages Hearing Conservation Programs for companies all over the United States. Dr. Mouser is currently licensed in 26 states. In addition, Dr. Mouser owns and operates an Ophthalmology and Clinical Audiology practice, Southeastern Eye Care, PA, with her husband who is an Ophthalmologist.

• Kirsten McCall, Au.D., CCC-A, CPS/A Practicing as an occupational audiologist for over 25 years, Kirsten’s passion is the prevention of noise-induced hearing loss. She is a member of the American Speech-Language-Hearing Association (ASHA) and the National Hearing Conservation Association. Kirsten became a certified Council for Accreditation in Occupational Hearing Conservation (CAOHC) Course Director in 1994. Dr. McCall teaches numerous initial and recertification courses to nurses, physicians, industrial hygienists, safety personnel, and medical assistants from occupational health clinics. She currently serves on the CAOHC Council, representing ASHA, and is chair of the OHC / CD committee. Kirsten is also a CAOHC-certified Professional Supervisor. As a consulting audiologist to industry, Dr. McCall serves as the Professional Supervisor of numerous hearing conservation programs.  Her responsibilities include audiometric data review and reporting, determination of work-relatedness, compliance audits, and professional supervision of audiometric technicians, hearing loss prevention training, and comprehensive noise surveys.In 2015, Dr. McCall launched her own company, Audiology Consulting and Training. Recreationally, Kirsten’s other passion is golf.

Program Level: Intermediate

Learning Objectives: 

1. Operate the available virtual audiometric patient simulators
2. Employ the tools available to conduct virtual audiometry training in their courses.
3. Identify the steps required to plan a partially or fully virtual CAOHC practicum training session. 

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Over the past decade, several companies have worked to develop novel platforms to enable hearing assessment outside of the sound booth, to improve accessibility as well as efficiency. Effective solutions must include capabilities to meet additional requirements for specialty populations and markets, including foreign and domestic militaries as well as U.S. veterans. Expanded awareness and knowledge of boothless technologies is needed to inform and accelerate adoption and application of boothless audiometry to provide hearing health services. However, it can be challenging to track technological advancements in boothless audiometry products. This webinar will present an overview of boothless audiometry technologies currently available to the hearing conservation professional. Attendees will be provided overview presentations from participating boothless audiometry representatives and how these specific devices can be used for hearing conservation monitoring audiometry.

Presenters:

• Laura Prigge is an Application Specialist with GSI. Laura received her Doctorate of Audiology degree from AT Still University. Laura’s 20+ years of experience includes providing manufacturing support for a leading hearing aid manufacturer as well as technical audiology training and support for an international audiologic equipment company. Prior to that, she managed education and training at another hearing aid manufacturer and conducted audiologic evaluations on children, adults, and geriatric patients at a retail hearing center. 

The Automated Method for Testing Auditory Sensitivity, or AMTAS (Grason-Stadler, Inc. [GSI]), is a software program that functions with a GSI audiometer or as a stand-alone system using a tablet (see Figure 2). AMTAS allows a patient to take a self-directed hearing test. The AMTAS diagnostic and screening procedure uses patented test methods and accuracy algorithms researched, developed, implemented, and validated over 10 years.

• James (Jesse) A. Norris, Ph.D., has a background in biomedical engineering and applied research. Within auditory science, he has studied relationships between attenuation and comfort for custom earplugs; developed algorithms and hardware to support otoacoustic emissions research; and designed and built new hearing test equipment that pairs with mobile devices to increase the reach of hearing health care. He currently works at Edare and has been focused on transitioning hearing related technologies from research into products. He has helped Edare develop a production-ready quality system, register with the FDA, and oversees product development, manufacturing, and support.

The Wireless Automated Hearing Test System, or WAHTS, (Edare) was developed to increase access to hearing health care by eliminating the need for soundproof booth and highly trained personnel (Meinke et al., 2017). The Edare WAHTS device is an FDA-approved device for clinical application. The WAHTS system includes multiple test options, including manual audiometry, manual or automated screening, speech-in-noise testing, and additional tests for research initiatives.

• Renée Lefrançois obtained her degree in Audiology from the University of Ottawa, Canada in 1999. The first fifteen years of her career focused on cochlear implantation; first as a clinician and then managing the Canadian arm of Advanced Bionics LLC. Renée has also been a seasonal lecturer at the University of Ottawa teaching both full courses and individual modules in Audiology. As a founding member of CanHEAR Uganda (2007), Renée delivered hearing health care services and training in several cities in Uganda. In 2014, Renée joined the SHOEBOX Ltd. team as their Director of Audiology. Having obtained her CAOHC PS(A) certification in November 2018, she has spent the last several years focusing on occupational health and is currently managing the professional supervision and clinical review activities for many occupational health customers. Current areas of interest include occupational health, noise-induced hearing loss, teleaudiology, population health, ototoxicity, and the genetics of hearing loss.

The SHOEBOX audiometer (SHOEBOX, Ltd.) is the first portable, iPad-based audiometer listed as a Class II device by both the U.S. FDA and Health Canada. The SHOEBOX audiometer (see Figure 5) is calibrated to ANSI S3.6-2018 and meets ANSI S3.1-1999 (R2018) for testing outside of a sound booth. It includes options for both manual and automated testing and is designed to be used by audiologists or other trained personnel. SHOEBOX has been clinically validated for use as a diagnostic audiometer even when testing is performed outside of a sound booth. 

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• Describe the origin of the NIOSH age tables used by OSHA.
• Identify the differences in cross-sectional hearing loss trends over time.
• Explain how cross-sectional trends are conceptually different from longitudinal change.

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Topic: Impulsive Noise: Understanding, Measuring, and Assessing

When: June 17, 2021
2 pm EST 

About the Webinar: Exposures to high-level impulsive noises such as collisions of objects, firearms, or explosions significantly increase the risk for developing noise induced hearing loss. Although Impulse and impact noise are generated through different processes, they are often grouped into impulsive noise. When measuring impulsive noise, sound level meters may not be the best choice due to technological limitations. The selection and use of microphone, preamplifier, and processing systems are critical to capturing high-quality data. In many cases, recordings are more beneficial than capturing a peak level or a single integrated level to understand the exposure and to mitigate the risk. Understanding technological limitations and learning about specific techniques for capturing and measuring impulse noise can result in accurate and repeatable data.