Canadian Occupational Safety

October/November 2016 39 mine and certain warning bells that let you know the machine — which could pin you to the wall and kill you — is moving and you are hearing this rushing in your ears, it can be a distrac- tion," says Masterson. But the biggest issue with tinnitus is it affects sleep and concentration. This means general safety and effectiveness is hampered. "If you are coming to the job fatigued, that can be a problem for your level of alertness. You're miss- ing cues, you're basically just going through the motions," says Masterson. "If you are driving a vehicle as part of your job, dangerous equipment as part of your job or if you are in a job where communication is absolutely critical — police, fi re — you could be missing communication because you are really tired and not alert." Tinnitus is also associated with depression and anxiety, noted the report. There have even been a few suicides due to extreme tinnitus, says Masterson. "As hearing loss worsens it really has a detrimental effect on the communi- cations you have with others… You have to keep asking people to repeat themselves; you get frustrated, they get frustrated, the conversations with important people in your life become shorter because it's a frustrating experi- ence," she says. "You lose the volume and quality of the sounds you want to hear: music, TV, a child's voice. You lose enjoyment." The lack of public awareness around tinnitus also contributes to mental health issues, says Chrostowski, as individuals suffering with the condi- tion feel as though no one understands what they are going through. PREVENTION Occupational hearing loss is entirely preventable and the fi rst thing employ- ers need to do is measure the noise in their workplace, says Wisdom. "They need to measure their noise sources, tools and equipment as to levels being generated — and then measure employee exposure with noise dosimetry," she says. "They need to determine what their noise levels are — they can't fi x something if they don't know they have a hazard." The next step is to develop a noise conservation program, which will include many elements, such as methods of noise control. For this, employers need to follow the hierar- chy of controls and start with looking for ways to eliminate the noise. One way to do this is by properly maintain- ing and lubricating tools. The next step is substitution. For example, there are some tools on the market with low noise levels, so the purchasing department needs to know to look for ones with reduced decibel ratings, says Wisdom. Next is engineering controls. Encasing the noise is one example. Employers can put a noisy machine in a room that's soundproof, so only the person who has to go in there to work that machine is exposed. Administrative controls, such as work scheduling, are the next best thing. "See if you can split the noise," says Masterson. "Instead of one in there for eight hours, have two people go in — one for four and another person for four. We just reduced the exposure for that person by half." The last step is hearing protection, which unfortunately is often the go-to for employers, says Wisdom. "They just throw earplugs at people, with no training on how to put them in. Hearing protection should always be the last resort, but it's actually the fi rst resort in many workplaces," she says. Employers should make sure to fi t test all workers for their hearing pro- tection and teach them how to use it properly. Supervisors and managers need make sure they are continually enforcing the use of hearing protec- tion, says Chrostowski. A hearing conservation program should also outline the require- ments for audiometric testing and the maintenance of test records. Workers should undergo annual testing so they can know if hearing loss is occurring, says Wisdom. A plan needs to be in place to educate workers on the hazards of exposure to excess noise. "It's important to educate workers on what tinnitus is, what it sounds like and know what their risks are," says Chrostowski. "With hearing loss, every- one has an idea of what it is and it's easy to assume it's not a big deal or they won't have issues. A lot of us are guilty for taking our hearing for granted." One effective education tool is to play an example of what tinnitus sounds like (which is easy to fi nd on YouTube). For workers currently suffering from tinnitus, health and safety managers need to be even more vigilant with hearing protection, so they prevent these workers from losing any more hearing, says Chrostowski. If possible, the noise exposure should be reduced for workers with tinnitus or elimi- nated for those with severe cases. "Treat it as if you would a back injury. You wouldn't ask a person with a back injury to lift heavy loads, and you shouldn't ask a person with tinni- tus to be exposed to high noise levels," says Wisdom. The workplace can also put in place non-verbal communication techniques (hand signals) as well as visual cues (fl ashing lights), so there is less depen- dence on hearing for these workers. The good news is tinnitus can be managed and reduced, says Chrostowski. There are various treat- ment options available for tinnitus on which employers can provide information. These include tinnitus sound therapies that are available through some hearing clinics or tin- nitus retraining therapy provided by trained hearing professionals. "With the right therapies and sup- port from employers, employees with tinnitus can regain a sense of control and quality of life. Tinnitus can affect a person's life in many ways, but what makes it worse is feeling that nothing can be done and nobody understands," says Chrostowski. "Employers have the opportunity and means to address these issues… and in so doing they will improve the lives and productiv- ity of employees with tinnitus." From the classroom to the workplace. We use our insight and expertise to develop e ective, practical training solutions that work for your business. WSPS training goes beyond compliance, o ering real world challenges and impactful solutions that ensure participants can bring their training back to their workplace. AT WSPS, YOUR SAFETY MATTERS. wsps.ca/training 1 877 494 WSPS (9777) Register Today! WSPS.CA Complete Health and Safety Solutions WSPS Training in Action 1_2pg ad COS_Final.indd 1 2016-08-26 12:07 PM TINNITUS TREATMENTS Although there may be no cure for tinnitus, it can often be successfully managed through various treatments: • Auditory habituation (tinnitus retraining therapy): A noise generator presents a sound into the affected ear at a soft enough level such that the brain perceives both the noise and the tinnitus. Eventually, over a period of 18 to 24 months, the brain may re-learn a pattern that will de-emphasize the importance of the tinnitus. • Masking: The use of an external electronic device to produce sound that can cover up the tinnitus. • Amplifi cation: If a hearing loss is present along with tinnitus, hearing aids can be very effective in relieving tinnitus. • Medications: Certain anti- depressants and anti-anxiety medications have proven successful for some, as well as herbal medications ,such as ginkgo biloba. • Alternate approaches: Hypnosis, acupuncture, chiropractic treatment, ear candling and naturopathy. • Diet: Often high levels of salt and caffeine, as well as nicotine, can cause an increase in tinnitus. • Stress management and relaxation: There is a high correlation between stress and an increase in the loudness of tinnitus; therefore, strategies aimed at reducing stress can be very effective. Source: Canadian Academy of Audiology

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