Eight years ago, Jeff Ammon, now 55, began noticing a feeling of pressure in his ears every day after work.

Over the next months, when his symptoms progressed into a slight loss of hearing and sensitivity to noise, he became worried. Ammon, a construction worker for 32 years, eventually started wearing ear protection hoping this would address these complaints but it was too late.
    From that point on, sounds ranging from the hum of a lawnmower to normal tones of conversation caused a piercing, jabbing pain in his inner ear. He stopped working in 2011, when the pain became unbearable. He also hears ringing in his ears and experiences dizziness, both side effects of the auditory damage.
    “It’s debilitating … completely,” he said.
    Ammon spent almost all of his working life surrounded by the loud noises of jackhammers, saws and air compressors. Now he avoids going outdoors, choosing instead to stay in his soundproof basement in Lebanon, Pennsylvania, and communicate with his doctor mostly through an online patient portal.
    For general industry workers who are exposed to noise for eight hours a day at or above a time-weighted average of 85 decibels, OSHA requires employers to provide notification, audiometric testing and free hearing protectors. Employers also have to offer training programs for affected workers. The limit is 90 decibels for an eight-hour exposure for construction industry workers.
    Cullen said employers could build noise barriers or eliminate noisy equipment, but old factories often choose to just offer hearing protection gears.
    “But the problem with hearing protections is it is way too easy, unsupervised, to take it off,” he said. “What would really make a difference is to train employers.”
    He said there is also existing technology that will measure noise exposure in real time in each worker’s hearing protection gear, with lights that will flash when the level becomes hazardous. The data can be downloaded each day to monitor daily exposures.
    Theresa Schulz, hearing conservation manager at Honeywell Safety Products, said many companies, including hers, already have such products. While she sees more large employers expressing interest in these technologies, the cost might be a deterrent for others.
    “But when you think about it … the cost of having these electronics to protect the workers is nothing compared to the damage after that,” she said.
    Meanwhile, the CDC, as part of its Buy Quiet campaign has an online database of power tools with information about sound levels of different tools to encourage businesses to invest in quieter tools and machinery.
    Ammon worked for several small construction companies building houses. He said he was never told to wear ear protection. His colleagues didn’t wear it either. No one talked about it and, even when he worked with loud equipment, he wasn’t aware of the need for it.
    “It costs money. That’s my opinion on why it’s gotten as bad as it has, at least for small construction companies,” Ammon said, and the rules are “just not enforced.”
    Some of the steps taken by the federal government to move toward tightening regulations and increasing awareness suggest this might be changing. But in the meantime, people like Ammon, who feel disabled by their condition, might face difficulties in getting recognition for their symptoms and financial support.

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    He applied for Social Security disability benefits but was rejected because his condition was not on the Social Security Administration’s list of medical diseases considered disabling. When he first experienced his symptoms, he visited dozens of audiologists who only told him he had slight hearing loss. Research linking hyperacusis — unusual tolerance towards ordinary sounds — and pain was only at its infancy. Specific treatments still are not available for people with this type of hearing damage.
    These days, he experiments with new medications or therapies, hoping for more awareness about the illness — and about protecting hearing at the workplace. He is waiting for the third appeal for Social Security disability benefits.
    “I’m hearing a little more about it, but not nearly enough,” he said. “And it needs to start at the workplace.”

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