The impact of hearing impairment on work: Results from the Netherlands Longitudinal Study on Hearing Mariska Stam, PhD Österreichische Gesellschaft für Arbeitsmedizin September 29 th, 2017
Impact of hearing impairment on adult life Dept. of Otolaryngology Head and Neck Surgery VUmc Audiology Center Research group: Ear & Hearing - prof. Sophia Kramer 1
Prevalence of hearing loss Worldwide 360 million people with disabling hearing loss 12 % 9 % Dutch 18+, population difficulty hearing Dutch people in labour force, exposed to hazardous noise levels 225.000 Dutch people in labour force, problems with hearing 2
More numbers USA: 5-10% communication disorders Employment rate Total population People with hearing loss USA 75 % 64 % Australia 81 % 72 % Austria Male: 75% Female: 65%? Denmark: 30 % of hearing impaired adults (20 35 years) unemployed compared to 12 % among all - in that age group Sweden: 12 % of early retirement group (20 65 years) is hearing impaired wheares the proportion of hearing impaired in general pupulation is 5.4 % 3
Hearing impairment and work Large body of literature on risk-factors for noise induced hearing loss & prevention strategies Occupation Health?! How affects hearing impairment individual s performance at work? 4
Workplace = challenging environment Group conversations Disturbing sounds Bad acoustics Localisation of sounds Detection of sounds Discrimination of sounds BACKGROUND NOISE It is all about the signal-to-noise ratio! 5
Netherlands Longitudinal Study on Hearing 6
Hearing ability in noise Hearing Test over the Internet Speech-reception threshold (SRT) corresponding to 50% intelligibility in stationary noise, as measured with the National Hearing Test Smits et al., 2004; Smits et al., 2006 Digit-triplet speech-in-noise test 23 triplets - adaptive procedure 7
Focus areas in our study 1. Hearing status, hearing assistive technologies 2. Psychosocial health 3. Chronic conditions, health care, and medication use 4. Participation in work & work performance Included online questionnaires, for instance: Job Content Questionnaire (JCQ) Health Performance Questionnaire (HPQ) Need for recovery after work-scale 8
Todays focus Study 1 Study 2 Study 3 9
Study 1: Reported categories of work % 10
Differences in participation in work Adults (18-64 yr) with poorer hearing ability have significantly: less often paid work more often unemployed, or unfit for work But.. are not more often participating in voluntary or household work, or being early retired Stam et al. 2013, WORK: Journal of Work, Prevention and Rehabilitation 11
Functioning at work Demands versus capacity, at various levels Effort and concentration Fatigue Uncertainty / Suspiciousness Feeling unsafe Feeling stupid / incapable Lack of information Lack of understanding Frustration about unawareness WORKPLACE PROFILE AUDITORY PROFILE 12
Study 2: Need for recovery In general, it takes me over an hour to feel fully recovered after work At the end of the day I am really feeling worn out Job demand model (Karasek & Theorell, 1990) Work characteristics Short term effects Long term effects Job demand Job control Need for recovery Hearing? Sick leave Nachtegaal et al. 2009 Int. Journal of Audiology Significant association: Per db worsening in hearing 9% higher risk for NFR 13
db SNR Study 3: Hearing decline during working life From age 50 onwards, increase in % of people reporting hearing difficulties Decline 1 in hearing ablity in noise, compared to 18-39 yr olds 0,8 0,6 0,4 0,2 0 0.65 0.46 0.18 40-49 yr 50-59 yr 60-69 yr NL-SH results (N=427) Acceleration in in hearing decline around the age of 50 Stam et al. 2015 Ear and Hearing Higher risk on emotional and social loneliness Stam et al. 2016 Ear and Hearing 14
To summarize People with hearing impairment are a vulnerable group Participation in paid work Need f or recovery Sick leave Monitoring their need for recovery at work may be important as a preventive measure Stakeholdes should be aware that (the development of) hearing difficulties may the underlying cause of need for recovery!! 15
Hearing@Work Rehabilitation Vocational Enablement Protocol = maintaining, facilitating, and improving the employment situation of employees with hearing impairment Multi-level & multidisciplinary hearing health care at VUmc: Evaluation of the problem from various perspectives Diagnostic examination of hearing status Recommendations (multidisciplinary) Written report 16
Interventions to facilitate occupational performance: Intervention Professional MEDICAL Medical examination E.N.T physician AUDIOLOGICAL, TECHNICAL Hearing aids Assistive listening devices Acoustics Audiologist SPEECH-THERAPEUTICAL Speech reading Communication strategies Speech Therapist PSYCHOSOCIAL Person with loss (coping) Significant others (collegues) Social worker AT WORK Providing control Adjustment of the environment Adjustment of job tasks Occupational Physician 17
Multifactorial understanding: ICF HEALTH CONDITION Hearing impairment BODY FUNCTION Hearing loss ACTIVITY Detection of sounds Identification of sounds Speech comprehension in quiet Speech comprehension in noise Localization of sounds PARTICIPATION Participation in work ENVIRONMENTAL FACTORS Room acoustics Context (furniture, light, machines) Tasks / Function / Demand / Control / Supervisor / Colleagues PERSONAL FACTORS Age Education Coping styles Cognitive abilities 18
Take home messages Most important issues at the workplace: Signal-to-noise ratio Higher need for recovery Job demands, job control Evidence that a multifactorial approach, e.g. audiological, psychosocial, and work-related solutions, is effective Continuation of participation in work now and into the future 19
Thanks for your attention Netherlands Longitudinal Study on Hearing (NL-SH) For more information: Co-projectleader: E-mail: Project leader: Our website: Mariska Stam, PhD mari.stam@vumc.nl prof. Sophia Kramer, PhD www.ac-vumc.nl/research NL-SH is financially supported by Heinsius Houbolt Foundation, Phonak AG, Switzerland, and the EMGO+ Institute