Development and evaluation of hearing conservation program among vector control workers / Rama Krishna Supramanian
Noise-induced hearing loss (NIHL) is one of the highest recorded occupational disease despite being preventable. In 2018, occupational noise-induced hearing loss was the highest reported occupational disease experienced by workers in Malaysia accounting for 87.7% of all occupational diseases....
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| Format: | Thesis |
| Published: |
2020
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| Online Access: | http://studentsrepo.um.edu.my/13281/4/rama.pdf http://studentsrepo.um.edu.my/13281/ |
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| Institution: | Universiti Malaya |
| Summary: | Noise-induced hearing loss (NIHL) is one of the highest recorded occupational disease
despite being preventable. In 2018, occupational noise-induced hearing loss was the
highest reported occupational disease experienced by workers in Malaysia accounting for
87.7% of all occupational diseases. The aim of this study is to develop, implement and
evaluate the effectiveness of a Hearing Conservation Program (HCP) in preventing noise�induced hearing loss among vector control workers. This study is divided into two phases:
development of HCP (phase 1) and implementation and evaluation of HCP (phase 2). The
development phase (phase 1) included a review, interview with key stakeholders and
reviewing local and international guidelines. In phase 2, the HCP was implemented and
evaluated using a cluster-randomized controlled trial design. A total of 183 vector control
workers from nine district health offices in the state of Perak, Malaysia were randomized
to intervention or control group. The multifactorial intervention included noise exposure
monitoring, noise control, proper use of hearing protection devices, training and
education session, audiometric testing and hazard communication. Three strategies for
NIHL prevention were identified from the review: championed by leaders, one-off
training and multifactorial intervention (combination of multiple strategies). The mean
age of the participants were 37.7 and 36.6 years old in the intervention and control group
respectively. The majority of participants in both groups were males, Malay ethnicity,
and general workers with a highest education level of secondary education. The baseline
mean hearing threshold observed for the grouped frequencies (2, 3 and 4 kHz) was higher
among the intervention group (24.9 dB) compared to the control group (16.1 dB) for the
left ear. Similar trends were observed for the right ear with 23.6 dB (intervention) and
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14.8 dB (control). As for the grouped frequencies (0.5, 1, 2 and 3 kHz) the intervention
group also showed higher mean hearing threshold compared to the control group with
20.8 dB (left ear) and 22.1 dB (right ear). The baseline mean score for knowledge, attitude
and practice score towards NIHL was 77.8, 75.1 and 62.9 for intervention group while
the control group participants averaged 73.5, 70.7 and 71.2. After 3 months, the
intervention group showed a greater reduction (0.06 dB reduction) in mean hearing
threshold in the left ear for the grouped frequencies (2, 3 and 4 kHz). As for the grouped
frequencies (0.5, 1, 2 and 3 kHz) both intervention and control group showed a reduction
in mean hearing threshold of 1.4 dB and 2.6 dB respectively for the left ear. There was
also a greater improvement in the mean score for knowledge, attitude and practice
towards noise-induced hearing loss (NIHL) in the intervention group as compared to the
control group but were not statistically significant. The HCP has shown to be effective in
preserving hearing of vector control workers as well as improving their knowledge,
attitude and practice towards NIHL.
Trial registration: TCTR20190109002
Funding: University of Malaya Grand Challenge (PEACE) (GC001A-14HTM)
Keywords: noise-induced hearing loss, vector control worker, occupational exposure
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