Rehabilitation for PersonsSuffering from Occupational Deafness

Dr. Lawrence K. C. LI, MBBS(NCLE), FRCS(ENG), FHKAM (Otorhinolaryngology)

Chairman, Occupational Deafness Compensation Board

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Occupational Deafness in Hong KongOccupational Deafness in Hong Kong

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50

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2000 2001 2002 2003 2004

Occupational Deafness Silicosis

Tenosynovitis of Hand or Forearm Tuberculosis in Health Care Workers

Gas Poisoning Occupational Dermatitis

Others

Occupational Deafness is one the most common

occupational diseases detected in Hong Kong

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Occupational Deafness (Compensation) Ordinance enacted in June 1995

Compensate workers suffering noise-induced hearing loss due to employment in Hong Kong

Occupational Deafness in Hong KongOccupational Deafness in Hong Kong

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Occupational Deafness CompensationOccupational Deafness Compensation

Two requirements for entitlement to compensation

1. Occupational requirement: Employed in Hong Kong in one of the 29

specified noisy occupations for at least 10 years in aggregate (or five years in four of the particularly noisy ones)

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Occupational Deafness CompensationOccupational Deafness Compensation

Two requirements for entitlement to compensation

1. Occupational requirement: Employed in Hong Kong in one of the 29

specified noisy occupations for at least 10 years in aggregate (or five years in four of the particularly noisy ones)

2. Medical requirement: Hearing loss not less than 40dB in both ears

At least the hearing loss of one ear due to noise

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Measurement of Hearing LossMeasurement of Hearing Loss

Pure tone audiometry, cortical evoked response audiometry, acoustic reflex threshold test

Average hearing loss over 1, 2 and 3kHz(this range of frequencies will most likely affect a person’s daily communication)

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Occupational Deafness CompensationOccupational Deafness Compensation

Two requirements for entitlement to compensation

1. Medical requirement:

Noise-induced hearing loss not less than 40dB in both ears

At least the hearing loss of one year due to noise

2. Occupational requirement:

Employed in Hong Kong in one of the 29 specified noisy occupations for at least 10 years in aggregate (or five years in four of the particularly noisy ones)

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Profile of Occupational Deafness Profile of Occupational Deafness SufferersSufferers

Position as at 31.8.2005

No. of applications received………………… 4 455

No. of applications approved…………………2 215

Total amount of compensation paid………$216.8 m

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Profile of Occupational Deafness Profile of Occupational Deafness SufferersSufferers

Age

6%

46%48%

Under 4040 to under 5656 or above

Sex

97%

3%

Male

Female

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Profile of Occupational Deafness Profile of Occupational Deafness SufferersSufferers

Average length of employment in noisy occupations: 16 years

58%

11%

8%5% 6%

12%

Grinding, chiselling or cutting of rocks, concrete or marbleGrinding of metalWeavingDescaling of shipsWorking near combustion engines, turbines, pressurised fuel burners or jet enginesOthers

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Responsibilities of the Board - Responsibilities of the Board - EvolvementEvolvement

1995 - Board established to compensate workers suffering from

occupational deafness

1998 - Board empowered to conduct education and publicity

programmes for the prevention of occupational deafness

2003 - Board empowered to conduct or finance rehabilitation

programmes for persons suffering from occupational deafness.

Board empowered to reimburse the expenses for hearing assistive devices

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Responsibilities of the Board - Responsibilities of the Board - EvolvementEvolvement

The Occupational Deafness Compensation Board now administers a comprehensive range of services for the protection of benefits of those who are affected by noise at work.

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Objective: To gauge the rehabilitation needs of

occupational deafness sufferers To facilitate the planning and design of

rehabilitation programmes

Researcher: A cross-disciplinary research team from the

Hong Kong Polytechnic University

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 1 - investigation of the needs of rehabilitation services

Questionnaire survey of all 2 061 occupational deafness sufferers

Focus groups discussion

Out of 2 061 questionnaires sent out, some 655 had sent back the return representing a response rate of 31.8%.

About 30 respondents and their family members had been invited and took part in the focus group discussions

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Findings: Some common problems faced by occupational

deafness sufferers 87% had difficulties when dealing with daily

activities Particularly in taking part in socializing or

entertainment activities 50% considered hearing loss had adverse impact on

getting new employment

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Findings: Some common problems faced by occupational

deafness sufferers Psychological problems

Worries, frustration, signs of depression, low self image and non-acceptance of disability

Communication blocks and relationship problems with immediate family

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Findings: Some common problems faced by occupational

deafness sufferers Psychological problems Lack of initiative to overcome communication barrier

Most used hearing aids sparingly to help them communicate

83.9% simply asked the other party to raise their voice

Only a small proportion used sign language (4.8%) or lip reading (3.3%)

Problems in using hearing aid and want support in check-up, guidance and maintenance

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Findings: Some common problems faced by occupational

deafness sufferers Psychological problems Lack of initiative to overcome communication barrier Lack of rehabilitation services designed specifically

to occupational deafness sufferers Lack of services targeted to meet their needs Sufferers generally passive in seeking assistance Lack of information on available network

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 2 – practical study by pilot programmes Information and orientation workshops

To provide participants with information about various aspects of occupational deafness and possible sources of services to them

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 2 – practical study by pilot programmes Information and orientation workshops Support group

To encourage participants to express their feelings, develop social support and learn new coping skills

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 2 – practical study by pilot programmes Information and orientation workshops Support group Parallel group

To strengthen spousal support and enhance family integration

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 2 – practical study by pilot programmes Information and orientation workshops Support group Parallel group Return-to-work programme

To assist occupational deafness sufferers to return to work.

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Phase 2 – practical study by pilot programmes Information and orientation workshops Support group Parallel group Return-to-work programme

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Pilot programmes helped the participants: Ventilating feels and difficulties Enhancing understanding of family dynamics and

relationship Developing support Improving social learning on coping with positive life

styles

Return-to-work programmes More effective in improving work readiness Not so effective in leading to actual job placement

(maybe due to the relatively short duration of the pilot programme)

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Study of the Rehabilitation NeedsStudy of the Rehabilitation Needs

Some highlights of the study: An information and referral system related to

services for occupational deafness sufferers is needed

Better support in use of hearing aid

Psychological support, in particular family integration, social life and community participation

Vocational guidance and counseling services for those who are still fit for work, but demoralised because of hearing impairment

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Rehabilitation – Way ForwardRehabilitation – Way Forward

Some characteristics of OD sufferers: Hearing loss developed gradually, usually not so

aware of problems at the early stage

Cultural background and family status hold them back from communicating the problems to others

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Rehabilitation – Way ForwardRehabilitation – Way Forward

Rehabilitation service at three levels: Medical Rehabilitation

Social Rehabilitation

Occupational Rehabilitation

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Rehabilitation – Way ForwardRehabilitation – Way Forward

Medical Rehabilitation: Since May 2003, the Board has been empowered to

finance OD sufferers to acquire hearing assistive devices

The Scheme already assisted about 500 persons to acquire hearing assistive devices (mainly hearing aids)

To strengthen services by organising pre-and-post fitting workshops

To consider studying some common medical ailments that might affect OD sufferers

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Rehabilitation – Way ForwardRehabilitation – Way Forward

Social Rehabilitation: Provide relevant information on available services

Develop programmes in partnership with other organizations to promote social/family integration

Workshops and mutual support groups

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Rehabilitation – Way ForwardRehabilitation – Way Forward

Occupational Rehabilitation: Retraining programmes and job replacement

programmes

Partnership with Labour Department and the Employees Retraining Board

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Thank you