User:Chad.bailey/sandbox

''Occupational hearing loss (OHL) is hearing loss that occurs as a result of occupational hazards, such as excessive noise and ototoxic chemicals. OHL OHL, damage to one or both ears from exposures related to one's occupation, is a prevalent occupational concern in various work environments worldwide (added citation). Organizations such as the Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) and the Mine Safety and Health Administration (MSHA) work with employers and workers to reduce or eliminate completely hazards to hearing occupational hearing hazards through a hierarchy of hazard controls. OHL Occupational hearing loss is one of the most common work-related illness in the United States (changed citation to direct citation). Hazards to the hearing of workers Occupational hearing hazards include industrial noise, and exposure to various ototoxic chemicals. Combined exposure to both industrial noise and ototoxic chemicals may cause more damage than either one would by itself (added citation). Many chemicals have not been tested for ototoxicity, so unknown threats may exist.''

Background
'' OHL Occupational hearing loss is defined as damage to either or both ears, at the inner ear or auditory nerve any type of hearing loss, i.e. sensorineural, conductive, or mixed hearing loss, that occurs due to hazardous characteristics of a work environment. The hearing loss can range in severity from mild to profound (added citation). Hazards of a work environment that can result in OHL include excessive noise, ototoxic chemicals, or physical trauma (re-used added citation). OHL caused by excessive exposure to noise is also known as noise-induced hearing loss, or NIHL. Noise exposure combined with ototoxic chemical exposure can result in more damage to hearing. OHL caused by physical trauma may include foreign bodies in the ear, vibration, barotrauma, or head injury. Although high levels of noise are the main cause of occupational hearing loss  (also called noise-induced hearing loss) there are also other factors in the work environment that can result in it.Chemicals, foreign bodies, vibration,  barotrauma, along with other hazards can result in hearing loss. These losses that these workers obtain, affect many aspects of their life, mainly social interactions OHL, as well as hearing loss in general, can cause negative secondary social and emotional effects that can impact quality of life. (added last two citations) ''

''Within the United States of America, approximately 10 million people have noise-related hearing loss NIHL. Over twice that number are occupationally exposed to dangerous noise levels. Hearing loss accounted for a sizable percentage of occupational illness in 2007, at 14% of cases. As in many countries, in the US United States organizations such as the Occupational Safety and Health Administration (OSHA) OSHA, and the National Institute for Occupational Safety and Health (NIOSH) NIOSH, and MSHA are working to understand the causes of occupational hearing loss and how it can be prevented while providing They work to produce regulations and guidelines to help protect the hearing of workers in all occupations. ''

Prevention
'' Several methods of prevention exists to eliminate or reduce the hearing loss caused by workplace exposure. OHL is very preventable, but currently the interventions to prevent noise-induced hearing loss NIHL are complex, having many of the components described above. A 2017 Cochrane review found that hearing loss prevention programs revealed that stricter legislation might reduce noise levels. Hearing protection devices, such as earmuffs and earplugs can reduce noise exposure to safe levels, but, instructions are needed on how to put plugs into the ears correctly to achieve potential attenuation. Giving workers information on their noise exposure levels by itself was not shown to decrease noise. Engineering solutions might lead to similar noise reduction as that provided by hearing protection. Better evaluation of the noise exposures resulting from engineering interventions is needed, as most of the available information is limited to observations in laboratory conditions. Overall, the effects of hearing loss prevention programs are unclear. Better use of hearing protection as part of a program but does not necessarily protect against hearing loss. The review concluded that in order to prevent noise-induced hearing loss NIHL in the workplace, the quality of the implementation of prevention programs affects results, and that better quality of studies, especially in the field of engineering controls, and better implementation of legislation are needed. While the 2017 systematic review concluded there is a lack of conclusive evidence it highlighted that this should not be interpreted as evidence of lack of effectiveness. The implications is that further research could affect conclusions reached. ''