|DIRECTIVE NUMBER: PER 04-00-004
||EFFECTIVE DATE: 6/23/2008|
|SUBJECT: Hearing Conservation Program|
||This Instruction initiates and establishes a hearing conservation program to protect OSHA personnel covered by OSHA Instruction PER 04-00-003 "CSHO Medical Examinations" from the effects of occupational noise exposure.|
||OSHA personnel who are covered by OSHA's Medical Examination Program Instruction PER 04-00-003 are covered by this Instruction.|
||29 CFR 1910.95, Occupational noise exposure.|
29 CFR 1904.10, Recording criteria for cases involving occupational hearing loss.
29 CFR 1910.1020, Access to employee exposure and medical records.
OSHA Instruction, PER 04-00-003 - PER 8-2.5 - CSHO Medical Examinations.
OSHA Instruction, PER 04-00-002 - PER 8-2.4 - CSHO Pre-Employment Medical Examination
OSHA Technical Manual TED 01-00-015 [TED 1-0.15A].
CPL-02-00-135, Recording Policies and Procedures Manual, December 30, 2004, or current update.
||Directorate of Science, Technology and Medicine|
||By and Under the Authority of|
Edwin G. Foulke, Jr.
This Instruction describes requirements for establishing a Hearing Conservation Program (HCP) for all OSHA personnel covered by the Agency's medical examination program, Instruction PER 04-00-003. The components of this HCP include noise monitoring, audiometric testing, hearing protection, training, and recordkeeping. In addition to the hearing conservation program elements, this Instruction delineates the roles and responsibilities of the Directorate of Science, Technology and Medicine, Regional Administrators, Directorate Heads, the Hearing Conservation Coordinator in each Area office, and affected OSHA personnel covered by PER 04-00-003 to effectively implement this Instruction. This HCP complies with the provisions of the Hearing Conservation Amendment to 29 CFR 1910.95, Occupational noise exposure.
This Instruction establishes a new program.
Table of Contents
- Action Offices
- Federal Program Change
- Significant Changes
- Noise Monitoring
- Audiometric Testing Program
- Hearing Protection
- Training Program
- Records Program
- Roles and Responsibilities
APPENDIX A: Sample of Audiogram History / Report Form.
- Directorate of Science, Technology and Medicine
- Regional Administrators
- Hearing Conservation Coordinator
- OSHA personnel covered by PER 04-00-003
- Director, Hearing Conservation Program
APPENDIX B: Sample of Employee Notification Letter.
APPENDIX C: Sample of Employer Notification Letter.
This Instruction initiates and establishes a hearing conservation program that complies with 29 CFR 1910.95 to protect OSHA personnel covered by PER 04-00-003 from the effects of occupational noise exposure. The Hearing Conservation Amendment to the OSHA Occupational noise exposure standard, 29 CFR 1910.95, requires that employers establish a hearing conservation program for employees whose noise exposures equal or exceed an 8-hour time-weighted average (TWA) of 85 dBA.
This Instruction establishes HCP for OSHA personnel covered by PER 04-00-003 who are assigned to field duties where noise exposures are anticipated to be at or above 85 decibels (dBA) as an 8-hour time-weighted average (TWA).
See OSHA Instruction, PER 04-00-003 for information on scope of coverage of OSHA personnel for the Agency's Medical Examination Program.
- 29 CFR 1910.95, Occupational noise exposure
- 29 CFR 1904.10, Recording criteria for cases involving occupational hearing loss
- 29 CFR 1910.1020, Access to employee exposure and medical records.
- OSHA Instruction, PER 04-00-003 - PER 8-2.5 - CSHO Medical Examinations.
- OSHA Instruction, PER 04-00-002 - PER 8-2.4 - CSHO Pre-Employment Medical Examination.
- OSHA Technical Manual TED 01-00-015 [TED 1-0.15A].
- 29 CFR 1913.10, Rules of agency practice and procedure concerning OSHA access to employee medical records.
- CPL 02-02-072, Rules of agency practice and procedure concerning OSHA access to employee medical records.
- CPL-02-00-135, Recording Policies and Procedures Manuals, December 30, 2004, or current update.
- Action Offices.
All Federal OSHA offices.
- Federal Program Change.
This instruction initiates and establishes a HCP. Although this Instruction does not apply to State Plan States, State Plans may consider implementing a similar HCP for their field employees.
- Significant Changes.
Not applicable. This Instruction establishes a new Federal program.
The Agency's Medical Program established in 1989 included audiometric testing as a determinant of eligibility for duty. At that time, it was not anticipated that OSHA personnel covered by PER 04-00-003 would experience noise exposures that warranted the implementation of an HCP. However, noise survey measurements have since demonstrated that OSHA personnel covered by PER 04-00-003 periodically work in environments that warrant enrollment in a HCP in accordance with the hearing conservation amendment to 29 CFR 1910.95, Occupational noise exposure.
A HCP includes noise monitoring, audiometric testing, employee notification, use of appropriate hearing protection, administration of pertinent training and education, and associated recordkeeping. Specific implementation protocols are delineated below in Section X. Procedures.
This Instruction establishes an OSHA HCP that is consistent with the hearing conservation amendment to 29 CFR 1910.95, Occupational noise exposure.
Whenever feasible, OSHA personnel covered by PER 04-00-003 are encouraged to avoid exposure to hazards, including noise. The personnel covered by PER 04-00-003 are to limit their exposure to noise to the minimum duration necessary, and to wear hearing protection as required for the safe completion of their duties. In addition, while OSHA personnel covered by PER-04-00-003 are at facilities in which employees are required by their employers to wear hearing protection, OSHA personnel are to wear hearing protectors that provide equivalent hearing protection to that which the facility employees are wearing.
- Noise Monitoring.
Due to the wide variety of worksites encountered and the variability of working conditions in each site, OSHA personnel covered by PER 04-00-003 may encounter periods of noise exposure in excess of 85 dBA, as an 8-hour TWA. Newly hired OSHA personnel receive orientation training that prepares them to evaluate and protect themselves from potentially harmful noise exposures. OSHA personnel covered by PER 04-00-003 are to follow procedures in the OSHA Technical Manual TED 01-00-015, Chapter 5, in order to determine the indications of potentially harmful workplace noise levels and the need to conduct screening noise monitoring using a sound level meter (SLM). The results of screening measurements will be used by OSHA personnel covered by PER 04-00-003 to select appropriate hearing protectors.
Intensity and duration of the noise exposure, in addition to professional judgment, must be used in determining how best to measure the exposure of the affected employee.
(Technical Manual TED 01-00-015: http://www.osha.gov/dts/osta/otm/noise/exposure/index.html). Also, see Section E. Records Program for procedures for recording and reporting noise exposure measurements.
- Audiometric Testing Program.
Audiometric testing will be conducted in concert with the Agency's Medical Examination Program. All audiometric exams performed as part of the Agency's Medical Examination Program must take place in an appropriate test environment that does not interfere with the accuracy of the audiometric test thresholds. Audiometric test frequencies shall include: 500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz, 4,000 Hz, 6,000 Hz, and 8,000 Hz. Requirements for test equipment and calibration must conform, at a minimum, to the calibration and audiometric test requirements set forth in the hearing conservation amendment 29 CFR1910.95(g) to the occupational noise exposure standard.
Prior to receiving audiometric testing, OSHA personnel covered by PER 04-00-003 will complete an audiometric history form in order to document pertinent medical history, noise exposure, and use of hearing protection. (See Appendix A).
- Scheduling. Baseline and annual audiometric exams will be scheduled concurrently with pre-placement and annual medical examinations respectively. Retest audiograms will be conducted within 30 days of the time that a Standard Threshold Shift (STS) is identified.
- Baseline Audiogram. The baseline audiogram must be preceded by a minimum period of 14 hours of quiet without exposure to workplace noise. The use of hearing protection is an acceptable alternative to the 14-hour quiet period before the baseline audiogram is taken. The baseline audiogram for covered OSHA personnel is defined as follows:
- OSHA personnel covered by PER 04-00-003 hired prior to the establishment of the 1989 Medical Examination Program will have their 1989 audiogram or their oldest qualifying audiogram on file identified as their baseline audiogram.
- OSHA personnel covered by PER 04-00-003 hired after 1989 will have their pre-placement audiogram identified as their baseline audiogram. Valid baseline audiograms are obtained prior to field assignment as required by the pre-employment medical requirements program (See OSHA Instruction, PER 04-00-002).
- Annual audiogram. Audiometric testing will be conducted annually. Each annual audiogram shall be compared to the baseline audiogram to validate its accuracy, and detect significant changes in hearing. The 14-hour quiet period is not necessary for annual audiograms.
- Notification of Audiogram Results. Immediately following audiometric testing, covered OSHA personnel will receive preliminary verbal feedback on their test results by an individual qualified to administer the audiometric exam. A preliminary determination of an STS will result in covered OSHA personnel automatically receiving an appointment for a retest audiogram. A definitive interpretation of all audiograms will take place following audiogram review by the physician acting as the HCP Director (see Section XI. E.). Formal written notification letters will be sent to each employee in the program from the HCP Director regarding: findings of annual audiograms that do not warrant retesting, findings of retest audiograms including STS, indications of possible otological pathology, and recommendations for audiological or otological follow-up. If covered OSHA personnel receive a retest audiogram, he/she will receive a single notification letter that explains the findings of both the annual and retest audiograms. (See Sample Notification Letter, Appendix B). The OSHA Office of Occupational Medicine (OOM) will contact covered OSHA personnel with specific information in order for them to obtain follow-up testing and treatment as needed (see section B.7.e. below).
- Retest audiogram. OSHA personnel covered by PER 04-00-003 with annual audiograms that meet the STS criteria will be retested within 30 days of the annual audiogram to determine whether the threshold shift is temporary or persistent. Retest audiograms should be conducted after a 14-hour quiet period. However, hearing protection may be used as an alternative to the 14-hour quiet period. A retest audiogram conducted within 30 days of the annual audiogram may be substituted for the annual audiogram. The retest audiogram may confirm a newly identified STS, or it may reveal an improvement in hearing threshold. In both of these cases, the results of the retest audiogram can be substituted for the annual audiogram.
- Revised Baseline Audiogram. An annual audiogram may be substituted for the baseline audiogram when: (a) the STS is persistent; or (b) the hearing threshold shown in the annual audiogram indicates significant improvement over the baseline audiogram. The audiometric findings from each ear are evaluated independently for improvement or worsening of the auditory threshold of the person on whom the audiogram was performed. If only one ear meets the criteria for an STS, the baseline may be revised for that ear only. Thus, future audiometric tracking will be based on separate left and right ear baseline revisions.
- Standard Threshold Shift. The criterion for STS is a change in hearing threshold relative to the baseline audiogram of an average of 10 dB or more at 2,000, 3,000, and 4,000 Hz in either ear. Age corrections will be applied in determining STS. If an STS has occurred, the employee will be informed of this fact in writing, within 21 days of the final determination. When the HCP Director (Section Xl.E.) has determined that an STS has occurred, the following actions will take place:
- The HCP Director will send a notification letter to the affected employee. The HCP Director will send a separate notification letter to the OSHA Office of Occupational Medicine (OOM) as the employer representative. The HCP Director will provide both notification letters within 21 days of determining that an STS has occurred. If the STS did not persist on the retest audiogram, or if there is an improvement in hearing thresholds, the notification letter will indicate these findings.
- OOM will notify the Regional Administrator, his/her designee, or Directorate Head as appropriate, of the presence of an STS, and of the required follow-up actions, including the need for an OSHA 300 log entry per paragraph X.E.4. Recording Criteria for Cases Involving Occupational Hearing Loss.
- The designated Hearing Conservation Coordinator (HCC) (see Section XI. C.) will ensure proper evaluation of the adequacy of hearing protectors. If the affected employee is not using hearing protectors, that employee shall be fitted with hearing protectors, trained in their use and care, and be required to use them. If the affected employee is already wearing hearing protectors, he/she will be refitted and retrained in the use of hearing protectors and be required to use them. Alternative hearing protectors will be provided as appropriate.
- The HCP Director will advise OOM of recommendations for additional audiological or otological evaluations (See Appendix C). OOM will make final determinations on appropriate referrals as necessary.
- OOM will inform the affected employee of the purpose for additional testing, the logistics for obtaining additional testing, and of the implications of test results.
- Hearing Protection. Hearing protectors shall be provided at no cost to all OSHA personnel covered by PER 04-00-003. They shall be fitted with hearing protectors and trained in their use and care. Covered OSHA personnel shall wear hearing protectors when exposed to 90 dBA or greater as an 8-hour TWA. Covered personnel who have experienced an STS shall wear hearing protectors when exposed to sound levels of 85 dBA or greater as an 8-hour TWA. Dual hearing protection shall be worn if exposures exceed 105 dBA as an 8-hour TWA.
In addition, when OSHA personnel covered by PER 04-00-003 are at facilities in which employees are required by their employers to wear hearing protection, OSHA personnel are required to wear hearing protection equivalent to that worn by employees at the facility. See OSHA Field Inspection Reference Manual CPL 2.103, Section 5-Chapter I. Pre-Inspection Procedures, E. 2. a. which states: "29 CFR 1903.7(c) requires that the CSHO comply with all safety and health rules and practices at the establishment and wear or use the safety clothing or protective equipment required by OSHA standards or by the employer for the protection of employees."
- OSHA personnel covered by PER 04-00-003 will be provided the opportunity to choose their hearing protectors from a variety of types, with suitable attenuation characteristics. Factors to consider include comfort, communication, hearing ability, compatibility with other personal protective equipment, and the environment in which they will be worn.
- Training in the use and care of hearing protectors is required. Hearing protectors must be properly fitted and their correct use must be demonstrated.
- Hearing protectors must provide appropriate attenuation. (See 29 CFR 1910.95 Appendix B.)
- Hearing protectors must attenuate noise exposure to at least 90 dBA as an 8-hour TWA.
- For OSHA personnel covered by PER 04-00-003 who have experienced an STS, hearing protectors must attenuate noise exposure to at least 85 dBA as an 8-hour TWA.
- 29 CFR 1910.95 Appendix B, should be referred to for assistance on how to determine appropriate hearing protector attenuation. Additional information is available in the OSHA Technical Manual, Section III, Chapter 5. Also refer to NIOSH for additional methods to evaluate hearing protector performance and for updated and emerging information on individual fit testing at 1-800-CDC-INFO (1-800-232-4636). See http://www.cdc.gov/niosh/topics/noise/
- Training Program.
OSHA personnel covered by PER 04-00-003 shall be trained prior to beginning work in noisy environments and annually thereafter with updated information. Training must be conducted by a qualified individual, designated by the Regional Administrator, or Directorate Head, who is capable of answering questions on the Hearing Conservation Program. (Refer to section XI.Roles and Responsibilities.) Training shall include, at a minimum, the following:
- The effects of noise on hearing;
- The purpose of hearing protectors, the advantages, disadvantages, and attenuation of various types, and instructions on selection, fitting, use, and care of hearing protectors. (The NIOSH website has demonstrations for the correct fitting of different types of hearing protectors. This is available at 1-800-CDC-INFO (1-800-232-4636); See http://www.cdc.gov/niosh/topics/noise/
- The purpose of audiometric testing and an explanation of the test procedures; and
- A description of the HCP including a description of roles and responsibilities under the HCP.
- Records Program.
- Noise Exposure Measurements. Noise exposure measurements including self monitoring data shall be recorded on the OSHA-92 Noise Survey Report. The form is to be completed in the same way as for any sample taken during the inspection. The name of person being sampled is to be entered on line item 7 "Person Performing Sampling". The form should be entered into the Integrated Management Information System (IMIS) for tracking. The Area Director, or Directorate Head as appropriate shall create and keep a hard copy file that contains the covered employees' noise exposure records.
Additionally, all covered OSHA personnel shall store and maintain their own exposure monitoring records in an individual exposure file. Noise exposure measurement records shall be retained for 2 years in accordance with 1910.95(m)(3)(i).
(See standard interpretation letter dated 8/17/2000- which states: "The two year retention time for employee noise exposure measurements takes precedence over the general record retention requirement for employee exposure records in 1910.1020.")
- Audiograms. Audiometric test results and medical records related to this program will be maintained by OSHA's Medical Program Administrator in the Directorate of Science, Technology and Medicine in accordance with: The Privacy Act of 1974, 29 CFR Part 71; Occupational noise exposure, 29 CFR 1910.95(m); and Recording criteria for cases involving occupational hearing loss, 29 CFR 1904.10. Audiometric test results shall be maintained in OOM for the duration of the employee's employment, along with the employee's Medical Program records, in accordance with 29 CFR 1910.1020, Access to employee exposure and medical records. Audiometric test results of former employees will be archived in the Federal Records Center and are available through Human Resources.
- Access to Records. OSHA personnel covered by PER 04-00-003 or former OSHA personnel covered by PER 04-00-003 may request a copy of his/her own exposure, audiological, and medical records required by this HCP or may request that a copy be sent to his/her designated representative. All activities involved in complying with the access to medical records provisions can be carried out on behalf of OSHA by the physician or other health care professional in charge of employee records (29 CFR 1910.1020, Access to employee exposure and medical records).
- Recording Criteria for Cases Involving Occupational Hearing Loss. (Refer to section XI. for Roles and Responsibilities.) An STS must be recorded on the OSHA 300 log and the hearing loss column must be checked on the log when the following conditions are met: an audiogram for a covered OSHA employee reveals a work-related STS in hearing in one or both ears and the person's total hearing level is 25 dB or more, averaged at 2000, 3000 and 4000 Hz in the same ear(s) as the STS. The audiometric results will be age-adjusted (Appendix F, 29 CFR 1910.95). Age adjustment will not be used when determining whether the person's total hearing level is 25 dB or more above audiometric zero. The OSHA Intranet provides a hearing loss "decision tree" to assist in determining whether the results of an audiometric exam, given on or after January 1, 2003, reveal a recordable STS. If the retest audiogram, conducted within 30 days of the annual audiogram, does not confirm a recordable STS, the hearing loss case does not need to be recorded on the OSHA 300 log. If the retest audiogram confirms a recordable STS, the hearing loss case must be recorded on the OSHA 300 log within 7 calendar days of the retest. OOM will notify the Regional Administrator, his/her designee, or Directorate Head, as appropriate, of the need to record an STS within sufficient time to satisfy this recording requirement. If the STS does not persist, the recorded entry on the log may be erased or lined-out. See Recording criteria for cases involving occupational hearing loss, 29 CFR 1904.10.
- Roles and Responsibilities.
- Directorate of Science, Technology and Medicine.
The Office of Occupational Medicine, in the Directorate of Science, Technology and Medicine (DSTM) shall maintain oversight of the audiometric testing portion of the HCP. These responsibilities shall include:
- Ensuring that vendors' audiometric testing protocols are in compliance with 29 CFR 1910.95, the Statement of Work, and the Inter-Agency Agreement when applicable. These protocols shall include: proper calibration and functioning of audiometric hardware and software; proper certification and training of staff who conduct audiometric examinations; proper supervision of audiometric testing staff; maintaining and updating a skills competency checklist for audiometry; completion of requisite documentation including audiometric history/report, baseline, annual, and retest audiograms, audiogram summaries and test results, all generated reports, STS notification letters, and other criteria in accordance with the HCP Statement of Work.
- Appointing a competent physician as the HCP Director. OOM shall maintain oversight of all activities of the HCP Director, including the following: ensure that HCP Director reviews audiograms in a timely manner and ensure that HCP Director participates in quality assurance activities. (See Section E for a full list of HCP responsibilities.) Quality assurance includes a periodic performance review of: audiometric testing equipment; audiometric testing personnel; audiometric policies and procedures.
- Ensuring that OSHA personnel covered by PER 04-00-003 are scheduled for examinations in a timely fashion.
- Ensuring that all notification letters and reports generated by vendors, as applicable, conform to this Instruction and to criteria delineated in the Statement of Work.
- Performance of an annual evaluation of the overall effectiveness of the HCP. The results of this review will be provided to the Regional Administrator, Directorate Head or other designated OSHA personnel. DSTM will take the lead in developing and standardizing criteria to be used by the Regional Administrators to evaluate regional program effectiveness.
- Ensuring that any problems or discrepancies in the administration of the hearing conservation program are resolved.
- Regional Administrators, and Directorate Heads.
The Regional Administrators and Directorate Heads (as appropriate) shall ensure the overall administration of the HCP on regional, local and office levels. Their duties include:
- Ensuring that effective hearing protection devices are provided to and used by OSHA personnel covered by PER 04-00-003 when required.
- Upon receipt of notification from OOM that a covered OSHA employee was identified with an STS, the Regional Administrator or Directorate Head as appropriate, will ensure that the designated Hearing Conservation Coordinator (HCC) is informed of the STS and initiates required follow-up actions.
- Ensuring that all designated Hearing Conservation Coordinators perform their required responsibilities, including training as necessary.
- Evaluating the effectiveness of the HCP on a regional and local level through a compliance audit and submitting the results to the Directorate of Science, Technology and Medicine.
- Ensuring proper implementation and maintenance of the records program for noise exposure data and OSHA 300 logs.
- Upon receipt of the annual review of HCP effectiveness provided by DSTM, the Regional Administrator or appropriate Directorate Head shall ensure that recommended changes are incorporated into procedures for implementing the HCP.
- Hearing Conservation Coordinator.
The Regional Administrator or Directorate Head, as appropriate, shall designate a Hearing Conservation Coordinator (HCC) for each local Office or Directorate to effectively implement elements of this HCP, including:
- Ensuring that all OSHA personnel covered by PER 04-00-003 are participating in all the required components of the audiometric testing program.
- Evaluating the quality of audiometric services provided, e.g., timely notification of STS and scheduling of audiograms.
- Ensuring that the hearing protection requirements of this Instruction are implemented, including providing appropriate hearing protectors and ensuring that covered OSHA personnel are trained in their use and care and required to wear them. For covered OSHA employees already wearing hearing protectors, ensure that alternative hearing protectors are provided as appropriate and that such employees are appropriately retrained.
- Ensuring compliance with maintenance of records for noise exposure data and OSHA 300 logs.
- Establishing a mechanism for covered employees to report problems in the administration of the HCP.
- OSHA Personnel Covered by PER 04-00-003.
OSHA personnel covered by PER 04-00-003 shall:
- Participate in audiometric testing protocols and required actions when scheduled.
- Select, use, and care for hearing protectors as required by this Instruction and 29 CFR 1910.95.
- Report hearing-related problems to the audiometric technician, to the physician conducting OSHA Medical examinations, or to a Medical Officer in the Office of Occupational Medicine.
- Report problems relating to the HCP to the Hearing Conservation Coordinator, as they arise.
- Participate in training as required by this Instruction.
- Hearing Conservation Program Director.
The Director is responsible for the definitive review of all audiograms. The Director shall:
- Closely evaluate all audiograms that indicate an STS and other problem audiograms. Provide timely notifications to the affected person and to OOM when problem audiograms are identified. Participate in quality assurance by reviewing accuracy and appropriate performance of: audiometric testing equipment; audiometric testing personnel; audiometric policies and procedures.
- Supervise audiometric technicians; establish a mechanism for technicians to report problem audiograms to physicians as well as problems related to the audiometric testing process.
- Provide recommendations to OOM regarding personnel follow-up with audiology or otolaryngology professionals, as appropriate.
- Provide annual reports on group data, including trends, as requested.
Sample of Audiogram History / Report Form
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