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Hearing Loss Prevention
Review & Evaluation: National Academies Evaluation
NIOSH understands that external expert review is one of the most valid
and accepted methods of evaluating research programs. Consequently,
NIOSH requested that the National Academies (NA) evaluate NIOSH's research
programs with respect to their impact, relevance, and future directions.
The NA was asked to evaluate not only what NIOSH research programs are
producing, but also to determine the extent to which NIOSH research
is responsible for changes in the workplace that reduce the risk of
occupational injuries, illnesses, and deaths. The evaluation is being
undertaken by the National Research Council (NRC) and the Institute
of Medicine (IOM) in the NA.
In August 2006, the National Academies completed a review of the NIOSH Hearing Loss Research Program. The purpose for this review was to provide NIOSH with useful feedback on ways in which its hearing loss prevention research program could be improved. The complete text of this review is available at: http://www.iom.edu/CMS/3740/31265/36811.aspx . Upon the completion of their program review, the National Academies Institute of Medicine Committee provided 15 recommendations for improving NIOSH’s Hearing Loss Research Program. These recommendations are listed below. To see the complete text from the program review, including a discussion of the Committee recommendations, the reader is referred to: http://books.nap.edu/openbook.php?record_id=11721&page=115
IOM Recommendations
- Foster effective leadership. NIOSH should ensure that the Hearing Loss Research Program and its components have leadership with appropriate technical expertise as well as skills in managing in a complex environment, mobilizing resources, promoting collaboration within the program, and increasing program coherence. All of these leaders must serve as champions of the program within and outside NIOSH and help to garner adequate resources and recruit expertise. The leaders should be respected and involved in the hearing loss prevention community and in their own fields of expertise. NIOSH should provide the overall program leader with sufficient authority to make appropriate program and budgetary decisions.
- Recruit additional expert researchers to the NIOSH Hearing Loss Research Program staff. The Hearing Loss Research Program should recruit and retain experienced professionals with recognized expertise in the fields of epidemiology and noise control engineering who can exercise leadership in planning, conducting, and evaluating the program’s work in these crucial areas. It is essential for the program to make gaining this additional expertise a priority.
- Expand access to outside expertise. The program should make efforts to draw upon a wider representation of the communities responsible for the prevention of occupational hearing loss as reviewers, conference participants, and collaborators. As part of this effort, the program should strengthen ties to the National Institute on Deafness and Other Communication Disorders and other components of the National Institutes of Health to benefit from additional interactions with the scientific researchers there. The program should also explore collaborations with noise control engineers inside and outside the federal government.
- Develop a strategic plan. The Hearing Loss Research Program should develop a strategic plan that takes into account the strengths, weaknesses, and external factors identified in this evaluation. It should reflect a focus on the program’s mission and serve to guide decision making about the value of projects and proposed collaborations. It should also reflect coordination with the strategic plans developed by the sector-based NIOSH research programs that may need to address hearing loss as one of several health hazards faced by the workforce.
- Use surveillance data as well as stakeholder input to identify priorities. The Hearing Loss Research Program should make the rationale for its research prioritization more explicit, using analyses of surveillance data to the extent possible as well as the concerns and interests of stakeholders from a variety of industrial sectors to guide allocations of resources and effort.
- Use information from evaluation of hearing loss prevention measures to guide program planning. The Hearing Loss Research Program should use information gained from evaluation of the effectiveness of its program activities to help identify approaches to hearing loss prevention that should be emphasized, revised, or possibly discontinued.
- Systematize collaboration with regulatory partners. The Hearing Loss Research Program should establish regular means for conferring with OSHA, MSHA, and the Environmental Protection Agency to better anticipate research needs relevant to regulatory decision making.
- Place greater emphasis on evaluation of the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and the incidence of occupational hearing loss. The Hearing Loss Research Program should implement consistent and concerted evaluation activities that inform and focus its work on hearing loss prevention. Prospective evaluations of the recommended components of hearing loss prevention programs are needed to determine which features have the most significant impacts on reducing noise exposure levels or hearing loss incidence rates. These evaluations should address actual (not just intended) worker and employer behavior and the end results of exposure levels and hearing loss.
- Initiate national surveillance for occupational hearing loss and hazardous noise. The Hearing Loss Research Program should rally expertise and resources to lead surveillance of the incidence and prevalence of work-related hearing loss and the occurrence of exposure to hazardous noise levels in occupational settings in the United States. Surveillance efforts should be accompanied by plans for appropriate analyses of the data.
- Integrate the noise control engineering perspective into overall program efforts for all sectors. The Hearing Loss Research Program should apply its dissemination expertise to further emphasize the application of “quiet by design,” “buy quiet,” and engineered noise control approaches to industrial settings as part of hearing loss prevention programs.
- Develop noise control engineering approaches for non-mining sectors. The Hearing Loss Research Program should increase efforts to develop noise control approaches applicable in industrial sectors outside mining where workers are also at risk from hazardous noise. Where possible, “dual-use” applications from work done in mining could help bring noise reduction benefit to both miners and workers from other industrial sectors.
- Increase the visibility of noise control engineering as a component of the Hearing Loss Research Program. The Hearing Loss Research Program should use means such as periodic workshops on noise control engineering topics to raise the visibility of its noise control engineering projects within the field. Such workshops can facilitate information exchange, can provide specialized technical training, and may attract qualified professionals who can serve as advisers, consultants, collaborators, or recruits to the NIOSH program.
- Accredit laboratories used to conduct studies for the Hearing Loss Research Program. The Hearing Loss Research Program should work to accredit all laboratories that are involved in the acquisition of data that are published or shared externally. To the extent possible, testing on behalf of the NIOSH intramural program should be carried out at facilities owned or controlled by NIOSH.
- Target more of the extramural research funding. The Hearing Loss Research Program should increase its use of Requests for Applications and focused Program Announcements to target more of its extramural research funding toward program priority areas.
- Increase collaboration and mutual awareness of ongoing work among intramural and extramural researchers. For the Hearing Loss Research Program to maximize the benefit of extramural research, it is important for intramural and extramural researchers to each be aware of the work that the others are doing relevant to occupational hearing loss or noise control. Where appropriate, intramural researchers should be building upon extramural work within the Hearing Loss Research Program. Toward this end, after a grant has been awarded, NIOSH should facilitate increased communication between intra- and extramural researchers.
NIOSH wishes to express its appreciation to the Institute of Medicine and to each of the members of the review committee for their time and effort devoted to this review. NIOSH is currently studying these recommendations and is preparing a response to each recommendation. Additionally, NIOSH is using these recommendations to draft updated strategic goals for the Hearing Loss Prevention Research Program. The NIOSH response to these IOM recommendations, and the NIOSH strategic goals for hearing loss prevention research are expected to be completed by the Summer of 2007. As required by the Office of Management and Budget (OMB), these strategic goals will be organized by outcomes such as recommended exposure limits, and recommended interventions to reduce injuries and illnesses instead of more general goals such as eliminating all occupational hearing loss.
NIOSH is interested in your opinions about the relevance and value of its Hearing Loss Prevention Research Program, and we encourage you to consider partnering with us on issues of interest to you and your organization. When a draft response to the IOM recommendations and the corresponding draft updated goals for the NIOSH Hearing Loss Prevention Program are completed, they will be posted here for review and comment. We will also use the NIOSH eNews to announce that draft goals are available for review.
More information is available at the National Academies Evaluation of NIOSH Research Programs page.
Specific information on the National Academies review of the NIOSH hearing loss research portfolio may be found at http://www.cdc.gov/niosh/nas/hlr/default.html.
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NIOSH Program: Hearing Loss Prevention
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