Hearing Conservation in Hunter Education Programs

How many people do we see a day with high frequency hearing loss due to noise exposure (noise notch!)? Hearing conservation is not taken seriously enough, and those who expose themselves to noise routinely are experiencing it's wrath! This blog is based on an article "Hearing Conservation in Hunter Education Programs" written by Dr. Charles M. Woodford (formerly a West Virginia University professor in the audiology department) and Dr. Norman J. Lass (currently a West Virginia University professor). This article dealt mostly with determining how much hearing conservation is preached in hunter education programs in the United States and Canada. A questionnaire was sent out to all hunter education directors in all 50 states and 12 Canadian provinces. The studied showed that the directors who teach these education programs, mostly, have not been properly trained. Only 87% actually provide hearing conservation details in their training programs. The study also showed that there is little information on hearing conservation in hunter education training manuals. The authors of the work suggest a training session for these hunter education directors to be completely aware of hearing conservation so as to provide this information to their students (hunters.)
I actually went on the West Virgina DNR website to see if I could find anything about hearing conservation in education courses, but not to my surprise, I found nothing. West Virginia is a popular hobby of youth and adults in West Virginia. I do not believe that hunters realize the effect that hearing loss can have on their lives. They stick to the here and now, hunt as they wish with no hearing protection, and suffer later. I know a family from "back hills West Virginia" that has at least six members who hunt. All of them are over age 40, and all of them have hearing loss to the extent that it affects their communication. When I mention hearing protection to them concerning their hunting habits, they act like it won't really help. They also don't believe that their hearing loss comes from their hunting habits. From this experience, I believe ignorance is bliss for many. Education is the best way to reach these folks, and as an audiologist, it is our job to be the educators. Hopefully, with all the Baby Boomers living to be very old, the necessity for hearing conservation will be visible, not only to audiologists, but to others.
Here is the link for the West Virgina DNR:
http://www.wvdnr.gov/

The following website is through Cabelas. They offer many forms of hearing protection.
http://www.cabelas.com/cabelas/en/templates/index/index-display.jsp?id=cat20801&navAction=jump&navCount=1&cmCat=MainCatcat20712&parentType=category&parentId=cat20712

Reference:
Woodford, C.M. & Lass, N.J. (1994, July). Hearing conservation in hunter education programs. American Speech-Language-Hearing Association.

Conductive loss or equipment malfunction?

The client I observed today was a female in her late teens/early twenties. Her case history revealed noise exposure and intermittent tinnitus. Her noise exposure is from a history of playing the saxophone since the third grade. She still currently plays in a band. She notes that her tinnitus comes from both ears and is not a continuous noise. She did not report any instances of dizziness.
Otoscopy was normal for both ears. Tympanometry showed a normal type A tympanogram for both ears with all measures being within normal limits. From this point, testing was somewhat inconsistent. First speech testing was done. SRTs from the right ear first revealed 55dB. A restest also showed 55dB. The left ear was tested with a 15dB result. Puretone testing was then done. Puretone results showed a mild conductive loss in the left ear. SRTs were done again to show 5dB in the right ear and 15dB in the left ear. Discrimination was normal. The supervisor suggested that otosclerosis may be the cause. Otosclerosis in its early stages may show a conductive loss for frequencies between 250Hz and 1000Hz which was shown in this case (Hughes & Pensak, 2007) The client was referred to an ENT for an evaluation for the conductive component.
Technical problems may also have been an issue. The supervisor made this suggestion after the client had left. A thorough daily listening check may have helped assess this. Some testing did show that narrowband noise was not coming in until around 20-30dB.

The following site is a good reference for otosclerosis. The site is from the Boys Town Hospital. http://www.boystownhospital.org/Hearing/info/genetics/syndromes/otos.asp

References:
Hughes, G. B. & Pensak, M. L. (2007). Clinical otology. New York: Thieme Publishers, Inc.

BiCROS WiFi Aid.... Interesting Case!

The client I saw in this observation I had seen a few weeks before for a hearing aid evaluation. The client was now being seen for the hearing aid orientation because his aids had arrived at the clinic. During the previous session, the client stated that he had Meniere's disease and had the eighth nerve severed in his left ear due to extreme attacks of vertigo. The left ear, therfore, was dead as shown through testing. Puretone and speech testing were performed. MCLs and UCLs were also obtained. Amplification was then discussed. The client wanted a Unitron BiCROS system with a Unison 6 for the right ear, better ear, and a WiFi microphone for the left ear. The clinician and the client discussed this option, and it was determined that this aid would be an option for him. The aids were ordered. It should be noted that the molds were ordered through Microsonic, and the client was charged an additional $80 during the session.

This session was for the hearing aid orientation. Steps were first taken before the client was brought to the fitting room. Due to the clinician and supervisors being new to the aid, the team gathered to discuss how the aid worked and how to program it. The team then programmed the aid. The Unifit programming software through Unitron was used for programming. Program 1 was set for "Quiet/Match Target" using a BiCROS and digital wide dynamic range compression (WDRC). Program 2 was set for "Group/Party Noise" using BiCROS and ASP noise suppression. Program 3 was set for "Acoustic Telephone" using a BiCROS and linear limiting. This program requires the T-coil to be activated.

The client was then brought to the fitting room. The tubing was cut and adjusted to fit the clients molds with the aid and microphone. It was noticed that the mold for the right ear did not come with a vent. The supervisor then lowered the gain for the lower frequencies to make up for this so the clients voice did not sound as "boomy." The clinician then began to inform the client about the hearing aid. The clinician instructed the client to pay attention to how the aid sounded while the system was being explained; therefore, adjustments could be made if necessary. The client was informed about the 30 day return policy (shipping cost not refundable). The clinician also informed the client that he may return for adjustments but would definately need to return annually to check for hearing changes in his left ear. The accessories were then explained. The aid came with different cases, a warranty card, a user manual, a cleaning brush, and an extra battery door. The clinician also gave the client a DryAid kit to keep moisture out of the product. Next, the beeps for different settings and a low battery were testted to be sure the client was hearing the beeps. The settings for the programming were saved in the database and the aid and mic. The clinician then explained to the client how to change the battery, the volume control, and switch programs. The clinician then opened the user manual to the front page and wrote down the contact information for the clinic, information on the different programs, and the type of battery that the client would need. This makes this information easily accessible for the client. The warranty was then discussed. The warranty is for 3 years, while loss and damage are only covered for one.
This is definately the most interesting case that I have seen thus far. Due to the aid being unfamiliar to many, I have included the website for the Unitron aid and WiFi mic (BiCROS system). http://www.unitronhearing.us/ccus/professionals/products_us/accessories/wifimic.htm That website actually describes how the WiFi microphone works in the system. The actual aid is the Unison 6 through Unitron.
I also found the DryAid kit very interesting. I had not seen these before. The following website shows a Dry Aid kit. http://www.azhearing.com/cgi-bin/shopper.cgi?preadd=action&key=SDA