Au.D. Educational Perspective

 Lipin/Dietz Associates, Inc.

Many clients have asked why I have returned to the University of Connecticut  to pursue a doctoral degree in audiology -  32 years since receiving my M.B.A. and  almost 40 years after completing undergraduate studies in engineering science and electrical technology. The following excerpt from my 2005 doctoral letter of application highlights some of the more compelling reasons, but in essence I believe that the field of audiology can benefit from engineering professionals engaged in practical applications of audiology and hearing science.  

"Traditional estimates of those individuals exposed within all sectors of the economy to levels of hazardous noise or other ototraumatic agents generally reference the 1980 NIOSH study and 1992 Statistical Abstracts of the United States . The consensus among hearing health professionals place the total number of American workers affected by these exposures at 30 million.  In the 1996 NIOSH publication entitled “Preventing Occupational Hearing Loss – A Practical Guide” it was estimated that one out of four workers will experience a permanent hearing loss based upon these occupational noise exposures1. Second only to presbycusis, noise-induced hearing loss is the most common form of sensorineural hearing deficit2.

For thirty years, I have had the unique opportunity to assess the published estimates of occupational and non-occupational hearing losses. I have concernedly observed the efforts of New England’s largest employers as they have addressed the noise exposure issues within their manufacturing facilities; providing guidance in areas of noise monitoring, audiological testing, data acquisition, clinical interpretation, legislative compliance and archival management. I have performed audiometric threshold testing on thousands of noise-exposed employees each year, and concurrently managed more than 100,000 audiometric test records   and the computer systems that archive and evaluate this data.  Employers such as New York City Transit, FDNY, Pratt and Whitney, Sikorsky Aircraft, Exxon-Mobil, General Dynamics, Pfizer, Clairol, General Electric, and hundreds of other clients rely on my expertise to service their audiometric testing systems, assist with instrumentation replacement, maintain audiometric and demographic data or provide overall assistance with medical surveillance protocols. I have trained hearing conservationists at all professional levels; from medical assistants to corporate medical physicians and provided the appropriate accreditation certifications.

Within our school health market, I have examined the evaluation protocols of most Connecticut public school hearing testing programs, offering training to  school nurses and paraprofessionals on the use and care of audiometers and portable impedance instruments. For a number of districts I have helped school health administrators develop appropriate screening protocols that supplement state testing mandates.

From the beginning of federal regulation of occupational noise exposure under the Walsh-Healy Public Contracts Act of 1968 and subsequent expansions under the Williams-Steiger Occupational Safety and Health Act of 1970 through the most recent OSHA mandates regarding revised STS recordability criteria, I have monitored the hearing health histories of thousands of affected employees. I have concluded that in spite of stringent legislative mandates and OSHA enforcement, increased liability carrier interest, technological innovation, and significantly improved data management tools, we as a society, have fallen far short of any reasonable expectation of reducing noise-induced hearing losses. Concurrently, there has developed an increasing risk of non-occupational noise–induced hearing losses as we continue to create greater opportunities for excessive noise exposure and acoustic insult though a myriad of audio, recreational and multimedia innovation. In essence, the gains we have made in managing middle ear disease early in our lives have been offset by the noise-induced losses that destroy our cochlear and hearing ability later in life.

Effective application strategies that positively influence the fields of occupational and non-occupational noise exposure are most effective when based upon a relevant practical and academic foundation. From personal experience, I have found that hearing conservation programs that sought improvement through innovative application of administrative, testing and analysis protocols were most successful when designed with intelligent intervention. Program development that fails to utilize the full scope of audiological assessment resources, rehabilitative options and evaluation strategies, generally compromise long-term effectiveness.

While a number of factors influence program effectiveness, I believe that standardization of STS follow-up methodologies, implementation of aggressive noise intervention strategies, technological improvements to active earplug protection, and a broad educational initiative offer the best approaches for prevention. Cochlear regeneration via stem cell research, pharmaceutical intervention for outer and inner hair cell preservation,  and continued improvements in implant technology represent the best approaches to rehabilitative enhancement. However, without a broader academic foundation, any personal investigation of these areas would be most inappropriate."

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