Rehabilitation for Persons Suffering from Occupational Deafness

1. Rehabilitation for PersonsSuffering from Occupational Deafness Dr. Lawrence K. C. LI, MBBS(NCLE), FRCS(ENG), FHKAM (Otorhinolaryngology)Chairman, Occupational Deafness Compensation Board

2. Occupational Deafness in Hong Kong • Occupational Deafness is one the most common occupational diseases detected in Hong Kong

3. Occupational Deafness in Hong Kong • Occupational Deafness (Compensation) Ordinance enacted in June 1995 • Compensate workers suffering noise-induced hearing loss due to employment in Hong Kong

4. Occupational Deafness Compensation • Two requirements for entitlement to compensation • 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)

5. Occupational Deafness Compensation • Two requirements for entitlement to compensation • 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) • Medical requirement: • Hearing loss not less than 40dB in both ears • At least the hearing loss of one ear due to noise

6. Measurement 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)

7. Occupational Deafness Compensation • Two requirements for entitlement to compensation • Medical requirement: • Noise-induced hearing loss not less than 40dB in both ears • At least the hearing loss of one year due to noise • 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)

8. Profile of Occupational Deafness Sufferers • 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

9. Profile of Occupational Deafness Sufferers

10. Profile of Occupational Deafness Sufferers • Average length of employment in noisy occupations: 16 years

11. Responsibilities of the Board - Evolvement 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

12. Responsibilities of the Board - Evolvement 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.

13. Study 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

14. Study 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

15. Study 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

16. Study 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

17. Study 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

18. Study 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

19. Study 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

20. Study 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

21. Study 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

22. Study 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.

23. Study of the Rehabilitation Needs Phase 2 – practical study by pilot programmes • Information and orientation workshops • Support group • Parallel group • Return-to-work programme

24. Study 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)

25. Study 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

26. Rehabilitation – 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

27. Rehabilitation – Way Forward Rehabilitation service at three levels: • Medical Rehabilitation • Social Rehabilitation • Occupational Rehabilitation

28. Rehabilitation – 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

29. Rehabilitation – 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

30. Rehabilitation – Way Forward Occupational Rehabilitation: • Retraining programmes and job replacement programmes • Partnership with Labour Department and the Employees Retraining Board

31. Thank you