As firefighters, we are exposed to risks and hazards on a daily basis. We do what we can, as individuals and organizations, to reduce our exposure to these risks. When one of us is injured (or worse), we can typically point to a proximate cause: the event that triggered the injury. To get ahead of these injuries, however, we need to prevent the root causes.
During my 32 years of firefighting, I was fortunate as far as injuries are concerned. Oh sure, I had the typical bumps and bruises, but I only sustained one injury I would consider major, the result of a fall one dark night on a steep mountainside in Trinity County, Calif.
If we have hearing safeguards in place, why do so many firefighters retire with hearing loss? Well, one reason is emergency response. We can go from performing station duties, sitting in our recliners, or even sleeping in our beds, to arriving on the scene of an emergency within a matter of minutes.
My engine company was part of a strike team conducting initial attack on a new—and growing—wildfire. Our strike team had just put in about 5,000 feet of 1½” fire hose up a steep mountainside along the left flank of the fire. We had tied in the line and were holding it with the help of hand crews. I made one misstep downhill and went tumbling over. Everyone heard my right knee pop as my anterior cruciate ligament (ACL) gave way. Down I went.
I spent the next four or five years healing, having surgery, and healing again. This injury changed my career, moving me temporarily to a desk job and out of the firehouse. But in the end, it doesn’t hold me back much; I can still swim, ride my bike, ski and run (I sometimes wish my knee prevented that last one!). The short-term pain and down time was no fun at all, but fortunately I suffered no long-term effects.
I cannot say the same about my hearing.
As a result of long-term occupational noise exposure, I suffer from permanent hearing loss in my left ear. The proximate cause of this disability is not a single event, like my knee, but chronic exposure to noise. I first started to notice the problem when I heard a noise in my head that sounded like a C-130 Hercules aircraft. This noise was noticeable when things around me were very quiet. I initially thought it was congestion due to allergies, but it got progressively louder over time. The first real indication of a big problem was when I could not hear my wife’s voice very well at all (that can be trouble!).
Long story short, I was diagnosed with significant hearing loss in my left ear due to industrial noise exposure. The hearing loss is bad enough, as I have difficulty hearing conversations, especially in loud places. But the worst part is the tinnitus (noises or ringing in the ear). This constant noise in my head is loud and it drowns out other sounds. There is no place that I can go where it is quiet; I hear this noise all the time.
Fire Service Work Is Loud!
The National Institute of Occupational Health and Safety sets the noise exposure limit (REL) at 85 decibels (dBA) over a time weighted average (TWA) of eight hours. Noise level measurements taken in the typical environment where a firefighter works often exceed this threshold. Consider:
- When riding in or operating fire apparatus, the dBA levels range from 75 to 88 dBA. Spikes in noise levels have been measured between 105 and 109 dBA. These numbers indicate that firefighters need to wear hearing protection when they are working in and around their fire apparatus.
- During the performance of our duties we use a lot of power saws and other power equipment. We use chainsaws to vent roofs, rotary saws to cut metal and force entry, power fans to remove smoke from buildings, and hydraulic powerplants to run hydraulic tools for vehicle rescue. These and numerous other noises on the emergency scene often exceed recognized safety levels.
- Working around the firehouse is also a noisy activity. Fire apparatus, bells and whistles, air compressors and exhaust fans can all raise the noise level above the allowable limit.
Firefighters are routinely exposed to loud noises at fires and emergency scenes, including hydraulic tools.
These situations are the proximate causes of hearing loss, and they require us to take steps to protect ourselves and our personnel, including training personnel to recognize unsafe noise levels and take appropriate steps to protect themselves, initiating engineering and administrative controls, and providing appropriate personal protective equipment (PPE). The PPE needs to be adequate for the noise level involved and fit-tested to the individual firefighter.
We usually have adequate hearing protection devices available to us in situations where noise exposure is common. Supervisors are tasked with ensuring firefighters use hearing protection as required by the department’s policies and procedures. We have this weird situation in our industry, however, during which protecting our hearing becomes more challenging.
Hearing Protection During Emergency Response
If we have hearing safeguards in place, why do so many firefighters retire with hearing loss? Well, one reason is emergency response. We can go from performing station duties, sitting in our recliners, or even sleeping in our beds, to arriving on the scene of an emergency within a matter of minutes. We go from a resting state to potentially performing work at our highest level of physical ability. This emergent environment requires us to take quick and decisive action. We don our PPE and go to work. We have turnouts to protect our bodies from thermal insult and SCBA to protect our airways from smoke and heat, but do we have anything to protect our hearing when we are wearing all this other gear?
If we donned hearing protection (ear plugs) before we threw on our mask that might help, but is it practical? We need to hear our radios over the rest of the loud noises. Orders or safety messages are too important to miss—and radio communications are often difficult to hear under the best fireground conditions. Further, PPE is an ensemble. We cannot just add components without proper testing to ensure the additions don’t interfere with the fit or function of other parts.
Let’s face it, there are no bulletproof solutions to hearing protection on the fireground. However, that doesn’t mean we just throw up our hands and reconcile ourselves to hearing loss. Much of the work we do at fires and emergencies is done after the initial fast-paced, rescue and/or extinguishment activity. Once the fire is under control or the vehicle is stabilized, things slow down a little. That’s when we should consider whether hearing protection is appropriate. While each situation will differ, firefighters and supervisors should remember that it is long-term exposure that usually damages our hearing. We won’t be able to eliminate our exposure, but that doesn’t mean we shouldn’t take steps to reduce it.
As I noted at the beginning, injuries have proximate causes and root causes. If proximate causes of hearing loss are all the loud noises we’re exposed to, the root cause is lack of effective steps to reduce exposure.
All fire departments should have policies that outline hearing conservation programs and training, including:
- A schedule and process for evaluating and monitoring noise levels in the workplace
- Administrative and engineering controls to reduce noise exposure
- The requirement that firefighters will wear PPE when noise levels cannot be adequately reduced
- Annual audiometric testing and tracking for all exposed personnel
- Initial and ongoing training for all members
- Documentation of all the above
When a member experiences a shift in hearing (discovered by comparison to past audiometric tests), your organization should perform a reevaluation of the noise levels in the work environment and the adequacy of engineering controls and PPE. If you discover one or more processes are not being adequately addressed, further evaluation and training may be in order.
Take It Seriously
Hearing is a precious sensory function for humans; living without it is not impossible, but it is difficult. We tend to take our hearing for granted when we have it, but go without it for a day and you’ll see how precious it becomes.
Take your hearing conservation program seriously. You may save your brothers and sisters the heartache that comes from missing key parts of conversations, or not being able to experience music the same way.
Or, in the case of those of us with tinnitus, knowing true silence is something we left on the fireground.
Lexipol’s Fire Policy Manual and Daily Training Bulletin Service provides essential policies to enhance the safety of firefighters in all areas of department operations. Contact us today to find out more.