Amendments to OSHA's Final Rule for Recording Occupational Hearing Loss
by Susan C. Megerson, MA CCC-A
The University of Kansas
Intercampus Program in Communicative Disorders

In the last issue of CAOHC's UPDATE, I provided a summary of OSHA's new rule for recording occupational hearing loss on the Form 300 Log of Work-Related Injuries and Illnesses (Megerson, 2002). This rule, 1904.10, was finalized July 1, 2002 with an effective date of January 1, 2003. It requires that employers record work-related cases of Standard Threshold Shift (STS), but only when the employee also shows an overall hearing level outside the normal range (OSHA, 2002a). At the time the final rule was released, OSHA also announced that it was delaying the requirement for, and seeking further comment on, a separate hearing loss column on the Form 300 (OSHA, 2002b).

With only a few weeks remaining before the effective date, OSHA released its final decision on a separate column for recording hearing loss and also amended some of the provisions of 1904.10 as initially published in July. This amendment to the final rule appeared in the December 17 Federal Register (OSHA, 2002d), preceded by a Trade Press Release issued December 16 (OSHA, 2002c). Following are highlights:

• Separate Column: After reviewing comments of interested parties, OSHA has decided to retain the hearing loss column requirements of 1904.10 with an effective date of January 1, 2004. OSHA expects the separate column to facilitate analysis of hearing loss data at individual workplaces and to improve the Agency's ability to track and assess occupational hearing loss and to prioritize hearing loss prevention efforts. In the interim, during 2003, employers are expected to record cases of occupational hearing loss on the Form 300 as follows: as an "injury" [column (m)(1)] if due to a single event/acoustic trauma or "other illness" [column (m)(5)] if due to long term noise exposure.
  
  
• Baseline/reference audiogram: The most significant change to 1904.10 published in December is the modification of OSHA's definition of "revised baseline" for hearing loss recording purposes. In the final rule issued July 2002, OSHA defined revised baseline as "the audiogram reflecting the employee's previous recordable hearing loss case." This requirement was problematic in that it would have required employers to track separate baselines for each employee: revised baselines for hearing conservation purposes and revised baselines for recordability purposes. In order to simplify the process, OSHA now defines revised baseline according to existing definitions provided in the noise standard 1910.95. This modification allows companies to track both hearing conservation program STS and recordable STS/hearing loss cases using the same baseline audiogram.

• Applicable industries: OSHA clarified an error that appeared in the July 2002 final rule: the shipbuilding industry was incorrectly indicated to be exempt from OSHA's noise standard 1910.95, which it is not.

• Trend analysis: Lastly, in response to employer concerns regarding an increase in the number of reported hearing loss cases beginning in 2003, OSHA issued a note of caution. It is recognized that the data captured in 2003 and future years will not be comparable to prior years when less stringent hearing loss criteria may have been used.

As a reminder, each potentially recordable shift that meets the specified OSHA criterion should receive careful review by an audiologist or physician knowledgeable in the effects of noise and in hearing conservation programs. See Table 1 for an example protocol for processing potentially recordable cases under the new final rule, and of course, check with your audiometric program professional supervisor for further guidance.

Table 1: Example Protocol for Determining STS Recordability* (If at any step a "no" is encountered, the process ends and the hearing change is not recorded on Form 300) Step 1: Compared to the baseline or revised baseline audiogram as defined by 1910.95, is there an STS in either ear (age adjustments allowed)? If yes, continue to step 2: Step 2: Is the average hearing level on the current hearing test at 2000, 3000, and 4000 Hz in the same ear greater than or equal to 25 dB HL (no age adjustments allowed)? If yes, continue to step 3: Step 3: Is the STS confirmed upon 30-day retest (or was a retest not conducted)? If yes, continue to step 4: Step 4: Has a qualified health care professional determined that the shift in hearing is more likely than not work-related? If yes, continue to step 5: Step 5: Record the case on Form 300 within 7 days of retest (or within 37 days of test if a retest was not conducted). *revised from Megerson (2002) to include OSHA supplementary information issued 12/17/2002

References:
Megerson, S. C. (2002). "OSHA's Final Rule for Recording Occupational Hearing Loss," CAOHC Update, 14(3), 1.

OSHA (2002a). Occupational Injury and Illness Recordkeeping and Reporting Requirements; Final Rule, Occup. Safety and Health Admin., Federal Register, Vol. 67, 44037-44048, July 1, 2002.

OSHA (2002b). Occupational Injury and Illness Recordkeeping and Reporting Requirements; Proposed Delay of Effective Dates/Request for Comment, Occup. Safety and Health Admin., Federal Register, Vol. 67, 44124-44127, July 1, 2002.

OSHA (2002c). OSHA Recordkeeping Form to Include Hearing Loss in 2004, Occup. Safety and Health Admin., Trade News Release, December 16, 2002.

OSHA (2002d). Occupational Injury and Illness Recordkeeping and Reporting Requirements; Supplementary Information, Occup. Safety and Health Admin., Federal Register, Vol. 67, No. 242, 77165-77170, December 17, 2002.