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CAOHC

CAOHC Newsletter: UPDATE

Developing a Curriculum for Supervising Professionals of Hearing Conservation Programs
Alex F. Sanchez, Jr., MD
CAOHC Representative of the American College of Occupational & Environmental Medicine

The Council for Accreditation in Occupational Hearing Conservation (CAOHC) for twenty-five years has certified occupational hearing conservationists (OHCs); trained and certified course directors (CDs) and approved their courses in order to fulfill its mission: the establishment and maintenance of training standards for those who safeguard hearing in the workplace. The government specifically recognizes CAOHC as the major certifying body for occupational hearing conservationist in the United States. However, one integral component of the Hearing Conservation Program has been overlooked, the training of the supervising professional.

The Occupational Safety and Health Administration (OSHA) Noise Amendment of 1983 (1910.95) requires employers to administer "a continuing, effective hearing conservation program....whenever employee noise exposures equal or exceed an 8 hour time-weighted average sound level (TWA) of 85 decibels." The standard goes on to state: "a technician who performs audiometric tests must be responsible to an audiologist, otolaryngologist or physician."

1910.95 {(g) (7) (iii)} specifically describes the role of the professional supervisor "(1) the audiologist, otolaryngologist, or physician shall review problem audiograms and (2) shall determine whether there is a need for further evaluation....(3) revise audiometric baselines when appropriate and (4) supervise and be responsible for the training and competence of the occupational hearing conservationists (OHC)."

In 1997, CAOHC surveyed a large group of OHCs (see the "OHC Corner" page in the printed copy of this newsletter) to ascertain a profile of their supervising professionals. This survey revealed that the OHC identified their professional supervisor as:

  • otolaryngologists (<1%)
  • audiologists (21%)
  • physicians (64%)
  • other (15%)

Further delineation of other revealed registered nurses, industrial hygienists, safety directors, employee relations managers, human resource executives, office managers and even business owners were often mistakenly identified as "supervising professionals". Nevertheless the majority of occupational hearing technicians turn to occupational physicians for guidance in the area of hearing conservation.

To certify as an OHC, CAOHC requires attendance at an approved training course. The course must consist of at least 20 hours of class work to be taught in a minimum of two and a half days. Specific topics must be covered, during minimum time periods stipulated, by an instructor physically present during the presentation. Continuing in this direction, CAOHC believes that an extensive training program leading to certification should be created for supervising professionals. CAOHC's Educational Development committee has therefore proposed a two (2) day training course to educate occupational physicians, audiologists, and otolaryngologists regarding their responsibilities as professional supervisors for occupational hearing programs.

The course will require a minimum of 15.5 hours of lecture time. Both groups, physicians and audiologists, will require information with regard to the role of the supervisor in the hearing conservation program, evaluation of hearing conservation programs and medical-legal aspects of hearing impairment.

The following outline details each learning objective for the PS course. The minimum time allotment for each objective is included. The course outline is designed to meet the needs of physicians and audiologists who are most likely to provide these services to hearing conservation programs.

TOPIC TIME
Introduction, Pre-test, Defining the Role of the PS 30 min.
Acoustics 60 min
Normal Human Hearing 30 min.

Basic Audiometry/Hearing Loss

120 min.
Differential Diagnosis & Medical Treatment of HL 90 min.
Pathophysiology of NIHL 60 min.
Hearing Protectors 60 min.
Elements of an Occupational HCP 90 min.
Standards & Requirement in OHCP 60 min.
Role of Professional Supervisor 105 min.
Evaluation of HCP 60 min.
Medical-Legal Aspects 60 min.
Future Issues in Hearing Conservation 60 min.
Conclusion & Post-test 30 min.

CAOHC presented an introductory seminar entitled, "The Role and Qualifications of the Professional Supervisor in the Occupational Hearing Conservation Program" at the American College of Occupational and Environmental Medicine's STATE OF THE ART CONFERENCE (SOTAC) in Phoenix, Arizona, October 18, 1998.  An upcoming seminar to be announced for Spring, 1999.

Bibliography:

  1. 29 CFR 1910.95 Occupational Noise Standard Amendment
  2. Suter, A.H., Hearing Conservation Manual, 3rd Ed. Milwaukee: Council for Accreditation in Occupational Hearing Conservation, 1993