by Marat Moore
A coalition of diverse groups led by ASHA is opposing a proposed year-long delay in implementing a regulation related to occupational hearing loss. Earlier this year, audiologists involved with hearing conservation won a victory when their 15-year effort to gain federal regulations on occupational hearing loss resulted in the issuance of a final rule.
In the July 3 Federal Register, however, OSHA proposed postponing the implementation of the final rule on Occupational Injury and Illness Recording and Reporting Requirements, which includes strict criteria for recording hearing loss as an occupational injury. The regulation, due to be implemented on Jan. 1, 2002, would not go into effect until 2003 under OSHA's proposed delay.
The criteria specified by the final rule requires an employer to record any hearing loss that reaches the level of standard threshold shift (STS). An STS is defined by the occupational noise standard as a 10 dB shift in hearing averaged across 2000, 3000, and 4,000 Hz in one or both ears compared to the employee's baseline audiogram.
The issuance of the final rule represented a major regulatory victory for ASHA, which led the 15-year effort by the Coalition to Protect OSHA and NIOSH and Workers' Hearing. The core strength of the rule—its strict recordability criterion—was recommended by the coalition, a diverse group of health professionals, labor organizations, and businesses committed to improving the quality of records maintained under the Occupational Safety and Health Act.
"The fact that this is a coalition response is crucial—and that organizations representing diverse disciplines are coming together in support of STS as the criterion," noted Theresa Schulz, an audiologist with the U.S. Air Force and the incoming chair of the Council for Accreditation in Occupational Hearing Conservation.
The coalition, which ASHA reconvened in July, has addressed a wide range of regulatory initiatives from OSHA, the National Institute for Occupational Safety and Health (NIOSH), and the Mine Safety and Health Administration (MSHA), as well as other agency reform efforts initiated by Congress.
The coalition has filed comments strongly objecting to OSHA's delay in implementing the rule, fearing that OSHA may reconsider the criteria for recording hearing loss (Section 1904.10). The agency's proposal followed pressure by industry trade groups that argued that an STS is not a serious health problem and is not a reliable criterion under real-world testing conditions.
"The STS, which is accepted as a sign of significant change in hearing, would be much easier for providers to use than the current criteria, which, frankly, are very obtuse," Schulz said. "Using STS would make protection of workers easier, and it would give us a national database on workers' hearing.
In written testimony to OSHA, the Coalition addressed the following issues:
- The appropriate criterion for recording cases of occupational hearing loss. The coalition reaffirmed its 1996 recommendation that employers should record on Form 300 those instances of age-corrected OSHA standard threshold shift (STS) which are persistent and work-related.
- The use of a sliding scale in which smaller incremental shifts would be recordable for employees with significant pre-existing hearing loss. The coalition disagrees with the use of a "sliding scale" criterion for STS. "This approach assumes that the detrimental effect of a fixed amount of hearing change, such as OSHA STS, is less for a person with initially normal hearing than for a person with pre-existing borderline hearing or hearing impairment," said Julia Royster, an audiologist and coalition member. "The amount of pre-existing hearing loss is not the issue. Regardless of a person's hearing sensitivity, a confirmed STS indicates that permanent damage has occurred."
- Audiometric variability of testing equipment. The coalition challenged OSHA's position that the 10 dB recordability criterion does not allow for audiometric variability. When random measurement variability does occur, re-testing reduces it. To further address the problem, the coalition recommended that only persistent, confirmed shifts be recorded.
- The appropriate benchmark against which to measure hearing loss (e.g., employee's baseline or audiometric zero). Hearing change from the employee's own baseline audiogram is the appropriate measure, the coalition stated in testimony, reaffirming its position first advanced in 1996. Tabulating absolute hearing loss from audiometric zero is inappropriate, because an employee might be hired with a pre-existing hearing loss that exceeds the shift criteria under consideration.
- Subsequent hearing losses in the same employee. Subsequent STS after baseline revision, the coalition believes, is an additional injury and should be treated as a new case for recording purposes.
ASHA and other coalition members asked that OSHA inform them as soon as possible if the agency's reconsideration of the rule will require a delay of the effective date. If the rule takes effect Jan.1, 2002, industry will need to convert existing recordkeeping systems so that they meet the new rule's requirements.
Besides ASHA, the coalition includes as longstanding members the American Industrial Hygiene Association, the National Hearing Conservation Association, the Council for Accreditation in Occupational Hearing Conservation, and Self Help for Hard of Hearing People, Inc. In July, following OSHA's latest announcement, the American Academy of Audiology, the American Association of Occupational Health Nurses, and the American College of Occupational and Environmental Medicine expressed their interest in joining the effort.
For more information, contact Maureen Thompson through the ASHA Action Center at 800-498-2071, ext. 4431, or by email at mthompson@asha.org.
