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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health B Methods Section: Committee Information Gathering This appendix provides additional detail regarding the methods used by the Institute of Medicine (IOM) Committee to Review the NIOSH Hearing Loss Research Program to gather information to carry out its work. These methods included reviewing written information from NIOSH, conducting site visits to facilities operated or used by NIOSH, inviting comments from stakeholders, and hearing presentations at two information-gathering meetings. INFORMATION GATHERING Written Information from NIOSH The NIOSH Hearing Loss Research Program provided a roughly 400-page notebook of information to the committee in advance of the committee’s first meeting. The notebook, referred to by NIOSH and the committee as the “evidence package,” contained information on the history of the Hearing Loss Research Program; the program’s resources, goals, and objectives; intramural research activities; extramural research funded by NIOSH; program products and technology transfer; and relevant NIOSH-wide processes and activities. The Hearing Loss Research Program and others in NIOSH provided extensive additional information to the committee in response to questions that arose during the evaluation process. All interactions and follow-up with NIOSH were carried out through
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health staff. A list of materials provided to the committee by NIOSH is found in Appendix C. In addition to written materials provided by NIOSH, the committee also had independent access to other NIOSH papers and conference materials. Site Visits In response to an invitation from NIOSH and after careful consideration, a subset of the committee made site visits to the Pittsburgh Research Laboratory on March 21, 2006, and to the Robert Taft Research Laboratory in Cincinnati, Ohio, on March 22, 2006. Committee members used the site visits to address specific questions that had arisen in the course of their review and to further inform their impressions from the materials provided by NIOSH. During the site visits, NIOSH staff provided committee members with tours of the research facilities and showed them the testing equipment available onsite. In Cincinnati, committee visitors also had the opportunity to visit the laboratory at the University of Cincinnati, where noise emissions from powered hand tools have been measured under a contract from the NIOSH Hearing Loss Research Program. Agendas for the site visits are presented in Box B-1. Opportunity for Stakeholders to Comment on the NIOSH Hearing Loss Research Program The committee was directed by the Framework Document to consider stakeholder input in assessing the impact and relevance of the NIOSH Hearing Loss Research Program. Issues of interest included whether stakeholder input was taken into consideration in shaping the NIOSH research program and stakeholders’ views on the program’s research activities and products. The Framework Document did not specify the means for eliciting input from stakeholders. The committee determined that conducting a systematic survey was not feasible within the constraints of the project. As an alternative, the committee invited stakeholders to provide comments relevant to its evaluation of the impact and relevance of the NIOSH Hearing Loss Research Program. The objective was to assemble comments from a diverse group of organizations and individuals. Individual invitations to comment were sent to approximately 200 people and organizations. The invitation was also posted on a publicly available website. Identification of Stakeholders The committee identified possible stakeholders for the NIOSH Hearing Loss Research Program through several means. The research program provided a list of
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health BOX B-1 Agendas for Site Visits NIOSH Pittsburgh Research Laboratory March 21, 2006 9:30–11:00 a.m. Pick up from airport Ed Thimons, Branch Chief, Respiratory Hazard Control Branch (RHCB) 11:00–11:05 a.m. Dr. Güner Gürtunca, Ph.D. Laboratory Director, Pittsburgh Research Laboratory Bldg. 155, Conference Room 11:05–11:10 a.m. R. J. Matetic, Branch Chief, Hearing Loss Prevention Branch (HLPB) Introduction to Hearing Loss Program 11:10–11:25 a.m. Dr. Eric Bauer, Ph.D., P.E., Mining Engineer Exposure Source and Dose Bldg. 155, Conference Room Engineering Controls 1 11:25–11:35 a.m. Peter Kovalchik, Team Leader, Noise Control Team Overview of Noise Control Bldg. 154, Acoustical Testing Laboratory 11:35–12:25 p.m. J. Shawn Peterson, Electrical Engineer Coated Flight Bars—Continuous Mining Machine Reverberation Chamber Accreditation of Laboratory Facilities Mist System—Roof Bolting Machine 12:35–1:20 p.m. Lunch and Worker Empowerment and Education Robert Randolph, Team Leader, Audiology and Intervention and Support Teams Bldg. 155, Conference Room Engineering Controls 2 1:20–1:50 p.m. David Yantek, Mechanical Engineer Hemi-anechoic Chamber Shaker on Continuous Mining Machine Tail Section Bldg. 153, Hemi-anechoic Chamber
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health 1:50–2:05 p.m. Adam Smith, Mechanical Engineer Sound Intensity on Tail Roller—Continuous Mining Machine 2:05–2:15 p.m. David Yantek, Mechanical Engineer Beam Forming Technique 2:15–2:20 p.m. Ellsworth Spencer, Mining Engineer Longwall Pilot Study 2:20–2:40 p.m. Dr. Efrem Reeves, Ph.D., Acoustical Engineer Communication and Personal Protective Equipment Bldg. 154, Auditory Research Laboratory 2:40–3:00 p.m. R. J. Matetic, BC, HLPB, and Ed Thimons, BC, RHCB Mine Roof Simulator; Human Performance Research Mine; Full-Scale Continuous Miner Dust Gallery; Full-Scale Longwall Dust Gallery 3:00 p.m. Return to Airport NIOSH Cincinnati Division of Applied Research and Technology (DART) March 22, 2006 8:00 a.m. Meet at Mariemont Inn Drive to NIOSH Taft Laboratory Building check-in with security Greg Lotz, Ph.D. Assistant Director for Science (ADS), DART 8:30–9:00 a.m. DART Conference Room, Taft Room 349 Welcome and introductions Plans for the day Mary Lynn Woebkenberg, Ph.D., Director, DART Greg Lotz, ADS, DART 9:00–10:00 a.m. Hearing Loss Research Program Labs, Taft 3rd Floor Tour of Hearing Protector Lab and discussion of research Tour of Audiometric Lab and discussion of research William Murphy, Ph.D., DART 10:00–10:30 a.m. Travel to University of Cincinnati Charles Hayden, DART
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health 10:30–11:15 a.m. University of Cincinnati (UC), College of Engineering Tour of UC/NIOSH Anechoic Lab Charles Hayden, DART Jay Kim, Ph.D., Associate Professor, UC College of Engineering Ed Zechmann, DART 11:15–12:30 p.m. Conference room (ERC 435, UC) Discussion of NIOSH powered hand tools research; Q&A session Charles Hayden, DART Jay Kim, Ph.D., Associate Professor, UC College of Engineering Ed Zechmann, DART 12:30–2:00 p.m. Working lunch 2:00–2:30 p.m. Wrap-up discussion Greg Lotz William Murphy Charles Hayden 2:30 p.m. Return to airport its stakeholders, which included collaborators and partners. Working independently and drawing on suggestions from committee members and staff research, the committee identified as possible stakeholders individuals and organizations with an interest in audiology, hearing conservation, hearing protection devices, noise control engineering, and occupational epidemiologic research. This group included researchers from academia and private organizations, professional societies, organizations representing labor and industry, and others who deal directly with occupational hearing loss or were considered likely to be aware of this issue. Stakeholders were identified in a variety of industrial sectors, including construction, mining, agriculture, manufacturing, transportation, and the military. The committee also identified potential stakeholders among minority professional organizations and small business associations. The list of stakeholders included representatives of federal and state agencies as well as researchers and organizations in other countries.
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Letters to Stakeholders The invitation to comment on the NIOSH Hearing Loss Research Program was issued in a letter from committee chair Dr. Bernard Goldstein (see Box B-2). The committee staff sent the letter by e-mail in late January 2006 to each of the identified stakeholders. Committee members did not contact any stakeholders directly. The letter was also made available publicly from late-January through mid-May 2006 in a posting on a National Academies website. In addition, a NIOSH web page noted the opportunity for NIOSH stakeholders to provide input to the review and provided a link to the National Academies site. Interested stakeholders were asked to send their comments to the study staff via postal mail, e-mail, or the project website. Responses could be submitted anonymously through the website. The committee invited stakeholder comments on several points: familiarity with NIOSH activities and products related to occupational hearing loss and noise control; experience working with NIOSH; the relevance and impact of NIOSH’s work over the past decade in occupational hearing loss and noise control; and the major research challenges over the past decade and significant emerging research needs in occupational hearing loss and noise control. By June 2006, approximately 40 responses had been received. Stakeholder comments are available to the public through the National Academies Public Access file and were provided to NIOSH in their original form. Overall, the NIOSH stakeholders who responded provided positive feedback. The committee recognizes that the responses to the request for comment are not necessarily representative of all NIOSH stakeholders. However, the comments provided to the committee gave helpful insights on responders’ perspectives toward the NIOSH Hearing Loss Program and informed the committee’s understanding of the program’s relationship with some of its stakeholders. Stakeholder Comments on Emerging Research Needs or Opportunities To assist the committee in reviewing stakeholder input, the staff compiled the comments on significant emerging research needs or opportunities. This compilation is presented in Box B-3, with some comments captured in abbreviated form and others listed nearly verbatim. No attempt was made to evaluate the merits of individual stakeholder suggestions or to prioritize within or across the broad research categories used by the staff to group the comments. The presentation of these suggestions in the report does not represent an endorsement by the committee.
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health BOX B-2 Letter Inviting Comment on the NIOSH Hearing Loss Research Program Dear Colleague: I write as chair of the Institute of Medicine (IOM) Committee to Review the NIOSH Hearing Loss Research Program to invite your assistance in the work of this group. The committee’s charge is derived from a request by the National Institute for Occupational Safety and Health (NIOSH) that the National Research Council and the Institute of Medicine convene individual committees to review as many as 15 NIOSH programs with respect to the impact and relevance of their work in reducing workplace injury and illness and to identify future directions their work might take. As part of our effort, we are seeking input and advice from a variety of individuals and organizations that we believe are likely to have an interest in occupational hearing loss and noise control. The committee’s charge is to examine the following issues for the NIOSH Hearing Loss Research Program: Progress in reducing workplace illness and injuries through occupational safety and health research, assessed on the basis of an analysis of relevant data about workplace illnesses and injuries and an evaluation of the effect that NIOSH research has had in reducing illness and injuries. Progress in targeting new research to the areas of occupational safety and health most relevant to future improvements in workplace protection. Significant emerging research areas that appear especially important in terms of their relevance to the mission of NIOSH. The committee will evaluate the Hearing Loss Research Program using an assessment framework developed by the NRC/IOM Committee to Review the NIOSH Research Programs. The evaluation will consider what the NIOSH program is producing as well as whether the program can reasonably be credited with changes in workplace practices, or whether such changes are the result of other factors unrelated to NIOSH. For cases where impact is difficult to measure directly, the committee reviewing the Hearing Loss Research Program may use information on intermediate outcomes to evaluate performance. NIOSH has provided information to the committee on its work on occupational hearing loss using four categories of research and research transfer activities: (1) development, implementation, and evaluation of effective hearing loss prevention programs; (2) evaluation of hearing protection devices; (3) development and use of engineering controls to reduce noise exposure; and (4) improved understanding of occupational hearing loss through surveillance and investigation of risk factors. We would be very grateful for your comments on any of several points. It would be
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health valuable for the committee to know whether you are familiar with NIOSH activities and products related to occupational hearing loss and noise control and what kind of experience you may have had working with the agency or its products. The committee would be particularly interested in comments you may have on the relevance and impact of NIOSH’s work on occupational hearing loss and noise control over the past 10 years in any of the four areas of research it has defined. In addition, we would value your views on two other matters included in the committee’s charge. First, what do you see as having been the major research needs and challenges over the past 10 years in occupational hearing loss and noise control? Second, what do you see as significant emerging research needs or opportunities concerning occupational hearing loss and noise control? The committee will review the comments it receives at its two remaining meetings, which will be held on February 23–24 and March 30–31, 2006. We encourage you to submit your comments in time for consideration at the February meeting, if possible. You are welcome to comment as an interested individual or from the perspective of your organization. In addition, you should feel free to share this letter with other individuals or organizations with an interest in occupational hearing loss. If you wish to comment, please do so through our IOM staff, using any of a variety of routes: e-mail, mail, fax, telephone, or through the project website (where providing name and affiliation is optional). Contact details are provided at the end of this letter. Please note that any written comments submitted to the committee (whether by mail, e-mail, fax, or the project website) will be included in the study’s public access file. If you have any questions about contacting the committee or providing materials for the committee’s consideration, I encourage you to speak with our study director Lois Joellenbeck or her colleague Jane Durch. Thank you very much for any assistance you can provide to our study committee as we conduct our review of the NIOSH Hearing Loss Research Program. Sincerely, Bernard Goldstein, M.D. Chair, Committee to Review the NIOSH Hearing Loss Research Program Submitting Comments to the Study Committee Mail: Dr. Lois Joellenbeck Institute of Medicine, Keck 775 500 Fifth Street, N.W. Washington, DC 20001
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health BOX B-3 Emerging Research Areas in Occupational Hearing Loss and Noise Control Suggested by Stakeholders Hearing Loss Prevention Programs (HLPPs) Overcoming barriers to hearing conservation programs Best practices for implementing hearing conservation programs and hearing loss prevention training Evaluation of the effectiveness of hearing conservation programs and detection of significant threshold shifts Methods of motivating and training employees in hearing conservation Documentation of the benefits of HLPPs, over and above the prevention of noise-induced hearing loss Practical limits of hearing conservation programs that rely on use of hearing protection devices Development of methods and technologies to increase the use of hearing protection by miners as a component of a hearing conservation program Hearing Evaluations Analysis of the forced-whisper test Markers for early threshold shift Early indicators of hearing loss Evaluating the most appropriate audiometric test frequencies for monitoring noise-induced hearing loss Assessment of audiograms to determine if noise-induced hearing loss was a causative factor in the audiometric profile Monitoring hearing more frequently in nonclinical settings Hearing Protection Devices (HPDs) Developing more reliable and cost-effective hearing protection and hearing testing equipment Reasons for HPD failure in the real world Improved mechanisms for HPD evaluation Determination of reasons for the discrepancy between field and laboratory attenuation evaluations Evaluation of HPD performance in individual users Development and dissemination of HPDs with better sound quality and targeted attenuation; their benefits and limitations Developing HPDs that maintain situational awareness and enhance communication-in-noise Effective applications of “augmented” HPDs Performance of level-dependent and electronic hearing protectors Effective methods of motivating workers to wear HPDs correctly Improved and validated real-world assessments of the performance of hearing protection in the workplace Relationship between HPDs, hearing loss, and occupational injuries NIOSH should support American National Standards Institute (ANSI) in the development and particularly the dissemination of hearing protector standards Labeling of hearing protectors Determining the actual incentives that will change worker behavior to use hearing protection
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Noise Metrics Developing “kurtosis” as a noise metric Noise exposure measurement and estimation techniques Impulsive Noise The effects of impulse or impact noise Measurement of impact noise Develop damage risk criteria for impulse noise and blast, and intervention or mitigation of acute acoustic trauma Noise Control Working with the industry to reduce noise levels Further research and publication of noise control approaches Improved devices for noise control Targeting general categories of sources is impractical. Instead, NIOSH should support development of noise control and acoustical engineering curricula at the undergraduate level to make plant engineers more aware of issues and solutions Development and application of ambient noise cancellation technology Organizational factors in lack of compliance with noise exposure limits (lack of feasible engineering controls, not using feasible controls, etc.) Validation of engineering noise control research products with in-mine tests under actual mining conditions for full shifts with quantification of the reduction in miners’ noise exposure Research to assist MSHA in moving promising engineering and administrative noise controls to the technologically achievable category Reducing noise levels associated with air arcing Developing cost-effective engineering controls that can be integrated into industry process and procedures Determining how existing engineering controls can be augmented to further reduce the potential for hearing loss Product Design Design more technology to reduce cab noise Improve in-cab warning signal design Product noise labeling Overcoming obstacles to communication in noisy environments Information for Industry and Workers More information on noise emissions, noise control measures, and noise abatement approaches in user-friendly format Collection of training materials Collection of testimonials by recognized people and the average worker, voicing their perceived consequences of failed personal protection Effective training materials relevant to young, inexperienced miners Continued growth in mining and construction research
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Surveillance Ongoing research to monitor and assess the magnitude of occupational noise-induced hearing loss among miners Evidence Base for Regulation and Prevention Programs Translational research to produce and disseminate evidence-based interventions Evidence-based input for regulatory requirements Biological Factors Determining the genetic, life-style, and dietary factors in humans that may underlie the well-known intersubject variability in noise-induced hearing loss (need for correlation studies) Methods for separating age and other factors contributing to hearing loss Hearing loss susceptibility in children Prevention and Treatment Pharmacologic intervention for prevention and remediation of noise trauma Mechanisms of hair cell death and the possible benefits of otoprotectants Other Contributors to Hearing Loss More knowledge and research into determining which chemicals affect hearing Effects of personal listening devices on hearing High-Risk Groups or Vulnerable Populations Effects of noise on aging workers Interventions to promote hearing health in a diverse workforce Dealing with hearing-impaired workers in the workplace and the potential use of hearing aids or hearing protection for such employees Hearing loss prevention programs for underserved worker populations, such as the lawn care industry, the car wash industry, and musicians Noise and hearing impairment as risk factors for injury among construction workers Research to identify and assess ototoxic hazards for miners Nonauditory Effects of Noise Effect of noise exposure on blood pressure Research to identify and assess nonauditory health effects of noise on miners
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Stakeholder Respondents The following individuals responded to the committee’s invitation for comments on the NIOSH Hearing Loss Research Program: Marin Allen National Institutes of Health Elliott Berger E•A•R/Aearo Company David Bies Adelaide University Jay Buckey Dartmouth-Hitchcock Medical Center Kathryn Butcher National Ground Water Association Kathleen Campbell Southern Illinois University School of Medicine Brent Chamberlain Queenstake Resources USA Inc. COL David Chandler U.S. Army William Daniell University of Washington Diane S. DeGaetano Merial Kyle Dennis Department of Veterans Affairs Robert Dobie University of California, Davis Albert G. Duble Member, Institute of Noise Control Engineering (INCE) Ronald W. Edgell Silver Bell Mining John Erdreich Ostergaard Acoustical Associates Laurence Fechter Veterans Affairs Loma Linda Healthcare System Jeffrey Goldberg Custom Protect Ear, Inc. Lee Hager Sonomax Hearing Healthcare Donald Henderson State University of New York at Buffalo Lonny Hofer (No affiliation provided) Ann-Christin Johnson Karolinska Institute Madeleine Kerr University of Minnesota Robert Kline-Schoder Creare Incorporated
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Joseph LaMonica Bituminous Coal Operators’ Association Eric LePage OAEricle Laboratory Peter McAllister Adelaide University Brian Metcalf (No affiliation provided) Luc Mongeau Purdue University Rick Neitzel University of Washington Richard J. Peppin Scantek, Inc. Susan Randolph American Association of Occupational Health Nurses CDR Glen Rovig U.S. Navy Emmett Russell International Union of Operating Engineers Scott Schneider Laborers’ Health and Safety Fund of North America Paul Schomer Acoustical Society of America Kathy Sotkovski (No affiliation provided) Martin Walker Federal Motor Carrier Safety Administration Laurie Wells National Hearing Conservation Association William Yost Parmly Hearing Institute, Loyola University Chicago
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health COMMITTEE MEETINGS The committee held three face-to-face meetings during the course of this study. The first two meetings included open sessions for information gathering. The agendas for these open sessions appear below. The third meeting was held in closed session. After the third meeting, the committee held four conference calls in order to finalize the report. Meeting I January 5–6, 2006 The Keck Center of the National Academies 500 Fifth Street, N.W. Washington, D.C. Thursday, January 5, 2006 10:15 a.m. Introductory remarks Bernard Goldstein, M.D. Chair, Committee to Review the NIOSH Hearing Loss Research Program Introductions by committee members and meeting attendees 10:30 Study Context and Goals, Sponsor Perspective Lewis Wade, Ph.D. Senior Science Advisor, NIOSH Discussion 11:00 Evaluation Framework David H. Wegman, M.D., M.Sc. Chair, Committee on the Review of NIOSH Research Programs Discussion Noon Lunch 1:00 p.m. Overview of the NIOSH Hearing Loss Research Program W. Gregory Lotz, Ph.D. Associate Director for Science Division of Applied Research and Technology, NIOSH
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Discussion 1:50 NIOSH Hearing Loss Research Program: Research Goal 1: Contribute to the development, implementation, and evaluation of effective hearing loss prevention programs Carol M. Stephenson, Ph.D. Chief, Training Research and Evaluation Branch, Education and Information Division, NIOSH Discussion 2:30 NIOSH Hearing Loss Research Program: Research Goal 2: Reduce hearing loss through interventions targeting personal protective equipment William J. Murphy, Ph.D. Co-Team Leader, Hearing Loss Prevention Team Division of Applied Research and Technology, NIOSH Discussion 3:10 Break 3:25 NIOSH Hearing Loss Research Program: Research Goal 3: Develop engineering controls to reduce noise exposures R. J. Matetic, M.S. Chief, Hearing Loss Prevention Branch Pittsburgh Research Laboratory, NIOSH Discussion 4:05 NIOSH Hearing Loss Research Program: Research Goal 4: Contribute to reductions in hearing loss through the understanding of causative mechanisms Rickie R. Davis, Ph.D. Co-Team Leader, Hearing Loss Prevention Team Division of Applied Research and Technology, NIOSH Discussion 4:45 Adjourn Open Session
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Friday, January 6, 2006 9:30 a.m. Discussion with NIOSH on study task and Hearing Loss Research Program, as needed 11:00 Adjourn Open Session Meeting II February 23–24, 2006 The Keck Center of the National Academies 500 Fifth Street, N.W. Washington, D.C. Thursday, February 23, 2006 11:00 a.m. Introductory remarks Bernard Goldstein, M.D. Chair, Committee to Review the NIOSH Hearing Loss Research Program Introductions by committee members and meeting attendees 11:15 Questions and discussion with NIOSH representatives 12:15 p.m. Lunch 1:00 Presentations by selected NIOSH stakeholders Noah Sexias, Ph.D. Professor of Environmental and Occupational Health Sciences University of Washington Discussion 1:40 Mine Safety and Health Administration (MSHA) John Seiler, P.E. Chief, Physical and Toxic Agents Division Directorate of Technical Support, MSHA
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Melinda Pon Special Assistant to the Administrator for Coal Mine Safety and Health, MSHA Discussion 2:20 Occupational Safety and Health Administration (OSHA) Jim Maddux Director, Office of Maritime Standards and Guidance OSHA Mike Seymour Acting Deputy Director, Office of Maritime Standards and Guidance OSHA Discussion 3:00 Environmental Protection Agency (EPA) Ken Feith Senior Scientist/Advisor Office of Air and Radiation, EPA (by telephone) Discussion 3:45 Additional discussion among presenters, NIOSH, committee 4:45 Adjourn open session ACKNOWLEDGMENTS The committee would like to extend its sincere gratitude to the NIOSH staff. The Hearing Loss Research Program staff at both the Pittsburgh Research Laboratory and the Robert Taft Laboratory in Cincinnati faced the substantial task of assembling the initial set of materials that were provided to the committee for this study. They also assembled a considerable amount of material in response to the
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Hearing Loss Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health committee’s requests for additional information and devoted time and effort to ensure the success of the committee’s site visits. The committee extends particular thanks to the NIOSH staff who gave presentations or responded to questions from the committee at its meetings or site visits, including Dr. Eric Bauer, Dr. Rickie Davis, Dr. Güner Gürtunca, Mr. Charles Hayden II, Dr. Peter Kovalchik, Dr. W. Gregory Lotz, Dr. R.J. Matetic, Dr. Thais Morata, Dr. William Murphy, Mr. J. Shawn Peterson, Mr. Robert Randolph, Dr. Efrem Reeves, Mr. Adam Smith, Mr. Ellsworth Spencer, Dr. Carol Stephenson, Dr. Mark Stephenson, Mr. Ed Thimons, Dr. Lewis Wade, Dr. Mary Lynn Woebkenberg, and Mr. David Yantek. The committee also thanks NIOSH staff member Mr. Rohit Verma, Dr. Jay Kim of the University of Cincinnati, and Mr. Edward Zechmann of Constella. The committee thanks as well the many members of the communities involved in occupational hearing loss prevention outside NIOSH who contributed to the study by providing comments on the NIOSH Hearing Loss Research Program, making presentations at the committee’s meetings, or providing additional information in response to committee requests. In addition to the individuals listed earlier in this appendix, the committee wants to acknowledge Mr. Mark Rotariu of the National Institute on Deafness and Other Communication Disorders; Mr. Ryan German, Ms. Shelly McCoy, Mr. Gregory Meikle, Ms. Melinda Pon, and Mr. John Seiler of MSHA; Mr. Ken Feith and Ms. Catrice Jefferson of EPA; Mr. Jim Maddux and Mr. Mike Seymour of OSHA; Dr. Noah Seixas of the University of Washington; and Dr. David Wegman of the University of Massachusetts Lowell and chair of the National Academies Committee for the Review of NIOSH Research Programs. The committee would especially like to recognize the assistance of Dr. W. Gregory Lotz. Dr. Lotz served as the committee’s point of contact for the NIOSH Hearing Loss Research Program and was tireless and gracious in his efforts to respond to the committee’s many information requests and questions. The committee is also grateful for the assistance of Dr. Raymond Sinclair, who ably and patiently acted as a liaison between the committee and NIOSH as a whole. The committee appreciates the support of Andrew Pope, director of the IOM Board on Health Sciences Policy, and Evan Douple and Sammantha Magsino, who serve as staff to the Committee for the Review of NIOSH Research Program. In addition, several members of the National Academies staff helped in the report review, preproduction, dissemination, and financial management for the report, including Judy Estep, Amy Haas, Clyde Behney, Bronwyn Schrecker, Elisabeth Reese, Tyjen Tsai, Sally Stanfield, Hallie Wilfert, Christine Stencel, David Codrea, and Cathie Berkley.
Representative terms from entire chapter: