CHESS

Computerised Health & Environment Surveillance System

CHESS Pty Ltd, Reg. No. 2000/016690/70

Room 102, Premier Center, 451 Main Road, Observatory, 7925 Phone: 021-4484466, Fax 0866724144.

Directors: Dr AMT Thomson (MD), Dr A Combrinck, Dr GP Kew

Audiometries in CHESS The CHESS system can draw such report in many different formats as demonstrated below.

Note above NIHL = Noise induced hearing loss, PNIHL = Possibly NIHL

PLH change on groups (NIHL and PNIHL) from CHESS

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Computerised Health & Environment Surveillance System

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Injuries on Duty In CHESS

PLH, in the South African context, is used for calculating disability, and is probably not optimal as a measure for tracking progression of NIHL, since PLH calculations look at the speech frequencies (lower frequencies) and not at the “noise induced hearing loss frequencies”. Progress of NIHL internationally is determined by the depth and change in depth of the “notch”. CHESS focuses on the “Noise frequencies” of 4KHz and 6KHz when tracking the progress (depth of notch) in NIHL. Another important note is that not all employees have a valid baseline audiogram, and so in those with no baseline audiogram you would not be able to track change. Note that a valid baseline is one that:

Was done in the 2 year window period 2001 to 2003 for those previously exposed to noise

Is done in an employee that has never previously been exposed to noise An employee who has been exposed to noise for many years, and who never had a baseline in the above window period, by definition can never have a valid baseline – it is too late. Many OHN’s and OMP’s are doing “Baselines” on these employees. These have no legal standing and may mitigate against the rights of the employee to compensation. For our purposes we assess progress of NIHL by looking at progression of the depth in the Noise notch – this is the correct thing to do. CHESS tracks all of the following and can report all of them in any combination, or export them to spread-sheet if required:

a. They type of hearing i. Normal hearing ii. Noise Induced Hearing Loss (NIHL) iii. Possibly NIHL (PNIHL) iv. Non-Occupational Hearing Loss

b. PLH’s i. Of current test ii. Of Baseline iii. Change in PLH from Baseline iv. PLH change from Pre-employment

c. The Length of Service (LOS) of the employee at the time of the hearing test d. Where the test is considered NIHL or PNIHL; then

i. The severity of the hearing test based on the depth of the Noise Notch; 1. Borderline (less than 30dB) 2. Mild (30 to 40dB) 3. Moderate (45-60dB) 4. Severe (65dB and over)

ii. The change in severity of the noise notch as listed above 1. Improved 2. No change 3. Deterioration but still “within a category”

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Computerised Health & Environment Surveillance System

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Injuries on Duty In CHESS

4. Deterioration by more than a category iii. Whether this is a “new” NIHL iv. Whether this was reported to the Department of Labor & Date Reported v. Whether the case was referred:

1. To Occupational Medical Practitioner 2. To Audiometrist for Diagnostic Audio 3. To Ear Nose and Throat (ENT) Specialist

vi. Whether the test is compensatable vii. Whether NIHL were referred for compensation viii. Date Referred for compensation ix. Status of compensation claim

1. Pending 2. Awaiting further tests 3. Accepted 4. Rejected 5. Unknown

x. If Accepted then the percentage compensation. An example is this employee tracked on CHESS

Or the spread-sheet view (exportable)

The above employee had a baseline in 2003, where he was diagnosed as “Possibly NIHL”, with a PLH of 17.1. He initially deteriorated then stabilized. In 2009 he had an exit medical which showed he was now compensatable. He was referred to the ENT surgeon, then COID for compensation (compensation claim is pending, and reported to the department of labor on the 8/01/2008. This really does cover a very extensive and complete management tool for NIHL with systems in place to ensure cases are closed off.

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Computerised Health & Environment Surveillance System

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Injuries on Duty In CHESS

Illustration of capture fields to show above.

As you can see multiple tests can be visualize and any one can also be” turned off” All of the data as listed can be analysed in multilevel analysis within the program. For example one can quickly find a query such as “show me the names of all those with NIHL that have deteriorated my more than one noise category within the last year”.