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Hearing Conservation Programs

Health for all is a major target of the Government of India, which also includes prevention of hearing impairment. Hearing plays a vital role in speech and language development, communication, education and job placements. Hence, prevention of hearing loss becomes essential which can be done at three levels: primary, secondary and tertiary. 

Primary Prevention:

Primary prevention of hearing impairment is the elimination or inhibition of the onset and development of the problem. Several activities are conducted for primary prevention of hearing loss. This is being done to educate the general public on various causes of hearing impairment with the aim of preventing the occurrence of a problem. The target group that has been provided such service includes medical and paramedical professionals (paediatricians, ENT doctors, family physicians, PHC doctors, post graduate medical students, nurses, ANMs and CBR workers), heads of schools, school teachers, social and health workers, anganwadi workers and different philanthropical organizations. During these interactive programs the groups get guidelines on prevention, identification and management of the hearing impaired individuals. They are also given handbills, pamphlets and posters regarding prevention of hearing impairment. These orientation programs promote ear care and hearing conservation. The cost incurred for primary prevention is far less compared to rehabilitating an individual after the occurrence of a hearing loss. 

Secondary Prevention:

Secondary prevention involves screening to identify individuals suspected to have hearing problems. This needs to be done in order to further diagnose and rehabilitate the individual early. Screening of different target groups is undertaken regularly. The screening is done by a team of specialists which include the audiologists and ENT specialists. The target population includes individuals of all age groups. Screening of newborn babies in the hospital set-ups, school children, industrial workers and senior citizens is undertaken as a routine activity. The newborn hearing screening program is undertaken with the aim of trying to identify children with hearing impairment as early as possible. There is a critical age for speech and language development. Those identified at a later stage in life find it difficult to communicate effectively through speech. They required more intensive and longer duration therapy than those who are identified at an earlier age. 

School children are screened to detect the presence of any acquired or late onset hearing loss. Early identification and rehabilitation of these children prevents a deterioration of speech acquired by them. It also enable them to achieve success in education. This program is being conducted in coordination with the educational department. 

Noise induced hearing loss is one of the preventable causes of hearing loss. Therefore, through hearing conservation program, the industrial employers and employees are being educated regarding the ill-effects of noise not only on hearing but also on general and mental health, through workshops and orientation programs. Follow -up evaluation are done subsequently to monitor the effects of noise. On account of the orientation programs given, the employees have taken to use ear protective devices more seriously.

With advancing age, as with other systems in the body, the auditory system also undergoes deterioration in its structure and function, especially in understanding speech. Since many senior citizens are now leading active lives, they require hearing assistance. Many of them may have systemic diseases which might interact in causing more hearing problems. Such sensory deficit can be overcome with a suitable hearing aid. With this they not only can hear others but also can hear themselves which prevents deterioration in their speech. 

Tertiary Prevention:

Tertiary prevention, which involves rehabilitation of individuals identified as having hearing impairment requires to be done in order to enable individuals to communicate effectively. In young children it is required for them to acquire speech and language. Early identification and rehabilitation is also required in those hearing impaired individuals who have already acquired speech, as hearing is necessary for monitoring his/her speech. Hearing impairment will also affect an individuals education and job placement. Hence, to prevent these adverse effects, secondary prevention, followed by tertiary prevention of the problem, has been undertaken. Individuals diagnose to have a hearing impairment are either provided a medical/surgical line of treatment or audiological management. The audiological management involves providing or prescribing devices that will enable them to hear better. Hearing aids are distributed free of cost under the Aids and Appliance scheme of the Government of India to those who are eligible. It is not only the hearing aids which can overcome the specific requirements of the of the hearing impaired, assistive listening devices (ALDs) such as TV listening system, telephone amplifier, are also prescribed in individual cases to overcome the unique problems. The hearing aids being used by them are brought periodically for trouble shooting, repair, etc. Individuals who require further training in auditory skills are provided with the same. 

The impact of these hearing conservation programs is that a larger number of individuals are seeking help at a younger age. This program has enabled detection of individuals with milder problems and with unilateral hearing loss.
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