I recently attended the 40th annual National Hearing Conservation Association (NHCA) convention in New Orleans. The meeting was quite interesting, and not just because it took me to New Orleans, a city I had never visited before and where, after 5 days of eating raw oysters and jambalaya, I was dying for something bland like a peanut butter sandwich. It was also interesting because of the topic. I tend to go to conventions that deal with hearing aids or hearing loss. Rarely do I go to conferences about hearing loss prevention.
In my practice I deal with hearing loss prevention a lot, and spend a large proportion of my time in this area. But this is not typical of many audiologists. Depending on the jurisdiction where one lives and works, there may or may not be any funding for this work. In some countries (such as the United States), health care and hearing loss prevention is delivered nationally (such as through the U.S. Occupational Safety and Health Administration [OSHA]). In other countries (such as Canada) health care and hearing loss prevention is delivered provincially with many differing (and in some cases competing) policies and regulations.
There are some advantages to having a national mandate to deliver services or policies: consistency among jurisdictions, larger data bases, greater and more centralized funding, and greater overall awareness of the problems and issues.
Being Canadian, there are two things that I love about the United States: (1) my wife, Kim, who is an American, and (2) federally mandated policies for hearing loss prevention in industry.
Summer in Ottawa, Canada
While this appears, on the surface, to be just a different approach for a country to deliver services and policies, the problems of giving individual states or provinces their own jurisdiction are many. While there may be some constitutional and historical reasons for state or provincial statutes, the advantages of a national (or an international approach such as in the European Union) are many.
A person working in British Columbia, Canada, as a musician or as a factory worker may decide to move to New Brunswick, Canada, and perform the identical occupation, in a very similar factory. (This is entirely theoretical because nobody would ever move away from British Columbia, Canada’s most beautiful province; I don’t live there but I did go to graduate school there.) In British Columbia this person would be subject to healthy measures to prevent hearing loss, and might even receive compensation for their hearing loss after many years working in a noisy environment. In New Brunswick this same person might not qualify for a hearing loss prevention program and might never receive compensation for their hearing loss.
Disagreement between federal and provincial regulatory bodies
A hearing loss prevention advocate from British Columbia may talk about the benefits or limitations of a certain policy, technology, or regulation but that may be meaningless to someone working in New Brunswick (also a nice province by the way, with the eastern edge on the Bay of Fundy and the famous reversing falls). That is because policies in Canada are just not coordinated, regardless of the research that comes out of universities, industries, and governmental bodies such as the National Institute for Occupational Safety and Health (NIOSH) in the United States.
To make matters worse, different branches of government may not communicate as easily. In a “federal” policy environment such as that in the United States with OSHA, it is easier for one governmental agency to communicate with another. For example, a federal government agency dealing with health can easily deal with a federal government agency dealing with noise and its effects. Even the thought that these two areas would be treated separately- health issues and noise issues- is rather silly. Hearing loss is a health issue despite the fact that noise from industry, military, or music sources which contributes to hearing loss is a noise or labor issue.
Federal policies are based on archaic and historical perspectives
Imagine how difficult it would be for one provincial department of health having to deal with 10 or 12 other individual departments of health (or even a federal department of health having to deal with 10 or 12 provincial departments of health or of labor)… welcome to Canada.
Canada is the home of great hockey players- yes, Howe, Gretzky and Sidney Crosby are Canadian- but also the home of a fractionated public policy that is not-so-neatly divided among 10 provinces and 3 territories.
Well, back to the National Hearing Conservation Association meeting in New Orleans. One of the talks was given by Jeffrey Goldberg, who is a member of the ANSI Working Group WG11 Hearing Protector Attenuation and Performance committee. He is also an associate member of the Canadian Standards Association Technical Committee on Noise and Vibration. Most importantly, Jeff is the chair of the subcommittee SC5, which is developing North America’s first standard for Hearing Loss Prevention Management.
If this standard flies, then not only will Canada be drawn into the modern era, but rules and regulations will be consistent with those found in other federal jurisdictions. There are still many hurdles- one of which is that the proposed standard will be based on the research that is in the literature, much of it derived from the excellent work of NIOSH in the United States. This would be inconsistent with the American regulatory agency’s Occupational Safety and Health Administration (OSHA) policy, but that is another blog altogether.
Having only federal regulations, or failing that, harmonizing of federal and provincial/state policies and regulations would be a major step forward in the development and application of hearing loss prevention programs whether they be for industry or music environments.
AND – and it’s the “ands” that contain the important stuff – there is a conference that will be held in Washington, DC, sponsored by the Association of Adult Musicians with Hearing Loss (www.AAMHL.org). Check out the link or go to http://bit.ly/1D4G27K.
