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Best Practices in Hearing Conservation

Best Practices in Hearing Conservation. Richard L. Stepkin, MS, CCC-A Occupational Audiologist, President Enviromed Corp. Phone: 1-800-521-5051 Website: www.protectyourhearing.com E-Mail: rstepkin @protectyourhearing.com. Hearing Conservation Objectives.

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Best Practices in Hearing Conservation

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  1. Best PracticesinHearing Conservation Richard L. Stepkin, MS, CCC-A Occupational Audiologist, President Enviromed Corp Phone: 1-800-521-5051 Website: www.protectyourhearing.com E-Mail: rstepkin@protectyourhearing.com

  2. 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

  3. 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 Workers Comp

  4. 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

  5. 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

  6. 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 OSHA NIOSH

  7. 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

  8. 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

  9. 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)

  10. STS Determination Audiologist Evaluation • Evaluation includes as a minimum: • Air-Bone-Speech Audiometry • Otoscopic Exam • Detailed Hearing History • Employee one-on-one consultation

  11. 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

  12. 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

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