Eight years ago, Jeff Ammon, now 55, began noticing pressure in his ears every day after work.
When his symptoms progressed into a slight loss of hearing and sensitivity to noise, he became worried. Ammon, a construction worker for 32 years, eventually started wearing ear protection hoping this would address these problems — but it was too late.
From then on, sounds ranging from the hum of a lawnmower to normal tones of conversation caused a piercing, jabbing pain in his inner ear. He stopped working in 2011, when the pain became unbearable. He also hears ringing in his ears and experiences dizziness, both side effects of the auditory damage.
“It’s debilitating … completely,” he said.
Ammon spent almost all of his working life surrounded by the loud noises of jackhammers, saws and air compressors. Now he avoids going outdoors, choosing instead to stay in his soundproof basement in Lebanon, Pennsylvania, and communicate with his doctor mostly through an online patient portal.
“The medication to address pain has not been very successful at all. … I’m also on some medication for stress, anxiety and depression,” he said. “It has isolated me from society.”
According to the Centers for Disease Control and Prevention, hearing loss is the most common work-related injury. About 22 million workers are exposed annually to hazardous levels of occupational noise. Workers in the mining sector, followed by those in construction and manufacturing, are most likely to suffer from it. An estimated $242 million is spent on worker’s compensation annually for hearing loss disability, according to the Department of Labor.
To reduce these numbers, the Labor Department launched a project earlier this summer called “Hear and Now,” in which it is soliciting innovative ideas and technology to alert workers to hazardous noise levels.
Critics say that while these efforts might help, technology to reduce hearing injuries already exists. And they contend that the maximum level of noise exposure allowed before employers are required to provide sound-protection equipment is too low. Also, they say, the regulations developed by the Occupational Safety and Health Administration are outdated. For example, they don’t factor in the noise exposures that occur beyond the workplace — at restaurants, concerts and sporting venues, for instance — that can add to workers’ cumulative risks.
OSHA officials say the agency will issue a request for information later this year about current regulations at construction sites to figure out whether companies are complying with the rules and whether more stringent protections are needed. (The construction industry has often been held to separate noise-related rules and requirements than those in place for other industries.) The review may lead to an update to these rules, most of which date back to the 1970s. A similar call for information was issued in 2002, but no changes resulted from the action.
Employers may also have to instill greater awareness of the risks and and provide education to workers. Employees sometimes choose not to wear hearing protection at work sites because they are not aware of the potential for harm — especially when they are not operating loud equipment.
Mark Cullen, a professor at Stanford University who explores workplace hazards, found in a study that the employees who suffer most from hearing loss were those who in jobs involving moderate noise levels rather than high-noise environments.
“At very high noise exposures, people very faithfully wear hearing protection and at low noise situations, people don’t,” he said.
For general industry workers who are exposed to noise for eight hours a day at or above a time-weighted average of 85 decibels, OSHA requires employers to provide notification, audiometric testing and free hearing protection. Employers also have to offer training programs for affected workers. In the construction industry, the limit is 90 decibels for an eight-hour exposure.
Cullen said employers could build noise barriers or eliminate noisy equipment, but old factories often just offer hearing protection gear.
“But the problem with hearing protections is it is way too easy, unsupervised, to take it off,” he said. “What would really make a difference is to train employers.”
He said there is also technology that allows each worker’s protection gear to measure noise exposure in real time, with lights that will flash when the level becomes hazardous. The data can be downloaded each day to monitor exposures.
Theresa Schulz, hearing conservation manager at Honeywell Safety Products, said many companies, including hers, already have such products. While she sees more large employers expressing interest in these technologies, the cost might be a deterrent for some.
“But when you think about it … the cost of having these electronics to protect the workers is nothing compared to the damage after that,” she said.
Meanwhile, the CDC, as part of its Buy Quiet campaign has an online database of power tools with information about sound levels of different tools, an attempt to encourage businesses to invest in quieter tools and machinery.
Ammon worked for several small construction companies building houses. He said he was never told to wear ear protection. His colleagues didn’t wear it either. No one talked about it and, even when he worked with loud equipment, he wasn’t aware of the need.
“It costs money. That’s my opinion on why it’s gotten as bad as it has, at least for small construction companies,” Ammon said, and the rules are “just not enforced.”
Some of the steps taken by the federal government to move toward tightening regulations and increasing awareness suggest this might be changing. But in the meantime, people like Ammon can face difficulties in getting recognition for their symptoms and financial support.
He applied for Social Security disability benefits but was rejected because his condition was not on the Social Security Administration’s list of medical diseases considered disabling. When he first experienced symptoms, he visited dozens of audiologists who told him he had only slight hearing loss. Research linking hyperacusis — unusual intolerance towards ordinary sounds — and pain was only at its infancy. Specific treatments still are not available for people with this type of hearing damage.
These days, he experiments with new medications or therapies, hoping for more awareness about the illness — and about protecting hearing at the workplace.
“I’m hearing a little more about it, but not nearly enough,” he said. “And it needs to start at the workplace.”
This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.