Best Practices in Hearing Conservation Richard L. Stepkin, MS, CCC-A Occupational Audiologist, President Enviromed Corp Phone: 1-800-521-5051 Website:

Best Practicesin

Hearing Conservation

Richard L. Stepkin, MS, CCC-AOccupational Audiologist, President

Enviromed Corp

Phone: 1-800-521-5051

Website: www.protectyourhearing.com

E-Mail: [email protected]

Hearing Conservation Objectives

Protect employees hearing

Comply with OSHA criteria

Stabilize Worker’s Compensation

Which is the most Important ??

Unfortunately - OSHA Compliance is not a Best Practice in Hearing

Conservation

OSHA Workers Comp

STS = 2k, 3k, 4kHz Allows Age Adjustment to

Age 60 Allows Waivers 85dBA(TWA) Mandatory

Action Level – must have HC Program

85-90dBA(TWA) Voluntary HP 90dBA(TWA) Mandatory HP Baseline to compare

Annually

MD = .5K, 1K, 2kHz PA = .5k, 1k, 2k, 3kHz NJ = 1k, 2k, 3k MD allows Age

Adjustment PA/NJ No Age Adjustment Not tied to 85dBA(TWA) Voluntary HP suggests it

may cause a problem Baseline to identify Pre-

Existing loss

OSHA NIOSH

Action Level = 85dBA(TWA) PEL = 90dBA(TWA) 5dB Exchange Rate

85dBA = 16hrs 90dBA = 8hrs 95dBA = 4hrs

Noise Surveys = 1x Update Periodically as needed

Hearing Protection 85dBA Voluntary except with STS 90dBA Mandatory

Hearing Protection Derating NRR

50% all type earplugs

REL = 85dBA(TWA) PEL = REL 85dBA(TWA) 3dB Exchange Rate

85dBA = 8hrs 88dBA = 4hrs 91dBA = 2hrs

Noise Surveys = 1x Every 2 years

Hearing Protection 85dBA Mandatory 100dBA Double Protection

Hearing Protection Derating NRR

50% Foam; 70% all other earplugs 25% Earmuffs

OSHA NIOSH

Audiometric Technician CAOHC Certified; Competence

to Supv; Microprocessor Audiometer

Hearing Testing Baseline within 6 months of hire

14 Hour Quiet Time – incl HP

Mobile Services – up to 1 year HP is Mandatory

Annual thereafter Test Environment

Well above ANSI Criteria

Audiometric Technican CAOHC Certified or Equivalent

Certification Hearing Testing

Baseline within 30 days of Exposure

12 Hour Quiet Time – no HP No Mobile Service exception Annual thereafter +100dBA(TWA) every 6 months

Test Environment Must meet ANSI Criteria

OSHA NIOSH

Audiogram Review Employee Notified if STS

STS = 10dB Avg above Baseline at 2k, 3k, 4kHz.

Retest within 30 days STS Follow-up Action

Notify EE within 21 days Re-Fit HP – Select Higher NRR

STS Log 300 Recordable Current Test = 25dB Avg – no age Difference between Baseline and

Current Test is 10dB – with age

Audiogram Review Employee Notified if STS

STS = 15dB from Baseline at any one test frequency .5k-6kHz

Retest within 30 days STS Follow-up Action

Notify EE within 30 days Educate effects of Noise on

Hearing Re-Fit HP – Select Higher NRR

STS Log 300 Recordable Not indicated – a Non-NIOSH

issue Use OSHA Form for Work Injury

Who Uses NIOSH Criteria

Military 3dB Exchange Rate

No TWA – simply exposed – protect

European Union 80dBA(TWA) Hearing Protection available

Includes Annual Hearing Testing Noise Survey data for all EE at or above 80dBA

85dBA Hearing Protection Mandatory 87dBA under HP is the max allowed

STS DeterminationThe Facts

When is an STS Log 300 Recordable? 25dB Avg on Current Test at 2k, 3k, 4kHz – not Age

adjusted PLUS a 10dB Avg shift from Baseline – Age adjusted

OSHA assumes all STS’s are Work-Noise Related Recordable even if part of the STS is due to work noise Hearing Protection alone will not be a reason

How to prove the STS is “other” than work noise Noise levels are below 82dBA Medical and/or Audiologic Evaluation justifying why the

STS is not work-noise related

STS DeterminationThe Professional

Work closely with an Audiologist or Physician:

Company controls the Referral Source & Pays for

Evaluation

Not Insurance – Not a HIPAA issue – Gets you a Report

This is about Surveillance – Not a Medical referral

Educate them on your product operation & HCP

Know they understand the intent of the referral & Log

300

Provide them good Job Description info (past & present)

Provide them Current Noise Levels (Dosimetry and SLM)

STS Determination Audiologist Evaluation

Evaluation includes as a minimum:

Air-Bone-Speech Audiometry

Otoscopic Exam

Detailed Hearing History

Employee one-on-one consultation

STS DeterminationThe Report

Look at all factors affecting hearing, not just work noise.

Consider all noises: military, recreational, prior jobs, hunting or target shooting, lighting firecrackers etc.

Threshold patterns relative to noise exposures, length of employment, use of hearing protection

Does the Report “justify” why the STS is or is not work noise related

Best Practices inLoss Prevention

Noise Surveys every 2-3 years – the more data the better

Mandatory HP at 85dBA regardless of time exposed

Mandatory Audiometry at 85 dBA regardless of time

exposed

Professional Reviewer of test data beyond OSHA criteria

Ask for an “Early Warning” of EE’s getting close to STS (8.6 – 9.9 shifts)

Consider the State Compensation criteria in the review process

Use a dependable Referral Source for STS Determinations

Education the Professional and provide all information necessary to make

a justifiable Professional Opinion based upon all facts