Classical noise induced hearing loss presentation in a domestic worker: Lessons Learnt

Introduction
Noise Induced Hearing loss contributes a significant portion of occupational diseases. Workplace hearing conservation programs play a critical role in the prevention of noise induced hearing loss. Occupational hygiene noise surveys and a thorough occupational history that includes employment in the informal sector are important factors to be considered at pre placement.

Methods
This is a case study of a 40-year-old man who had developed severe noise induced hearing loss by the age of 28. He was formally employed for the first time in 1999. Before then, he was a domestic worker with no history of any significant noise exposure. The records did not show any previous history of ear infections, exposure to ototoxic antibiotics, treatment for tuberculosis, history of mumps or orchitis or any exposures to chemicals and heavy metals.

Results
A pre-placement audiogram done in 1999 depicted a classical noise induced hearing loss pattern with notching at the 3000Hz area with a percentage loss of hearing of 35.9%. In 2011, a more detailed review of the employee’s occupational history was done that then revealed that he had worked part time for about 5 years at a grinding mill from the age of 15.

Discussion
An occupational hygiene evaluation of noise levels in all at risk areas plays a critical role in a hearing conservation programs even in the informal sector. A detailed occupational history that includes employment in the informal sector is critical. Pre placement audiograms are important in establishing a baseline and also critical in guiding the determination of compensation for employees with pre existing noise induced hearing loss. Elimination of child labor in all sectors is vital in the prevention of occupational diseases. The informal sector is one work place area that has been neglected in a very big way particularly in developing countries.