Hearing Loss Research at NIOSH
Reviews of Research Programs of the National Institute for Occupational Safety and Health
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was requested by the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention and supported by Contract Nos. 200-2000-00629 (Task Order #0033) and 200-2005-10881 (Task Order #0004), between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested Citation: Institute of Medicine and National Research Council. 2006. Hearing Loss Research at NIOSH. Committee to Review the NIOSH Hearing Loss Research Program. Rpt. No. 1, Reviews of Research Programs of the National Institute for Occupational Safety and Health. Washington, DC: The National Academies Press.
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COMMITTEE TO REVIEW THE NIOSH HEARING LOSS RESEARCH PROGRAM
BERNARD D. GOLDSTEIN (Chair), Professor,
Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
BETH A. COOPER, Manager,
Acoustical Testing Laboratory, NASA John H. Glenn Research Center at Lewis Field, Cleveland, Ohio
SUSAN E. COZZENS, Professor,
School of Public Policy, Georgia Institute of Technology, Atlanta
KAREN J. CRUICKSHANKS, Professor,
Department of Population Health Sciences and Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison
JUDY R. DUBNO, Professor,
Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston
DENNIS A. GIARDINO, Acoustical Consultant,
Pittsburgh, Pennsylvania
RENA H. GLASER, Manager of Medical Surveillance (Retired),
3M Corporation, St. Paul, Minnesota
WILLIAM W. LANG, President, Noise Control Foundation,
Poughkeepsie, New York
LAURA C. LEVITON, Senior Program Officer for Research and Evaluation,
Robert Wood Johnson Foundation, Princeton, New Jersey
BRENDA L. LONSBURY-MARTIN, Research Professor,
Division of Otolaryngology, Department of Surgery, Loma Linda University School of Medicine, Loma Linda, California
MICHAEL A. SILVERSTEIN, Clinical Professor,
Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle
Framework Committee Liaison
FRANKLIN E. MIRER, Director,
Health and Safety Department, United Automobile, Aerospace and Agricultural Implement Workers of America (UAW), Detroit, Michigan
Project Staff
LOIS JOELLENBECK, Senior Program Officer
JANE DURCH, Senior Program Officer
KRISTEN GILBERTSON, Research Assistant
Independent Report Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Kathleen Campbell, Department of Surgery, Southern Illinois University School of Medicine
William W. Clark, Program in Audiology and Communication Sciences, Washington University School of Medicine in St. Louis, Missouri
Christine Dixon-Ernst, Occupational Health Issues and EHS Information Systems, Alcoa, Pittsburgh, Pennsylvania
Joseph A. Main, Consultant, Mining Health and Safety, Spotsylvania, Virginia
Susan Megerson, Intercampus Program in Communicative Disorders, The University of Kansas
David Roessner, School of Public Policy, Georgia Institute of Technology
Kenneth Rosenman, Division of Occupational and Environmental Medicine, Michigan State University
Scott D. Sommerfeldt, Department of Physics and Astronomy, Brigham Young University, Provo, Utah
Evelyn Talbott, Department of Epidemiology, University of Pittsburgh, Pennsylvania
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Paul D. Stolley, University of Maryland School of Medicine, and David G. Hoel, Medical University of South Carolina. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
Preface
It has been a great pleasure to work with the group of consummate professionals who served on the Committee to Review the NIOSH Hearing Loss Research Program. The committee was fortunate that the Institute of Medicine’s recognition of the unusual challenges posed by this report led to its assigning particularly superb staff to work with us. The dedication, hard work, and patience of Lois Joellenbeck and Jane Durch were essential to the completion of this task. Kristen Gilbertson’s very able assistance deserves high praise as well.
We also want to thank the many individuals working for NIOSH (National Institute for Occupational Safety and Health) with whom we interacted. Being reviewed produces anxiety in any organization—and this is particularly true now that accountability is so prominent in the pronouncements of the Office of Management and Budget and of Congress. The discomfort of NIOSH participants was no doubt exacerbated by our committee’s own learning curve, which led to many requests for different types of information, and by the lack of familiarity of NIOSH professionals with this new review process, which was still evolving during their preparation of materials for this committee. We hope that this has been a valuable learning experience both for NIOSH and for future National Academies committees reviewing NIOSH research programs.
Our committee was presented with a number of challenges that went beyond the usual assignment of analyzing and synthesizing information about a program and then making recommendations. No previous committee had worked under this new NIOSH review program, which may include up to 14 other similar re-
views in the next few years, so we had no template to follow and were constrained to develop a format that would work not only for us but for future committees. Fortunately, we were provided with very helpful guidance for this new approach, including meeting the challenge of scoring the Hearing Loss Research Program both for impact and for relevance, by the National Academies’ Committee for the Review of NIOSH Research Programs (known as the Framework Committee). We greatly appreciated the valuable and patient input of Frank Mirer, the liaison from the Framework Committee; Evan Douple and Sammantha Magsino, the Framework Committee study staff; and David Wegman, the Framework Committee chair. Of particular note is that the scoring system for impact and relevance is in whole numbers and is not linear (i.e., a score of 3 is not equidistant from a 1 and a 5). Determining the scores required careful review of the definitions that were provided to us by the Framework Committee. Conforming to the definitions and outline of the Framework Committee required many iterations.
When the overall review process is completed, scores for impact and relevance will be available for the 15 NIOSH components evaluated. Inevitably, and unfortunately, comparisons among these NIOSH programs are likely to be made based on the score alone. I urge readers to go beyond the scores to read both the commentary that is the basis for the score and the specific committee recommendations.
The need to go beyond the scores for impact and relevance is particularly pertinent for a cross-cutting matrix organization such as the Hearing Loss Research Program. A standard linear logic model of the type on which this review is based begins with inputs, such as funding and staff; moves through outputs, the direct products of the program; and proceeds to outcomes, the extent to which the mission and goals of the organization have been attained. Evaluating whether the NIOSH Hearing Loss Research Program uses its inputs appropriately is complicated by two factors. First, as a classic matrix organization that has its components within various NIOSH line organizations, the Hearing Loss Research Program does not really have its own budget and staff. As such, it is difficult to evaluate whether the program is making appropriate decisions about inputs. This is further complicated by the need to follow congressional budgetary dictates that can distort the relevance score of the program—for example, devotion of more than half of the Hearing Loss Research Program budget to mining is not consonant with the relative extent to which miners represent the American workforce at risk for hearing loss. Comparisons of final scores may lead the very valuable NIOSH cross-cutting matrix organizations to be ranked lower than NIOSH line organizations due to the dictates of the logic model on which the Framework Committee based its guidance.
The outcomes portion of the logic model also presents some difficulty when evaluating a research organization that does not control how its output is used. NIOSH research output is added to the pool of knowledge from which many others may dip, often in unforeseen ways that do not follow the linearity of a logic model. These externalities are addressed in our review but may be lost if the focus is solely on a numerical score.
What follows is the committee’s review of the NIOSH Hearing Loss Research Program. It is our hope that the results of this review will help to further build a dynamic research program responsive to protecting the hearing of American workers and will contribute to the challenging task of developing processes to fairly evaluate government health research organizations.
Bernard D. Goldstein
Committee Chair
Tables, Figures, and Boxes
TABLES
1-1 |
NIOSH Hearing Loss Research Program Funding by Fiscal Year, 1997–2005, |
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2-1 |
Research Goals and Subgoals of the NIOSH Hearing Loss Research Program, as of February 2006, |
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2-2 |
NIOSH Hearing Loss Research Program Budget and Staffing by Research Goals, |
FIGURES
1-1 |
NIOSH organization chart, as of December 2005, |
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1-2 |
Location of Hearing Loss Research Program activities in NIOSH, |
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1-3 |
Logic model for the Hearing Loss Research Program, |
BOXES
2-1 |
Logic Model Terms and Examples, |
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2-2 |
Scale for Rating Program Relevance, |
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2-3 |
Scale for Rating Program Impact, |
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3-1 |
Participants in the NIOSH Hearing Loss Prevention Futures Workshop, |
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3-2 |
Emerging Research Issues Identified by the Hearing Loss Research Program, |
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3-3 |
Hearing Loss Prevention Goals in the NIOSH Mining Research Plan, |
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B-1 |
Agendas for Site Visits, |
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B-2 |
Letter Inviting Comment on the NIOSH Hearing Loss Research Program, |
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B-3 |
Emerging Research Areas in Occupational Hearing Loss and Noise Control Suggested by Stakeholders, |
Abbreviations and Acronyms
AAA American Academy of Audiology
AAOHNS American Academy of Otolaryngology–Head and Neck Surgery
AAS American Auditory Society
ACGIH American Conference of Governmental Industrial Hygienists
ACOEM American College of Occupational and Environmental Medicine
AGES Age, Gene/Environment Susceptibility Study
AIHA American Industrial Hygiene Association
ANSI American National Standards Institute
ASHA American Speech–Language–Hearing Association
BLS Bureau of Labor Statistics
CAOHC Council for Accreditation in Occupational Hearing Conservation
CDC Centers for Disease Control and Prevention
CHABA Committee on Hearing, Bioacoustics, and Biomechanics
CRADA Cooperative Research and Development Agreement
DART Division of Applied Research and Technology
DBBS Division of Biomedical and Behavioral Sciences
DoD Department of Defense
DPSE Division of Physical Sciences and Engineering
DSHEFS Division of Surveillance, Hazard Evaluations, and Field Studies
EID Education and Information Division
EPA Environmental Protection Agency
FTE Full-time equivalent
FY Fiscal year
HHE Health Hazard Evaluation
HLPP Hearing loss prevention program
HPD Hearing protection device
INCE Institute of Noise Control Engineering
IOM Institute of Medicine
ISO International Organization for Standardization
MSHA Mine Safety and Health Administration
NASA National Aeronautics and Space Administration
NHANES National Health and Nutrition Examination Survey
NHCA National Hearing Conservation Association
NIDCD National Institute on Deafness and Other Communication Disorders
NIH National Institutes of Health
NIHL Noise-induced hearing loss
NIOSH National Institute for Occupational Safety and Health
NORA National Occupational Research Agenda
NRC National Research Council
NRR Noise Reduction Rating
NSF National Science Foundation
NVLAP National Voluntary Laboratory Accreditation Program
OEP Office of Extramural Programs
OHC Office of Health Communications
ORTT Office of Research and Technology Transfer
OSHA Occupational Safety and Health Administration
PA Program Announcement
PRL Pittsburgh Research Laboratory
r2p Research to Practice
RFA Request for Applications
SENSOR Sentinel Event Notification System for Occupational Risks
SRL Spokane Research Laboratory
STS Standard threshold shift
UAW United Automobile, Aerospace and Agricultural Implement Workers of America
USACHPPM U.S. Army Center for Health Promotion and Preventive Medicine
WHO World Health Organization