Tympanic membrane injury in welders: is prevention neglected?

Injury to the ear in welders is a recognized but poorly documented entity. Five cases are described to demonstrate a spectrum of severity of injury, ranging from minor burns to tympanic membrane perforation requiring myringoplasty. Welders are most at risk when working overhead, in cramped conditions or adjacent to other welders. Conventional safety helmets offer inadequate protection to the ears and it is recommended that insert ear plugs should be offered to all workers at risk, in addition to safer working practices. An increased awareness of these risks among occupational physicians, welders and employers is required before these recommendations can realistically be implemented.