OHC Scope of Practice
Hearing Health History
Prior to conducting a hearing test, a thorough hearing health and occupational history should be obtained. This information helps determine the need for a medical referral or work-relatedness.
Visual Inspection of the Ear
A visual inspection of the ear is an important step to help rule out certain conditions (eg, cerumen impaction) that might interfere with testing or earplug fitting.
Pure Tone Air Conduction Audiometric Testing
Audiometric testing includes a baseline, an annual test and retesting on a manual or microprocessor audiometer. The COHC is responsible for identifying problem audiograms to be reviewed by a professional supervisor.
Employee Referral
The COHC may need to refer employees to medical sources for further audiometric testing or medical treatment.
Audiometric Equipment Maintenance
The COHC is responsible for ensuring that functional checks of the audiometer and booth/environment are conducted before use each day. The COHC is also responsible for coordinating annual calibrations of the audiometer and ensuring that related equipment logs and forms are kept up-to-date.
Employee Notification of a Standard/Significant Threshold Shift (STS)
The COHC must ensure that employees are notified in writing within 21 days after identifying an STS. The COHC may also refit or retrain employees on the appropriate use of their hearing protection devices.
Recordkeeping
According to the Occupational Safety and Health Administration (OSHA), the employer maintains records of all employees’ noise exposure measurements and their audiometric tests (see OSHA Guidance 29 CFR 1910.95 (m)1-5 for more information). The COHC may assist in the recordkeeping.
Education, Training and Counseling
The COHC works primarily with those in the hearing conservation program (HCP). Training and education must cover the following areas:
- The adverse effects of noise on hearing
- The purpose of hearing protection, their use and care
- The purpose of the annual hearing tests and an explanation of test procedures
Hearing Protection Education
Education and training regarding hearing protection includes:
- Selection of appropriate hearing protection for the environmental noise level
- Fitting for the individual user
- Supervision of usage compliance
- Use and care (cleaning) of hearing protection equipment
Limitations
The COHC training and certification has limitations and does not prepare individuals for the following (unless they are also a licensed audiologist or physician):
- Assume the role of a Professional Supervisor (PS)
- Assume the role of an instructor of other non-certified medical personnel
- Interpret audiograms
- Conduct audiometric testing other than pure tone air conduction (eg, bone conduction testing, speech audiometry)
- Diagnose hearing disorders
- Independently evaluate HCP effectiveness
- Conduct noise surveys and analyses or be responsible for noise-control solutions, unless specifically trained
OHC Training Curriculum for Certification
A downloadable version of the OHC Curriculum is available here.
Hearing Conservation
Training curriculum and certification is intended to ensure the COHC is able to:
- List three OHC activities that are relevant to the CAOHC mission.
- Cite two examples of the differences between hearing conservation regulations and best practices.
- List the seven elements of a hearing conservation program and list the main concept of each of the seven elements of a hearing conservation program.
- Identify three auditory effects of hazardous noise exposure.
- Identify two sources of hazardous noise in an occupational (workplace) setting.
- Identify two sources of hazardous noise in a non-occupational (non-workplace) setting.
- Describe how hearing loss impacts social and psychological health.
- List three of the professions that are represented on the CAOHC Council.
- Describe the responsibilities and limitations of the Occupational Hearing Conservationist.
- Describe the role of the Professional Supervisor.
- Cite three examples of CAOHC’s role in hearing conservation.
- Identify the prevalence of hearing loss in various noise-exposed populations.
Anatomy, Physiology, and Diseases of the Ear
Training curriculum and certification is intended to ensure the COHC is able to:
- Identify the major parts of the ear and describe their function
- Understand the relationship between tinnitus and noise induced hearing loss
- Differentiate between the configurations of a normal audiogram versus an audiogram with noise-induced hearing loss.
- Explain the symptoms associated with various types of hearing loss.
- Understand medical conditions that can cause hearing loss
- List three medical conditions that can cause conductive hearing loss.
- List three medical conditions that can cause sensorineural hearing loss.
- Describe three different audiogram configurations.
Physics of Sound and Hearing
Training curriculum and certification is intended to ensure the COHC is able to:
- Describe sound by its temporal characteristics (continuous, intermittent, impulse/impact).
- Describe the use of the three sound weighting scales in hearing conservation.
- Define frequency (Hz).
- Describe the relationship of frequency (Hz) to noise measurement.
- Describe the relationship of frequency (Hz) to hearing threshold data.
- Define Intensity (dB).
- Describe the relationship of intensity (dB) to noise measurement.
- Describe the relationship of intensity (dB) to hearing threshold data.
- Define audiometric thresholds and how they apply to a hearing conservation program.
Standards and Regulations
Training curriculum and certification is intended to ensure the COHC is able to:
- Specify the area of jurisdiction that four federal agencies that enforce hearing conservation regulations. (i.e., OSHA, MSHA, FRA, and DoD).
- Name three ways in which the OSHA, MSHA, FRA and DoD hearing conservation regulations differ in application.
- Specify under what circumstance state, local, or company regulations would supersede federal regulations.
Audiometer and Testing Environment
Training curriculum and certification is intended to ensure the COHC is able to:
- Identify three situations in which manual-mode audiometry is indicated.
- Identify five controls of a manual audiometer.
- List three variables that affect either the reliability or validity of the hearing test.
- Name three possible audiometric equipment malfunctions.
- Identify three types of audiometer calibrations/checks.
- Define the purpose of the functional listening check of the audiometer.
- Perform a functional listening check of the audiometer.
- Explain three advantages of using a manual audiometer.
- Explain three advantages of using a microprocessor audiometer.
- Describe the requirement for background noise levels for the audiometric testing environment.
Audiometric Testing
Training curriculum and certification is intended to ensure the COHC is able to:
- Explain the audiogram in terms of frequency (Hz), intensity (dB), and configuration.
- Demonstrate the manual pure-tone air-conduction threshold testing technique.
- Identify three audiometric testing challenges and their corrective procedures.
- List the components of an aural history.
- Explain the benefits of performing an ear inspection.
Audiometric Review and Evaluation
Training curriculum and certification is intended to ensure the COHC is able to:
- Describe three limitations of the role of the OHC as it pertains to audiogram review and evaluation.
- Provide three examples of problem audiograms requiring review by the Professional Supervisor (PS).
- Calculate a standard threshold shift (STS) with and without using age correction.
Noise Measurement and Control
Training curriculum and certification is intended to ensure the COHC is able to:
- Describe the purpose of time-weighted average (TWA) in hearing conservation programs.
- Explain the difference between Action Level (AL) and Permissible Exposure Limit (PEL).
- Describe when noise dosimeters versus sound level meters would be used in hearing conservation programs.
- List three types of noise control strategies that are used in hearing conservation programs.
Find more information on noise measurement and control in the Noise Measurement Course.
Hearing Protection Device (HPD) Fitting
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand and explain the rationale for using hearing protection devices.
- Define Noise Reduction Rating (NRR) and its relation to real-world attenuation.
- State three variables that may influence the selection of HPDs for different work settings.
- Demonstrate the proper fitting technique for each type of HPD.
- Explain the proper care and maintenance for each type HPD.
- Identify strategies to motivate noise-exposed workers to use HPDs effectively.
- Explain the various self-test methods to check for proper fit of HPDs.
Hearing Conservation Training
Training curriculum and certification is intended to ensure the COHC is able to:
- List three OSHA-mandated hearing conservation training topics.
- Describe three training delivery methods that result in more effective hearing conservation programs.
- Outline the components of a comprehensive HPD training program.
Recordkeeping
Training curriculum and certification is intended to ensure the COHC is able to:
- List two types of records that must be maintained in a hearing conservation program.
- Describe three characteristics of good records.
- Identify the regulatory requirements for the length of record retention for audiograms and noise exposure measurements.
This page was created with guidance from CAOHC component professional organizations: the American Society for Safety Professionals, American College of Occupational and Environmental Medicine, American Industrial Hygiene Association, American Academy of Audiology, American Speech-Language-Hearing Association, Institute of Noise Control Engineering and American Academy of Otolaryngology-Head & Neck Surgery.
This page was last updated March 2022.
Re-certification Curriculum
Hearing Conservation
The recertification curriculum is intended to ensure the COHC is able to:
- Understand the elements of a hearing conservation program (HCP)
- Understand the impact (social and psychological consequences) of hearing loss, tinnitus and associated disorders with regards to the quality of life
Anatomy, Physiology, and Diseases of the Ear
The recertification curriculum is intended to ensure the COHC is able to:
- Classify and describe the function of major parts of the ear
Hearing and Physics of Sound
The recertification curriculum is intended to ensure the COHC is able to:
- Understand the definition of frequency (Hz) /pitch and its relationship to noise measurement and hearing threshold data
- Understand the definition of intensity (dB)/loudness and its relationship to noise measurement and hearing threshold data
- Understand sound by its temporal characteristics (intermittent, steady state and impulse/impact)
Federal and State Regulations Related to Occupational NIHL
The recertification curriculum is intended to ensure the COHC is able to:
- Describe federal hearing conservation regulations (OSHA, MSHA, FRA and DoD) and how they differ in application
- Understand how state and local regulations differ from federal regulations
Audiometer and Testing Environment
The recertification curriculum is intended to ensure the COHC is able to:
- Understand the process of performing a pure-tone air-conduction threshold hearing test
- Understand the variables affecting the reliability and validity of a hearing test
- Understand audiometer calibration requirements
Audiometric Techniques and Testing
The recertification curriculum is intended to ensure the COHC is able to:
- Understand an audiogram in terms of frequency (Hz)/pitch intensity (dB) /loudness and configuration
- Understand challenges associated with audiometric testing and procedures for managing them
Audiometric Review and Evaluation
The recertification curriculum is intended to ensure the COHC is able to:
- Understand limitations of the COHC in review, referral and counseling
- Identify problem audiograms for the Professional Supervisor (PS) to review
- Calculate a standard threshold shift with and without age correction
Noise Measurement and Control
The recertification curriculum is intended to ensure the COHC is able to:
- Understand the meaning and importance of the time-weighted average (TWA)
Find more information on noise measurement and control in the Noise Measurement Course.
Hearing Protection Device (HPD) Fitting
The recertification curriculum is intended to ensure the COHC is able to:
- Understand and can explain reasons for using HPDs
- Understand noise reduction rating (NRR) and its relation to actual attenuation
- Understand the importance of proper fitting techniques for HPDs and how to ensure an adequate fit
- Identify strategies to motivate workers and management to use HPDs consistently and effectively
Counseling and Training
The recertification curriculum is intended to ensure the COHC is able to:
- Identify the required training components
- Understand the importance of conducting regular comprehensive employee hearing protection training programs
Recordkeeping and the Hearing Conservation Team
The recertification curriculum is intended to ensure the COHC is able to:
- Understand the importance of maintaining accurate hearing conservation and employee records according to federal, state and local guidelines and regulations
- Understand the role of the Professional Supervisor (PS) within the (HCP) team.