Current Medical Exantination Practiees for the Determination of Occupational Noise Induced Hearing Losses / 대한산업의학회지

ABSTRACT

Occupational hearing loss became the leading occupational disease by constituting 56% of all work-related diseases in Korea. However, the prevalence rates showed wide variations among the specific medical examination providers (SHFEPs) and were very low (0.8-1.4%) compared with those of 8.4% in Japan. This study was designed to identify sources of these variations by inyestigating current audiometric testing methods and the diagnostic criteria utilized by the ShfEPs. A questionnaire was distributed to each of 27 SMEPS selected from total 70 SMEPS. Among them, 20 ShfEPs were interviewed and the rest of them were given the questionnaire from by mail. Included in the survey from were questions concerning audiometric testing methods and procedure equipment, facility personnel and the diagnostic criteria utilized, The results were as follows 1. Employee audiometric testings were primaTily conducted by nurses and nurse-aids who had formal training for audiometry because no training program had been established. No requirement about the quality of audiometric testing personnel was specified in the regulation. 2. Although audiometric testing equipment used by the SDfEPs should be periodically calibrated, a significant number of them were not properly calibrated. Most of the calibration services were provided by the outside contractors and were done with no uniformly established periods. No SMEPS conducted the daily functional calibration. Most of the ShfEPs did not keep their calibration records. 3. Initial audiometric testings were conducted at any available spaces in the workplace or at the testing room without considering noise level in that place. Follow-up audiometric testings were also provided without considering the worker's noise exposure. Although audiometric booths were used during tHe follow-up testinga most of them did not meet the ANSI noise reauirement for audiometric booths. 4. AltHough a standard diagnostic criterion was promulgated in the law, the criterion was not used uniffrmly by the SMEPs. In addition, some SMEPS were applying age corrections which were not incorporated into the regulation yet. Therefore wide range of prevalence in NIHU among SMEPS could have possibly been caused by variable audiometric testing procedures and methods. In conclusion, it was recommended that systematical and general measures, such as formal and regular training program for testers, quality control regulation of instnlment calibration, and establishment of standard diagnostic criteria, be established for solving current problems and assuring equity among SMEPs in diagnosing occupational hearing losses.