3 HR Processes Human Resources Practices Hearing Loss
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Hearing loss

What is hearing loss?

Hearing loss is a decrease in ability to hear and can occur at birth, suddenly, or gradually over time. Depending on the cause, hearing loss can range from mild to severe and can be reversible, temporary, or permanent (WebMD, 2008). There are three types of hearing loss; conductive, sensorineural, and mixed.

Conductive hearing loss is associated with the bones of the ear, the eardrum, or the membranes that relay sound to the inner ear. Essentially, sound is not conducted through the ear and usually involves a reduction in sound level, or the ability to hear faint sounds. Conductive hearing loss may be caused by fluid build-up from a cold, allergies, ear infections, and benign tumors (ASHA, 2008).

Sensorineural loss is associated with the nerves that transmit messages from the inner ear to the brain. Sensorineural hearing loss involves a reduction in sound level, ability to hear faint sounds, and also affects ability to clearly hear and understand speech. Sensorineural hearing loss can be caused by noise exposure, head trauma, viruses, tumors, birth injury, drugs that are toxic to the auditory system, and genetic syndromes (ASHA, 2008).

Mixed hearing loss is characterized by a combination of both conductive and sensorineural hearing loss, where there is damage in the outer or middle ear as well as in the inner ear or auditory nerve (ASHA, 2008).

How prevalent is hearing loss ?
Results of the 2002 National Health Interview Survey estimate that nearly 31 million of all adults in the U.S. have trouble hearing.43 Among military veterans, hearing impairment is one of the most common service-connected disabilities. According to Groenewold, Tak, and Masterson (2011),44 the prevalence of severe hearing impairment among non-veterans was 2.5%. Among all veterans, the prevalence for severe hearing impairment was 10.4%. The VA has reported that nearly 70,000 of the more than 1.3 million troops, who have served in Iraq and Afghanistan, collect disability payments for tinnitus, and more than 58,000 collect disability payments for hearing loss.45

What does it mean to have a mild, moderate, severe, or profound hearing loss?
Degree of hearing loss refers to the severity of the loss. The degree of hearing loss is determined by measuring hearing threshold. Hearing threshold refers to the levels in decibels (dB) at which a signal is just barely heard. A mild hearing loss is characterized as loss at 26-40 dB. Mild hearing loss may result in difficulty hearing soft voices, speakers at a distance, or understanding conversation in noisy environments. A moderate hearing loss is characterized as loss at 41-55 dB and moderate to severe at 56-70 dB. In this range, conversation even in quiet environments can be difficult and speech may need to be loud. A severe hearing loss is characterized as loss at 71-90 dB. At this level, hearing is difficult in all situations. An individual with profound hearing loss, loss at 91+ dB, may not hear even loud speech or sounds. In this instance, hearing would not be used as a primary method for processing information and communicating (House Ear Institute, 2008).

What accommodations are suggested to support individuals who are diagnosed with hearing loss?
The Job Accommodation Network (JAN) has listed several accommodations for hearing loss. These include activities or actions around various topics such as:

Communicating face-to-face

  • Write notes with pen and paper, tablet PC, dry erase or chalk board, etc.
    Note: Some individuals who are deaf may not be able to read or write English. A language barrier can exist when American Sign Language (ASL), or some other form of manual or visual communication, is the primary or only language the individual uses. If the individual does not read or write English, written communication will not be an effective form of communication. When written communication is not effective consider providing a qualified sign language interpreter on an as-needed basis.
  • Use a computer and keyboard to type messages back and forth
  • Use a computer and speech-recognition software to communicate one-on-one
  • Send e-mail or text messages as an alternative to face-to-face communication
  • Hire a qualified sign language or oral *interpreter, or *video remote interpreter (VRI) on an as-needed basis (e.g., during a job interview, orientation, benefits seminar, training, or disciplinary meeting)
    Note: The Registry of Interpreters for the Deaf (RID) offers an interpreter/agency referral service.  Visit www.rid.org to locate an interpreter/agency by state or zip code.
  • Use a personal *assistive listening device (ALD) or portable assistive listening system (ALS) if the individual can benefit from amplification
  • Use portable *communication access technology designed for individuals who are deaf or hard of hearing
  • Use an *augmentative and alternative communication device (AAC), with or without speech
  • Encourage employees to learn and use basic sign language
  • Install mirrors to communicate the presence of other workers or customers (e.g., in areas where an employee’s back may be turned) and ask the employee how he or she prefers to be approached so that he or she is not startled
  • Position a small sign at the employee’s workstation (e.g., check-lane register, help desk) that indicates the person has a hearing loss and that communication should be direct, in writing
    Note: The employee with hearing loss may volunteer to have such a sign at his or her workstation; the employer should not require such a sign.
  • Provide disability awareness training when integrating employees who are deaf into the work environment

Communicating in groups, meetings, or training

  • Meet in a small group and sit at a round table to facilitate lip-reading
  • Meet in a quiet room to avoid distractions and exposure to extraneous noise (e.g., office equipment, hallway chatter, machinery, etc.) and if necessary install noise abatement panels to reduce noise
  • Adjust lighting and seating to create an optimal listening experience
  • Educate staff regarding meeting etiquette (e.g., one person talk at a time, do not cover mouth with hands or papers, maintain eye contact)
  • Provide written materials in advance, such as the meeting agenda, training outline, or course materials, or offer minutes afterwards
  • Allow extra time for training
  • Use an FM, infrared, or induction loop *assistive listening system (ALS)
  • Hire a qualified sign language or oral *interpreter, or *video remote interpreter (VRI) on an as-needed basis (e.g., during a job interview, orientation, benefits seminar, training, or disciplinary meeting)
    Note: The Registry of Interpreters for the Deaf (RID) offers an interpreter/agency referral service.  Visit www.rid.org to locate an interpreter/agency by state or zip code.
  • Contract for on-site or remote real-time captioning services, known as communication access real-time translation or *(CART)
  • Provide computer-assisted note taking where a skilled note taker/typist uses a laptop to compose notes during the meeting
  • Record and transcribe meetings
  • Caption training DVDs/videos and web-based training modules that include sound
  • Use *relay conference captioning (RCC) during group conference calls
  • Use high quality conferencing equipment during group conference calls
  • Use a conferencing phone with a headset for more direct sound

Communicating by telephone

  • Use telephone *amplification/clarity technology
  • Use a hearing aid compatible headset or amplified noise canceling headset. Hearing aid compatible headsets are designed for use with t-coil equipped hearing aids.
  • Use a *cochlear implant patch cord
  • Use a *captioned telephone
  • Use a *TTY
  • Use a *voice carry over phone (VCO)
  • Use *video relay service (VRS)
  • Use a voicemail transcription service to send an e-mail or a text message of voicemail messages. For employees who are deaf who receive direct calls, voicemail messages could be left so the employee could call the caller back using the relay system.
  • Include the *Telecommunications Relay Service (TRS) number (711) with the employee’s business number on his or her business card, as well as a note about using the relay service
  • For employees who are severe to profoundly deaf, and who do not use speech, methods for receiving and handling incoming telephone calls include:
  • Use the relay service with a TTY (analog line required) or VCO phone,
  • Use the relay service with PC as a TTY (software),
  • Use the relay service with videophone equipment (video relay (VRS) calls),  or
  • Use an interpreter to interpret calls
  • Use e-mail or instant messaging (IM) instead of voice phone
  • Use mobile two-way text messaging instead of voice phone
  • Use *Bluetooth technology and mobile phone amplification and clarity devices with cell phone
  • Use *relay conference captioning (RCC) during group conference calls
  • Use high quality conferencing equipment during group conference calls
  • Use a conferencing phone with a headset for more direct sound

Communicating in the field

  • Use a high-end professional two-radio system with noise-canceling technology
  • Use a two-way radio with text-messaging capability
  • Use a cellular phone with text messaging, a two-way mobile device, or a cellular phone that has both text messaging and two-way radio capability
  • If "in the field" communication takes place within sight, workers may be able to use hand signals and signs to communicate instead of two-way radios
  • Use a portable TTY and relay service

Operating or working around vehicles safely

  • Establish set paths of travel for industrial vehicles and pedestrians using industrial tape, paint, or ropes
  • Establish and enforce rules requiring all moving equipment, forklifts, and vehicles to stop and flash lights/beep horn at intersections
  • Install flashing strobe lights on moving vehicles
  • Install a *directional worker alert system that provides a visual warning of oncoming vehicles
  • Install industrial mirrors in strategic locations (e.g., blind corners) at the work environment
  • The individual who is deaf or hard of hearing may be willing to wear a hat or vest of a unique color to serve as a warning to others to be cautious
    Note: An employer should not require such a vest or hat if other employees do not wear such vests or hats.
  • Use a *vibrating personal pager to alert the person who is deaf. Pagers can be useful when it is possible to have another employee send a warning signal to the person who is deaf.
  • Install a *vehicle rear vision system in the forklift or other vehicle, to improve the operator's ability to visually assess the environment

Difficulty responding to sounds in the environment

  • Use a visual or vibrating *alerting device
    Note: Alerting devices are used to alert people to a broad range of sounds, including (but not limited to) abnormal machine sounds, timers, a telephone ringing, doorbell, baby crying, and emergency signals.
  • Modify equipment by adding a light to the sound source
    Note: Speak with the manufacturer of the equipment for suggestions before making modifications and consult with an electrician, or appropriate professional.
  • Install lighted fire strobes and other visual or vibrating alerting devices to supplement audible alarms
  • Provide a vibrating text pager that may be triggered by the emergency alerting system or establish a web-based text alert system
  • Allow the employee to bring his or her *hearing dog into the workplace
  • Wearing hearing protection
  • Turn-off hearing aids and use ear muffs
  • Turn-off hearing aids and use *active hearing protection, ear muffs that block sound but use electronic circuitry to transmit low-level sounds through the earmuffs
  • Remove hearing aids and use ear plugs or muffs
  • Turn-off/remove hearing aids and use communication headset that provides noise attenuation and radio communication
  • Use hearing aid turned-off, with no protector, only if the ear piece of the hearing aid is not vented and fits snugly in the ear
  • Use custom-made hi-fidelity ear plugs; see an audiologist

For more information about hearing loss and accommodations, please visit http://askjan.org/media/Hearing.html .

 

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