Impact of statutory medical examinations on control of noise-induced hearing loss.

Noise at work is ubiquitous and presents a major occupational health problem in many countries. Prolonged exposure to loud noise can cause deafness of varying degrees. This is insidious in the early stages, but can be detected by audiometric examination. In the prevention of noise-induced hearing loss, control of noise at its source would be ideal. But for practical purposes, a multipronged approach is often necessary. Every noisy workplace should set up an in-plant Hearing Conservation Programme (HCP) which includes periodic audiometric examination of workers. In Singapore, since 1985, workers in many noisy workplaces are required to undergo statutory pre-employment and annual audiometric examinations arranged by their employers. The examinations are carried out by Designated Factory Doctors who have undergone a course of training in occupational health and are registered with the Labour Ministry. The doctors' role includes advising workers and employers on the prevention of noise-induced deafness (NID). Doctors notify cases of NID to the Ministry of Labour which conducts investigations where indicated. Since NID is insidious, workers with the condition would not be detected in the early stages without an audiometric examination. With the introduction of the statutory examinations, more noise-exposed workers were examined and cases of early hearing impairment picked up. The statutory medical examinations have helped to highlight the problem of the noise hazard. Individual companies are able to monitor the noise problem in their workplaces, using the audiometric results to supplement the noise assessments. Susceptible workers can be identified and followed up more closely, and health education intensified.(ABSTRACT TRUNCATED AT 250 WORDS)