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COCHLEAR IMPLANTS HAVE A POSITIVE IMPACT ON EMPLOYMENT AND INCOME POTENTIAL

Cochlear implantation (CI) signifies a life changing event for many patients. The downstream benefits of hearing rehabilitation are many, including improved communication, increased employment opportunities, higher income, greater job satisfaction, and more social engagement.

WORKPLACE PARTICIPATION

Workplace participation is a measure of the proportion of economically active individuals within an economy. It is defined as the ratio of the employed and unemployed (or the workforce) to the working age population greater than or equal to age 15 years (Abhayaratna & Lattimore, 2006). People with sensorineural hearing loss experience issues and significant barriers to engage in employment even if they are willing and capable of working. Cochlear implantation offers adult recipients with an opportunity to regain or enhance their communication skills and improve their opportunities for workplace participation.

Hogan and colleagues analysed results from 43,233 study participants in the 2003 Australian Survey of Disability, Ageing and Carers (SDAC) (Hogan et al, 2009). People with a self-reported hearing disability reported higher levels of unemployment. Earlier onset of hearing loss was related to later employment difficulties. 


Left untreated, people experiencing hearing loss with communication difficulties (CD) have lower employment outcomes (Hogan et al, 2009). They were almost twice as likely to be unemployed (6.5% vs. 3.2%), and 1.7 times more likely not to be in the labour force (31.4% vs. 18.5%) when compared with normal hearing peers. Not being in the labour force is a conscious choice not to work or not to look for work. 

COCHLEAR IMPLANTS AND CHANGES IN EMPLOYMENT AND INCOME STATUS

Change in employment status as a result of cochlear implantation was reported in four studies (Monteiro et al, 2011; Kos et al, 2007; Chee et al, 2004; Fazel et al, 2007). All of these studies reported positive changes in employment status. Two of these studies were conducted in Toronto, Canada (Moneiro et al, 2011; Chee et al, 2004), one was conducted at the Emmeline Centre, UK (Fazel et al, 2007) and one was conducted in Geneva, Switzerland (Kos et al, 2007). 

Monteiro and colleagues (2011) also reported changes in income status. Employment status pre-implant was reported at 40.3% and after CI increased to 51.1%, representing a change in employment status amongst the 637 participants of 27%. Significantly, their income levels also improved. The average pre-implant income was CAD 30,432, while the average post-implant income was CAD 42,672. This represents a significant 40% increase of CAD 12,240 (p=0.007; Monteiro et al, 2011). 

A study comparing pre and post-implant employment outcomes by Kos and colleagues (2007) reported that 13.8% of
the group who maintained employment reported positive developments in their workplace, 6.9% were promoted to management, and 6.9% changed to better skilled jobs (Kos et al, 2007). About 34.5% of employed participants engaged in non-professional courses, indicating a positive change in personal development and social engagement after CI.

JOB SATISFACTION AND IMPROVED CONFIDENCE

Three studies reported outcomes measured for job satisfaction and improved confidence (Fazel et al, 2007; Kos et al, 2007; Hogan et al, 2002). The Fazel study (2007) surveyed 60 respondents from the Emmeline Centre, UK, using a standardised measure of job satisfaction. Pre-implant scores on a Likert Scale from 1 to 10 averaged 5.56, with a range from 1 to 10 while post-implant scores significantly improved and averaged 6.82 with a range from 4 to 10 (p<0.05). They also reported 92.6% of respondents had increased confidence post CI. 


CHANGES IN UNEMPLOYMENT STATUS

Fazel and colleagues (2007) conducted a retrospective survey of CI recipients implanted over a 14 year period from 1998- 2001 at the Emmeline Centre, UK. Of 65 respondents, 30.8% were unemployed prior to CI, with 60% indicating it was due to their hearing loss. Unemployment decreased after CI to 16.9% while 45% of those unemployed were able to find employment post CI and 20% changed their employment.

Two-thirds of those who gained employment believed it was due to improved hearing (Fazel et al, 2007). There were 57.7% of respondents who believed their career was adversely affected by HL. Post implant, 40% believed their career improved due to their cochlear implant. 


References

  1. Abhayaratna, J. & Lattimore, R. 2006. Workforce Participation Rates-How Does Australia Compare? Available at SSRN 1018871

  2. Beadle, E.A.R., McKinley, D.J., Nikolopoulos, T.P., Brough, J., O’Donoghue, G.M., & Archbold, S.M. 2005. Long-term functional outcomes and academic-occupational status in implanted children after 10 to 14 years of cochlear implant use. Otology and Neurotology, 26, (6) 1152-1160 available from: http://www.embase. com/search/results?subaction=viewrecord&from=ex port&id=L41697370

  3. Chee, G.H., Goldring, J.E., Shipp, D.B., Ng, A.H.C., Chen, J.M., & Nedzelski, J.M. 2004. Benefits of cochlear implantation in early- deafened adults: The Toronto experience. Journal of Otolaryngology, 33, (1) 26-31 available from: http://www.embase.com/search/ results?subaction=viewrecord&from=export&id=L38714996

  4. Fazel, M.Z. & Gray, R.F. 2007. Patient employment status and satisfaction following cochlear implantation. Cochlear implants international, 8, (2) 87-91 available from: http://www.embase.com/ search/results?subaction=viewrecord&from=export&id=L46958373

  5. Hogan, A. 1997. Implant outcomes: Towards a mixed methodology for evaluating the efficacy of adult cochlear implant programmes. Disability and Rehabilitation, 19, (6) 235-243 available from: http:// www.embase.com/search/results?subaction=viewrecord&from=ex port&id=L27254864 ​

  6. Hogan, A., Stewart, M., & Giles, E. 2002. It’s a whole new ball game! Employment experiences of people with a cochlear implant. Cochlear implants international, 3, (1) 54-67 available from: http://www. embase.com/search/results?subaction=viewrecord&from=ex port&id=L34521079

  7.  Hogan, A., O’Loughlin, K., Davis, A., & Kendig, H. 2009. Hearing loss and paid employment: Australian population survey findings. International Journal of Audiology, 48, (3) 117-122 

  8.  Hogan, A., O’Loughlin, K., Miller, P., & Kendig, H. 2009. The health impact of a hearing disability on older people in Australia. Journal of aging and health, 21, (8) 1098-1111

  9.  Huber, M., Wolfgang, H., & Klaus, A. 2008. Education and training of young people who grew up with cochlear implants. International Journal of Pediatric Otorhinolaryngology, 72, (9) 1393-1403 available from: http://www.embase.com/search/results?subaction=viewre cord&from=export&id=L50209107

  10. Kos, M.I., Degive, C., Boex, C., & Guyot, J.P. 2007. Professional occupation after cochlear implantation. Journal of Laryngology and Otology, 121, (3) 215-218 available from: http://www.embase.com/ search/results?subaction=viewrecord&from=export&id=L46833138

  11.  Migirov, L., Borisovsky, G., Carmel, E., Wolf, M., & Kronenberg, J. 2010. Integration of cochlear-implanted children into the general Israeli community. Israel Medical Association Journal, 12, (2) 97-99 available from: http://www.embase.com/search/results?subaction=viewre cord&from=export&id=L358364545

  12.  Monteiro, E., Shipp, D., Chen, J., Nedzelski, J., & Lin, V. 2012. Cochlear implantation: A personal and societal economic perspective examining the effects of cochlear implantation on personal income. Journal of Otolaryngology - Head and Neck Surgery, 41, (SUPPL1) S43-S48 available from: http://www.embase.com/search/results?subaction=viewrecord

 SOURCE: COCHLEAR LTD: WORKPLACE PARTICIPATION SUMMARY REPORT, OCTOBER 2014.

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