SHIB Emerging Issues Hearing Impaired..6.30.NEW

Document Sample
SHIB Emerging Issues Hearing Impaired..6.30.NEW Powered By Docstoc
					                        U. S. Department of Labor
                        Occupational Safety and Health Administration
                        Directorate of Science, Technology & Medicine
                        Office of Science and Technology Assessment
                              Innovative Workplace Safety Accommodations
                                  for Hearing-Impaired Workers
                                      Safety and Health Information Bulletin
                                                                                 SHIB 07-22-2005
Introduction                                               This Safety and Health Information Bulletin is not a
                                                           standard or regulation, and it creates no new legal
Approximately 28 million Americans have some               obligations. The Bulletin is advisory in nature, infor-
degree of hearing loss [1,9]. Hearing loss can result      mational in content, and is intended to assist employ-
from a variety of factors, including: heredity, disease,   ers in providing a safe and healthful workplace.
physical trauma, and exposure to loud noises. The          Pursuant to the Occupational Safety and Health
National Institute for Occupational Safety and Health      Act, employers must comply with hazard-specific
(NIOSH) estimates that 10 million American workers         safety and health standards promulgated by OSHA or
have permanent hearing loss resulting from exposure        by a state with an OSHA-approved state plan. In
to excessive noise at work [2]. The number of              addition, pursuant to Section 5(a)(1), the General
American workers with hearing loss from all sources is     Duty Clause of the Act, employers must provide their
expected to increase over time as the workforce ages.      employees with a workplace free from recognized
                                                           hazards likely to cause death or serious physical harm.
Hearing-impaired workers face challenges responding        Employers can be cited for violating the General Duty
to emergencies, working safely around machinery,           Clause if there is a recognized hazard and they do not
communicating with coworkers, and receiving training.      take reasonable steps to prevent or abate the hazard.
Accommodations necessary to address these                  However, failure to implement any recommendations
challenges may not be part of an employer’s current        in this Safety and Health Information Bulletin is not, in
hearing conservation practice. This Safety and Health      itself, a violation of the General Duty Clause. Cita-
Information Bulletin (SHIB) focuses on (1)                 tions can only be based on standards, regulations, and
Emergency/Evacuation Response Considerations               the General Duty Clause.
for Hearing-Impaired Workers; and (2) Workplace
Safety and Health Considerations for Hearing-
Impaired Workers.                                          2. Informs employers of the wide range of
                                                           accommodations available for the hearing-impaired
Purpose                                                    worker and their application in the workplace as they
                                                           relate to emergency evacuation, training, responding to
The purpose of this SHIB is to provide employers,          safety hazards and communication.
workers and professional organizations guidance on
accommodating the safety and health needs of               3. Encourages employers to develop and establish
hearing-impaired individuals in the workplace.             procedures for hearing-impaired workers that further
Specifically, this SHIB:                                   safety and health in their workplaces.

1. Raises awareness about the safety and health            4. Encourages worker participation in the
challenges faced by hearing-impaired workers.              development, planning, and implementation of these
Background                                                        A. Emergency/Evacuation Response
                                                                  Considerations for Hearing-Impaired Workers
The Occupational Safety and Health Administration’s
(OSHA) Occupational noise exposure standard                       Customizing Worksite Emergency Preparedness
includes requirements for a hearing conservation                  for Hearing-Impaired Workers
program (29 CFR 1910.95(c)). It covers employers
in general industry with employees exposed to noise at            The OSHA Emergency action plans standard (29
85 decibels (dBA) or above measured as an 8-hour                  CFR 1910.38) requires an employer to develop a
time-weighted average sound level (TWA). It                       written emergency action plan when such a plan is
requires these employers to include their noise-                  required by a specific OSHA standard, such as 29
exposed employees in a hearing conservation program               CFR 1910.120 hazardous waste operations and
that consists of noise exposure assessment,                       emergency response, and 29 CFR 1910.160 fire
audiometric testing, hearing protection and training.1            extinguishing systems. When the plan is required, it
The nature of the workplace has changed since the                 must describe the actions employees should take to
standard took effect; many workers in the United                  ensure their safety if a fire or other emergency situation
States are aging and have some degree of hearing                  occurs. At a minimum, the plan must include:
loss. There is also greater concern among workers                 emergency escape procedures; procedures for
about readiness to safely react to catastrophic events.           employees who remain to operate critical plant
In addition to emergencies caused by natural                      operations before they evacuate; procedures to
disasters, and technological accidents; possibility of            account for all employees after emergency evacuation;
acts of terrorism have become a concern.                          and procedures for reporting fires and other
Accommodations are available to enable hearing-                   emergencies. The plan must also include the types of
impaired workers to evacuate safely, and certain                  evacuation to be used in emergency circumstances.
accommodations may benefit workers with no hearing                The employer must review the plan with each
loss, since some emergencies may adversely impact all             employee covered by the plan when it is developed,
workers’ ability to hear or communicate.                          whenever the plan changes and upon an employee’s
Accommodation measures in the workplace are an                    initial assignment. Employers must consider
extension of good communication and safe practices                employees with disabilities in the development of an
for all workers.                                                  emergency action plan when such a plan is required by
                                                                  a specific OSHA standard.
Hearing-impaired workers also face routine
workplace safety and health challenges. In particular,            The plan must be in writing, kept in the workplace,
hearing-impaired workers may have difficulty                      and available to employees for review. For employers
understanding audible warning signals and alarms                  with 10 or fewer employees, the plan may be
designed to indicate the approach of motorized                    communicated orally and the employer does not have
vehicles. For those with severe and profound hearing              to maintain a written plan. The Appendix to 1910,
losses, a common safety concern is localization. For              Subpart E, Exit Routes, Emergency Action Plans, and
example, “I know there are forklifts in the area but I            Fire Prevention Plans is a nonmandatory guideline to
do not know where they are coming from.” Other                    assist employers in complying with the requirements of
concerns expressed by hearing-impaired workers                    the employee emergency plan [3].
include difficulty understanding conversation on the
telephone, at meetings and in training sessions [16].             The Americans with Disabilities Act (ADA) does
Fortunately, accommodations and equipment                         not require employers to have an emergency
modifications are available to assist hearing-impaired            evacuation plan, but if an employer decides to have
workers to perform their jobs safely [4,9].                       such a plan, they are required to include people with
                                                                  disabilities [10,14].
    OSHA’s standard at 29 CFR 1926.52 addresses occupational noise exposure in the construction industry.

To help prepare workers for emergencies, the Office               Alerting Device Options
of Disability Employment Policy (ODEP), at the U.S.
Department of Labor, provides recommendations on                  Traditionally, notification of an emergency has been
emergency preparedness for people with disabilities.              done through the use of auditory devices which are
The ODEP report suggests three essential parts to an              effective for most workers. OSHA’s Employee Alarm
emergency evacuation plan: plan development, plan                 Systems standard (29 CFR 1910.165), addresses all
implementation and plan maintenance [4].                          emergency alarms required to be installed by specific
                                                                  OSHA standards. The standard indicates that an
Plan development includes identifying the potential               alarm system must provide warning for necessary
hazards, the accommodation needs of persons with                  emergency actions and be capable of being perceived
disabilities, and key personnel who will be involved in           above ambient noise by all employees. Since hearing-
an emergency. In developing a plan, employers                     impaired employees may not be able to hear auditory
should ask their employees for their input, and                   alarms, OSHA considers strobe lights or similar
workers with disabilities should take responsibility for          lighting devices and tactile devices to meet the
their safety by offering their ideas and input. The plan          requirement of the standard [3].
should address after-hours situations, and include a
method to identify visitors with special needs. The               Hearing-impaired workers may also have difficulty
plan also should include details on how information               understanding voice communication over the public
will be conveyed to hearing-impaired workers when                 address (PA) system. The alarm may interfere with or
they are away from their work areas. Finally, the plan            drown out voice announcements, making the
should be easy to read and understandable.                        emergency voice communication system ineffective.
                                                                  Alerting device accommodations are available to
Employers should consult with local fire, police and              notify hearing-impaired workers of emergencies, and
emergency departments as well as community-based                  they cause minimal distraction to other workers.
organizations in developing the plan. While the plan              Visual alarms equipped with flashing strobe lights or
should be in writing, it should be viewed as an ongoing           vibrating alerting devices can be hard-wired into the
process, periodically revised and updated to reflect              existing emergency notification system. The
changes in technology, personnel and procedures.                  Underwriters Laboratories Standard for Emergency
                                                                  Signaling Devices for the Hearing-Impaired (UL
Plan implementation involves distribution of the plan             1971), establishes criteria for systems used for
in an accessible format to all employees and the                  emergency notification [5].
integration of the plan into the employer’s standard
operating procedures. Drills, both scheduled and                  Section 4.28 of the ADA Accessibility Guidelines
unscheduled, should be performed regularly. Such                  (ADAAG) 2 specifically addresses specialized alarms
practice drills should encompass the needs of all                 (
individuals, including workers with disabilities, to              htm#4.28). To be effective for notification, visual
ensure familiarity with the procedures and to                     alarms must be installed where hearing-impaired
determine where improvements are needed.                          persons can see them [6].

Plan Maintenance involves developing a system for                 Many alerting device options are available for use in
identifying new safety concerns and the needs of new              the workplace, depending on the particular needs of
disabled employees, reviewing and modifying plans                 the hearing-impaired worker. However, not all of the
after practice drills, and ensuring that emergency                devices listed below are appropriate for every
equipment is being properly maintained in good                    hearing-impaired worker. Some of the devices are
operating condition [4,5,9,10].
2  ADAAG contains scoping and technical requirements for accessibility to buildings and facilities by individuals with
disabilities under the ADA. These scoping and technical requirements are to be applied during the design, construction, and
alteration of buildings and facilities covered by Titles II and III of the ADA to the extent required by regulations issued by
Federal agencies, including the Department of Justice and the Department of Transportation, under the ADA.
more appropriate for individuals with a severe-to-                  •   A modem that converts the personal computer
profound hearing loss, while others are appropriate for                 into a Telecommunications Device for the
workers with a mild hearing impairment. The                             Deaf (TDD).
employer should work together with hearing-impaired
employees, and perhaps with an occupational                         •   Instant messaging or e-mail pop-up.
audiologist, in determining the device or combination
of devices that work best for their particular situation.           •   A flashlight provided to hearing-impaired
                                                                        individuals for signaling their location in the
Some alerting device options include:                                   event they are separated from the rescue team
                                                                        or buddy.
    •   Exit signs set to flash when an emergency
        alarm sounds. These signs are typically                 The Job Accommodation Network (JAN) website, a
        connected to the emergency power system.                service of the Office of Disability Employment Policy,
                                                                has a wealth of information on alerting devices at
    •   Strobe lights [7] or vibrating alarm signals   JAN’s “Employers’ Guide to
        placed in all areas occupied by hearing-                Including Employees with Disabilities in Emergency
        impaired workers.                                       Evacuation Plans” covers requirements for including
                                                                people with disabilities, guidelines and accommodation
    •   Visual or vibrating alarm signals at the                considerations. Toll-free (800) 526-7234 [14].
        worker’s workstation.
                                                                Other useful resources are DisabilityInfo,
    •   Vibrating pagers worn by hearing-impaired     , and the Center for Disability
        workers.                                                Issues and Health Professionals,

    •   Vibrating watches or other type of body alarm           The United States Fire Administration publishes many
        that is strapped on to the individual to alert a        guides on the subject of disability and related
        hearing-impaired worker.                                emergencies at, toll-free (800)
                                                                561-3356 [5,6,8].
    •   Two-way vibrating pagers that receive text
        messages and have the ability to respond in             Other Safety and Health Workplace
        full length text.                                       Accommodations

    •   “Hearing Dogs”- trained to alert the hearing-               •   TTY: A teletypewriter (TTY) is a telephone
        impaired worker to a person entering the                        device that enables hearing-impaired
        room, abnormal machinery sounds,                                individuals to make and receive telephone
        malfunctioning equipment, the telephone                         calls. The device requires two TTY users to
        ringing or other alerting needs.                                type messages back and forth to
                                                                        communicate. When messages are typed on
    •   Buddy systems [5,7] where a coworker alerts                     the TTY keyboard, the information is
        a hearing-impaired worker to an emergency                       displayed on the TTY display panel and
        situation. This system should not be relied on                  transmitted through the phone line to a
        as the sole means of alerting the hearing-                      receiving TTY.
        impaired worker to an emergency situation                   •   TRS: The Telecommunications Relay Service
        because of the relatively low reliability of this               (TRS) is a 24-hour, 7 day a week, free
        approach.                                                       nationwide relay network service that handles
                                                                        voice-to-TTY and TTY-to-voice calls. Using
    •   Amplified telephone ring signaler to alert the
        worker to a phone ringing.
        a TTY or other mechanism (Voice Carry Over                 •   Use tape, paint or ropes to highlight paths of
        phone, voice phone or videophone), an                          travel for forklifts, vehicles and heavy
        individual dials the toll-free number to contact               equipment.
        the TRS system which will connect the caller               •   Designate separate doors for mechanized and
        to a communications assistant (CA) who                         people traffic.
        directs the call. When the recipient answers               •   Establish rules requiring that all forklifts and
        the call, the CA explains his or her role in the               vehicles must stop at all intersections.
        call and will relay the communication between              •   Install sensor warning lights that blink as the
        the two parties exactly as stated by both                      vehicle approaches. Directional warning lights
        parties, either in text or voice. For more                     such as the left light signals traffic on the left,
        information about Telecommunications Relay                     and the right light signals traffic on the right,
        Services, link to:                   may be beneficial.
        health/pubs_hb/telecomm.htm, and                           •   Install flashing strobe lights on vehicles or                                            forklifts to alert hearing-impaired workers to
                                                                       oncoming vehicles.
    •   Cell phone with a portable TTY. It is                      •   Install mirrors at all intersections within the
        important to make sure that the cell phone is                  warehouse. Dome mirrors situated along
        TTY compatible.                                                aisleways may be beneficial.
    •   Wireless TTY. Provides instant TTY access                  •   Use vibrating pagers - place a transmitter in
        anywhere within a selected wireless data                       the moving equipment so that the driver can
        network. Such TTYs have e-mail, fax, text-                     press a button that sends a signal to the
        to-speech and speech-to-text message                           vibrating receiver worn by the hearing-
        capabilities.                                                  impaired employee to alert the worker to the
                                                                       approaching forklift.
The ADA Standards for Accessible Design, as well as                •   Position a rear vision camera so that a vehicle
other technical assistance materials, can be obtained                  operator will be able to see behind him/her.
from the U.S. Department of Justice ADA website at The Department of Justice operates a              Training Accommodations
toll-free ADA Information Line at (800) 514-0301
(voice), or TTY (800) 514-0383, which directs                  Training is an integral component of a safe workplace,
callers to an ADA specialist [5,6,10,12,14].                   yet training may pose unique challenges for employers
                                                               who have workers with hearing impairments. Training
B. Workplace Safety and Health Considerations                  programs that ensure that procedures are understood
for Hearing-Impaired Workers                                   and followed are paramount to creating a safe work
                                                               environment [15].
Responding to Vehicles in the Workplace
                                                               Hearing-impaired workers often need customized
Workers with hearing loss working around or                    training tools to ensure their safety. There are a
operating powered industrial trucks (e.g., forklifts) or       variety of training mechanisms that can be tailored to
other heavy equipment may be concerned about their             hearing-impaired individuals in the workplace. Again,
ability to detect dangerous situations. The employer           the decision to use a particular training
should work together with hearing-impaired                     accommodation is one that should be made by the
employees in determining the accommodation or                  employer and employee after considering the needs of
combination of accommodations that work best for               a specific situation.
their particular situation. The following are suggested
accommodations that can be made to minimize such                   •   Assisted Listening Devices (ALDs). These
safety risks:                                                          devices amplify sound and transmit it to a

    person’s hearing aid or to a receiver worn by                possibly a PC projector. Typically, a typist
    the individual. The speaker talks into a                     who participates in the group activity acts as a
    microphone or transmitter and the listener                   notetaker while the hearing-impaired individual
    either uses the telecoil (t-coil) on their own               either watches the computer monitor or the
    hearing aid or wears a receiver designed to                  text projected onto a wall or screen.
    work with the specific ALD.                              •   Web-based training. Use web-based meeting
•   Captioned videotapes; open or closed.                        software or video conferencing.
    Closed captioning requires the use of a                  •   Tape recorded meetings. After the training
    decoder to view the captions, while open                     session, the tape can be listened to separately
    captioning displays the text automatically.                  in a controlled listening environment with the
    These captions are identical to captions                     ability to rewind and playback as often as
    displayed at the bottom of the screen in                     necessary. The tapes can also be transcribed.
    foreign language films. No special equipment             •   TTY Videophone in a video conferencing
    is required to view open captioning.                         format. This allows for full view of the group in
•   Scripting. A script of the video might be                    addition to TTY communication directly on the
    provided as a last resort if there is no                     TV monitor.
    captioning, and if the visual content is not of          •   Communication Access Software. Currently,
    great significance to the information provided               there are innovative systems that provide
    through the video. However, providing the                    multisensory, interactive communication by
    script as a supplement to the captioned video                converting speech to text, and to real-time on-
    in advance of viewing the video gives the user               screen sign language. More information about
    additional preparation time to understand what               these products is provided at
    will be communicated.                               and
•   Qualified sign language interpreter. For more      
    information, see the Equal Employment                    •   Area and meeting room systems. Options
    Opportunity Commission’s (EEOC) ADA                          may include: FM desktop systems: portable
    Technical Assistance Manual for Title I,                     sound field-desktop or tote bag; FM System
    Chapter III, 3.10.9 Providing Qualified                      with Speakers–Wireless; Conference
    Interpreters at                Microphone; Ceiling Speakers.
    ADAtam1.html#111.                                            [9,12,13,14,16].
•   Communication Access Realtime Translation
    (CART) Services. CART is a service in                 Tips for Assisting People with Hearing
    which an operator types the spoken word into          Impairments
    a computer that instantly displays the typed
    words in English on a monitor or other display.          •   Speak in a clear, normal tone; do not over-
    This service is useful during small and large                enunciate or exaggerate words.
    group situations when verbatim conversation is           •   Speak directly to the individual, even if there is
    essential to effective communication. CART                   a sign language interpreter present.
    offers word-for-word translation. This service           •   Face into the light when speaking and do not
    typically needs to be scheduled in advance of                cover or turn your face away.
    a meeting.                                               •   Flick the light on and off when entering a room
•   Computer-Assisted Notetaking. This service                   to draw attention to your presence.
    can be used to provide effective                         •   Offer pencil and paper. While writing a
    communication during group training sessions.                message, do not talk; a hearing-impaired
    It involves the use of a laptop or personal                  person cannot read a note and your lips at the
    computer, word processing software, and                      same time.

                                                              7) USDA Employee Emergency Response
    •   In situations where lights may be inadequate,            Guide. Emergency Evacuation Suggestions for
        provide the individual with a flashlight to help         Individuals with Disabilities, pp. 29-30.
        the hearing-impaired person lip-read in the
        dark. [5,8,13].                                       8) U.S. Fire Administration. Orientation Manual
    •   Use a microphone when speaking to a group.               for First Responders on the Evacuation of
    •   A presenter should repeat a question raised by           People with Disabilities. Publication FA-235,
        the audience into the microphone before                  August 2002.
        answering the question.                               9) National Organization on Disabilities.
                                                                 Emergency Preparedness Initiative: Guide on
Conclusion                                                       the Special Needs of People with Disabilities
                                                                 for Emergency Managers, Planners and
The risk of miscommunication, injury, and other                   Responders 2002., (202) 293-
dangers presented to hearing-impaired workers in the              5960, TDD: (202) 293-5968.
workplace can be minimized through the
implementation of the practical steps described above.        10) U.S. Equal Opportunity Commission. U.S.
The best way to help hearing-impaired employees feel              Department of Justice, Civil Rights Division.
prepared for a workplace emergency and be                        “Americans with Disabilities Act:
motivated to use safe work practices is to                        Questions and Answers.” August 23, 2002.
solicit their input and provide knowledge, information,
and accommodation choices.                                    11) U.S. Department of Justice, Civil Rights
                                                                  Division, Disability Rights Section.
                                                                  Enforcing the ADA: A Status Report
                                                                  from the Department of Justice. Issue
    1) Northern Virginia Resource Center for Deaf
                                                                  4, 2003.
       and Hard of Hearing Persons. “Emergency
       Preparedness and Emergency Communication
                                                              12) U.S. Department of Justice, Civil Rights
       Access” December 2004.
                                                                  Division, Disability Rights Section.
                                                                  ADA Business Brief: Communicating
    2) NIOSH,
                                                                  with People Who Are Deaf or Hard
                                                                  of Hearing in Hospital Settings,
    3) U.S. Department of Labor/OSHA.
                                                                  October 2003.
                                                              13) NJ Arts Access Task Force. ADA Self-
    4) U.S. Department of Labor, Office of Disability
                                                                  Assessment Survey and Planning Tool.
       Employment Policy. “Emergency
                                                                  March 2003.
       Preparedness for People with Disabilities,
       Summary Report”. April 2004.
                                                              14) Job Accommodation Network. “Employers’
                                                                  Guide to Including Employees with
    5) Federal Emergency Management Agency,
                                                                  Disabilities in Emergency Evacuation
       U.S. Fire Administration. Emergency
       Procedures for Employees with Disabilities in              Plans”. Linda Batiste and Beth Loy.
       Office Occupancies.
                                                              15) Occupational Health and Safety. “Safety
                                                                  First”. Jennifer Juergens, June 2004,
    6) U.S. Fire Administration. Fire Risks for the
                                                                  Vol. 73, No. 6, p. 94.
       Deaf or Hard of Hearing. Publication FA-202,
       December 1999.

   16) ADA and Accommodation of the Hard of               5) The Better Hearing Institute,
       Hearing. Presentation at the National       
       Hearing Conservation Association                       hearing_solutions/listeningDevices.cfm
       Conference, February 2005. George
       R. Cook, Au.D. CCC-A,                              6) The Access Board, An independent federal
       Occupational Audiologist. Workplace                   agency devoted to accessibility for people
       Group (336) 931-0300.                                 with disabilities. Provides technical assistance                               in ADA and ADAAG.

Other Useful Resources                                    7) U.S. Department of Transportation,
                                                   , Federal Transit Administration,
   1) U.S. Department of Justice, Civil Rights               Easter Seals Project ACTION,
      Division, Disability Rights Section. “ADA     ACTION is a
      Information from the Department of Justice”.           national technical assistance program to
      The Department of Justice answers questions            facilitate cooperation between the disability
      about the ADA and provides free publications           and transportation communities. It offers
      by mail and fax. This 7-page document lists            various resources, training and technical
      pertinent ADA legal documents, general                 assistance to make the ADA work for every-
      publications and guides, Technical Assistance          one.
      Publications for Businesses and Non-Profit
      Service Agencies, and Technical Assistance
      Publications for State and Local

   2) The Office of Disability Employment Policy
      Technical Assistance Programs: Training and
      Technical Assistance to Providers (T-TAP) at, The National Center on
      Workforce and Disability for Adults (NCWD-
      Adults) at, National
      Collaborative on Workforce and Disability for
      Youth (NCWD/Youth) at www.ncwd-, The Job Accommodation Network
      (JAN) at, and The
      Employer Assistance Referral Network
      (EARN) at

   3) Resources for Assisted Listening Devices.
      Hearing Products Report

   4) U.S. Department of Justice, Disability Rights
      Section, ADA Information Services, Revised
      February 2004.

Federal Agency Resources-Public Education
  1)   U.S. DOL ODEP - Job
       Accommodation Network (JAN)

  2)   U.S. Department of Justice
       ADA Information Services
U.S. Department of
 3) U.S. Fire Administration
 4) Federal Emergency Management Agency

 5) ADA Information and
     National Institute Occupational Safety
 6) The Access Board
     Independent Federal Agency

 7) adahom1.htm
     U.S. Department of Commerce
       National Oceanic and Atmospheric

 8) U. Fire
U.S. S. Department of Transportation
    Easter Seals Project Action
  9)   U. S. Department of Education
       National Institute on Disability and
       Rehabilitation Research (NIDRR)
Federal Emergency
10) U.S. Federal Communications Commission
   Management on For information
    Telecommunication Relay Services

National Institute
  Occupational Safety
  and Health…