The Long Term Benefits of Audiometric Testing

OSHA’s occupational noise standard 1910.95 requires employers to make audiometric testing available to all employees whose exposures equal or exceed an 8-hour time-weighted average of 85 decibels. Within six months of an employee’s first exposure at or above the 85 decibel action level, employers must provide a valid baseline audiogram against which subsequent audiograms can be compared to determine if a standard threshold shift (STS) has occurred. OSHA defines a STS as a change in hearing threshold relative to the baseline audiogram of an average of 10 decibels or more at 2000, 3000 and 4000 Hz in either ear. It is worth noting that any frequency of sound over the decibel threshold can result in hearing impairment; however hearing loss generally impacts hearing high frequency noises. Tests are performed by a licensed or certified audiologist, otolaryngologist, or other physician, or by a technician certified by the Council of Accreditation in Occupational Hearing Conservation.

It’s important to note that OSHA allows healthcare professionals to make the decision whether an employee’s hearing loss can be attributed to his or her job. This crucial distinction underscores the benefits of partnering with experienced professionals when you implement your audiometric testing program.

Here is another consideration: during the span of your employees’ careers they may be subject to multiple audiometry exams administered by different physicians. These physicians are often unaware of baseline tests that have been previously performed. This lack of knowledge makes it extremely difficult to know what is the true cause of hearing loss—or even if any hearing loss has occurred.

Partnering with an established, national medical surveillance service can close gaps in your audiometric testing program. A centralized testing and support service can pinpoint the cause of hearing loss and save you unnecessary worry by handling all facets of audiometric testing, ensuring that the quality of the test is credible and valid, maintaining employee test record results, and assuming overall management of your program.

Research shows that gaps do exist in a number of occupational audiometric testing programs.  In a NIOSH study of worker, supervisor and hearing conservation program (HCP) manager perceptions about working with a hearing loss, hearing-impaired workers in the study  consistently reported that management “couldn’t care less” if workers lost their hearing. They described workplaces where minimal safety standards were often ignored and several workers reported that annual hearing tests were offered or mandated at their work sites, but in many cases the workers never saw the test results. None of the workers indicated they received information comparing recent results with a baseline audiogram.

Only 51% of so-called blue-collar workers believe that hearing tests are readily accessible to them, according to NIOSH. And even when hearing tests are administered some of the requirements may not be met. When tests are conducted the examiners are required to provide education about hearing and hearing loss. If no materials are provided, an OSHA citation can be issued. Make sure your hearing test administrators are providing your workforce with hearing education materials that can help prevent hearing loss, and rising healthcare costs in the future.

Supervisors in the study consistently reported that at least a third of the workers in their manufacturing plants had some type of hearing loss. How did they know? “Having to repeat” what you’re saying was the most common indicator cited. Supervisors would also notice hearing-impaired workers “cocking their heads” to maximize use of “the good ear.” None of the supervisors said they identified hearing-impaired workers on the basis of audiometric tests, and, more significant, only three of the HCP managers reported that they identified workers with hearing loss by reviewing audiometric test results. 

This study shows that the critical question remains unanswered: is the hearing loss of up to one-third of workers due to on-the-job exposures? The NIOSH study indicates that supervisors and hearing-conservation program managers don’t have a good handle on audiometric test results. This includes not having access to test results, not knowing an employee’s history of test results, and not being able to compare tests over time.

The need to test – beyond compliance

Significant gaps in your hearing test program also can be due to  workers  being too embarrassed or afraid of being fired or transferred to another job to self-report hearing loss, or go to a physician for a hearing test. (Hearing impaired workers are protected from discrimination by the Americans with Disabilities Act.) One worker posted on an Internet chat board: “Our health and safety advisor asked me what percentage of deafness I had. I’m wondering why this sudden interest. My supervisor is terrified of me causing an accident. One time on my forklift I failed to acknowledge a verbal command, and once I failed to acknowledge a verbal greeting by the health and safety advisor.”

Another gap:  many adults—and even physicians themselves—fail to address hearing loss. Only 39% of adults have had a hearing test in the past three years, according to NIOSH. People with hearing loss wait an average of seven years before seeking help, according to the Center for Hearing and Communication. Only 16% of physicians routinely screen for hearing loss, and 15 million people in the United States with hearing loss avoid seeking help, according to the Center.

If these disconnects or “holes” exist in your hearing testing program, they can cause injuries, near-misses, compliance penalties, rising costs and uninformed employees and supervisors. Lean safety staffs are increasingly challenged to plug these holes. Consider the benefits of teaming up with medical surveillance experts with the technology and personnel to “lock down” your hearing testing program through comprehensive and consistent testing, results analysis, and records management.