Occupational Midterm: Audiometric
Monitoring & Record Keeping
1. Purpose of Audio Monitoring - ANS--track hearing over time to see if NIHL is occurring
-allows for annual check in of employee compliance and an opportunity for reinstruction
-may not be obvious like other workplace injuries
\10. Audios Should Be Performed: - ANS--pre-employment baseline
-prior to initial start in hazardous envi
-annually
-at time of reassignment to a noisy job
-at time of termination
-good business should offer screenings to all employees as part of company health care
program
\11. Audio Record Should Include - ANS--purpose of audio (baseline, annual, retest)
-equipt info including calibration date
-name of tester
-date and time
-audio hx (noise in and out of work)
-thresholds
-response reliability
-HPD inspection results
-tester comments
\12. When to Test - ANS--OSHA: after 14 hours of acoustic rest
-NIOSH: baseline after acoustic rest, annual test mid-shift to catch TTS that need correcting,
can catch inadequate HPD use
\13. Baseline Audio - ANS--administered within 6 mo after 1st expsoure
-all subsequent audios are compared to this one
-need to ID existing otological conditions from the start
\14. Screening CHx - ANS--ear/balance concerns
-related health concerns
-hx ofNE: past jobs in noise, hobbies, recreation
-tinnitus
\15. Audio Protocol - ANS--doesn't require otoscopy
-PT AC only
-threhsolds for ecach ear separately
-5-6
-missing: BC, 8, 250, speech, tymps,
\16. Annual Audio - ANS--compare back to this
-update if there's a shift
\17. OSHA Shift - ANS--Standard Threshold Shift
-avg change in heraing from baseline of 10+ dB at 2,3,4
-retest after 30 days
-re-eval HPDs
\18. NIOSH Shift - ANS--Significant Threshold Shift
, -change by 15+ dB at any freq 5-6 from baseline (NOT an average)
-retest after 30 days
-see if same 15 dB shift is present in the same ear at the same freq
\19. If an STS Occurs - ANS--repeat test in 30 days (rules out TTS)
-shift is still there -> need to revise baseline
\2. OSHA Requirements - ANS--audio testing when employee has been exposed at or above
85 dB TWA
-est baseline within 6 mo
-need to be noise free for 14 hours before
-compare annual test to baseline for validity and check for threshold shifts
-if standard threshold shift -> retest 30 days
-AuD reviews shift and sees if referral is necessary
\20. OSHA 300 Log of Workplace Injuries & Illnesses - ANS--shift ID'ed = workplace injury
=employers submit and incident report and annual summaries (part of workplace
transparency)
**NOT same as workplace comp
\21. After a Positive STS - ANS--responsibilities of employer:
1. refit and retrain on HPD use
2. refer to professional supervisor
3. referred to healthcare provider if needed
4. employee needs to be informed in writing of shift
-may mean that HCP isn't working
\22. Baseline Revision - ANS--not always clear which audio baseline should be revised to
-looking for persistent shifts
-need to wait for 1 year for persistency (shift is real after 30 days and it held after 1 year)
-pick which audio has lowest overall thresholds (lowest sensitive)
-may need to revise also if there's an improvement (ex; CHL)
-need to consider each ear individually
\23. Post Test Counseling - ANS--provide results and have baseline to refer to
-needs to be personal and impactful
-discussion of HPD use
-employee signs paper that they received this info
\24. ARHL - ANS--increased amounts of HL with age
-gradual and progressive
-impacts similar freq as NIHL
-controversy around age-corrections
\25. Age Corrections - ANS--OSHA: allows emplyers the option of making an allowance for
the contribution of age
-NIOSH dev'ed correction tables (pop level data)
-reduce amount of shift by age correction -> results in fewer shfits
\26. How to Calculate Age Correction - ANS-1. find age at most recent audio and get age
correction values from table at 1-6
2. find baseline age and correction factor from table
3. subtract the two
-difference = portion of change in dB that may be due to aging
-NIOSH Appendix F
\27. Ethics of Age Corrections - ANS--Wash and Oregon: age corrections can't be used
-def not recommended by NIOSH
Monitoring & Record Keeping
1. Purpose of Audio Monitoring - ANS--track hearing over time to see if NIHL is occurring
-allows for annual check in of employee compliance and an opportunity for reinstruction
-may not be obvious like other workplace injuries
\10. Audios Should Be Performed: - ANS--pre-employment baseline
-prior to initial start in hazardous envi
-annually
-at time of reassignment to a noisy job
-at time of termination
-good business should offer screenings to all employees as part of company health care
program
\11. Audio Record Should Include - ANS--purpose of audio (baseline, annual, retest)
-equipt info including calibration date
-name of tester
-date and time
-audio hx (noise in and out of work)
-thresholds
-response reliability
-HPD inspection results
-tester comments
\12. When to Test - ANS--OSHA: after 14 hours of acoustic rest
-NIOSH: baseline after acoustic rest, annual test mid-shift to catch TTS that need correcting,
can catch inadequate HPD use
\13. Baseline Audio - ANS--administered within 6 mo after 1st expsoure
-all subsequent audios are compared to this one
-need to ID existing otological conditions from the start
\14. Screening CHx - ANS--ear/balance concerns
-related health concerns
-hx ofNE: past jobs in noise, hobbies, recreation
-tinnitus
\15. Audio Protocol - ANS--doesn't require otoscopy
-PT AC only
-threhsolds for ecach ear separately
-5-6
-missing: BC, 8, 250, speech, tymps,
\16. Annual Audio - ANS--compare back to this
-update if there's a shift
\17. OSHA Shift - ANS--Standard Threshold Shift
-avg change in heraing from baseline of 10+ dB at 2,3,4
-retest after 30 days
-re-eval HPDs
\18. NIOSH Shift - ANS--Significant Threshold Shift
, -change by 15+ dB at any freq 5-6 from baseline (NOT an average)
-retest after 30 days
-see if same 15 dB shift is present in the same ear at the same freq
\19. If an STS Occurs - ANS--repeat test in 30 days (rules out TTS)
-shift is still there -> need to revise baseline
\2. OSHA Requirements - ANS--audio testing when employee has been exposed at or above
85 dB TWA
-est baseline within 6 mo
-need to be noise free for 14 hours before
-compare annual test to baseline for validity and check for threshold shifts
-if standard threshold shift -> retest 30 days
-AuD reviews shift and sees if referral is necessary
\20. OSHA 300 Log of Workplace Injuries & Illnesses - ANS--shift ID'ed = workplace injury
=employers submit and incident report and annual summaries (part of workplace
transparency)
**NOT same as workplace comp
\21. After a Positive STS - ANS--responsibilities of employer:
1. refit and retrain on HPD use
2. refer to professional supervisor
3. referred to healthcare provider if needed
4. employee needs to be informed in writing of shift
-may mean that HCP isn't working
\22. Baseline Revision - ANS--not always clear which audio baseline should be revised to
-looking for persistent shifts
-need to wait for 1 year for persistency (shift is real after 30 days and it held after 1 year)
-pick which audio has lowest overall thresholds (lowest sensitive)
-may need to revise also if there's an improvement (ex; CHL)
-need to consider each ear individually
\23. Post Test Counseling - ANS--provide results and have baseline to refer to
-needs to be personal and impactful
-discussion of HPD use
-employee signs paper that they received this info
\24. ARHL - ANS--increased amounts of HL with age
-gradual and progressive
-impacts similar freq as NIHL
-controversy around age-corrections
\25. Age Corrections - ANS--OSHA: allows emplyers the option of making an allowance for
the contribution of age
-NIOSH dev'ed correction tables (pop level data)
-reduce amount of shift by age correction -> results in fewer shfits
\26. How to Calculate Age Correction - ANS-1. find age at most recent audio and get age
correction values from table at 1-6
2. find baseline age and correction factor from table
3. subtract the two
-difference = portion of change in dB that may be due to aging
-NIOSH Appendix F
\27. Ethics of Age Corrections - ANS--Wash and Oregon: age corrections can't be used
-def not recommended by NIOSH
