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Best Practices in Hearing Conservation. Mark F Miller, AuD, CCC-A Occupational Audiologist, President Enviromed Corp. Phone: 1-800-521-5051 Website: www.protectyourhearing.com E-Mail: mmiller @protectyourhearing.com. Hearing Conservation Objectives. Protect employees hearing
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Best PracticesinHearing Conservation Mark F Miller, AuD, CCC-A Occupational Audiologist, President Enviromed Corp Phone: 1-800-521-5051 Website: www.protectyourhearing.com E-Mail: mmiller@protectyourhearing.com
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
STS = 2k, 3k, 4kHz Allows Age Adjustment to Age 60 Allows Waivers 85dBA(TWA) = Action Level Must have HC Program 85-90dBA(TWA) Voluntary HP 90dBA(TWA) Mandatory HP Baseline to compare Annually PA/NY = .5k, 1k, 2k, 3kHz NJ = 1k, 2k, 3k MD = .5K, 1K, 2kHz MD allows Age Adjust PA/NJ/NY No Age Adjust Not tied to 85dBA(TWA) Voluntary HP suggests it may cause a problem Baseline to identify Pre-Existing loss OSHA Workers Comp
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 -7 then 50% all type earplugs Foam Earplug 33 NRR – 7 / 2 = 13 NRR 93dBA Noise – 13NRR = 80dBA at your ear Action Level = 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 (+5dBA) Hearing Protection Derating NRR 50% Foam; 70% all other earplugs 25% Earmuffs OSHA NIOSH
Audiometric Technician CAOHC Certified or Show competence to Professional Supervisor or use a Microprocessor Audiometer Hearing Testing Baseline within 6 months of hire 14 Hour Quiet Time Can include use of HP Mobile Services – up to 1 year Annual Testing (every 12 months) Test Environment Well above ANSI Criteria Audiometric Technician CAOHC Certified or Equivalent Certification Licensed to Test Hearing Physician Hearing Testing Baseline within 30 days of Exposure 12 Hour Quiet Time – no HP No Mobile Service exception Annual Testing (every 12 months) +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 adj. Age Adjustment only goes to age 60 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 A Non-NIOSH issue OSHA thing – not NIOSH Comply with OSHA requirements OSHA NIOSH
European Union Criteria • OSHA estimates @ 97% of workers are exposed to below 100dBA and 85dBA is a “safe” level. • EU estimates over 29% of all workers are exposed to “hazardous noise” in at least ¼ of their time in the workplace and 11% are exposed at all times and 80dBA is a “safe” level • 80dBA(TWA) EU Action Level • Requires Hearing Protection be made available • Requires Annual Hearing Testing & Noise Surveys • 85dBA Hearing Protection mandatory • 87dBA under HP is the max allowed • If exceeds this criteria – rotate out of noise • Hearing Protection Single Noise Rating (SNR) • Based upon Human Ear measurements – not Kemar • Subtract the SNR from the dBA = Noise under HP
Army Hearing Conservation • Applies to Military and Gov’t Contracted Industrial Facilities • 85dBA Action Level - 3dB Doubling Rate (OSHA is 5dB) • Criteria for Airborne High Frequency Noise • Criteria for Ultra-Sonic Noise • Exposures to Ototoxins (Paint; Styrene; Lead etc) • Requires Noise Survey • At least once and also 30-days from an changes in production or equip. • Hearing Protection is mandatory • 85dBA – regardless of time exposed • NIOSH Derating • Annual Audiometry • Includes Terminations; removal from noisy jobs • STS’s require retests; confirmation by MD or Audiologist • Reportable Injuries on DA Form 285 – includes civilians
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 inHearing Loss Prevention • Noise Surveys every 2-3 years • No one survey will provide the info needed to protect liability or hearing • The more data – the better • Mandatory HP at 85dBA regardless of time exposed • Recommend purchasing a Hearing Protection “fit tester” to better educate employees and also has nice reporting to document training • Target 75-80dBA under the hearing protector • Mandatory Audiometry at 85dBA 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 • Educate the Professional and provide all information necessary to make a justifiable Professional Opinion based upon all facts