Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 Best Practices in Hearing Conservation Richard L. Stepkin, MS, CCC-A Occupational Audiologist, President Enviromed Corp Phone: 1-800-521-5051 Website: www.protectyourhearing.com E-Mail: rstepkin@protectyourhearing.com Richard Stepkin, Audiologist www.protectyourhearing.com

Hearing Conservation Objectives Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 Hearing Conservation Objectives Protect employees hearing Comply with OSHA criteria Stabilize Worker’s Compensation Which is the most Important ?? Employees are always our primary concern, but OSHA regulations do not protect all employees for Noise Induced Hearing Loss. By setting up a Hearing Conservation Program to stabilize liability, we will more than protect employees hearing and OSHA criteria. Unfortunately - OSHA Compliance is not a Best Practice in Hearing Conservation Richard Stepkin, Audiologist www.protectyourhearing.com

Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 OSHA Workers Comp STS = 2k, 3k, 4kHz Allows Age Adjustment to Age 60 Allows Waivers 85dBA(TWA) Mandatory Action Level – must have HC Program 85-90dBA(TWA) Voluntary HP 90dBA(TWA) Mandatory HP Baseline to compare Annually MD = .5K, 1K, 2kHz PA = .5k, 1k, 2k, 3kHz NJ = 1k, 2k, 3k MD allows Age Adjustment PA/NJ No Age Adjustment Not tied to 85dBA(TWA) Voluntary HP suggests it may cause a problem Baseline to identify Pre-Existing loss Different perspectives in looking at hearing loss from the OSHA & Worker’s Comp point of view. Richard Stepkin, Audiologist www.protectyourhearing.com

Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 OSHA NIOSH Action Level = 85dBA(TWA) PEL = 90dBA(TWA) 5dB Exchange Rate 85dBA = 16hrs 90dBA = 8hrs 95dBA = 4hrs Noise Surveys = 1x Update Periodically as needed Hearing Protection 85dBA Voluntary except with STS 90dBA Mandatory Hearing Protection Derating NRR 50% all type earplugs REL = 85dBA(TWA) PEL = REL 85dBA(TWA) 3dB Exchange Rate 85dBA = 8hrs 88dBA = 4hrs 91dBA = 2hrs Noise Surveys = 1x Every 2 years Hearing Protection 85dBA Mandatory 100dBA Double Protection Hearing Protection Derating NRR 50% Foam; 70% all other earplugs 25% Earmuffs Different perspectives in looking at hearing loss from the OSHA & Worker’s Comp point of view. Richard Stepkin, Audiologist www.protectyourhearing.com

Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 OSHA NIOSH Audiometric Technican CAOHC Certified or Equivalent Certification Hearing Testing Baseline within 30 days of Exposure 12 Hour Quiet Time – no HP No Mobile Service exception Annual thereafter +100dBA(TWA) every 6 months Test Environment Must meet ANSI Criteria Audiometric Technician CAOHC Certified; Competence to Supv; Microprocessor Audiometer Hearing Testing Baseline within 6 months of hire 14 Hour Quiet Time – incl HP Mobile Services – up to 1 year HP is Mandatory Annual thereafter Test Environment Well above ANSI Criteria Different perspectives in looking at hearing loss from the OSHA & Worker’s Comp point of view. Richard Stepkin, Audiologist www.protectyourhearing.com

Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 OSHA NIOSH Audiogram Review Employee Notified if STS STS = 15dB from Baseline at any one test frequency .5k-6kHz Retest within 30 days STS Follow-up Action Notify EE within 30 days Educate effects of Noise on Hearing Re-Fit HP – Select Higher NRR STS Log 300 Recordable Not indicated – a Non-NIOSH issue Use OSHA Form for Work Injury Audiogram Review Employee Notified if STS STS = 10dB Avg above Baseline at 2k, 3k, 4kHz. Retest within 30 days STS Follow-up Action Notify EE within 21 days Re-Fit HP – Select Higher NRR STS Log 300 Recordable Current Test = 25dB Avg – no age Difference between Baseline and Current Test is 10dB – with age Different perspectives in looking at hearing loss from the OSHA & Worker’s Comp point of view. Richard Stepkin, Audiologist www.protectyourhearing.com

Who Uses NIOSH Criteria Military 3dB Exchange Rate No TWA – simply exposed – protect European Union 80dBA(TWA) Hearing Protection available Includes Annual Hearing Testing Noise Survey data for all EE at or above 80dBA 85dBA Hearing Protection Mandatory 87dBA under HP is the max allowed

STS Determination The Facts When is an STS Log 300 Recordable? 25dB Avg on Current Test at 2k, 3k, 4kHz – not Age adjusted PLUS a 10dB Avg shift from Baseline – Age adjusted OSHA assumes all STS’s are Work-Noise Related Recordable even if part of the STS is due to work noise Hearing Protection alone will not be a reason How to prove the STS is “other” than work noise Noise levels are below 82dBA Medical and/or Audiologic Evaluation justifying why the STS is not work-noise related

STS Determination The Professional Work closely with an Audiologist or Physician: Company controls the Referral Source & Pays for Evaluation Not Insurance – Not a HIPAA issue – Gets you a Report This is about Surveillance – Not a Medical referral Educate them on your product operation & HCP Know they understand the intent of the referral & Log 300 Provide them good Job Description info (past & present) Provide them Current Noise Levels (Dosimetry and SLM)

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

STS Determination The Report Look at all factors affecting hearing, not just work noise. Consider all noises: military, recreational, prior jobs, hunting or target shooting, lighting firecrackers etc. Threshold patterns relative to noise exposures, length of employment, use of hearing protection Does the Report “justify” why the STS is or is not work noise related

Best Practices in Loss Prevention Best Practices in Hearing Conservation ASSE Luncheon Salisbury MD Wed May 7th, 2014 Best Practices in Loss Prevention Noise Surveys every 2-3 years – the more data the better Mandatory HP at 85dBA regardless of time exposed Mandatory Audiometry at 85 dBA regardless of time exposed Professional Reviewer of test data beyond OSHA criteria Ask for an “Early Warning” of EE’s getting close to STS (8.6 – 9.9 shifts) Consider the State Compensation criteria in the review process Use a dependable Referral Source for STS Determinations Education the Professional and provide all information necessary to make a justifiable Professional Opinion based upon all facts Richard Stepkin, Audiologist www.protectyourhearing.com