Types of Hearing Loss

hearing loss

Source: Better Hearing Institute

A comprehensive audiologic evaluation must be completed in order to determine the types and severity of hearing loss to make appropriate recommendations for each patient. Pure tone and speech audiometry as well as the immittance test battery must be completed, in addition to any additional assessments necessary for an exhaustive profile of the hearing system. A balance test called electronystagmography (ENG) might also be needed if dizziness or imbalance is also a complaint. Some patients who are bothered by tinnitus only might have a complete tinnitus evaluation. Finally, the audiologic data provides a clinical foundation for recommendations on hearing aids and other assistive devices suitable for treating the types of hearing impairments listed below.

In general terms, there are two types of hearing loss, conductive and sensorineural. A combination of both is also seen as a mixed hearing loss. Each is discussed below.


Conductive Hearing Loss

Conductive hearing loss is caused by any condition or disease that impedes the conveyance of sound in its mechanical form through the middle ear cavity to the inner ear. A conductive hearing loss can be the result of a blockage in the external ear canal or can be caused by any disorder that unfavorably effects the middle ear’s ability to transmit the mechanical energy to the stapes footplate. This results in reduction of one of the physical attributes of sound called intensity (loudness), so the energy reaching the inner ear is lower or less intense than that in the original stimulus. Therefore, more energy is needed for the individual with a conductive hearing loss to hear sound, but once it’s loud enough and the mechanical impediment is overcome, that ear works in a normal way. Generally, the cause of conductive hearing loss can be identified and treated resulting in a complete or partial improvement in hearing. Following the completion of medical treatment for cause of the conductive hearing loss, hearing aids are effective in correcting the remaining hearing loss.

The audiometric profile that indicates a conductive hearing loss is the presence of air-bone gaps (better hearing by bone conduction than by air conduction), excellent word recognition at a comfortable listening level, and evidence of a middle ear dysfunction on immittance. For situations where a blockage is noted in the external ear canal, hearing testing is deferred until the canal is cleared.

See full article here.

Too Much Noise: Bad for Your Ears and for Your Heart


Source: Better Hearing Institute

We’ve long known that too much noise — too loud and for too long — damages our ears and our ability to hear.

But did you know that it also may pose a risk to your heart?

That’s right. A growing body of research shows that people with long-term exposure to loud noise may be more likely to develop heart disease.

So what else do our heart and ears have in common?

Many studies show a tie between cardiovascular disease and hearing loss. In fact, researchers from Wichita State University conducted an analysis of 84 years of work from scientists worldwide on the connection between cardiovascular health and the ability to hear and understand what others are saying. Their work, which reviewed 70 scientific studies, confirmed a direct link.

In a separate study, researchers went as far as to conclude that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.

“The inner ear is so sensitive to blood flow that it is possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body,” according to David R. Friedland, MD, PhD, Professor and Vice-Chair of Otolaryngology and Communication Sciences at the Medical College of Wisconsin in Milwaukee, as quoted in a 2015 BHI press release.

See entire article here.

NC Posting of Injury and Illness Summary Required

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Employers must post OSHA Form 300A: Summary of Work-related Injuries and Illnesses
By Neal O’Briant, Public Information Officer, NC DOL.

Employers are reminded that they must post a summary of work-related injuries and illnesses that occurred in 2015.  The N.C. Department of Labor requires the summary be posted from Feb. 1 through April 30.

Many employers must keep a Log of Work-Related Injuries and Illnesses (Form 300) to record work-related fatalities, injuries and  illnesses. The Summary of Work-Related Injuries and Illnesses (Form 300A) is compiled from the data on the log. Companies without  any injuries and illnesses should post the summary with zeroes on the total lines. A company executive must certify that they have  examined the OSHA 300 Log and that they reasonably believe that the annual summary is correct and complete.

“This posting requirement is an important way employers keep their employees informed about safety and health conditions in the workplace,” said Wanda Lagoe, bureau chief of the Education, Training and Technical Assistance Bureau.  Companies that had 10 or fewer employees at all times during the previous calendar year are exempt from keeping injury and illness logs and posting summaries. Certain businesses classified in specific low-hazard industry classifications are also exempt from keeping injury and illness logs and posting summaries unless requested to do so for survey purposes. The list of exempt industries changed effective Jan. 1, 2015.

For more information about recording criteria or for a list of exempt industries, contact the Education, Training and Technical Assistance Bureau at 1-800-625-2267 or locally at 919-807-2875. The OSHA 300/300A 301 are available in Workplace Applications software.

To download a free copy of the OSHA 300, OSHA 300A or OSHA 301, as well as recordkeeping instructions, visit our website at www.nclabor.com, click on the Publications tab, then click on the Forms link. The list of exempt industries is also available here.


Earphones Used on Monitor Audiometers v.2

Monitor-headset Monitor-TDH29

James J. Jerome, Senior Occupational Audiologist

I recently calibrated a Monitor MI-5000B and noticed that Telephonics TDH-39 earphones were being used. I found this strange, since, in my experience, all Monitor audiometers exclusively use Telephonics TDH-49 earphones.

I contacted Van Anderson, President of Monitor Instruments, and asked him if they had dropped using TDH-49 earphones. His answer was no. At times TDH-49 earphones can be in short supply. If they cannot find other supply sources for TDH-49 earphones, Monitor will use TDH-39 earphones until TDH-49 earphones become available again.

Does this alternate earphone have an impact on the performance of Monitor audiometers? The answer is no, since the earphones are calibrated to ANSI audiometer standards. All things equal, they will yield the same hearing threshold levels as TDH-49 earphones.

Can either TDH-39 or TDH-49 earphones be calibrated to Monitor audiometers? The answer is yes and no. Mr. Anderson stated that Monitor audiometer firmware version 9.23 has the best output latitude to accommodate both models of earphones. For lesser firmware versions, TDH-39 earphone may be used, but it’s best to contact Monitor Instruments to discuss feasibility before proceeding.

How does this impact the customer? This does not impact the customer in any way. They can be assured that Monitor audiometers will perform as specified.

How does this impact service providers who distribute and calibrate audiometric equipment? If the technician is calibrating the same Monitor audiometer year after year, there should be no problem in knowing what model earphone is being used. However, if a new Monitor audiometer is ordered for a customer and that audiometer is calibrated to TDH-39 earphones, distributors will be given the choice of taking possession or deferring possession until the TDH-49 earphone becomes available again. If a customer states that they just acquired a new Monitor audiometer, technicians will need to pay attention to the model earphone being used and calibrate accordingly. Mr. Anderson stated that TDH-49 earphones will always be the preferred earphone for their Monitor audiometers. Thus, few audiometers will ever be using the TDH-39 earphones.  Regardless, anyone who calibrates Monitor audiometers will need to be vigilant.


OSHA penalties – after 25 years there will be an increase

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Source: lexology.com

The new two-year bipartisan budget, signed by President Obama on November 2, 2015, allows (in fact requires) OSHA to raise its citation penalties for the first time in 25 years.  Since 1990, OSHA has been one of only three federal agencies that were specifically exempted from a law that required federal agencies to raise their fines to keep pace with inflation.  A section of the budget bill—entitled the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015—eliminates this exemption for OSHA.

The law now requires an initial penalty “catch-up adjustment,” which must be in place by August 1, 2016. The catch-up adjustment is tied to the percentage difference between the October 2015 Consumer Price Index (CPI) and the October 1990 CPI.  Because the October 2015 CPI will not be available until November 17, 2015, the actual percentage increase is unknown at this time. However, based on recent CPI, the increase will likely be in the range of 75% to 80% over current penalty amounts.

Read full article here.

Workplace INTEGRA Mobile Units on the road!

WPI Mobile Unit 15 on the road in KY- Jan 2016
WPI Mobile Unit 15 on the road in KY-


Pictured is one of Workplace Integra’s Mobile Units in KY, January 2016.  The Van Technician looks at a slight delay caused by Winter Storm Jonas.    He cleaned off the van and arrived on-time at the clients site, ready to test!

Contact us for your mobile testing needs.

Mobile Services




Leisure Noise and the Hearing Health of Young People


Source: Williams, Warwick PhD
The Hearing Journal, Volume 68, Issue 12, pp 28, 30

The possibility of leisure activities—especially listening to music on portable music players—causing hearing loss in young people never fails to excite the press. The many stories on this topic seem to reflect genuine concern in the population about this issue.

As this article by Warwick Williams, PhD, shows, however, this concern does not seem well founded for nearly all young people. This is not to say that leisure noise cannot cause hearing loss, but it certainly does not seem to be very common.

There are two caveats: First, recent analysis of the extensive data discussed by Dr. Williams has shown a significant relationship between total leisure-induced noise exposure and the occurrence of tinnitus, so it seems that noise exposure is indeed having some effects on the ears of some young people, even if it is not reflected in their hearing thresholds. These effects seem to occur even with accumulated noise doses much lower than those that would occur in a workplace with average daily levels of 85 dBA.

Second, the study that Dr. Warwick describes was carried out before we realized the importance of looking for the symptoms of “hidden hearing loss”—the loss of high-threshold nerve fibers that have no effect on hearing thresholds but probably contribute to the accurate analysis of sound at moderate or high noise levels. A new, large-scale study is now under way to explicitly look for these symptoms, one of which may well be an increased prevalence of tinnitus.

Although the study was done on an Australian population, ears are the same everywhere, and the types of devices that people use for music are international, so it seems likely that the results would apply to other populations. If so, then the safety message we have so far for other countries is that the most dangerous leisure noise activities seem to be dance parties.

For just a very small proportion of young people, the combination of high sound levels and exposures of several hours per outing repeated weekly for several years is certainly sufficient to provide noise exposure sufficient to damage hearing, even if the number who receive this much exposure is small.

—Harvey Dillon, PhD


National Acoustic Laboratories

See full article here.



Teen Invents Headphones That Prevent Hearing Loss


By Conner Carey on Sun, 10/04/2015

Aegis Acoustics headphones were designed by 16-year-old Kingsley Cheng as a stylish-but-safe way listen to music. “The American Academy of Audiology reports that approximately 12 percent of all children ages 6–19 have noise-induced hearing loss. We’re here to change all that and make listening safe,” said Kingsley in a recent press release.

Together with his father, Rayman Cheng, who has over 25 years of experience in consumer electronics, Kingsley founded Aegis in an effort to make headphones that look good and feel good. Their headphones ensure your volume remains in safe decibel range (under 85dB) while utilizing noise cancelling technology to provide clarity.

See full article here.

Afraid of Shark Attacks? Selfies Are Deadlier


By Conner Carey on Wed, 09/23/2015

Next time you go to take a selfie, make sure your life isn’t in danger first. According to the Telegraph, there have been 12 selfie deaths in 2015 alone. Compare that number to the eight people who were killed by a shark. Is this what Darwin meant by survival of the fittest?

In July, a woman was killed by a bison when she tried to pose for a selfie with it. In January, three students died by oncoming train when trying to take a “daredevil” photo. A man in California was hospitalized for five days after snapping a picture with a rattlesnake. There’s even a Wikipedia page listing selfie-related injuries and deaths. Meanwhile, selfie deaths are rampant enough in Russia that the government released a guide on “how not to die while taking a picture of yourself”.

See full article here.