Hearing Loss Among World Trade Center Firefighters and Emergency Medical Service Workers

Flamme, Gregory A.; Goldfarb, David G.; Zeig‐Owens, Rachel; Hall, Charles B.; Vaeth, Brandon M.; Schwartz, Theresa; Yip, Jennifer; Vossbrinck, Madeline; Stein, Cheryl R.; Friedman, Liza; Cone, James E.; Prezant, David J.

doi:10.1097/jom.0000000000001717

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…Firefighters are often exposed to sirens, air horns, and engine noise. According to previous studies, wearing personal protective equipment (PPE) was associated with reduced incidence of NIHL ( 18 ) and stated that wearing PPE was necessary to reduce noise exposure ( 19 ). In the case of IHD, firefighters had a higher risk of developing cardiovascular disease than general workers; this result is consistent with that of a previous study ( 20 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data

Lee

Lee²,

Nam³

et al. 2023

Front. Public Health

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ObjectivesNational Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters.MethodsThe observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants.ResultsThe standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group.ConclusionsThe standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.

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Section: Discussionmentioning

confidence: 99%

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data

Lee

Lee²,

Nam³

et al. 2023

Front. Public Health

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“…The specific nature and causes of hearing loss among World Trade Center survivors remain to be determined. Analysis of pre- and post-9/11 audiograms among New York City Fire Department workers involved in health surveillance has been recently published [4]. However, similar surveillance pre- and post-disaster is missing for survivors.…”

Section: Discussionmentioning

confidence: 99%

“…A Fire Department of the City Of New York (FDNY) study found that firefighters and emergency medical service workers who were the most exposed to the WTC disaster had greater odds of persistent ear symptoms [3]. An analysis of medical surveillance audiometry data for FDNY firefighters and emergency medical service workers found that FDNY responders with high levels of exposure to the WTC rescue and recovery operations were at greater risk of reductions in hearing sensitivity persisting over the subsequent fifteen years, even after adjusting for aging [4].…”

Section: Introductionmentioning

confidence: 99%

Persistent Hearing Loss among World Trade Center Health Registry Residents, Passersby and Area Workers, 2006–2007

Cone

Stein

Lee

et al. 2019

IJERPH

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Background: Prior studies have found that rescue and recovery workers exposed to the 9/11 World Trade Center (WTC) disaster have evidence of increased persistent hearing and other ear-related problems. The potential association between WTC disaster exposures and post-9/11 persistent self-reported hearing problems or loss among non-rescue and recovery survivors has not been well studied. Methods: We used responses to the World Trade Center Health Registry (Registry) enrollment survey (2003–2004) and first follow-up survey (2006–2007) to model the association between exposure to the dust cloud and persistent hearing loss (n = 22,741). Results: The prevalence of post-9/11 persistent hearing loss among survivors was 2.2%. The adjusted odds ratio (aOR) of hearing loss for those who were in the dust cloud and unable to hear was 3.0 (95% CI: 2.2, 4.0). Survivors with persistent sinus problems, headaches, PTSD and chronic disease histories had an increased prevalence of reported hearing problems compared to those without symptoms or chronic problems. Conclusions: In a longitudinal study, we observed an association between WTC-related exposures and post-9/11 self-reported hearing loss among disaster survivors.

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“…Other audiologists, organizations and regulatory agencies do not consider hearing to be “abnormal” or “recordable” for compliance purposes until at least one frequency or an average of frequencies (i.e., 2, 3, and 4 kHz) is ≥25 dB. Various arbitrary definitions of NIHL have been published, for example, ≥25 dB at one or more frequencies 41 or ≥20 dB for either ear at 1, 2, 3, and 4 kHz, 42 but none has been universally validated or adopted. Control data: Regulated companies are not required to collect nonexposed (i.e., “control”) audiometric data. Few, if any companies, therefore, do so—particularly because of cost concerns and potentially unwanted liability.…”

Section: Audiometric Data Interpretationmentioning

confidence: 99%

“…Nonoccupational or toxicological factors: The effect or contribution of sources of nonoccupational noise (e.g., firearms, loud music, motorcycles, lawnmowers, power equipment), lifestyle behaviors (e.g., cigarette smoking), or (uncommon) oto‐toxicant exposures (occupational or nonoccupational) cannot be quantitatively distinguished from occupational sources in their relative contribution to general or specific causation or progression of work‐related NIHL 42,44 …”

Section: Audiometric Data Interpretationmentioning

confidence: 99%

Audiometric data analysis for prevention of noise‐induced hearing loss: A new approach

Craner

2022

American J Industrial Med

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Compliance with noise regulations in the past three decades has significantly reduced workplace noise exposures, particularly in the loudest industries and occupations. However, the overall effectiveness of hearing conservation programs in preventing occupational noise‐induced hearing loss remains uncertain and unquantified, while the incidence and cost of occupational hearing loss remain inexplicably high. This review/commentary critically explores this paradox by examining why the billions of annual audiograms conducted worldwide have not been aggregately utilized or applied to predict early NIHL in groups of workers or to measure the efficacy of exposure controls. Principal contributory reasons include regulation of noise as a safety standard rather than as a health standard, the inherent complexity of audiometric data, and the lack of a standardized method of interpretation for audiograms. The unsuccessful history of efforts to develop and adopt methods and tools to analyze aggregate audiometric data is described. Consequently, the Standard Threshold Shift—a regulatorily defined, lagging indicator of individual, irreversible hearing loss that is not an effective preventive metric—remains the de facto standard of care. A population‐based Best Practices approach is proposed to leverage the raw audiometric data already available and turn it into actionable data for effective secondary prevention to strategically manage and reduce occupational hearing loss risk. This approach entails statistical methods and information management tools necessary to transform audiometry from a compliance‐driven, individual screening test with limited preventive capability into a medical surveillance process directly linked to aggregate corrective and prevention actions.

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Hearing Loss Among World Trade Center Firefighters and Emergency Medical Service Workers

Cited by 6 publications

References 18 publications

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data

Persistent Hearing Loss among World Trade Center Health Registry Residents, Passersby and Area Workers, 2006–2007

Audiometric data analysis for prevention of noise‐induced hearing loss: A new approach

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