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
Hearing Conservation
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand the mission of CAOHC and its significance to their role as an COHC
- Understand the relationship of hearing conservation regulations and compliance to best practices
- Understand the elements of a hearing conservation program
- Understand the auditory effects of noise
- Identify potential sources of hazardous noise in both occupational and non- occupational work settings
- Understand the impact of hearing loss, tinnitus and associated disorders on quality of life, social interactions and psychological consequences
- Understand and list the professional disciplines and their role in the hearing conservation program
- Understand the historical background of hearing conservation and CAOHC’s role in establishing best practices
- Detect the prevalence of noise-induced hearing loss (NIHL) in different 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 a normal audiogram and audiogram configuration which is typical for noise induced hearing loss
- Identify the typical symptoms associated with various types of hearing loss
- Understand medical conditions that can cause hearing loss
- Identify other disorders of the ear and the associated types of hearing loss (i.e. conductive, sensory/neural)
- Understand other types of audiogram configurations
Hearing and the Physics of Sound
Training curriculum and certification 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 and explain thresholds and how they apply to a hearing conservation program
- 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, impulse/impact)
- Understand sound weighting scales and how they apply to a hearing conservation program
Federal and State Regulations Related to Occupational NIHL
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand federal hearing conservation regulations, (i.e. OSHA, MSHA, FRA and DoD) and describe how they differ in application
- Understand how state, local and federal regulations apply
Audiometer and Testing Environment
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand when manual audiometry testing is needed
- Identify parts and functions of the different settings on a manual audiometer
- Understand the process of performing a pure tone air conduction threshold hearing test
- Understand the variables that affect reliability and validity of the hearing test
- Understand the steps necessary to rule out equipment malfunction
- Understand audiometer calibration requirements
- Understand and perform a functional check for an audiometer
- Understand the advantages and disadvantages of using a microprocessor versus a manual audiometer
- Identify the appropriate ambient noise standards for the testing environment
Audiometric Techniques and Testing
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand an audiogram in terms of frequency/pitch (Hz); intensity/loudness (dB) and configuration
- Understand the challenges associated with audiometric testing and the procedures for dealing with these challenges
- Identify the components and understand the importance of an aural history exam
- Understand the benefit and importance of performing otoscopic screening
Audiometric Review and Evaluation
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand limitations of the COHC as related to the review, referral and counseling process
- Identify problem audiograms for the Professional Supervisor to review
- Calculate a standard threshold shifts (STS) with and without using age correction
Noise Measurement and Control
Training curriculum and certification is intended to ensure the COHC is able to:
- Understand the meaning and importance of action levels and permissible exposure levels (PEL)
- Understand the purpose of noise measurement and control strategies related to the overall hearing conservation program
- Understand the types of instrumentation used to measure noise & the circumstances in which they would be used
- Understand the meaning and importance of time-weighted average (TWA)
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
- Understand Noise Reduction Rating (NRR) and its relation to actual attenuation
- Understand the proper selection of HPDs, (i.e. foam and pre-molded earplugs, semi-insert devices and earmuffs)
- Understand the importance of proper fitting techniques for HPDs to ensure adequate fit
- Understand and explain care and maintenance of HPDs
- Identify strategies to motivate workers and management to use HPDs consistently and effectively
- Understands various methods of fit verification for HPDs
Counseling and Training
Training curriculum and certification is intended to ensure the COHC is able to:
- Identify the required training components
- Provide several different training methods for hearing loss prevention within the workplace (i.e. face-to-face training, on-site posters, hearing protection distribution station, etc.)
- Provide ongoing training, education and motivation to improve compliance within the hearing conservation program
- Incorporate motivational strategies or simple incentives to encourage compliance
- Understand the importance of conducting a comprehensive employee hearing protection training program on a regular basis
Recordkeeping and Hearing Conservation Team
Training curriculum and certification is intended to ensure the COHC is able to:
- Document and maintain accurate employee records
- Understand the role of the Professional Supervisor within the Hearing Conservation Program team
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.
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.