Establishment of Matrix Risk Assessment Tool for Combined Noise and Chemical Exposure Affecting Hearing Ability among Workers
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Abstract
The objectives of this research were to: (1) develop a matrix-based risk assessment tool for the combined effects of noise exposure and chemical exposure on hearing ability; and (2) evaluate the quality and validity of this risk assessment tool. A cross-sectional study design was used, involving 21 experts, specifically certified professionals in preventive medicine with expertise in occupational health. These experts were tasked with reviewing and providing feedback on the quality and validity of the risk assessment tool using the Modified Delphi technique. The analysis focused on achieving a certain level of agreement, defined as the sum of proportions of levels 4 and 5 (indicating strong agreement) greater than 80%. The results showed that the level of agreement for the risk assessment tool assessing noise exposure alone ranged from 33.33% to 85.71% in the first round, and from 83.33% to 94.44% in the second round. For the combined risk assessment tool, considering both noise and chemical exposure on hearing ability, the agreement ranged from 61.90% to 90.47% in the first round, and from 83.33% to 100% in the second round. The matrix-based risk assessment tool, developed in the second round, considered both the risk level of chemical exposure and the noise exposure level. The matrix was designed to assess two separate risk factors: one for chemicals that affect hearing ability, based on the level of chemical exposure, and another for noise, based on the average noise level during an 8-hour workday (TWA(8)). This tool uses a 3x3 matrix, with risk levels categorized as low, medium, or high. In addition to the risk assessment, the tool provides recommendations for risk management measures and health surveillance actions to protect workers' hearing. In conclusion, the risk assessment tool passed the evaluation in the second round, demonstrating its validity and reliability. The results confirm that the tool is capable of accurately measuring outcomes and can be relied upon to effectively assess risk, ensuring it aligns with the research objectives.
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