Assessment of Noise Exposures in a Hospital Kitchen · Assessment of Noise Exposures in a Hospital...

Assessment of Noise Exposures in a Hospital Kitchen

Chandran Achutan, Ph.D.

Health Hazard Evaluation ReportHETA 2007-0183-3047Department of Veterans AffairsCincinnati, OhioAugust 2007

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention

WorkplaceSafety and Health

National Institute for Occupational Safety and Health

https://www.cdc.gov/niosh/hhe/reports

http://www.cdc.gov/niosh/hhe/

http://www.cdc.gov/niosh/hhe/

The employer shall post a copy of this report for a period of 30 calendar days at or near the workplace(s) of affected employees. The employer shall take steps to insure that the posted determinations are not altered, defaced, or covered by other material during such period. [37 FR 23640, November 7, 1972, as amended at 45 FR 2653, January 14, 1980].

Page �Health Hazard Evaluation Report 2007-0183-3047

RepoRt Abbreviations........................................................................ ii

Highlights.of.the.NIOSH.Health.Hazard.Evaluation............. iii

Summary............................................................................. iv

Introduction...........................................................................1

Assessment..........................................................................2

Results.and.Discussion........................................................4

Conclusions..........................................................................9

Recommendations................................................................9

References.........................................................................10

Contents

Appendix

ACknowledgments

Evaluation.Criteria..............................................................11

Acknowledgements.and.Availability.of.Report....................13

Page �� Health Hazard Evaluation Report 2007-0183-3047

AL Actionlevel

CFR CodeofFederalRegulations

dB Decibels

dBA Decibels,A-weightedscale

HHE Healthhazardevaluation

HPD Hearingprotectiondevices

Hz Hertz

Leq Equivalentcontinuousnoiselevel

NAICS NorthAmericanIndustryClassificationSystem

NIHL Noise-inducedhearingloss

NIOSH NationalInstituteforOccupationalSafetyandHealth

OSHA OccupationalSafetyandHealthAdministration

PEL Permissibleexposurelimit

REL Recommendedexposurelimit

SLM Soundlevelmeter

TWA Time-weightedaverage

AbbReviAtions

Page ��Health Hazard Evaluation Report 2007-0183-3047

NIOSH received a management request for an HHE at the Department of Veterans Affairs in Cincinnati, Ohio. Management submitted the HHE request because of employee concerns about noise exposure in the Nutrition and Food Services Department. NIOSH investigators conducted an investigation in March 2007.

HigHligHts of tHe niosH HeAltH HAzARd evAluAtion

What NIOSH DidWemeasuredfull-shiftandtask-basednoiselevelsforfoodserviceworkers,cooks,andamaterialshandler.

Wetooksoundlevelmeasurementsthroughouttheworkarea.

What NIOSH FoundNoneoftheemployeesexceededtheOSHAcriteriafornoise.

Twoemployeesworkinginthepotsandpansroom,acook,andoneemployeeworkinginthedishwashingroomexceededtheNIOSHREL.

Alotofthenoisecamefrommetal-to-metalcontactbetweenutensilsandmetalracks.

Thekitchenblendersandthepulperinthedishwashingroomwereveryloud.

What Department of Veterans Affairs Managers Can Do

Replacemetalracksandutensilswithnon-metalfood-safematerials.

Replacethepulperwithagarbagedisposalsystem.

Placeblendersinnoise-reductionenclosures.

Conductanoisesurveyafteranyengineeringoradministrativechangesaremade.

What Department of Veterans Affairs Employees Can Do

Untilnoiseexposuresarereduced,wearHPD(earplugsorearmuffs)inthedishwashingroom.

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OnMarch21,2007,NIOSHreceivedamanagementrequestfromtheIndustrialHygieneandSafetyOfficeattheDepartmentofVeteransAffairsinCincinnati,Ohio,toassessemployeenoiselevelsintheNutritionandFoodServicesDepartment.Therequeststatedthatemployeeswereconcernedaboutnoiseexposuresinthekitchen’spotsandpansroomaftertheinstallationofthePowerSoak®,acontinuousdishwashingsystem.OnMarch27–28,2007,aNIOSHinvestigatorevaluatedemployeeexposurestonoiseinthisdepartment.

Elevenemployees(twocooks,eightfoodserviceworkers,andamaterialshandler)whoworkedintheNutritionandFoodServicesDepartmentcontributed13full-shiftandtwotask-basedpersonalnoisedosimetrymeasuresover2days.NoneofthemeasuresexceededtheOSHAcriteria.Noiselevelsfortwofoodserviceworkersassignedtothepotsandpansroom,acookworkinginthefoodpreparationarea,andafoodserviceworkerassignedtothedishwashingroomexceededtheNIOSHREL.ThenoiselevelfromthePowerSoakdishwashingsystemalonewasnotexcessive,butadditionalnoisefromthefoodpreparationarea(primarilyfromblendersandutensils),andfrommetal-to-metalcontactbetweenstainlesssteelpotsandpansandmetalracks,mayexplainexposuresabovetheNIOSHRELforthepotsandpansroomemployees.Thecooksareexposedtomanyintermittentimpactnoisesourcesfromgeneralhandlingsuchasmetal-to-metalcontactbetweenutensilsandtheuseofindustrial-sizeblenders.Thefoodserviceworkersassignedtothedishwashingroomareexposedtointermittentimpactnoisefromcontactbetweenutensilsandchina,andcontinuousnoisefromthepulper,awaste-reductionmachine.

NoiseexposurestothecooksandtheemployeesassignedtothepotsandpansroomshouldbeloweredtomaintainexposuresbelowtheNIOSHRELbyreducingimpactnoisefrommetal-to-metalcontactbetweenutensilsandmetalracks.Inaddition,thepulpershouldbereplacedwithagarbagedisposalsystemtoreducenoiseexposures,andtopreventunsanitaryworkconditionsfrompossiblepulpermalfunction.

Keywords:..NAICS.622110.(General.Medical.and.Surgical.Hospitals),.intermittent.noise,.impact.noise,.dose,.kitchen,.dishwasher,.pulper,.blenders,.metal-to-metal.contact.

Some employees in the hospital kitchen are exposed to excessive noise levels due to impact noise from metal-to-metal contact between utensils, between utensils and metal racks, and continuous noise from a waste-reduction machine. Noise exposures should be reduced through engineering and administrative controls.

summARy


intRoduCtionOnMarch21,2007,NIOSHreceivedamanagementrequestfromtheIndustrialHygieneandSafetyOfficeattheDepartmentofVeteransAffairsinCincinnati,Ohio,toassessemployeenoiselevelsintheNutritionandFoodServicesDepartment.Therequeststatedthatemployeeswereconcernedaboutnoiseexposuresinthekitchen’spotsandpansroomaftertheinstallationofthePowerSoak®,acontinuousdishwashingsystem.OnMarch27–28,2007,aNIOSHinvestigatorconductedanoiseassessment.

TheNutritionandFoodServicesDepartmentpreparesandprovidesmealstohospitalinpatients.Thedepartmentemploysapproximately30full-timeandpart-timefoodservicesworkers,threecooks,andonematerialshandler.Thefull-timefoodserviceemployeesworkfrom6:00a.m.to2:30p.m.orfrom11:00a.m.to7:30p.m.,andthepart-timeemployeesworkfrom6:00a.m.to10:00a.m.orfrom3:30p.m.to7:30p.m.Thecooksworkfrom6:00a.m.to2:30p.m.orfrom8:00a.m.to4:30p.m.Thematerialshandlertypicallyworksfrom8:00a.m.to4:30p.m.

Mealsarepreparedbythecooksapproximately2–3daysinadvanceandstoredinplasticstoragecontainersinfreezers.Workactivitiesduringmealpreparationincludeslicingmeat,openingfoodcanswithametalcanopener,pureeingfoodinindustrial-sizeblenders,andcooking.Ingredientsandothermaterialsneededforfoodpreparationaretransportedbythematerialshandleroncartsfromfreezersinthehospitalbasement.Everyday,foodserviceworkerswarmthepre-cookedmeals,andplacethemoncartsthatarethentransportedtopatientrooms.Dietaides,ajobclassificationwithinfoodserviceworkers,alertthestaffpreparingpatientfoodcartswhenpatientsrequirespecialdiets.

Inthedishwashingroom,oneortwofoodserviceworkersremoveutensils(cups,plates,trays,andsilverware)fromcartsandplacethemonamechanicalstainlesssteeldishwashingtable.Whiletheemptycartsarebeingpower-washed,leftoverfoodfrompatientroomsisscrapedfromtheplatesandplacedinadrainwithrunningwaterthatispartofthedishwashingtable(Photo1).Thisfood/watermixisfedintoa“pulper,”amachinedesignedtoreducewastebyremovingthewaterandcuttingupthedriedfoodintosmallsizes.Thepulperisattachedtothedishwashingtable.Exceptforthetrays,utensilsareplacedinplasticracksorcontainersbeforetheyareplacedinadishwasher.Thedishwasherwashes,rinses,sanitizes,anddriestheutensils,whicharethenputawaybythefoodservicesworkers.

Photo1:MechanicalDishwashing

Table.Thetrayscoverthetable’s

drain.Onthefarleftsideofthe

photoisthepulper.

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intRoduCtion (Continued)Oversizedmetaltrays,pots,andpansthatareusedinfoodpreparation,andplasticfoodstoragecontainers,arecleanedinthepotsandpansroomusingthePowerSoakcontinuousdishwashingsystem,andair-driedonmetalracksinthisroom(Photo2).

Theobjectivesofthisevaluationwereasfollows:(1)evaluatepersonalnoiselevelsforemployeesinthekitchenarea,(2)identifyspecificsourcesofloudnoise,and(3)lookfornoisefrequenciesthatcauseNIHL.

Elevenemployees(twocooks,eightfoodserviceworkers,andamaterialshandler)contributed13full-shiftandtwotask-basedpersonalnoisemeasuresover2days.NoisePro™noisedosimetersfromQuest®Technologies(Oconomowoc,Wisconsin)werewornbytheemployeeswhiletheyperformedtheirdailyactivities.Thenoisedosimeterswereattachedtothewearer’sbeltandasmallremotemicrophonewasfastenedtothewearer’sshirtatapointmidwaybetweentheearandtheoutsideoftheshoulder.Awindscreenprovidedbythemanufacturerofthedosimeterwasplacedoverthemicrophoneduringrecordings.Attheendofthesamplingperiod,thedosimeterwasremovedandpausedtostopdatacollection.TheinformationstoredinthedosimeterswasdownloadedtoapersonalcomputerforinterpretationwithQuestSuite®ProfessionalIIcomputersoftware.Thedosimeterswerecalibratedbeforeandafterthemeasurementperiodsaccordingtothemanufacturer’sinstructions.

TheQuestdosimeterscollectdatasothatonecandirectlycomparetheinformationwiththethreedifferentnoisecriteriausedinthissurvey,theOSHAPELandAL,andtheNIOSHREL.TheOSHAcriteriausea90dBAcriterionanda5-dBexchangerate.Thedifferencebetweenthetwoisthethresholdlevelemployed,witha90dBAthresholdforthePELandan80dBAthresholdfortheAL.Thethresholdlevelisthelowerlimitofnoisevaluesincludedinthecalculationofthecriteria;valueslessthanthethresholdareignoredbythedosimeter

Photo2:PowerSoak®Continuous

DishwashingSystem.Ontherightside

ofthephotoaremetalpotsandpans.

Assessment


Assessment (Continued)TheNIOSHcriteriondiffersfromOSHAinthatthecriterionis85dBA,thethresholdis80dBA,anditusesa3-dBexchangerate.Thedosimetersalsoallowauser-definedfourthcriterion.Forthisevaluationthefourthcriterion,designedtobeatrueLeq,wasidenticaltotheNIOSHcriterionwiththeexceptionthatthethresholdlevelwassettoOFF.Thisallowedfortheintegrationofallsoundlevelsincludingthosebelow80dB.

Table1summarizesthedosimetersettingsusedinthisevaluation.Becauseofthedifferent8-hourcriteriaandexchangerates,thedoseequationsusedtocalculatetheequivalentTWAvaluesaredifferentfortheNIOSHandOSHAcriteria.TheOSHAdoseequationis

TWA=16.61xlog10[Dose/100]+90,

andtheNIOSHequationis

TWA=10.00xlog10

[Dose/100]+85.

Table1:DosimeterSettings

Parameters OSHAAL OSHAPEL NIOSHREL Leq

Response Slow Slow Slow SlowExchangerate 5 5 3 3

Criterionlevel 90 90 85 85

Threshold 80 90 80 OFF

Upperlimit 115 115 115 115

Spot-checksofareanoiselevelsandspectralanalysis(breakdownofnoiseintodifferentfrequencies)weremeasuredwithaSoundPro®handheldSLMandreal-timefrequencyanalyzer.Theinstrumentwassettomeasurenoiselevelsbetween70and140dBA.TheSLMwascalibratedbeforeandafterthemeasurementperiodsaccordingtothemanufacturer’sinstructions.


Table2:PersonalNoiseMeasuresintheHospitalKitchen

Area JobTitle Duration *PercentDose(hours:minutes) OSHAAL OSHAPEL NIOSHREL Leq

PotsandPansRoom Foodserviceworker 03:46 23.7 14.3 102.8 105.1PotsandPansRoom Foodserviceworker 03:35 6.2 2.0 28.4 32.3PotsandPansRoom Foodserviceworker 08:10 30.1 10.9 102.2 111.4

FoodPreparation Foodserviceworker 08:10 6.7 1.2 18.8 26.2FoodPreparation Foodserviceworker 01:00 3.6 1.4 12.2 13.2FoodPreparation Foodserviceworker 08:18 18.8 6.1 55.9 62.7FoodPreparation Foodserviceworker 09:07 11.6 3.0 32.5 38.3FoodPreparation Foodserviceworker 10:14 7.2 2.1 28.8 34.9FoodPreparation Cook 08:14 27.0 8.0 84.7 91.9FoodPreparation Cook 08:23 28.1 10.0 84.8 92.8FoodPreparation Cook 08:15 33.9 16.5 119.5 126.0

DishwashingRoom Foodserviceworker 04:30 27.6 18.8 151.9 154.4DishwashingRoom Foodserviceworker 04:03 4.7 1.4 14.8 17.5

Allareas Materialshandler 08:11 17.0 6.9 59.7 64.8Allareas Materialshandler 08:30 14.2 4.6 43.2 49.2

*Thevariousdosepercentagesaretheamountsofnoiseaccumulatedduringaworkday,with100%representingthemaximumallowabledailydose.

Results And disCussionInformationontheexposurelimitsfornoiseanditshealtheffectsisprovidedintheAppendix.

Table2showsthepersonalnoisedosimetryresults.Noneoftheemployees’levelsexceededtheOSHAcriteriafornoise.

Inthepotsandpansroom,noiselevelsfortwofoodserviceworkersexceededtheNIOSHREL.Inaddition,thelevelforacookinthefoodpreparationareaalsoexceededtheNIOSHREL.Thecook’sexposurewas85.9dBA,andthefoodserviceworkers’exposureswere85.1and85.2dBAfortheactualtimeworked.Thenoiseexposuresfromthepotsandpansroomalonearenotenoughtoexplainemployees’exposuresexceedingtheNIOSHREL.

ThecontinuousnoiselevelfromthePowerSoakmachinewas77dBAandthenoiselevelsfrommetal-to-metalcontactbetweensteelpansandracks,althoughhigh(80–90dBA),wereintermittentandshort.ThenoiselevelsforvariousactivitiesintheNutritionandFoodServicesDepartmentareprovidedinTable3.Thecloseproximityofthepotsandpansroomtothekitchenareasuggeststhatthepotsandpansroomemployeesareexposedtonoisefromthekitchenarea,primarilywhencookingisinprogress.EvidenceofthisisshowninFigures1and2.InFigure1,thenoiseexposureprofileforapotsandpansemployeeiscomparedtothatofacook’sworkingthesameshift.Thenoiseexposureprofilesaresimilar.


Results And disCussion (Continued)

Table3:SoundLevelMeasurementsintheHospitalKitchen

Area Activity SoundLevels(dBA)

PotsandPansRoom Potsandpansroom,empty 63PowerSoakmachineON,noemployees 77RadioandPowerSoakON,byemployee 79

Whenblendersoninkitchen,about15feetaway 84–86Byradio,withPowerSoakON 86–95

Metal-to-metalcontactbetweensteelpansandmetalracks 94

FoodPreparation Metalcanopener 69–81Compressor 73

Rollingcartsontiledfloor 77–80Ventilationsystem 79

Impactnoisefrommetalspoontometalcontainer 85–92Bagoffrozenpeaspouredonstainlesssteeldish 86

BlendersON 96

DishwashingRoom Regulardishwasher 72–81Powerwashingoffoodcarts 80–83

Contactbetweenplastictrays 83PulperON;dishwashingtableOFF 93

China-to-chinacontact 97PulperON;dishwashingtableON 110

Figure 1: Comparison of Noise Exposures for a Cook and a Pots and Pans Room Employee

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Some employees in the Nutrition and Food Services Department are exposed to excessive noise levels. These employees include cooks and food service workers assigned to the pots and pans and dishwashing rooms. Food service workers who are assigned as diet aides and materials handlers are not likely to exceed any regulatory or recommended noise criteria.

Some employees in the Nutrition and Food Services Department are exposed to excessive noise levels. These employees include cooks and food service workers assigned to the pots and pans and dishwashing rooms. Food service workers who are assigned as diet aides and materials handlers are not likely to exceed any regulatory or recommended noise criteria.

I

InFigure2,noiseprofilesfortwopart-timepotsandpansemployeesarecompared.Oneemployeeworkedthemorningshift(6:00a.m.to10:00a.m.),andtheotherworkedtheeveningshift(3:30p.m.to7:30p.m.).Theformerhadhighernoiseexposuresthatthelatter.Cookingceasedat2:30p.m.onthedaysoftheNIOSHevaluation.

Figure3comparesthenoiseprofilesoftwopart-timepotsandpansemployeeswiththatofafull-timeemployee.Thepart-timeemployee’exposureprofilesweresimilartothefull-timeemployee’sforthecomparabletimethattheyworkedinthepotsandpansroom.Thissuggeststhatemployeesworkinginthepotsandpansroomhaveuniformnoiseexposures.

Figure 2: Noise Exposures for Part-Time Pots and Pans Room Employees by Shift

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Figure 3: Noise Exposures for Part-Time and Full-Time Employees in Pots and Pans Room

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100110120

6:00:00 7:12:00 8:24:00 9:36:00 10:48:00 12:00:00 13:12:00 14:24:00

Time (hh:mm:ss)

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Twotask-basedpersonaldosimetrysamplesweretakeninthedishwashingroom.Anemployeewhowasunloadingutensilsfromthecartsandontodishwashingrackshada4-hourexposureof89.5dBA.Heexceededhisdailyallowabledoseof100%asdeterminedbytheNIOSHcriterion.Thisemployee’snoiseexposurescamefromthepulper(93dBA),china-to-chinacontact(97dBA),powerwashingofcarts(80–83dBA),andcontactbetweenutensilsandthewasharea(85dBA).Anemployeementionedthatthepulperoftengetscloggedand,duringmaintenanceofthemachine,itiscommonforthefood/watermixtobestrewninthedishwashingroom,creatinganunsanitarysituation.

Materialshandlersandfoodserviceworkerswhoareassignedasdietaidesareunlikelytoexceedanyregulatoryorrecommendednoisecriteria.ThematerialshandlerdoesnotspendlongperiodsatanyspecificpartoftheNutritionandFoodServicesDepartment.Thedietaidesspendmostoftheirtimeinafullyenclosedoffice,withthedoorsclosed.Spectralmeasurements,averagedover60seconds,werecollectedinthepotsandpansroomtodeterminefrequenciesatwhichtheloudestexposuresoccur(Figure4).Theloudestexposuresinthepotsandpansroomoccurredat315Hz.ThisfrequencyisnotassociatedwithNIHL,whichusuallyoccursbetween2000–6000Hz.

Figure 4: Spectral Data in Pots and Pans Room

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Results And disCussion (Continued) Inthedishwashingroom,spectralmeasurementswerecompared

withthedishwashingtableswitchedONandswitchedOFF.Thepulperwasoninbothinstances.Thedata,averagedover20–40seconds,areshowninFigure5.Asexpected,noiselevelsarehigherwiththedishwashingtableswitchedON,butonlyatfrequenciesfrom1250–20000Hz.Atlowerfrequencies(lessthan1000Hz),theaveragenoiselevelswerehigherwithonlythepulperswitchedON.Themaximumnoiselevelswere93.4dBAwiththedishwashingtableswitchedOFFand110dBAwiththedishwashingtableswitchedON.ThefrequenciesassociatedwithhighnoiselevelswiththedishwashingtableswitchedOFFwere1250and1600Hz.ThecorrespondingfrequencieswiththedishwashingtableswitchedONwerebetween2500–6300Hz,whichisintherangewhereNIHLcanoccur.

Figure 5: Spectral Data in Dishwashing Room with Pulper ON

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SomeemployeesintheNutritionandFoodServicesDepartmentareexposedtoexcessivenoiselevels.Theseemployeesincludecooksandfoodserviceworkersassignedtothepotsandpansanddishwashingrooms.Foodserviceworkerswhoareassignedasdietaidesandmaterialshandlersarenotlikelytoexceedanyregulatoryorrecommendednoisecriteria.

Basedontheobservationsandfindingsofthisevaluation,thefollowingrecommendationsareofferedtobetterprotectthehearingoftheemployeesintheNutritionandFoodServicesDepartment.Engineeringandadministrativecontrolsarethepreferredwaysofreducingworkplacehazards.

Reducemetal-to-metalcontactasmuchaspossible.Thiscanbeaccomplishedbyreplacingmetalrackswithplasticracks,andreplacingstainlesssteelutensils(e.g.,ladlesandtongs)withplasticmaterials.Makesurethatthereplacementproductsarefood-safe.

ContactWaring®,themanufacturerofthekitchenblenders,toseeifnoise-reductionenclosuresareavailableforthemodelsusedattheNutritionandFoodServicesDepartment.SomecommercialblendersmanufacturedbyWaringprovidenoise-reductionenclosures.Otherwise,lookintohavingnoise-reductionenclosuresmade.

Replacethepulperinthedishwashingroomwithagarbagedisposalsystem.Thismayreducethenoiseexposuretotheemployeesinadditiontopreventingunsanitaryworkingconditionswhenthepulperbecomesclogged.

ConductpersonalnoisedosimetrythroughouttheNutritionandFoodServicesDepartmentafteranyengineering,administrative,orprocesschangesaremade.IfemployeepersonalnoiseexposurescontinuetoexceedtheNIOSHREL,orifthesechangescauseemployeeexposurestoexceedtheOSHAAL,employeesmustbeenrolledinahearingconservationprogram.Thebasicelementsoftheprogramshould,ataminimum,meettherequirementsoftheOSHAhearingconservationamendment[29CFR1910.95].Othersourcesfordefiningeffectivehearingconservationprogramsarealsoavailable[Suter2002;NIOSH1996;RoysterJDandRoysterLH1990].

ProvideemployeesinthedishwashingroomwithHPDandtrainingonproperuseuntilengineeringandadministrativecontrolsareinplace.

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ConClusions

ReCommendAtions

Page �0 Health Hazard Evaluation Report 2007-0183-3047

RefeRenCesCFR.CodeofFederalRegulations.Washington,DC:U.S.GovernmentPrintingOffice,OfficeoftheFederalRegister.

NIOSH[1996].Preventingoccupationalhearingloss–apracticalguide.Cincinnati,OH:U.S.DepartmentofHealthandHumanServices,PublicHealthService,CentersforDiseaseControlandPrevention,NationalInstituteforOccupationalSafetyandHealth,DHHS(NIOSH)PublicationNo.96-110.

RoysterJD,RoysterLH[1990].Hearingconservationprograms:practicalguidelinesforsuccess.Chelsea,MI:LewisPublishers.

SuterAH[2002].Hearingconservationmanual.4thed.Milwaukee,WI:CouncilforAccreditationinOccupationalHearingConservation.


Theprimarysourcesofevaluationcriteriafornoiseintheworkplaceare:(1)theNIOSHREL[NIOSH1992],and(2)theU.S.DepartmentofLabor,OSHAPEL[29CFR1910.95].EmployersareencouragedtofollowthemoreprotectiveNIOSHREL,althoughtheyarerequiredtoadheretotheOSHAPELforcompliancepurposes.

NIHLisanirreversible,sensorineuralconditionthatprogresseswithexposure.Althoughhearingabilitydeclineswithage(presbycusis)inallpopulations,exposuretonoiseproduceshearinglossgreaterthanthatresultingfromthenaturalagingprocess.Thisnoise-inducedlossiscausedbydamagetonervecellsoftheinnerear(cochlea)and,unlikesomeconductivehearingdisorders,cannotbetreatedmedically[Wardetal.2000].Whilelossofhearingmayresultfromasingleexposuretoaverybriefimpulsenoiseorexplosion,suchtraumaticlossesarerare.Inmostcases,NIHLisinsidious.Typically,itbeginstodevelopat4000or6000Hz(thehearingrangeis20Hzto20000Hz)andspreadstolowerandhigherfrequencies.Often,materialimpairmenthasoccurredbeforetheconditionisclearlyrecognized.Suchimpairmentisusuallysevereenoughtopermanentlyaffectaperson’sabilitytohearandunderstandspeechundereverydayconditions.Althoughtheprimaryfrequenciesofhumanspeechrangefrom200Hzto2000Hz,researchhasshownthattheconsonantsounds,whichenablepeopletodistinguishwordssuchas“fish”from“fist,”havestillhigherfrequencycomponents[Suter1978].

ThedBAisthepreferredunitformeasuringsoundlevelstoassessworkernoiseexposures.ThedBAscaleisweightedtoapproximatethesensoryresponseofthehumaneartosoundfrequenciesnearthethresholdofhearing.Thedecibelunitisdimensionless,andrepresentsthelogarithmicrelationshipofthemeasuredsoundpressureleveltoanarbitraryreferencesoundpressure(20micropascals,thenormalthresholdofhumanhearingatafrequencyof1000Hz).Decibelunitsareusedbecauseoftheverylargerangeofsoundpressurelevelswhichareaudibletothehumanear.BecausethedBAscaleislogarithmic,increasesof3dBA,10dBA,and20dBArepresentadoubling,tenfoldincrease,andhundred-foldincreaseofsoundenergy,respectively.Itshouldbenotedthatnoiseexposuresexpressedindecibelscannotbeaveragedbytakingthesimplearithmeticmean.

TheOSHAstandardforoccupationalexposuretonoisespecifiesamaximumPELof90dBAforof8hoursperday[29CFR1910.95].Theregulation,incalculatingthePEL,usesa5-dBtime/intensitytradingrelationship,orexchangerate.Thismeansthatapersonmaybeexposedtonoiselevelsof95dBAfornomorethan4hours,to100dBAfor2hours,etc.Conversely,upto16hoursexposureto85dBAisallowedbythisexchangerate.Thedurationandsoundlevelintensitiescanbecombinedinordertocalculateaworker’sdailynoisedoseaccordingtotheformula:

Dose=100X(C1/T

1+C

2/T

2+...+C

n/T

n)

whereCnindicatesthetotaltimeofexposureataspecificnoiselevelandT

nindicatesthereference

durationforthatlevelasgiveninTableG-16aoftheOSHAnoiseregulation.Duringany24-hourperiod,aworkerisallowedupto100%ofhisdailynoisedose.Dosesgreaterthan100%exceedtheOSHAPEL.

TheOSHAregulationhasanadditionalALof85dBA;anemployershalladministeracontinuing,effectivehearingconservationprogramwhenthe8-hourTWAvalueexceedstheAL.Theprogrammust

Appendix: evAluAtion CRiteRiA

Page �� Health Hazard Evaluation Report 2007-0183-3047

Appendix: evAluAtion CRiteRiA (Continued)

includemonitoring,employeenotification,observation,audiometrictesting,HPD,training,andrecordkeeping.Alloftheserequirementsareincludedin29CFR1910.95,paragraphs(c)through(o).Finally,theOSHAnoisestandardstatesthatwhenworkersareexposedtonoiselevelsinexcessoftheOSHAPELof90dBA,feasibleengineeringoradministrativecontrolsshallbeimplementedtoreducetheworkers’exposurelevels.

NIOSH,initsCriteriaforaRecommendedStandard,proposesanexposurecriterionof85dBAasaTWAfor8hours,5dBlessthantheOSHAstandard[NIOSH1998].Thecriterionalsousesamoreconservative3dBexchangerateincalculatingexposurelimits.Thus,aworkercanbeexposedto85dBAfor8hours,buttonomorethan88dBAfor4hoursor91dBAfor2hours.TheNIOSHRELfora12-hourexposureis83dBAorless.

ReferencesCFR.CodeofFederalRegulations.Washington,DC:U.S.GovernmentPrintingOffice,OfficeoftheFederalRegister.

NIOSH[1992].Recommendationsforoccupationalsafetyandhealth:compendiumofpolicydocumentsandstatements.Cincinnati,OH:U.S.DepartmentofHealthandHumanServices,PublicHealthService,CentersforDiseaseControlandPrevention,NationalInstituteforOccupationalSafetyandHealth,DHHS(NIOSH)PublicationNo.92-100.

NIOSH[1998].Criteriaforarecommendedstandard:occupationalnoiseexposure(revisedcriteria1998).Cincinnati,OH:U.S.DepartmentofHealthandHumanServices,PublicHealthService,CentersforDiseaseControlandPrevention,NationalInstituteforOccupationalSafetyandHealth,DHHS(NIOSH)PublicationNo.98-126.

SuterAH[1978].Theabilityofmildlyhearing-impairedindividualstodiscriminatespeechinnoise.Washington,DC:U.S.EnvironmentalProtectionAgency,JointEPA/USAFstudy,EPA550/9-78-100,AMRL-TR-78-4.

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TheHazardEvaluationandTechnicalAssistanceBranch(HETAB)oftheNationalInstituteforOccupationalSafetyandHealth(NIOSH)conductsfieldinvestigationsofpossiblehealthhazardsintheworkplace.TheseinvestigationsareconductedundertheauthorityofSection20(a)(6)oftheOccupationalSafetyandHealth(OSHA)Actof1970,29U.S.C.669(a)(6)whichauthorizestheSecretaryofHealthandHumanServices,followingawrittenrequestfromanyemployersorauthorizedrepresentativeofemployees,todeterminewhetheranysubstancenormallyfoundintheplaceofemploymenthaspotentiallytoxiceffectsinsuchconcentrationsasusedorfound.

HETABalsoprovides,uponrequest,technicalandconsultativeassistancetofederal,state,andlocalagencies;labor;industry;andothergroupsorindividualstocontroloccupationalhealthhazardsandtopreventrelatedtraumaanddisease.MentionofcompanynamesorproductsdoesnotconstituteendorsementbyNIOSH.

ThisreportwaspreparedbyChandranAchutanofHETAB,DivisionofSurveillance,HazardEvaluationsandFieldStudies(DSHEFS).DesktoppublishingwasperformedbyRobinSmith.EditorialassistancewasprovidedbyEllenGalloway.

CopiesofthisreporthavebeensenttoemployeeandmanagementrepresentativesattheDepartmentofVeteransAffairsandtheOSHARegionalOffice.Thisreportisnotcopyrightedandmaybefreelyreproduced.Thereportmaybeviewedandprintedfromthefollowinginternetaddress:http://www.cdc.gov/niosh/hhe.CopiesmaybepurchasedfromtheNationalTechnicalInformationServiceat5825PortRoyalRoad,Springfield,Virginia22161.

ACknowledgements And AvAilAbility of RepoRt

Recommended Citation: NIOSH [2007]. Health Hazard Evaluation Report: Assessment of Noise Exposures in a Hospital Kitchen, Department of Veterans Affairs, Cincinnati, Ohio. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, NIOSH HETA No. 2007-0183-3047.

To receive NIOSH documents or information about occupational safety and health topics contact NIOSH at:1-800-35-NIOSH (1-800-356-4674)Fax: 1-513-533-8573E-mail: [email protected] visit the NIOSH web site at:http://www.cdc.gov/niosh/hhe

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