Tracking Work-Related Hearing Loss OSHA Clarifies Recordkeeping Rule, Audiologists Rush to Respond Policy Analysis
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Policy Analysis  |   February 01, 2003
Tracking Work-Related Hearing Loss
Author Notes
  • Susan C. Megerson, is a consultant and instructor for the University of Kansas Intercampus Program in Communicative Disorders. She represented ASHA on the Council for Accreditation in Occupational Hearing Conservation (CAOHC) from 1991–2000 and is a former president of the National Hearing Conservation Association. She may be reached at scmegerson@mindspring.com. A similar version of this article first appeared in the Fall 2002 issue of the CAOHC UPDATE newsletter.
    Susan C. Megerson, is a consultant and instructor for the University of Kansas Intercampus Program in Communicative Disorders. She represented ASHA on the Council for Accreditation in Occupational Hearing Conservation (CAOHC) from 1991–2000 and is a former president of the National Hearing Conservation Association. She may be reached at scmegerson@mindspring.com. A similar version of this article first appeared in the Fall 2002 issue of the CAOHC UPDATE newsletter.×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   February 01, 2003
Tracking Work-Related Hearing Loss
The ASHA Leader, February 2003, Vol. 8, 1-31. doi:10.1044/leader.PA.08022003.1
The ASHA Leader, February 2003, Vol. 8, 1-31. doi:10.1044/leader.PA.08022003.1
In the early 1980s, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) promulgated regulations for preventing occupational hearing loss in general industry. OSHA’s Noise Standard and Hearing Conservation Amendment, 1910.95, provides guidance for identifying potentially hazardous noise, implementing noise controls, and providing hearing protection devices, employee education, and monitoring through annual audiometric evaluations.
Although many companies have long had occupational hearing conservation programs in place, until now OSHA had no formal system for tracking the annual incidence of work-related hearing loss. OSHA published general guidelines for reporting (or “recording") work-related injuries and illnesses in 1971, but requirements for reporting occupational hearing loss have historically been vague, confusing, and even controversial.
OSHA began work on clarifying the hearing loss recordkeeping criteria in the mid-1980s, but only published its final rule, 1904.10, in July 2002 with an effective date of Jan. 1, 2003 (OSHA, 2002a). Additional clarifications from OSHA were recently released in late December 2002 (OSHA, 2002b). Due to this short time frame to prepare, many audiologists providing hearing conservation services to industry are rushing to help companies understand and comply with the new hearing loss recordkeeping rule.
Following is a summary of the basic requirements of the new recordkeeping rule, 1904.10. The ASHA-led Coalition to Protect Workers’ Hearing recently requested further clarifications from OSHA.
• Basic recording criterion
Employers must record work-related “Standard Threshold Shift,” or STS (an average change of 10 dB at 2000, 3000, and 4000 Hz in either ear, compared to baseline; age-adjustments allowed), provided that the employee’s average hearing level at the same frequencies in the same ear is 25 dB HL or greater (an average hearing level of 25 dB or more, regardless of employee’s age). OSHA explained that it chose the new “two-part criterion” in the final rule because STS is a sensitive measure of noise exposure at the employee’s current place of employment, and overall hearing levels in excess of 25 dB “assures that all recorded hearing losses are significant illnesses.”
  • • Baseline/reference audiogram

    To determine whether an STS has occurred, the employer must compare the current hearing test results to the employee’s baseline audiogram. In the original final rule issued in July 2002, OSHA noted that if the employee has previously experienced a recordable hearing loss, then the employer must compare the current test results to the audiogram, which was previously designated a recordable case. However, this interpretation would have required employers to track separate baselines for each employee—revised baselines for hearing conservation purposes and revised baselines for recordability purposes. In order to simplify the process, OSHA changed the definition of revised baseline in its December 2002 amendment to the 1904.10 rule. Now, revised baseline will be determined according to existing hearing conservation program definitions under 1910.95, allowing companies to track both hearing conservation program shifts and work-related hearing loss cases utilizing the same baseline audiograms.

  • • Retest/confirmation of STS

    If the annual audiogram shows an STS, a hearing retest may be performed within 30 days. If the retest does not confirm the STS, then the case need not be recorded. However, if the retest confirms the STS, then the STS, if work-related, must be recorded within seven calendar days of the retest. If a retest is not performed, then the case (again, if work-related) must be recorded within seven calendar days of the end of the retest period (i.e., 37 days).

  • • Results of subsequent testing

    If later testing performed as part of the hearing conservation program indicates that the STS is not persistent, then the employer may erase or line-out the recorded entry. OSHA explained that it added this language to the final rule “to minimize the recording of temporary hearing loss cases while capturing complete data on the incidence of hearing loss disorders.”

  • • Determination of work-relatedness

    In the 1904.10 final rule, OSHA stressed the importance of case-by-case review, and stated that hearing loss work-relatedness must be determined according to specifications of section 1904.5. That is, if an event/exposure in the workplace caused or contributed to the shift in hearing or “significantly aggravated” a previously existing hearing loss, then the STS is recordable. In addition, OSHA specifically stated that a case need not be recorded if a physician or other licensed health care professional determines that the hearing loss is not work-related or not significantly aggravated by occupational noise exposure. OSHA later provided further guidance as part of a settlement agreement with the National Association of Manufacturers (NAM), following a NAM lawsuit over the recordkeeping rule. OSHA clarified that when cause is not obvious, the employer must make a determination of whether the case is “more likely than not” work-related. The burden of proof will rest with OSHA in the event of a citation for failure to record (OSHA, 2001).

  • • Forms

    Although OSHA also has updated its recordkeeping forms (now OSHA Form 300, 301, and 300A), designation of a separate column for recording hearing loss has been delayed until Jan. 1, 2004. OSHA stated that it agreed with commenters—such as the ASHA-led Coalition to Protect Workers’ Hearing—that a separate column is needed to facilitate analysis of hearing loss data at individual workplaces and to improve the agency’s ability to track and assess this common occupational illness and prioritize hearing loss prevention efforts. In 2003, employers should record cases of occupational hearing loss as an “injury” (single-event acoustic trauma) or ”other illness” (long-term noise exposure) on Form 300, as appropriate.

  • • State plans

    Although state-run OSHA plans were allowed to continue utilizing more stringent enforcement criteria during 2002, all are required to adopt the final federal rule for hearing loss recordability, effective Jan. 1, 2003.

  • • Applicable industries

    Certain industries are not covered under the hearing conservation amendment 1910.95 (construction, agriculture, oil and gas drilling, etc.), but are included under 1904. If such employers choose to conduct audiometric testing programs, then the hearing loss recordability provisions of 1904.10 will apply.

  • • Trend analysis

    In response to concerns among employers regarding an increase in the number of hearing loss cases to be reported beginning in 2003, OSHA issued a note of caution in December 2002. It is recognized that the data captured in 2003 and future years will not be comparable to prior years when less stringent hearing loss criteria may have been used.

  • Implications for Hearing Conservation Programs

It is important to remember that the new 1904.10 recordkeeping provisions in no way change an employer’s obligations under 1910.95. All employees showing STS must receive appropriate follow-up as defined by the hearing conservation amendment, whether the shift in hearing is recordable or not. In addition, individual case review remains an essential aspect of managing occupational hearing loss recordability.
Each potentially recordable shift that meets the specified OSHA criterion, and any other suspected work-related hearing loss, should receive careful review by an audiologist (or physician) knowledgeable in the effects of noise and in hearing conservation programs. (See table at left for an example protocol for processing potentially recordable cases under the new final rule.) Finally, employers should recognize that the requirements of 1904.10 represent a recordkeeping function. Recording a case on the OSHA log does nothing to protect that employee from further hearing loss. Companies must therefore remain diligent in their commitment to preventive measures that will truly have an impact on decreasing hearing loss and improving quality of life.
. . . .
Susan Megerson is a consultant and instructor for the University of Kansas Intercampus Program in Communicative Disorders. She represented ASHA on the Council for Accreditation in Occupational Hearing Conservation (CAOHC) from 1991–2000 and is a former president of the National Hearing Conservation Association. She may be reached at scmegerson@mindspring.com. A similar version of this article first appeared in the Fall 2002 issue of the CAOHC UPDATE newsletter.
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February 2003
Volume 8, Issue 2