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1. San Francisco Fire Department
Hearing Conservation Training
Shawn Holle, Safety Analyst
CCSF Department of Public Health
Occupational Safety & Health Section

2. 12/08/15 DPH/OSH 2
Overview
 Sound v Noise
 Ear Anatomy
 Cal-OSHA Regulations
 SFFD Hearing Conservation Program
 Evaluation
 Medical Surveillance
 Noise Control

3. 12/08/15 DPH/OSH 3
Sound v Noise
What’s The Difference Between Sound & Noise?

4. 12/08/15 DPH/OSH 4
Sound
Pressure Waves in Air
Waves Have:
 Physical Size
 Intensity (Frequency)

5. 12/08/15 DPH/OSH 5
How Do We Measure It?
Decibel (Db)
 Expresses Intensity of Sound
 Three Different Scales - A, B, & C
Hertz (Hz)
 Unit of Measurement for Sound Frequencies
 Human Hearing Ranges From 20 Hz & 20,000 Hz
 High Frequency: Dog Whistle, Siren
 Low Frequency: Engine Idling, Bass Drum

6. 12/08/15 DPH/OSH 6
Typical Sound Levels
Decibel Level Examples
0 Quietest Sound One Can Hear
30 Whisper: Quiet Library
60
Normal Converstation, Sewing Machine,
Typewriter
90
Lawnmower, Shop Tools, Truck Traffic
(8 Hours Per Day Maximum Exposure)
100
Chain Saw, Pneumatic Drill, Snow Mobile
(2 Hours Per Day Maximum Exposure)
115
Sandblasting, Rock Concert, Air Horn (15
Minute Per Day Maximum Exposure)
140
Shotgun, Jet Engine (Noise Causes Pain &
Possible Exposure Injury)

7. 12/08/15 DPH/OSH 7
Fire Department Sound Levels
Approximate Decibel
Level
Examples
73-120 Test Box
134 Air Horn (Morning Test)
112-117 Air Tank Bleed (4 Feet from Truck)
75-95 Engine Idling (Measured in Cab)
80-99 Engine Accelerating (Measured in Cab)
92-109 Air Horn (Measured in Cab)
104-108 Jaws of Life
93-104 Cement Cutter
103-105 Chainsaw

8. 12/08/15 DPH/OSH 8
Time Weighted Average (TWA)
Average Noise Level During 8-hour Period

9. 12/08/15 DPH/OSH 9
Hearing Loss Types
What Are Threshold Shifts?
 Temporary Threshold Shift (TTS)
 Permanent Threshold Shift (PTS)
Change in Hearing Threshold Compared to
Baseline Audiogram: Average of 10 Db or More in
Either Ear At:
 2000 Hz
 3000 Hz
 4000 Hz

10. 12/08/15 DPH/OSH 10

11. 12/08/15 DPH/OSH 11
Indicative of noise exposure

12. 12/08/15 DPH/OSH 12
Human Ear:
Anatomy & Mechanics

13. 12/08/15 DPH/OSH 13
Cochlea Contains Hair Cells
Cells Can Be Destroyed
Destroyed Cells Don’t GROW BACK

14. 12/08/15 DPH/OSH 14
Human Ear: Hair Cells

15. 12/08/15 DPH/OSH 15
Human Ear: Healthy Hair Cells

16. 12/08/15 DPH/OSH 16
Human Ear: Damaged Hair Cells

17. 12/08/15 DPH/OSH 17
Hearing Loss
 Cumulative - Over Time
 Permanent
 Totally Preventable

18. 12/08/15 DPH/OSH 18
Hearing Loss:
Important Factors
 Genetics / Heredity
 Illness (Measles)
 Medications
 Trauma
 Pressure Changes
 Age
 Lifestyle

19. 12/08/15 DPH/OSH 19
Hearing Loss: Not Just At Work
Non-Occupational Noise
Music
Guns
Motorcycles
Muscle Cars
Etc.

20. 12/08/15 DPH/OSH 20
Hearing Loss: Important Factors
 Hearing Can’t Be Turned On & Off
 Hearing Must Be Protected At All Times
 Workplace Standards

21. 12/08/15 DPH/OSH 21
Can I Toughen Up My Ears?
NO

22. 12/08/15 DPH/OSH 22
Firefighter Hearing Losses
8%
15%
22%
55%
Normal Hearing Mild High Frequency Hearing Loss
Moderate High Frequency Hearing Loss Severe High Frequency Hearing Loss

23. 12/08/15 DPH/OSH 23
Cal-OSHA
Title 8: 5097 Hearing Conservation
Standard
Noise Exposure Greater than 8 Hour
TWA of 85 dBA to be Covered
 Responsibilities
 Evaluation & Surveillance of Work Environment
 Medical Surveillance - Annual Tests
 Noise Control Methods
 Training
 Program Evaluation
 Recordkeeping

24. 12/08/15 DPH/OSH 24
Evaluation & Surveillance
Work Environment
Monitoring Results of Fire Stations
Indicate Noise Levels on the Job
Exceed 85 dBA Over 8 Hours

25. 12/08/15 DPH/OSH 25
Medical Surveillance
 Annually
 Audiogram
 Results Available on Request

26. 12/08/15 DPH/OSH 26
Audiometric Test Results
 Fire Fighters Notified of Standard Threshold Shift >10 dBA
 25 dBA Loss Requires Doctor’s First Report (Work Comp)
 STS >10 dBA & Loss of 25 dBA Requires Retest
 OHS Keeps Permanent Records
 Abnormal Tests Submitted to Department Physician & Entered In
Medical Record

27. 12/08/15 DPH/OSH 27
Controlling Noise
Engineering, Administrative, PPE
Noise Reduction Rating (NRR)
Attenuation
Fitting & Using Hearing Protection
Hearing Protection Maintenance

28. 12/08/15 DPH/OSH 28
Hearing Protection: PPE
Plugs Baby
Noise Reduction Rating (NRR)
 Rates Noise Reduction Amount Provided by
Hearing Protection
Attenuation
 Estimated Sound Reduction Provided by Hearing
Protection

29. 12/08/15 DPH/OSH 29
Demonstration: Wearing Hearing Protection

30. 12/08/15 DPH/OSH 30
Inspecting Hearing Protection
 Small Holes (Let In High Frequency Noise)
 Cracks On Earmuff Covers Reduce Insulation
Effectiveness
 Oils, Dirt, Soot Degrade Protection
 Clean Regularly: Manufacturer Specifications
 Use Mild Soap & Water Solution

31. 12/08/15 DPH/OSH 31
Hearing Protection Mandatory
 On All Department Vehicles
 Engines Running
 Fireboat
 Jaws of Life
 Jack Hammers
 Cement Cutters
 Outboard Motors
 Equipment Tested Outside
 Siren & Air Horn Testing Prohibited in Stations
 Officers Accountable for General Order
Compliance

32. 12/08/15 DPH/OSH 32
SFFD Hearing Protection
 Earmuffs
 Canal Caps When Overhauling, Testing, Using
Equipment
 Disposal Plugs

33. 12/08/15 DPH/OSH 33
Personal Protective Equipment
Hearing Protection
 Supplemental Hearing Protection OK
 Lost Equipment Replaced at Employee Expense
 Firefighters Responsible for Hearing Protection
Maintenance

34. Heat Stress

35. 12/08/15 DPH/OSH 35
Overview
 What Is Heat Stress?
 Normal Cooling Mechanisms
 First Aid
 Risk Factors & Evaluating Risk
 Prevention & Management
 Your Responsibility

36. 12/08/15 DPH/OSH 36
What Is Heat Stress?
 Heat Buildup in Body
 Generated by Muscles During Work
 Coming From Hot & Warm Environments
 Happens When Heat Load Too High

37. 12/08/15 DPH/OSH 37
Normal Cooling Mechanisms
When Body Core Temperature Rises
 Increased Blood Flow to Skin Surfaces
 Increased Sweating
 Increased Heart Rate Increases
When This Works Well
 Core Temperature Drops or Stabilizes

38. 12/08/15 DPH/OSH 38
Body Core v Peripherals
 Core: Heart, Lungs, & Other Vital
Organs
 Periphery: Extremities
 Core & Periphery Compete With
Each Other for Blood Supply

39. 12/08/15 DPH/OSH 39
When Cooling Mechanism Fails
 Dehydration Results
 Body Cannot Cool Itself
 Core Temperature Rises
 Salt Loss Causes Heat Cramps
 Blood Flows to Periphery…Organs Shut Down

40. 12/08/15 DPH/OSH 40
Environmental / Task Factors
Contributing to Heat Stress
 Ambient Temperature > 75ºF
 ^Relative Humidity
 Sources of Heat (Fire)
 Clothing (Heat Entrapment / Weight)
 Workload
 Microenvironment
 Physical Fitness

41. 12/08/15 DPH/OSH 41
Heat Stress Categories
Categories:
 Heat Rash
 Sunburn
 Heat Strain / Cramps
 Heat Stress / Exhaustion
 Heat Stroke

42. 12/08/15 DPH/OSH 42
Heat Rash
Skin Irritation or Eruptions
Red Clusters of Pimples or Blisters
Occurs in Skin Creases

43. 12/08/15 DPH/OSH 43
Sun Burn
 Premature Aging of Skin
 Skin Cancer (Melanoma)
 Symptoms Include:
 Red Skin (Discomfort)
 Blisters (Infection)
 Fever (Thermo-Regulation)
 Pain (2º or 3º Burns)

44. 12/08/15 DPH/OSH 44
Heat Strain / Cramps
 Involuntary Muscle Contractions
Caused by Not Replacing Fluids or
Electrolytes
 Occurs Usually in the Legs or
Abdomen, Which Warn That Heat
Stress Is Developing

45. 12/08/15 DPH/OSH 45
 Imbalance Between Heat Gain & Body Heat Loss
 Environmental & Workload Conditions Place
Excessive Demand on Temperature Regulation
Heat Stress / Exhaustion

46. 12/08/15 DPH/OSH 46
 Heavy Sweating
 Pale
 Nausea & Vomiting
 Headache
 Blurred Vision
 Dizziness & Fainting
 More Susceptible
Heat Stress / Exhaustion Symptoms

47. 12/08/15 DPH/OSH 47
Heat Stroke
 Body Unable to Control Temperature
 Oral Temperature Above 105 F in 10 to 15 Minutes
 Death or Permanent Damage If Untreated
 Heat Stroke Kills 4,000 Americans Annually

48. 12/08/15 DPH/OSH 48
Heat Stroke Symptoms
Oral Temperature Over 105F
No Sweating
Red, Hot, Dry Skin
Throbbing Headache
Dizziness
Nausea
Unconsciousness

49. 12/08/15 DPH/OSH 49
Sunburn Treatment
 Apply Cold Compresses to Burned Areas
 Apply Moisturizing Lotions to Affected Areas
 No Butter, Ointment, or Lard
 Do Not Break Blisters

50. 12/08/15 DPH/OSH 50
Heat Rash Treatment
 Provide Cooler, Less Humid, Environment
 Keep Affected Areas Dry
 Apply Powder
 Avoid Ointments & Creams

51. 12/08/15 DPH/OSH 51
Heat Stress
First Aid
Cool Victim
 Rest in Cool Place
 Drink Cool Water
 Loosen Clothing
 Remove Unnecessary Clothing
 Shower or Sponge With Cool Water

52. 12/08/15 DPH/OSH 52
Heat Stroke
First Aid
 Immediate , Aggressive, Effective Cooling
 Immerse Victim in Tub of Cool Water
 Place in Cool Shower
 Spray With Cool Water From a Hose
 Wrap in Cool, Wet Sheet & Fan Rapidly
 Nothing by Mouth – It Won’t Stay Down
 Transport to Hospital

53. 12/08/15 DPH/OSH 53
Risk Factors
 Overweight
 Small Body Size
 Poor Nutrition
 Poor Physical Condition
 Previous Heat Illnesses
 Lack of Acclimatization
 Over 40
 Heart Disease
 High Blood Pressure
 Diabetes

54. 12/08/15 DPH/OSH 54
Risk Factors for Individuals
 Recent Immunization
 Alcohol During Previous 24 Hours
 Medications That Limit Sweating
 Excessive Caffeine Intake
 Low-Salt Diet

55. 12/08/15 DPH/OSH 55
Weather
 Temperatures Above 70F During the Day, 80F at
Night
 Direct Sunlight Can Equal an Increase up to 130F in
Air Temperature
 High Humidity
 Little Air Movement

56. 12/08/15 DPH/OSH 56
Job Risk Factors
 Heavy Work
 Prolonged Shifts
 Heavy Clothing
 Protective Gear & Respirators
 Exposure to Any Toxic Agent

57. 12/08/15 DPH/OSH 57
Prevention & Management
Traditional Controls
 Clothing & Personal
Protective Equipment (PPE)
 Work Assignments, Work
Cycles
 Acclimatization
 Additional Controls

58. 12/08/15 DPH/OSH 58
Clothing & PPE
 The More Clothing Worn, the Longer
It Takes Evaporation to Cool the Skin
 Coated & Non-woven Personal
Protective Garments Block
Evaporation of Sweat

59. 12/08/15 DPH/OSH 59
PPE Selection
 Use Lightweight Garments & Respirators
 Light-Colored Garments Absorb Less
Heat From Sun
 Cooling Vests

60. 12/08/15 DPH/OSH 60
Work Rest Cycles

61. 12/08/15 DPH/OSH 61
Acclimatization
 Increases the Amount of Sweat Produced
 Speeds Up Onset of Sweating
 Resets Internal Thermostat
 Regulates Content of Sweat to Conserve Electrolytes
 Increases Blood Flow to Extremities
 Reduces Heart Rate
 Burns Fat
 Conserves Carbohydrates
 Reduces Core & External Temperatures
 7 to 10 Days to Achieve
 Lost in 2 to 3 Days

62. 12/08/15 DPH/OSH 62
Worker’s Responsibilities
 Hydration
 Being Alert for Symptoms in Themselves & Others
 Getting Adequate Rest & Sleep
 Carrying Out Instructions & Training for
Controlling Heat Stress