1. Purpose

   Hearing conservation is important for all OSHA Field personnel. This chapter documents OSHA’s Hearing Conservation Program (HCP) and provides guidance to protect employees from the risk of injury resulting from exposure to occupational noise. Program elements covered are roles and responsibilities; noise monitoring; audiometric testing; hearing protection devices (HPDs), including selection and fit testing; recordkeeping; and training.

2. Scope

   The program applies to all OSHA personnel within a regional, area, district, and satellite OSHA office and other OSHA organizational units (i.e., OSHA Technical Center (OTC), and Office of Training and Education (OTE)) covered by the OSHA SHMS Manual. Program elements impact personnel that are required to wear HPDs (i.e., employees whose noise exposures may equal or exceed an 8-hour time weighted average (TWA) of 85 decibels (dBA)) or use HPDs.

3. Definitions

   Hazardous Noise: As referred to in this program, noise exposures that equal or exceed the OSHA Action Level of 85 dBA as an 8-hour time-weighted average (TWA). All continuous, intermittent, and impulsive noise within 80-130 dB shall be integrated into noise measurements. In addition, hazardous noise also refers to exposures to impulsive/impact noise that exceed 140 dBA. It is the intent of this program to control noise exposures for OSHA personnel to below both the Action Level and impulsive/impact noise limits. See the OSHA Occupational Noise Exposure standard, 29 CFR 1910.95 for more information.

   Hearing Conservation Equipment: Equipment used to conserve hearing (e.g., noise monitoring equipment, HPD fit testing equipment, and HPDs.)

   Hearing Conservation Program Director (HCPD): OSHA personnel designated by the Directorate of Technical Support and Emergency Management (DTSEM) Director who oversees the OSHA HCP including noise monitoring, audiometric testing, hearing protection, training, and recordkeeping. The HCPD may delegate elements of the HCP as appropriate. The Safety and Occupational Health Manager (SOHM) typically is designated to this role.

   Hearing Protection Device (HPD): A type of personal protective equipment (PPE) used to protect individuals from noise exposures, also known as a hearing protector. Common examples include earplugs, canal caps, or earmuffs.

   HPD Fit Testing Devices: Devices used to assist workers in the selection and proper fitting of earplugs.

   Impact/Impulse Noise (Brief High-Level Noise): A hazardous noise characterized by a sharp rise and rapid decay in sound levels that is less than one second in duration.

   Local Hearing Conservation Program Coordinator (LHCPC): OSHA personnel, designated by the OSHA Manager, that coordinates the distribution and maintenance (e.g., repair, calibration, and care) of all hearing conservation equipment. This person has clearance for access to medical records, such as audiograms and associated correspondence. The LHCPC coordinates the HPD fit testing and maintains the HPD fit testing records of OSHA personnel of an area, district or satellite OSHA office or other organizational unit.

   Noise Monitoring Equipment: Equipment used for monitoring sound levels and evaluating exposure (e.g., sound level meters and noise dosimeters.)

   Noise Reduction Rating (NRR): A laboratory generated estimate of the attenuation achieved by a HPD, found on each HPD package.

   Nuisance Noise: Noise that is annoying but non-hazardous.

   Occupational Noise: Sound in the work environment.

   Personal Attenuation Rating (PAR): The estimate of the noise reduction a given HPD provides when inserted into an individual’s ear, measured during fit testing.

   Professional Supervisor of the Audiometric Monitoring Program (AMP) (Professional Supervisor): A representative of the Directorate of Technical Support and Emergency Management’s (DTSEM) Office of Occupational Medicine and Nursing (OOMN) who establishes and supervises an audiometric testing program, reviews audiograms, determines work-relatedness and recordability of hearing loss, ensures follow up of work-related auditory disorders, and manages the audiometric database in compliance with the Occupational Noise Exposure Standard, 29 CFR 1910.95 and OSHA recording criteria for cases involving occupational hearing loss, 29 CFR 1904.10. The professional supervisor may delegate portions of duties, as appropriate. See Professional Supervisor of the AMP Section in Appendix A: Responsibilities for the Audiometric Testing Program.

   Regional Hearing Conservation Program Coordinator (RHCPC): OSHA personnel designated by the Regional Administrator that supervises the distribution and maintenance (i.e., repair, calibration, and care) of all hearing conservation equipment. This person has clearance for access to medical records, such as audiograms and associated correspondence. They also coordinate the fit testing of OSHA personnel at the Regional/Directorate office level and maintain HPD fit test records. A SHMS representative, such as a Regional Safety and Occupational Health Manager (RSHM), is typically designated to this role.

   Standard Threshold Shift (STS): 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. See Appendix B: Procedures for Audiometric Testing Programs.

4. References

   ANSI/ASA S12.71-2018 – Performance Criteria for Systems that Estimate the Attenuation of Passive Hearing Protectors for Individual Users.

   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 04-00-004, Hearing Conservation Program

   OSHA Instruction, PER 04-00-005, OSHA Medical Examination Program (OMEP)

   OSHA Technical Manual (OTM) TED 01-00-015 [TED 1-0.15A], Section III, Chapter 5 Noise

   29 CFR 1913.10, Rules of agency practice and procedure concerning OSHA access to employee medical records

   OSHA Instruction CPL 02-02-072, Rules of agency practice and procedure concerning OSHA access to employee medical records

   OSHA Instruction CPL-02-00-135, Recording Policies and Procedures Manual

   Hearing Protection Device and Fit Testing Information - Available at the OSHA Technical Center (OTC) Noise Technical Resources Intranet page – Equipment notices and Equipment and Accessory Acquisition.

   National Institutes of Health (NIH) – Hearing Loss division – Hearing Protection: How to Use Formable Earplugs

   NIOSH Criteria for Recommended Standard Occupational Noise Exposure (Revised Criteria 1998)

   SHMS Chapter 8: PPE

5. Roles and Responsibilities

   1. National Office - DTSEM
      1. Office of Science and Technology Assessment (OSTA) Designates a Hearing Conservation Program Director (HCPD) with the following duties:
         1. Oversees the HCP in compliance with the Occupational Noise Exposure Standard, 29 CFR 1910.95, including monitoring, audiometric testing, hearing protection, training, and recordkeeping.
         2. Designates/delegates components of the HCP as outlined in this section V. Roles and Responsibilities.
         3. Standardizes criteria and performs an annual evaluation of the overall effectiveness of the HCP. The results of this review will be provided to the Regional Administrator (RA) or Directorate Director to evaluate their regional/organizational units HCP.
      2. Office of Occupational Medicine and Nursing (OOMN)
         1. Ensures that competent physicians fulfill the responsibilities of the Professional Supervisor of the AMP. Coordinates with the contractors (i.e., Federal Occupational Health Clinic (FOH)) to complete audiograms in accordance with the Occupational Noise Exposure Standard, 29 CFR 1910.95. See Appendix A: Responsibilities for the Audiometric Testing Program.
         2. Ensures that audiometric testing protocols are up to date.
         3. Maintains the audiometric history of OSHA personnel covered under OMEP.
         4. Orders service requests and ensures OSHA personnel covered under OMEP are scheduled for their examinations.
         5. Reviews/confirms audiogram results for personnel covered under OMEP who have an abnormal audiogram.
         6. Ensures that any problems or discrepancies in the administration of the audiometric testing portion of the HCP are resolved. See Appendix A: Responsibilities for the Audiometric Testing Program of this chapter for more information on OOMN’s responsibilities as it pertains to this HCP.
   2. Regional Office and Directorates
      1. Regional Administrators and Directorate Directors Regional Administrators and Directorate Directors (as appropriate) shall ensure the overall administration of the HCP at the regional, area and, district office levels and organizational units. Their duties include:
         1. Ensure that a Hearing Conservation Program Coordinator (HCPC) is designated for each local office or applicable directorate to implement the elements of the HCP. See Section V.B.2. Local: Hearing Conservation Program Coordinator, for more information.
         2. Ensuring that OSHA personnel covered under OMEP are provided and use effective HPDs, when required.
         3. Upon receipt of notification from OOMN that a covered OSHA employee was identified with an STS, ensuring that the designated HCPC is informed of the STS and initiate required follow-up actions. See Appendix A: Responsibilities for the Audiometric Testing Program for more information.
         4. Ensuring that all designated HCPCs perform their required responsibilities, including training, as necessary.
         5. Evaluating the effectiveness of the HCP on a regional and local level through an annual compliance review/audit and submitting the results to HCPD.
         6. Ensuring proper implementation and maintenance of the records program for noise exposure data, HPD fit testing results, and the OSHA Forms for Recording Work-Related Injuries and Illnesses. For more information about records programs, see VI. Procedures, I. Records Program.
         7. Upon receipt of the annual review/audit of HCP provided by the HCPD, ensuring that recommended changes are incorporated into the HCP.
      2. Hearing Conservation Program Coordinator(s) (HCPCs) There shall be a RHCPC in the Regional Office and LHCPCs in the Area and District Offices and applicable organizational units. Their duties shall include:
         1. Ensuring that all OSHA personnel covered by OMEP are participating in all the required components of the audiometric testing program. Note: The HCPC may be the regional point of contact for the OMEP and coordinate with OOMN to schedule OMEP required medical examinations, which includes audiograms.
         2. Timely notification of STS and scheduling of audiograms. See Appendix A: Responsibilities for the Audiometric Testing Program of this chapter for more information regarding contractor clinic responsibilities.
         3. Ensuring all requirements of this HCP are implemented, including providing appropriate HPDs; ensuring that OSHA personnel covered under OMEP are trained in the use and care of HPDs and understand they are required to wear them when appropriate per a Job Hazard Analysis (See Hazard Assessment in SHMS Chapter 8: PPE for more information). For OSHA personnel covered under OMEP with STS who already wear HPDs, ensure the employee receives appropriate alternative HPDs and training. Note: If earplugs are the selected HPD, the earplugs that are fit-tested should be readily available for personnel to wear when exposed to hazardous noise. If OSHA personnel require custom molded earplugs, see section VI. Procedures, F. Custom Molded Earplugs. OSHA personnel who use custom-molded earplugs must be fit-tested wearing those earplugs but can also be fit-tested with other available earplugs.
         4. Ensuring compliance with maintenance of records for noise exposure data, HPD fit testing, and occupational injuries and illnesses. See Appendix C. Records Program, Section C: HPD Fit Testing, for information on required data for HPD fit testing records.
         5. Establishing a mechanism for covered employees to report problems in the administration of the HCP.
   3. Area Offices, OTC and OTE
      1. OSHA Manager(s) have the primary responsibility for implementing the HCP in their work area and will:
         1. Ensure that a local HCPC is assigned.
         2. Ensure that all OSHA personnel covered under OMEP have current physicals including annual audiograms as directed by OOMN.
         3. Ensure that all OSHA personnel exposed to hazardous noise have at least two choices of HPDs and have ready access to HPDs. See Appendix D: Estimating HPD Attenuation using NRR or PAR, for more information.
         4. Ensure that OSHA personnel covered under OMEP have access to a fit test program and are fit tested at least annually. To obtain a fit testing device see section VI. Procedures, E. Obtaining HPD Fit Testing Equipment.
         5. Ensure that employees wear their HPD when exposed to a hazardous noise environment.
         6. Ensure that OSHA personnel have access to Noise Monitoring Equipment to measure noise exposure.
      2. OSHA personnel covered under OMEP shall:
         1. Participate in training related to this Chapter.
         2. Select, use, and care for HPDs as this chapter and the Occupational Noise Exposure Standard, 29 CFR 1910.95 require.
         3. Participate in audiometric testing protocols and required actions when scheduled.
         4. Report hearing-related problems to the audiometric technician, the physician conducting medical examinations, or to a Medical Officer in OOMN.
         5. Comply with HPD fit testing as indicated in Appendix E: HPD Fit Testing.
      3. OSHA personnel not covered under OMEP:
         1. Shall participate in training related to this Chapter.
         2. May be fit tested for HPDs for voluntary use.

6. Procedures

   1. Noise Monitoring

      Due to the wide variety of worksites visited and the variability of working conditions in each site, OSHA personnel may encounter periods of noise exposure more than 85 dBA, as an 8-hour TWA. 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. OSHA personnel covered by OMEP are to follow the guidance in the OSHA Technical Manual TED 01-00-015, Chapter 5, in order to assess workplace noise levels and direct the use of appropriate hearing protection. Noise monitoring results will be used to select HPDs that are adequate for noise exposures.

      OSHA personnel covered under OMEP shall perform noise exposure self-monitoring. For details and policy related to noise monitoring, see SHMS Chapter 27: Exposure Monitoring. Also, see Appendix C: Records Program for procedures for recording and reporting noise exposure measurements.

   2. Hearing Protector Use

      OSHA personnel can wear HPDs at their discretion but shall wear HPDs whenever exposures exceed an 8-hour TWA of 85 dBA. The HPDs must provide sufficient attenuation (noise reduction) to reduce exposures at or below 85 dBA. In addition, when OSHA personnel are at facilities in which employees are required by their employers to wear hearing protection, OSHA personnel are required to wear hearing protection at least as effective as that worn by employees at the facility. See OSHA Field Operations Manual (FOM) CPL 02-00-164, Chapter 3, Section II.C.3. which states: "29 CFR 1903.7(c) requires CSHOs to comply with all employer safety and health rules and practices at the establishment being inspected; CSHOs shall wear and use appropriate protective clothing and equipment."

   3. Obtaining HPDs

      HPDs shall be provided at no cost to all OSHA personnel. HPDs are available through OSHA’s Agency Expendable Supplies Program (AESP), a Field Support Program online catalog. The AESP provides OSHA offices with centralized shopping for expendable supply items used in supporting the agency’s mission.

      Note: OSHA personnel may browse the Field Support Program Online catalogs. You must be an authorized user to place an order.

   4. HPD Fit Testing

      Fit testing will be incorporated in HCP training to aid in meeting the regulatory requirements for training employees on proper selection, fit and training of HPDs as outlined in the Occupational Noise Exposure Standard, 29 CFR 1910.95.. OSHA personnel covered under OMEP will be fit tested prior to initial exposure to hazardous noise, or as soon as possible after exposure and annually thereafter.

      See Appendix E: HPD Fit Testing and Appendix F: How to Properly Insert Earplugs for further information.

   5. Obtaining HPD Fit Testing Equipment

      HPD fit testing equipment can be borrowed or purchased through the following Field Support Programs:

      1. Agency Loan Equipment Program (ALEP)

         Hearing protection fit testing equipment is available through the OSHA ALEP. The ALEP allows OSHA field offices to borrow equipment which is unique and/or costly and is kept on site at OTC. OTC provides all OSHA field offices the opportunity to borrow the equipment as they need it. The equipment is typically loaned for a 30-day period.

      2. Agency Technical Equipment Procurement Program (ATEPP)

         OSHA ATEPP provides OSHA field offices with centralized support to buy field technical equipment. HPD fit testing equipment may be purchased through OSHA’s ATEPP.

         Note: OSHA personnel may browse the Field Support Programs catalogs on the Field Support Programs intranet page. You must be an authorized user to place an order. Individual offices determine who is the authorized user.

         For more manuals and information on noise equipment and accessories, please see the OTC Noise Technical Resources Intranet page.

   6. Custom Molded Earplugs

      Custom molded earplugs will be provided when available HPDs do not provide the necessary protection for the employee. Custom molded earplugs provide a custom fit inside the ear canal of the individual employee. When approval to order custom molded earplugs is confirmed, the office of the affected OSHA personnel must complete a Standard Form (SF) 1034 Public Voucher for Purchases and Services Other Than Personal. See Appendix G: Resources for Custom Molded Earplugs for more information.

   7. Chemical Exposures

      Certain chemical exposures can increase the risk of hearing loss. For more information on how ototoxic chemicals affect hearing, see OSHA Technical Manual TED 01-00-015 [TED 1-0.15A], Section III, Chapter 5 Noise.

   8. Audiometric Testing Program

      Audiometric testing will be conducted in concert with the OSHA SHMS Manual, Chapter 25: Medical Management. See Appendix B: Procedures for Audiometric Testing Program.

   9. Records Program

      Records generated from noise monitoring and audiometric testing will be maintained in accordance to OSHA Technical Manual TED 01-00-015 [TED 1-0.15A], Section III, Chapter 5 Noise; OSHA SHMS Manual, Chapter 25: Medical Management; and OSHA SHMS Chapter 27: Exposure Monitoring.

      See section VII. Training and Record Keeping for more information.

7. Training and Record Keeping

   OSHA personnel shall be trained on this chapter, annually with updated information and per the requirements specified in the Occupational Noise Exposure Standard, 29 CFR 1910.95. Prior to beginning work in noisy environments, OSHA personnel should be refreshed on the details of this chapter. Training must be conducted by a competent individual capable of answering questions on this Hearing Conservation Program.

   Newly hired OSHA personnel receive orientation training that instructs them on how to evaluate and protect themselves from potentially harmful noise exposures. HPD Fit testing Equipment will be used for training/retraining on HPD use and fit.

   For more information on the maintenance of audiometry related records (exposure monitoring, audiological, medical, and HPD Fit Testing), refer to Appendix C: Records Program. For information on training schedules and records, refer to SHMS Chapter 2: Safety and Health Management System.

Appendix A: Responsibilities for the Audiometric Testing Program

1. Office of Occupational Medicine and Nursing

   The Office of Occupational Medicine and Nursing (OOMN) oversees the audiometric testing program of OSHA’s Hearing Conservation Program. OSHA contracts with an outside vendor to perform audiometric testing, evaluation, and notifications. Oversight includes:

   1. Ensuring that the contractor’s audiometric testing protocols are in compliance with the Occupational Noise Exposure Standard, 29 CFR 1910.95, the contractor’s Statement of Work, and the Inter-Agency Agreement when applicable. The protocols shall include:
      1. Proper maintenance of audiometric hardware and software (See the OTC Noise Technical Resources Intranet page – Equipment notices and Equipment and Accessory Acquisition).
      2. Proper certification and training of staff who conduct audiometric examinations.
      3. Proper supervision of audiometric testing staff.
      4. 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 OMEP and contractor’s Statement of Work.
      5. All notification letters and reports generated by contractors conform to this Instruction and to criteria delineated in the Statement of Work. See Appendix B: Procedures for Audiometric Testing Program, Section D: Notification of Audiogram Results.
   2. Ensuring that competent physicians fulfill the responsibilities of the Professional Supervisor of the AMP. The Professional Supervisor shall: Maintain oversight of all activities of the contractor’s Reviewing Medical Officer (RMO) and ensure the RMO is fulfilling their responsibilities outlined below.
      1. Ensure that the contractor is providing audiograms conducted in accordance with the Occupational Noise Exposure Standard, 29 CFR 1910.95.
      2. Review all audiograms to ensure accuracy and appropriate performance of audiometric testing.
      3. Ensure OSHA personnel are notified in writing, when a STS occurs, as defined in the Occupational Noise Exposure Standard, 29 CFR 1910.95, or other concerns are identified.
      4. Notify applicable Regional Administrators or Directorate Directors when a recordable hearing loss injury occurs. See Appendix B: Procedures for Audiometric Testing Program, Section G.2.
      5. Provide recommendations regarding personnel follow-up with audiology or otolaryngology professionals, as appropriate. See Appendix B: Procedures for Audiometric Testing Program for further details.
      6. Provide annual reports on group data, including trends, as requested to the HCPD.

4. Contractor Clinics

   The contractor is responsible for developing protocols for audiometric testing in compliance with the Occupational Noise Exposure Standard, 29 CFR 1910.95, the contract’s Statement of Work, and the Interagency Agreement, as applicable. The contractor will schedule and conduct baseline, annual and follow-up audiograms for OSHA personnel covered under OMEP and notify OOMN and OSHA personnel of results in a timely manner.

   1. Reviewing Medical Officer (RMO)
      1. Ensures that audiogram testing is performed in accordance with all requirements of the Occupational Noise Exposure Standard, 29 CFR 1910.95, including that equipment is calibrated and trained technicians conduct audiograms.
      2. Reviews audiograms in a timely manner and ensures appropriate follow-up and notification of results:
         1. If no STS has occurred, the RMO sends a letter to OOMN and the affected employee that "no STS has occurred".
         2. If results show an STS, within 21 days, the RMO sends a letter to the affected OSHA personnel notifying them of the need for a follow-up audiogram. In addition, the RMO notifies the contractor to request scheduling of a follow-up audiogram.
         3. Sends hearing conservation letters to OOMN and the affected employee when a follow-up audiogram is completed.
      3. Reviews follow-up audiograms and notifies OOMN if repeat audiogram confirms an STS. See Appendix B: Procedures for Audiometric Testing Program: Section D: Notification of Audiogram Results.
      4. Participates in quality assurance activities including a periodic performance review of audiometric testing equipment, audiometric testing personnel, and audiometric policies and procedures.
   2. Contractor Nurse
      1. Securely transmits audiogram results to RMO for quality assurance/data entry and review within 24-48 hours of completion.
      2. Notifies OSHA personnel covered under OMEP when follow-up audiograms are needed and contacts the employee to schedule the test within 28 days of the initial test date.
      3. Ensures that OSHA personnel covered under OMEP are scheduled for follow up audiograms in a timely fashion.
      4. Provides information to OOMN as needed for annual evaluation of the overall effectiveness of the HCP.

         Note: The annual evaluation of the HCP will be conducted by the HCPD.

      5. Ensures that any problems or discrepancies in the contractor’s administration of the HCP are resolved.

Appendix B: Procedures for Audiometric Testing Program

All audiometric exams performed as part of the OMEP 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 of the Occupational Noise Exposure Standard, 29 CFR 1910.95(g).

Prior to receiving audiometric testing, OSHA personnel covered under OMEP will complete an audiometric history form in order to document pertinent medical history, noise exposure, and use of hearing protection.

1. 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.

2. 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 under OMEP 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 under OMEP 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 OMEP for more information.
3. 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.

4. Notification of Audiogram Results:

   The RMO will perform a definitive interpretation of all audiograms. (See Appendix A: Responsibilities for the Audiometric Testing Program). The RMO will send OSHA personnel covered under OMEP a formal written notification letter regarding the following: 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 OSHA personnel covered under OMEP undergo a retest audiogram, they will receive a single notification letter that explains the findings of both the annual and retest audiograms. OOMN staff will contact the OSHA personnel with specific information and instructions if follow-up testing and treatment are needed.

5. Retest audiogram:

   OSHA personnel covered under OMEP 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, HPDs 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 cases, the results of the retest audiogram can be substituted for the annual audiogram.

6. 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.

7. 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 as directed by the OSHA Technical Manual (OTM) TED 01-00-015 [TED 1-0.15A], section III, Chapter 5 Noise, IV.B.1. When the RMO has determined that an STS has occurred, the following actions will take place:

   1. The RMO will send a notification letter to the affected employee. The RMO will send a separate notification letter to the OSHA OOMN as the employer representative. The RMO 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.
   2. OOMN will notify the Regional Administrator, Directorate Head, or their designee 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 29 CFR 1904.10 – Recording Criteria for Cases Involving Occupational Hearing Loss.
   3. The designated Hearing Conservation Program Coordinator (HCPC) will ensure proper evaluation of the adequacy of HPDs. If the affected employee is not using HPDs, that employee shall be fitted with appropriate HPDs, trained in their use and care, and be required to use them when exposed. If the affected employee is already wearing HPDs, he/she will be refitted and retrained in the use of HPDs and be required to wear them. HPD Fit testing Equipment will be used for training/retraining on HPD use and fit. See HPD Fit Testing. Alternative HPDs will be provided as appropriate.
   4. The RMO will advise OOMN of recommendations for additional audiological or otological evaluations (See Appendix A: Responsibilities for the Audiometric Testing Program). OOMN will make final determinations on appropriate referrals as necessary. Payment for these referrals is the responsibility of the Region or Directorate.
   5. OOMN will inform the affected employee of the purpose for additional testing, the logistics for acquiring additional testing, and of the implications of test results.

Appendix C: Records Program

1. Noise Exposure Measurements:

   Records generated through noise exposure measurements, including self-monitoring data, shall be maintained as specified in SHMS Chapter 27: Exposure Monitoring.

2. Audiograms:

   Audiometric test results and medical records related to this program will be maintained in OSHA's OMEP in accordance with: The Privacy Act of 1974, 29 CFR Part 71; Occupational Noise Exposure Standard, 29 CFR 1910.95(m); and recordkeeping and reporting criteria for cases involving occupational hearing loss, 29 CFR 1904.10. Audiometric test results shall be maintained in OOMN 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.

3. HPD Fit Testing

   Records generated through HPD fit testing will be maintained in the local office and made available to the HCPD and/or Professional Supervisor upon request. Information such as the following will be recorded each time an individual is fit tested. (See Table 1: Example of HPD Fit Testing Record for OSHA Personnel (Optional):

   1. Name and job/position of OSHA personnel fit testing and the Fit Tester.
   2. HPD fit test method and equipment used.
   3. Date of last test and next due date recommended for fit testing (e.g., annually).
   4. Reason for fit testing (e.g., initial training, annual training, post-STS, or post-TTS).
   5. Hearing protector tested, including manufacturer, make, model, size and NRR.
   6. OSHA Personnel’s measured noise exposure, if available.
   7. PAR achieved during the fit test. (The PAR of the left and right ear with at least two earplugs, preferably earplugs of a high and low NRR).
   8. Maximum allowable noise exposure with the tested HPD based on the PAR achieved if the earplug is inserted in a similar manner; see Appendix D: Estimating HPD Attenuation using NRR or PAR of this document for additional guidance on the use of PAR).
   9. Comments about the test sessions and recommendations for follow-up.

   
   Table 1: Example of HPD Fit Testing Record for OSHA Personnel (Optional)

4. Access to Records.

   OSHA personnel and former OSHA personnel covered under OMEP may request that OOMN send a copy of their exposure, audiological, and medical records to themselves or their designated representative.

5. Recording Criteria for Cases Involving Occupational Hearing Loss:

   An STS must be recorded on the OSHA Form 300 log and the hearing loss column must be checked on the log when the following conditions are met: 1) an audiogram for a covered OSHA employee reveals a work-related STS in hearing in one or both ears, and 2) the person's total hearing level is 25 dB or more above audiometric zero, averaged at 2000, 3000 and 4000 Hz, in the same ear(s) as the STS. The audiometric results will be age-corrected when determining if an STS has occurred (see OSHA Technical Manual (OTM) TED 01-00-015 [TED 1-0.15A], section III, Chapter 5 Noise, IV.B.1). Note that age correction is not used when determining whether the person's total hearing level is 25 dB or more above audiometric zero. Also refer to the OTC Noise Technical Resources Intranet page for additional job aids and worksheets that can be used for evaluating audiograms and determining recordability.

   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 OSHA’s Form 300 Log of Work-Related Injuries and Illnesses. If the retest audiogram confirms a recordable STS, the hearing loss case must be recorded on OSHA’s Form 300 Log of Work-Related Injuries and Illnesses within 7 calendar days of the retest. OOMN 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.

   Also see section V. Roles and Responsibilities.

Appendix D: Estimating HPD Attenuation using NRR or PAR

OSHA personnel shall wear HPDs whenever exposures exceed 85 dBA, and the HPDs must provide sufficient attenuation to reduce noise exposures at or below 85 dBA. In addition to attenuation, personnel should also consider comfort, communication, hearing ability, compatibility with other PPE, and the environment in which they will be worn.

OSHA personnel should ensure that the targeted amount of attenuation is below 85dBA, but not so low as to affect their safety and ability to hear important conversations and warning sounds. Generally, attenuations that decrease exposure below 70 dBA should be avoided.

There are two primary methods for estimating HPD attenuation:

1. The NRR Method

   This method for estimating attenuation and will be used to estimate attenuation for a given HPD on an interim basis until the worker is fit tested. The NRR method is described in detail in the OSHA Technical Manual – Noise Chapter, Appendix F, Noise Reduction Rating.

2. The Fit testing PAR Method

   This method uses HPD fit testing to provide a personal attenuation rating (PAR) for the individual and the HPD(s) tested. Once HPD fit testing is completed, PAR can be used to estimate the attenuation for a given HPD.

   When utilizing the HPD fit testing method, the PAR value obtained from testing is equivalent to the estimated attenuation provided for the given hearing protector, as follows:

   Equation 1)
   Attenuation (dBA) = PAR

   Accordingly, the estimated exposure is determined as follows:

   (Equation 2)
   Estimated Exposure (dBA) = Noise Level (dBA) – PAR

   Example: An employee performs fit testing and obtains a PAR value of 22 dBA for a given earplug. They plan to visit a worksite where the anticipated noise levels may reach 100 dBA. Using equation (2) above, their estimated exposure when using the tested HPD is calculated as follows:

   Estimated Exposure (dBA) = 100 – 22 = 78 dBA

   Based on this calculation, the estimated exposure is at or below 85 dBA, and would be considered adequate in this scenario.

   Alternatively, the maximum allowable noise level where a given protector may be utilized can be calculated as follows:

   (Equation 3)
   Maximum Allowable Noise Level (dBA) = 85 + PAR

   Using the same example as above, the maximum allowable noise level is calculated using equation (3) as follows:

   Maximum Allowable Noise Level (dBA) = 85 + 22 = 107 dBA

   According to this calculation, the employee could utilize the given HPD (PAR value of 22 dBA) in an environment with a noise level up to a maximum of 107 dBA.

   Double Hearing Protection

   There may be situations where noise levels may be exceedingly high and maximum attenuation is necessary. In this case, an earplug with a maximum PAR value can be selected and used in conjunction with earmuffs (double protection). When estimating attenuation, an additional 5 dBA of noise reduction is added to account for use of the earmuffs, as follows:

   (Equation 4)
   Estimated Exposure (dBA) = Noise Level (dBA) – [PAR + 5]

   Similarly, the maximum allowable noise level utilizing dual protection is estimated as follows:

   (Equation 5)
   Maximum Allowable Noise Level (dBA) = 85 + [PAR + 5]

   Example: Fit testing is performed on a variety of HPDs and a maximum PAR value of 29 dBA is obtained for one of the protectors. The employee will be visiting a worksite where continuous noise levels may reach 115 dBA. The employee will utilize the HPD with the 29 dBA PAR in addition to earmuffs, and the estimated exposure is calculated using equation (4) as follows:

   Estimated Exposure (dBA) = 115 – (29+5) = 81 dBA

   Since the estimated exposure of 81 dBA is less than 85 dBA, the attenuation provided by the double protection would be considered adequate. In this example, the maximum allowable noise level using the given earplugs and muffs is estimated using equation (5) as follows:

   Maximum Allowable Noise Level (dBA) = 85 + [29 + 5] = 119 dBA

   NOTE: If the chosen hearing protector does not provide sufficient PAR to attenuate the noise exposure level (based on fit testing results), the fit test conductor will instruct/assist the worker to ensure the HPD is properly inserted. If repeat fit testing PAR for that HPD is still inadequate, the OSHA personnel will choose another suitable hearing protector and repeat fit testing as needed to ensure proper fit and adequate attenuation. See Appendix E: HPD Fit Testing, for more information.

Appendix E: HPD Fit Testing

HPD Fit testing Equipment will be used for OSHA personnel covered under OMEP to train/retrain on HPD use and fit. HPD fit testing results in a “personal attenuation rate” (PAR). The PAR is used to determine “individual fit” which is different from determining the “suitability” of a hearing protector attenuation based on the NRR as mandated in the Occupational Noise Exposure Standard 29 CFR 1910.95 Appendix B: Methods for Estimating the Adequacy of Hearing Protector Attenuation. Even if an HPD is determined to be “suitable” based on the NRR, it may not be a good fit for a particular individual. HPD fit testing trains workers on proper HPD insertion of a particular earplug and provides a PAR that is unique to the user.

1. Obtaining HPD Fit testing Equipment

   Procedures for obtaining HPD Fit testing Equipment are found in section VI. Procedures, E. Obtaining HPD Fit Testing Equipment of this chapter.

2. Personnel Conducting HPD Fit Testing

   While there are no regulatory requirements for credentials to conduct fit testing. the fit test operator should be trained on HPD fitting (see Appendix F for instruction on HPD insertion), proper HPD use, basic knowledge about noise and hearing protection, and actions to take based on fit test results. The operator should be familiar with the operation and maintenance of the fit test system. Fit test operators may include safety professionals or non-medical personnel experienced in HPD fitting. Resources for training the fit test operator, include training materials from the manufacturer, are available from the OTC Noise Technical Resources Intranet page. Additional assistance can be obtained from the National Office SOHM, OOMN directly or via fieldshms@dol.gov.

3. Selection of HPDs

   Prior to HPD fit testing, the employer will use Occupational Noise Exposure Standard 29 CFR 1910.95 Appendix B: Methods for Estimating the Adequacy of Hearing Protector Attenuation to determine a selection of suitable HPDs for workers to choose. (For information on purchasing HPDs, see section VI. Procedures, C. Obtaining HPDs of this chapter.) Once an HPD is chosen, HPD fit testing will be used to meet the regulatory requirements for training workers on proper fit, attenuation, and use of HPDs. See Appendix F: How to Properly Insert Earplugs for guidance on HPD insertion.

   Note: Only earplug-style HPDs can currently be fit tested. It is recommended that each individual performs fit testing for a variety of HPDs, and that the PAR value for each HPD is documented accurately. This will ensure the wearer can select an appropriate HPD from available inventory and according to the amount of attenuation necessary for the anticipated exposure levels.

4. HPD Fit Testing Periodicity
   1. Initial/Periodic training:

      OSHA personnel covered under OMEP who wear in-ear hearing protectors will be fit tested prior to initial exposure to hazardous noise, or as soon as possible after exposure and annually thereafter.

   2. Training/Retraining after STS:

      OSHA personnel covered under OMEP who have experienced an STS will be fit tested as part of the refitting/retraining requirement noted in the Occupational Noise Exposure Standard, 29 CFR 1910.95.

   3. Training after Temporary Threshold Shift (TTS):

      Personnel who have experienced a TTS that resolved on repeat audiometric testing should be prioritized for fit testing prior to the annual fit test, if possible.

   4. Other:

      OSHA personnel not covered under OMEP can request to be fit tested as time and resources are available.

5. Personal Attenuation Rate (PAR) Results

   The PAR is measured in decibels and is intended to be directly subtracted from the A-weighted noise level of exposure (ANSI S12.71-2018; see Appendix D: Estimating HPD Attenuation Using NRR or PAR for further information on using PAR to determine HPD attenuation). A PAR reflects what users can achieve when the earplug is inserted in a similar way and “feels like” how the plug was inserted on the day of fit testing. Workers should be encouraged to replicate the “feel” of how the plug was inserted to obtain an appropriate attenuation.

   NOTE: If the chosen hearing protector does not provide sufficient PAR to attenuate the anticipated noise exposure level (based on fit testing results), the fit test conductor will instruct/assist the worker to ensure the HPD is properly inserted. If repeat fit testing PAR for that HPD is still inadequate, the OSHA Personnel will choose another suitable hearing protector and repeat fit testing as needed to ensure proper fit and adequate attenuation. See Appendix D: Estimating HPD Attenuation using NRR or PAR.

6. HPD Fit Testing Records

   Records created through HPD fit testing will be maintained in accordance with Appendix C: Records Program.

Appendix F: How to Properly Insert Earplugs

To get the best protection from your soft foam earplugs, remember to roll, pull, and hold when putting them in.

1. Roll

   

   Use clean hands to roll the earplug into a small, thin ribbon with your fingers.

2. Pull

   

   Pull the top of your ear up and back with your opposite hand to straighten and open the ear canal.  Insert the rolled earplug into the ear canal while holding this position.  

3. Hold

   

   Hold the earplug in with your finger until it expands to fill the ear canal. Your voice will sound muffled when the plug has made a good seal.

   Recommended Training Video:

   National Institutes of Health (NIH) – Hearing Loss division – Hearing Protection: How to Use Formable Earplugs

   Note: The NIOSH website has demonstrations for the correct fitting of different types of hearing protectors. This is available NIOSH Workplace Safety Health Topics page: Noise and Occupational Hearing Loss or NIOSH can be contacted at 1-800-CDC-INFO (1-800-232-4636).

Appendix G: Resources for Custom Molded Earplugs

Authorized Reimbursement Limits

Under certain circumstances, OSHA personnel covered under OMEP may be reimbursed for the purchase of custom molded earplugs (CMEP). CMEPs will be obtained using standard procurement mechanisms and issued to employees. The objective is to provide at least one pair of CMEPs that will enable noise proper protection during field duties. Employees who are provided CMEP must be fit tested with such earplugs to ensure effective attenuation is achieved. For OSHA personnel to be considered for CMEP, the following will be considered:

1. During fit testing, the PAR for each commercially available HPD shall be documented. The goal is to find one that is effective and comfortable that the worker will wear 100% of the time when HPDs are needed. If commercially available plugs cannot meet the required attenuation, the region can consider other options (e.g., administrative controls, double hearing protection using one of the available plugs plus muffs, or CMEP) to ensure that the worker’s exposure does not exceed 85 dBA.
2. OSHA personnel can provide a letter of medical necessity from a competent medical authority (e.g., a physician or audiologist) to demonstrate the need for CMEP. OOMN can also recommend that a region or directorate provide CMEP based on the audiometric review for OMEP. See SHMS Chapter 25: Medical Management for detailed information on OMEP.

If the CMEP cannot be purchased and obtained through standard procurement mechanisms, reimbursement for actual costs must be supported by a signed statement from competent medical authority which attests to the special needs.

Supervisors are also authorized to approve reimbursement for the cost of replacing CMEP if lost or accidentally broken while on duty.

For personnel who use CMEP, noise monitoring shall occur on each inspection to document the need for hearing protection and justify the cost of the continued need for replacing CMEPs at appropriate intervals (e.g., if fit testing demonstrates inadequate PAR; otherwise, replacement should not be needed more often than approximately every 2-3 years).

See SHMS Chapter 27: Exposure Monitoring for detailed information on Noise Monitoring.