Hearing aid trial periods: Audiologists' thoughts and practices in South Africa.

The process of adjusting and becoming accustomed to hearing aids may be best facilitated by providing a hearing aid trial period. Globally, there are no standardised frameworks or regulations on the recommended hearing aid trial period. The main purpose of this study was to explore audiologists' hearing aid trialing practices. A cross sectional study employed a quantitative, descriptive design to formulate the study. Ninety-five audiologists' were recruited by means of a purposive sampling strategy. Data were collected through the use of an online survey via Google forms. A pilot study was conducted prior to the commencement of the main study in order to ensure reliability of the main study. The results indicated that two weeks was the most recommended duration of a trial period from audiologists'. Majority of audiologists' (72.63%) offer hearing aid trials to their patients. Most audiologists' who offer hearing aid trials choose to trial their patients with two different hearing aids. Findings revealed a need for trialing periods to become standard practice by audiologists' when fitting hearing aids. Not enough audiologists' are providing this service.

Erratum: Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research.

No abstract available.

In pursuit of best practice through contextually relevant, accountable and responsive research.

No abstract available.

The impact of COVID-19 on speech-language and hearing professions in low- and middle-income countries: Challenges and opportunities explored.

BACKGROUND:  Since the advent of the coronavirus disease 2019 (COVID-19), the speech-language and hearing (SLH) professions globally have been confronted with novel and unexpected challenges. OBJECTIVE:  The aim of this article was to explore the impact of COVID-19 on SLH professions in low- and middle-income countries (LMICs) as presented in the Special Issue of the South African Journal of Communication Disorders in the year 2022. METHOD:  Divergent from the standard editorial writing style, this editorial adopted a research approach where a qualitative, descriptive scoping review design was conducted to meet the objectives of the study. Three specific objectives were targeted: (1) exploring the challenges to SLH research, teaching and practice; (2) establishing evidence-based solutions available for these challenges that can be used to improve the professions' response in the post-pandemic era; and (3) determining the areas that require further investigation, alternative solutions and innovation for improved readiness for future pandemics. A total of 21 manuscripts were reviewed that covered three predetermined themes - research, teaching and practice - that were constructed through a deductive approach as part of the call for papers for the special issue. These manuscripts were from academics, researchers and clinicians from various institutions in LMICs. The review is presented using thematic analysis. RESULTS:  The review raised important challenges, presented under various subthemes, to the three key themes. These challenges reflect on the impact of COVID-19 on the SLH professions in terms of research, teaching, service provision and ethical challenges, as well as its impact on speech language, hearing, swallowing and balance functions. The review also advanced solutions and future directions during and beyond COVID-19. CONCLUSION:  These findings raise global implications for research, teaching and practice that are not only relevant to the SLH professions.

Simulations as a mode of clinical training in healthcare professions: A scoping review to guide planning in speech-language pathology and audiology during the COVID-19 pandemic and beyond.

BACKGROUND:  Simulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes. OBJECTIVES:  The scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLPA) professions during the COVID-19 pandemic and beyond. METHOD:  A scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes. RESULTS:  A total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes. CONCLUSIONS:  Current findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLPA Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLPA, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.

A proposed artificial intelligence-based real-time speech-to-text to sign language translator for South African official languages for the COVID-19 era and beyond: In pursuit of solutions for the hearing impaired.

BACKGROUND:  The emergence of the coronavirus disease 2019 (COVID-19) pandemic has resulted in communication being heightened as one of the critical aspects in the implementation of interventions. Delays in the relaying of vital information by policymakers have the potential to be detrimental, especially for the hearing impaired. OBJECTIVES:  This study aims to conduct a scoping review on the application of artificial intelligence (AI) for real-time speech-to-text to sign language translation and consequently propose an AI-based real-time translation solution for South African languages from speech-to-text to sign language. METHODS:  Electronic bibliographic databases including ScienceDirect, PubMed, Scopus, MEDLINE and ProQuest were searched to identify peer-reviewed publications published in English between 2019 and 2021 that provided evidence on AI-based real-time speech-to-text to sign language translation as a solution for the hearing impaired. This review was done as a precursor to the proposed real-time South African translator. RESULTS:  The review revealed a dearth of evidence on the adoption and/or maximisation of AI and machine learning (ML) as possible solutions for the hearing impaired. There is a clear lag in clinical utilisation and investigation of these technological advances, particularly in the African continent. CONCLUSION:  Assistive technology that caters specifically for the South African community is essential to ensuring a two-way communication between individuals who can hear clearly and individuals with hearing impairments, thus the proposed solution presented in this article.

Application of machine learning approaches to analyse student success for contact learning and emergency remote teaching and learning during the COVID-19 era in speech-language pathology and audiology.

BACKGROUND:  The onset of the COVID-19 pandemic across the globe resulted in countries taking several measures to curb the spread of the disease. One of the measures taken was the locking down of countries, which entailed restriction of movement both locally and internationally. To ensure continuation of the academic year, emergency remote teaching and learning (ERTL) was launched by several institutions of higher learning in South Africa, where the norm was previously face-to-face or contact teaching and learning. The impact of this change is not known for the speech-language pathology and audiology (SLPA) students. This motivated this study. OBJECTIVES:  This study aimed to evaluate the impact of the COVID-19 pandemic on SLPA undergraduate students during face-to-face teaching and learning, ERTL and transitioning towards hybrid teaching and learning. METHOD:  Using course marks for SLPA undergraduate students, K means clustering and Random Forest classification were used to analyse students' performance and to detect patterns between students' performance and the attributes that impact student performance. RESULTS:  Analysis of the data set indicated that funding is one of the main attributes that contributed significantly to students' performance; thus, it became one of the priority features in 2020 and 2021 during COVID-19. CONCLUSION:  The clusters of students obtained during the analysis and their attributes can be used in identification of students that are at risk of not completing their studies in the minimum required time and early interventions can be provided to the students.

South African University Staff and Students' Perspectives, Preferences, and Drivers of Hesitancy Regarding COVID-19 Vaccines: A Multi-Methods Study.

COVID-19 vaccine hesitancy poses a threat to the success of vaccination programmes currently being implemented. Concerns regarding vaccine effectiveness and vaccine-related adverse events are potential barriers to vaccination; however, it remains unclear whether tailored messaging and vaccination programmes can influence uptake. Understanding the preferences of key groups, including students, could guide the implementation of youth-targeted COVID-19 vaccination programmes, ensuring optimal uptake. This study examined university staff and students' perspectives, preferences, and drivers of hesitancy regarding COVID-19 vaccines. A multi-methods approach was used-an online convenience sample survey and discrete choice experiment (DCE)-targeting staff and students at the University of KwaZulu-Natal, South Africa. The survey and DCE were available for staff and students, and data were collected from 18 November to 24 December 2021. The survey captured demographic characteristics as well as attitudes and perspectives of COVID-19 and available vaccines using modified Likert rating questions adapted from previously used tools. The DCE was embedded within the survey tool and varied critical COVID-19 vaccine programme characteristics to calculate relative utilities (preferences) and determine trade-offs. A total of 1836 staff and students participated in the study (541 staff, 1262 students, 33 undisclosed). A total of 1145 (62%) respondents reported that they had been vaccinated against COVID-19. Vaccination against COVID-19 was less prevalent among students compared with staff (79% of staff vs. 57% of students). The vaccine's effectiveness (22%), and its safety (21%), ranked as the two dominant reasons for not getting vaccinated. These concerns were also evident from the DCE, with staff and students being significantly influenced by vaccine effectiveness, with participants preferring highly effective vaccines (90% effective) as compared with those listed as being 70% or 50% effective (ß = -3.72, 95% CI = -4.39 to -3.04); this characteristic had the strongest effect on preferences of any attribute. The frequency of vaccination doses was also found to have a significant effect on preferences with participants deriving less utility from choice alternatives requiring two initial vaccine doses compared with one dose (ß = -1.00, 95% CI = -1.42 to -0.58) or annual boosters compared with none (ß = -2.35, 95% CI = -2.85 to -1.86). Notably, an incentive of ZAR 350 (USD 23.28) did have a positive utility (ß = 1.14, 95% CI = 0.76 to 1.53) as compared with no incentive. Given the slow take-up of vaccination among youth in South Africa, this study offers valuable insights into the factors that drive hesitancy among this population. Concerns have been raised around the safety and effectiveness of vaccines, although there remains a predilection for efficient services. Respondents were not enthusiastic about the prospect of having to take boosters, and this has played out in the roll-out data. Financial incentives may increase both the uptake of the initial dose of vaccines and see a more favourable response to subsequent boosters. Universities should consider tailored messaging regarding vaccine effectiveness and facilitate access to vaccines, to align services with the stated preferences of staff and students.

Quantifying traffic noise pollution levels: a cross-sectional survey in South Africa.

Despite the alarming increase in environmental noise pollution, particularly road traffic noise, in developing countries, there seems to be no awareness regarding the long-term impacts of noise, specifically traffic noise, on the health outcomes of individuals exposed to excessive noise. Additionally, there is a dearth of studies on noise and its effects utilising the pollution modelling technique known as Pollution Standard Index (PSI) to analyse the impact of noise pollution on exposed individuals. The aim of this study was to investigate the noise levels commuters are exposed to and to apply PSI to determine the level of exposure. We conducted a cross-sectional study at two taxi ranks, over 28 days. Eighty-four noise measurements were collected using a sound level meter and a dosimeter at different times of the day and month, peak vs off-peak hours and busy days vs quiet days. Data were collected between April and July 2019. We used the Pollution Standard Index to analyse the data. Noise levels were above the permissible commercial noise levels as they fell within the extremely dangerous noise sensitivity zone as determined by the PSI. Furthermore, the noise levels fell below the WHO maximum permissible level of 90 dB. There was no statistical difference between the means of the open and closed ranks. Dosimeter noise level recordings fell within the satisfactory zone as measurements were below 300 PSI, which is considered unhealthy. There is a need to raise awareness on the dangers and effects of noise pollution in developing countries, as their populations are exposed to road traffic noise.

Rehabilitation healthcare professionals' competence and confidence in differentially diagnosing deafblindness from autism spectrum disorders: a cross-sectional survey in South Africa.

BACKGROUND: Early diagnosis and management of children who are deafblind is important to alleviate the effects of deafblindness on the development of the child who is deafblind and their families. However, children who are deafblind are often misdiagnosed or diagnosed late. The misdiagnosis or late diagnosis has been attributed to many factors, one of which is the competence and confidence of healthcare professionals in differentially diagnosing deafblindness from other conditions, in most cases, autism spectrum disorder (ASD). The study therefore aimed to establish the competence and confidence of rehabilitation healthcare professionals in differentially diagnosing deafblindness from ASD in the South African context. METHODS: A cross-sectional survey design was employed for the study. An online questionnaire was distributed to rehabilitation healthcare professionals (N = 78) via Survey Monkey. Data were analyzed using descriptive and inferential statistics. Ethical clearance and permission were obtained from relevant stakeholders prior to the commencement of the study. RESULTS: Regarding the rehabilitation healthcare professionals in this study, 54% were competent in diagnosing ASD, while only 35% could correctly diagnose deafblindness. In some instances, symptoms were classified as associated with both ASD and deafblindness, when they were just those of deafblindness. Of all the rehabilitation healthcare professionals in this study, speech language therapists displayed the most knowledge of deafblindness. Furthermore, healthcare professionals who had between one and nine years of working experience had more knowledge of deafblindness than other professionals with more or less experience. CONCLUSION: Deafblindness is often underdiagnosed or misdiagnosed as ASD. This is due to the lack of competence and confidence of rehabilitation healthcare professionals in diagnosing it. The findings therefore highlight the need for training of rehabilitation healthcare professionals. Training on deafblindness could be included as part of the curriculum in the various undergraduate programs. Deafblindness could also form part of the Continuous Professional Development (CPD) training programs at various healthcare facilities. A team approach to the training would be ideal as it would facilitate peer learning and support. More research is required as it would inform evidence-based assessment, and management and support strategies for children who are deafblind and their families.

'The world is not only for hearing people - It's for all people': The experiences of women who are deaf or hard of hearing in accessing healthcare services in Johannesburg, South Africa.

BACKGROUND: Despite legal and adopted frameworks purporting access to healthcare and rehabilitation services, which are both a human right and key to developmental issues, women who are deaf and/or hard of hearing (HoH) are still excluded and experience barriers when accessing healthcare services. Largely, this is attributed to communication barriers between healthcare professionals and women who are deaf and/or HoH. There have been limited research studies carried out on women with invisible disabilities, such as deafness, especially amongst African women. OBJECTIVES: This study sought to gain insights into the communication experiences of women who are deaf or HoH when accessing public healthcare services in hospitals in Johannesburg. METHODS: A qualitative research study employing semi-structured interviews with 10 African women who are deaf and/or HoH residing in Johannesburg, South Africa and attending government healthcare facilities was conducted. Participants were purposively selected. Data were analysed using thematic analysis. RESULTS: Data revealed the following themes: communication barriers resulting in compromised quality of care and infringement on participants' right to confidentiality; accommodation that is not accommodative and negative attitudes of healthcare professionals. CONCLUSION: The findings of this study confirm the alienating, exclusion, marginalisation, discrimination, invisibility, lack of independence and autonomy of women who are deaf and/or HoH when accessing healthcare services. Therefore, this study argues for a need for the conscientisation of healthcare professionals on communication needs of persons who are deaf and/or HoH. This has implications for the implementation of training programmes that will address communication, reasonable accommodation and attitudes of healthcare professionals.

Speech-Language Pathology and Audiology in South Africa: Clinical Training and Service in the Era of COVID-19.

INTRODUCTION AND PURPOSE: The novel coronavirus (COVID-19) presented new and unanticipated challenges to the provision of clinical services, from student training to the care of patients with speech-language and hearing (SLH) disorders. Prompt changes in information and communication technologies (ICT), were required to ensure that clinical training continued to meet the Health Professions Council of South Africa's regulations and patients received effective clinical care. The purpose of this study was to investigate online clinical training and supervision to inform current and future training and clinical care provision in SLH professions. METHODOLOGY: A scoping review was conducted using the Arksey and O'Malley (2005) framework. The electronic bibliographic databases Science Direct, PubMed, Scopus, MEDLINE, and ProQuest were searched to identify publications about online clinical training and supervision and their impact on clinical service during COVID-19. Selection and analysis were performed by three independent reviewers using pretested forms. RESULTS AND CONCLUSIONS: The findings revealed important benefits of teletraining and telepractice with potential application to South African clinical training and service provision. Five themes emerged: (1) practice produces favorable outcomes, (2) appreciation for hybrid models of training and service delivery, (3) cost effectiveness is a "big win" (4) internationalization of remote clinical training and service provision, and (5) comparable modality outcomes. These findings may have significant implications for teletraining and telepractice in low-and-middle income countries (LMICs) in the COVID-19 era and beyond, wherein demand versus capacity challenges (e.g., in human resources) persist. Current findings highlight the need for SLH training programmes to foster a hybrid clinical training model. Few studies were conducted in LMICs, indicating a gap in such research.

Factors influencing speech language pathologists' and audiologists' decision to pursue postgraduate studies in South Africa.

BACKGROUND: Factors that influence various professionals to pursue postgraduate studies have been investigated. However, there is a dearth of evidence of factors that influence South African speech language pathologists (SLPs) and audiologists (As) to pursue their postgraduate studies. OBJECTIVE: Therefore, this study aimed to determine factors that influence the decision of South African SLPs and As to pursue postgraduate studies and potential barriers to this pursuit. METHOD: A quantitative survey research methodology with a cross-sectional research design was adopted, where a 21-item web-based survey was used to survey 127 speech therapists, As and speech therapists and As from across the country. All participants were qualified and registered with the Health Professionals Council of South Africa (HPCSA). Ethical clearance and permission from relevant stakeholders were obtained. Data were analysed descriptively. RESULTS: The findings suggested that over half of the participants pursued their postgraduate studies to fulfil a personal goal and improve their knowledge, whilst others did it to develop expertise and for job opportunities. Participants highlighted that a lack of time and funding, heavy workloads and bad experiences during their undergraduate studies were the main barriers to pursuing postgraduate studies. Whilst community service was not a barrier per se, participants felt that it delayed them from beginning their postgraduate studies immediately. CONCLUSION: The findings of this study highlighted the urgent need for institutions of higher learning, government and other stakeholders to provide the necessary support for SLPs and As in South Africa to pursue postgraduate studies.

Occupational noise induced hearing loss in the mining sector in South Africa: Perspectives from occupational health practitioners on how mineworkers are trained.

The aim of this study was to explore the perspectives of occupational health practitioners (OHPs) regarding education and training of mineworkers on occupational noise induced hearing loss (ONIHL) and its impact on mineworkers' health. Qualitative, in-depth telephonic and face-to-face interviews were conducted with 16 OHPs. Purposive and snowball sampling was utilized to recruit participants. Data were analysed using inductive thematic analysis. Three themes emerged from the data: seeing is believing, not my department, barriers and facilitators to raising awareness (with two subthemes -blame it on the language and level of education, and compensation pay-outs). Superficially, OHPs believe that mineworkers are aware of the impact of noise health, however, the OHPs are not knowledgeable on how the mineworkers are educated on ONIHL and its latent consequences. Furthermore, language, low levels of education and literacy, as well as financial constraints are factors found to affect education and training of the mineworkers about the risks of ONIHL. If the mining industry is committed in eliminating ONIHL, they should prioritize health literacy, and mines need to have an effective awareness raising plan in place at every mine. This plan should consider diversity of the workforce, including linguistic as well as educational level diversity.

Engineering noise control for mines: Lessons from the world.

OBJECTIVE: The main objective of this article was to present some of the engineering noise control methods that are currently being used across the world in the mining industry, while at the same time interrogating noise control measures that could be applied to effectively reduce noise emissions from the equipment utilised within South African mines. BACKGROUND: A brief summary of the hearing conservation programmes used in South Africa is presented. Summarised research on the use of engineering noise control in South Africa is also presented, with an overview of the various engineering noise control methods applied across the world in dealing with occupational noise. METHOD: For illustrative purposes, case studies were used to show how engineering noise controls could be used to reduce the noise levels and risks within this context. RESULTS: Some of the case studies used have cited a reduction in the noise intensity emitted by machinery from a range of 93 dBA - 104 dBA to a range of 90 dBA - 94 dBA, demonstrating quite a significant reduction in the noise emission of the equipment. This article further provides recommendations on how South African mines could contextualise these methods. CONCLUSION: One of the key recommendations is encouraging the South African mining industry towards the documenting and publishing of those engineering noise control methodologies that have proven to be effective for shared best practice. A need was identified for extensive research to be conducted and documented evidence to be made available to assist the South African mining industry with locating and assessing current engineering controls available in South Africa. Machines and processes that require noise control should be identified and, lastly, the current barriers to the use of engineering noise control methodologies should be identified, with the main goals of finding ways to overcome the noise challenges in the mines.

Feedback-based noise management matrix in action.

BACKGROUND: This article presents the details and findings of a practical implementation of a preliminary model for use in hearing conservation programmes (HCPs) in the mining sector in South Africa. OBJECTIVES: The implementation is based on a previously published model, called feedback-based noise monitoring model (FBNMM), and represents its implementation as a tool of predicting occupational noise-induced hearing loss (ONIHL), as well as monitoring and managing HCPs in the mining sector within the South African context. METHOD: The article, utilising real miners' data, demonstrates this basic static feedback model with its practical applications such as estimating, monitoring and providing quantitative information to aid miners, mining administrators and policymakers in decision-making around HCPs, as recommended in the previous 2019 publication by Moroe et al. This study was conducted in a South African platinum mine. Evidence on the model's sensitivity and practicability in early identification, intervention and management of ONIHL in the workplace is presented. RESULTS: Findings show how the use of the model within an HCP viewed as a complex intervention can allow for early prediction of ONIHL, consequently affording more accurate early intervention as part of preventive audiology within the health and safety goals of mines. CONCLUSION: The feedback-based model should be a useful tool for successful implementation and monitoring of HCPs within South African mines.

Occupational Hearing loss in Africa: An interdisciplinary view of the current status.

Noise-induced hearing loss is 100% preventable if the collaborative stakeholders in the prevention process are fully committed to the process and implement effective measures timely. Audiologists have within their scope of practice the prevention of hearing loss and this needs to be at the forefront of all advocacy campaigns to prevent occupational hearing loss (OHL). In a systematic review by Moroe, Khoza-Shangase, Kanji and Ntlhakana (2018), where literature into the exposure to occupational noise in developing countries suggested that the prevalence of occupational noise-induced hearing loss (ONIHL) is still high, significant gaps in locally relevant and responsive evidence were identified. There is also evidence that the mining industry is aware of this epidemic; however, the efforts to curb ONIHL are currently unsuccessful. These authors explored and documented current evidence reflecting trends in the management of ONIHL in the mining industry in Africa from 1994 to 2016 through the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Findings from this systematic review indicated that there is a dearth of research on the management of ONIHL in Africa. The limited research on the management of ONIHL focuses on some aspects of the hearing conservation programme pillars and not on all the pillars as suggested by some scholars in the field. Furthermore, they found that published studies had small sample sizes, thereby minimising their generalisation. This systematic review's findings highlighted a need for more studies on the management of ONIHL in the mining sector, as evidence suggests that this condition in African countries is still on the rise; hence, there is the importance of this Special Issue, based on South Africa.

South African hearing conservation programmes in the context of tele-audiology: A scoping review.

BACKGROUND: The limited involvement of audiologists in occupational noise-induced hearing loss (ONIHL) management through hearing conservation programmes (HCPs) is a global issue. In low- and middle-income (LAMI) countries such as South Africa, this is also exacerbated by demand versus capacity challenges. Tele-audiology is an option requiring serious deliberation by the audiology community within HCPs in LAMI contexts. OBJECTIVES: This scoping review explores if tele-audiology has a potential value in HCPs and reviews what has been documented in the literature on the use of tele-audiology in HCPs. METHOD: A scoping review was conducted using the Arksey and O'Malley's framework. A search was conducted in five electronic bibliographic databases including Science Direct, PubMed, Scopus Medline, ProQuest and Google Scholar and the grey literature to identify publications presenting considerations around tele-audiology in the implementation of HCPs. RESULTS: Findings revealed significant dearth of evidence specific to the use or application of tele-audiology in ONIHL and/or HCPs both within the African context and internationally, despite the purported potential benefit of this service delivery model, particularly in resource-constrained contexts such as LAMI countries. Of the publications deemed potentially relevant to this scoping review, none were found that specifically investigated or addressed the use of tele-audiology in ONIHL or HCPs as their main objective. Nuanced analysis of publications revealed that in the last decade, indication for potential growth in the use of tele-audiology within occupational audiology is indicated. CONCLUSION: Because of the significant demand versus capacity challenges in LAMI countries, and because of the need for scaling up audiology professionals' management of HCPs, careful consideration of teleaudiology as a platform to deliver services in these contexts is required.

Risk versus benefit: Should not audiologists assess this in the context of occupational noise-induced hearing loss in the mining industry?

BACKGROUND: Hearing conservation programmes (HCPs) are an important aspect of occupational health efforts to prevent occupational noise-induced hearing loss (ONIHL). In low- and middle income (LAMI) countries, where the incidence of ONIHL is significant, it is important to deliberate on the risk or benefit of HCPs. OBJECTIVES: This article is an attempt at highlighting important strategic indicators as well as important variables that the occupational health and audiology community need to consider to plan efficacious HCPs within the South African mining context. METHOD: The current arguments are presented in the form of a viewpoint publication. RESULTS: Occupational audiology vigilance in the form of engagement with HCPs in the mining industry has been limited within the South African research and clinical communities. When occupational audiology occurs, it is conducted by mid-level workers and paraprofessionals; and it is non-systematic, non-comprehensive and non-strategic. This is compounded by the current, unclear externally enforced accountability by several bodies, including the mining industry regulating body, with silent and/or peripheral regulation by the Health Professions Council of South Africa and the Department of Health. The lack of involvement of audiologists in the risk or benefit evaluation of HCPs during their development and monitoring process, as well as their limited involvement in the development of policies and regulations concerning ear health and safety within this population are probable reasons for this. CONCLUSIONS: Increased functioning of the regulatory body towards making the employers accountable for the elimination of ONIHL, and a more central and prominent role for audiologists in HCPs, are strongly argued for.

Recent advances in hearing conservation programmes: A systematic review.

BACKGROUND: Current evidence from low- and middle-income (LAMI) countries, such as South Africa, indicates that occupational noise-induced hearing loss (ONIHL) continues to be a health and safety challenge for the mining industry. There is also evidence of hearing conservation programmes (HCPs) being implemented with limited success. OBJECTIVES: The aim of this study was to explore and document current evidence reflecting recent advances in HCPs in order to identify gaps within the South African HCPs. METHOD: A systematic literature review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Electronic databases including Sage, Science Direct, PubMed, Scopus MEDLINE, ProQuest and Google Scholar were searched for potential studies published in English between 2010 and 2019 reporting on recent advances in HCPs within the mining industry. RESULTS: The study findings revealed a number of important recent advances internationally, which require deliberation for possible implementation within the South African HCPs context. These advances have been presented under seven themes: (1) the use of metrics, (2) pharmacological interventions and hair cell regeneration, (3) artificial neural network, (4) audiology assessment measures, (5) noise monitoring advances, (6) conceptual approaches to HCPs and (7) buying quiet. CONCLUSION: The study findings raise important advances that may have significant implications for HCPs in LAMI countries where ONIHL remains a highly prevalent occupational health challenge. Establishing feasibility and efficacy of these advances in these contexts to ensure contextual relevance and responsiveness is one of the recommendations to facilitate the success of HCPs targets.