SANTA CRUZ COUNTY
PERSONNEL ADMINISTRATIVE MANUAL

PURPOSE:

To establish policy and procedures to comply with state and federal regulations and to protect employees from noise-induced hearing loss.

LEGAL BASIS:

California Code of Regulations, Title 8, General Industry Safety Orders, Article 105
Control of Noise Exposure
29 Code of Federal Register, 1910.95, Occupational Noise Exposure

POLICY:

1. The Occupational Health and Safety Division (OSH) of the Personnel Department shall administer a continuing, effective hearing conservation program whenever employee noise exposures equal or exceed the action level of an 8-hour time-weighted average sound level(TWA) of 85 decibels measured on the A-scale.
   
   
2. The OSH Division shall establish and maintain an audiometric testing program for all employees whose exposures equal or exceed the action level.
   
   
3. When employees are exposed to sound levels exceeding those determined to be permissible by CAL/OSHA, feasible administrative or engineering controls shall be utilized. If such controls fail to reduce noise exposure to permissible levels, personal protective equipment shall be provided and used to reduce exposures to permissible levels.
   
   
4. County departments shall provide hearing protectors to all employees exposed to noise at or above the action level, and ensure that all such employees wear the hearing protection.
   
   
5. The OSH Division shall institute and coordinate a training program for all employees who are exposed to noise at or above theaction level. The training program shall be repeated annually for each employee included in the hearing conservation program.
   

DEFINITIONS:

Action Level--An 8-hour time-weighted average of 85 decibels measured on the A-scale, slow response

Audiogram--A chart, graph, or table resulting from an audiometric test showing an individual's hearing threshold levels as a function of frequency.

Audiologist--A professional, specializing in the study and rehabilitation of hearing, who is certified by the American Speech, Hearing and Language Association or licensed by a state board of examiners.

Baseline Audiogram--The audiogram against which future audiograms are compared.

Decibel (dB)--Unit of measurement of sound level.

dBA(Decibels-A-Weighted)--A unit of measurement of sound level corrected to the A-weighted scale, as defined in ANSI S1.4-1971.

Hertz(Hz)--Unit of measurement of frequency, numerically equal to cycles per second.

Standard Threshold Shift(STS)--a change in hearing threshold relative to the baseline audiogram of an average of 10 dB or more at 2000, 3000, and 4000 HZ in either ear.

PROCEDURE:

1. Monitoring
   
   
   1. When information indicates that any employee's exposure may equal or exceed an 8-hour time-weighted average of 85 decibels, the OSH Division will obtain noise measurements for employees who may be exposed at or above that level.
      
      
   2. The monitoring requirement can be met by either area monitoring or personal monitoring that is representative of the employee's exposure.
      
      
   3. Monitoring will be repeated whenever a change in production, process, equipment or controls increases noise exposures to the extent that additional employees may be exposed at or above the action level or hearing protectors may no longer be providing adequate attenuation.
      
      
   4. Employees or their representatives will be given an opportunity to observe any measurements of employee noise exposure.
      
      
   5. Each employee exposed at or above the action level will be notified of the results of the monitoring.
      
      
   6. Each employee who participates in personal monitoring will be informed of his/her results.
      

2. Audiometric testing program
   
   
   1. Audiometric tests will be performed by a licensed or certified audiologist or physician, or by a technician who is certified by the Council of Accreditation in Occupational Hearing Conservation. Such a technician must be responsible to an audiologist or physician.
      
      
   2. The Occupational Health (OH) physician will establish for each employee exposed at or above the action level a valid baseline audiogram against which subsequent annual audiograms can be compared.
      
      
   3. Testing to establish a baseline audiogram must be preceded by at least 14 hours without exposure to workplace noise. This requirement may be met by wearing hearing protectors which will reduce the employee's exposure to a sound level of 80 dBA or below.
      
      
   4. Employees will be informed of the need to avoid high levels of non-occupational noise exposure during the 14-hour period immediately preceding the baseline audiometric examination.
      
      
   5. Baseline audiometric testing will be done at an employee's preplacement examination.
      
      
   6. Each employee exposed at or above the action level will have follow-up audiograms done annually after the baseline. Departments will schedule these exams through the OSH Division and tracking will be done by the computerized system.
      

3. Evaluation of audiogram
   
   
   1. The OH physician will compare each employee's annual audiogram to that employee's baseline audiogram to determine if the audiogram is valid and a standard threshold shift has occurred.
      
      
   2. If the annual audiogram shows that an employee has suffered a standard threshold shift (STS), a retest will be obtained within 30 days and the results of the retest may be considered as the annual program.
      
      
   3. The employee and his/her supervisor will be notified of the need for the retest by Letter #1, Appendix A.
      
      
   4. If the retest also shows a standard threshold shift, the employee will be referred to an audiologist for confirmatory testing (see Appendix A, Letter #2). The audiologist will be provided with the baseline audiogram and most recent audiogram of the employee to be evaluated.
      
      
   5. The audiologist will also be provided with the following:
      
      
      1. A copy of the requirements for hearing conservation as set forth in Sections 5097, 5098, 5099 and 5100 of the General Industry Safety Orders.
         
         
      2. Measurements of background sound pressure levels in the audiometric test room.
         
         
      3. Records of audiometer calibrations.
         
         

   6. If the testing by the audiologist confirms that a standard threshold shift has occurred compared to the baseline audiogram, the employee will be informed of that fact in writing by the OH physician (See Appendix A, Letter #3).
      
      
   7. Unless the OH physician determines that the standard threshold shift is not work-related, the following steps will be taken when a confirmed standard threshold shift has occurred:
      
      
      1. The OH physician will inform the employee's department of the occurrence of the STS and the need to enter it as a recordable occupational illness or injury on the department's OSHA 200 log (See Appendix A, Letter #4). The hearing loss will generally be recordable as an occupational illness. Only if it resulted from an instantaneous exposure would it be considered to be an occupational injury. A hearing loss resulting from an instantaneous exposure is only recordable if it involves medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job. All job-related illnesses are recordable.
         
         
      2. An employee not using hearing protectors will be fitted with hearing protectors by the OSH Division, trained in their use and care, and required to use them.
         
         
      3. An employee already using hearing protectors will be refitted and retrained by the OSH division in the use of hearing protectors and provided with hearing protectors offering greater attenuation if necessary.
         
         
      4. If medical pathology of the ear caused or aggravated by wearing hearing protectors is suspected by the OH physician, the employee will be referred for further evaluation.
         
         
      5. If medical pathology unrelated to the use of hearing protectors is suspected, the employee will be informed of the need for further examination or testing, which the employee can arrange on his own.
         
         
      6. An annual audiogram may be substituted for the baseline audiogram when the OH physician feels that STS revealed by the audiogram is persistent. This will prevent the same STS from being recorded year after year.
         
         
      7. In determining whether an STS has occurred, allowance may be made for the contribution of aging (presbycusis) to the change in hearing level by correcting the annual audiogram according to the procedure described in Appendix F of Article 105 of the General Industry Safety Orders.
         

   8. Audiometric Test Requirements
      
      
      1. Audiometric tests will be pure tone, air conduction, hearing threshold examinations, with test frequencies including 500, 1000, 2000, 3000, 4000, and 6000 Hz.
         
         
      2. Audiometric tests will be conducted with audiometers that meet the specification of,and are maintained and used in accordance with, ANSI S3.6-1969.
         
         
      3. Audiometric exams will be administered in a room meeting the requirements described in Article 105 of General Industry Safety Orders.
         
         
      4. The functional operation of the audiometer will be checked before each day's use.
         
         
      5. Acoustic calibration will be performed annually and exhaustive calibration performed every two years, in accordance with ANSI standards.
         

   9. Hearing Protectors
      
      
      1. Departments will provide hearing protectors to all employees exposed to noise at or above the action level.
         
         
      2. Hearing protectors will be replaced as necessary.
         
         
      3. Departmental Safety Liaisons will ensure that hearing protectors are worn by all employees:
         
         
         1. who are required to wear them according to Section 5096 of General Industry Safety Orders, i.e. those exposed to 90 dBA for 8 hours, 95 dBA for 4 hours, or 100 dBA for 2 hours.
            
            
         2. who have experienced a standard threshold shift.
            

      4. Employees will be given the opportunity to select their hearing protectors from a variety of suitable hearing protectors provided by their departments.
         
         
      5. Departments will provide training in the use and care of all hearing protectors provided to employees. This training will be coordinated and monitored by the OSH Division.
         
         
      6. The OSH Division will ensure proper initial fitting and supervise the correct use of all hearing protectors.
         

   10. Hearing Protector Attenuation
       
       
       1. The OSH Division will evaluate hearing protector attenuation for the specific noise environments in which the protector will be used. One of the methods described in Article 105, General Industry Safety Orders will be used.
          
          
       2. Hearing protectors must attenuate employee exposure to an 8-hour time-weighted average of 85 dB or below.
          
          
       3. The adequacy of hearing protector attenuation will be reevaluated whenever employee noise exposures increase to the extent that the hearing protectors provided may no longer provide adequate attenuation. Departments will provide more effective hearing protectors where necessary.
          

   11. Training Program
       
       
       1. The OSH Division will coordinate a training program for all employees who are exposed to noise at or above the action level.
          
          
       2. The training program will be repeated annually for each employee included in the hearing conservation program. Information provided in the training program will be updated to be consistent with changes in protective equipment and work processes.
          
          
       3. In the training each employee will be informed of the following:
          
          1. The effects of noise on hearing.
             
             
          2. The purpose of hearing protectors; the advantages, disadvantages, and attenuation of various types; and instructions on selection, fitting, use and care.
             
             
          3. The purpose of audiometric testing, and an explanation for the test procedures.
             

       4. Departmental Safety Representatives will make available on request to affected employees or their representative copies of Article 105, General Industry Safety Orders, and will also post a copy in the workplace.
          

   12. Recordkeeping
       
       
       1. Records of all employee noise exposure measurements will be maintained for 30 years by the OSH Division.
          
          
       2. The Health Services Agency will maintain audiometric test records for the duration of the affected employee's employment plus 5 years. These records will include:
          
          
          1. Name and job classification of the employee.
             
             
          2. Date of the audiogram.
             
             
          3. The examiner's name.
             
             
          4. Date of the last acoustic or exhaustive calibration of the audiometer.
             
             
          5. Employee's most recent noise exposure assessment.
             

       3. Records of any personal noise monitoring will be placed in the employee's medical record and kept for the duration of employment plus 5 years.
          
          
       4. All records required by this section will be provided upon request to employees, former employees, and employee representatives.
          
          
       5. If a Workers' Compensation claim involving hearing loss is opened, the Workers' Compensation Unit of the Personnel Department will request a copy of all relevant records from HSA and OSH.
          

Appendix A -- Letters

_ _ 

Letter #1
_ _





_ _(date)


To: _ _(employee's name)


_ _(department)


Your recent audiogram (hearing test) showed a worsening of you hearing. to recheck these results we need to repeat the test.

Please make arrangements with your supervisor to return to the Health Services Agency for a repeat audiogram on:

_ _(date)

_ _(time)

Please stay away from loud noises for the 14 hours prior to test.



_ _
Kathleen Loughlin, M.D.
Occupational Health Program
425-3468


cc:_ _
(employee's supervisor) 

Letter #2
_ _






_ _(date)


To: _ _(employee's name)


_ _(department)


Your repeat audiogram again showed a hearing loss. To verify this you need to have further testing done by an audiologist, a specialist in hearing testing.


This has been scheduled for: _ _(date)

_ _(time)

Location: Hearing Services
550 Water St, Bdlg B
Santa Cruz
Phone: 423-6322

Please make arrangements with your supervisor to attend this appointment, and stay away from loud noises for the 24 hours prior to the test.




_ _
Kathleen Loughlin, M.D.
Occupational Health Program
425-3468


cc:_ _
(employee's supervisor)

_ _(date)


To: _ _(employee's name)


_ _(department)


Your recent test done by the audiologist confirms that you have had a hearing loss called standard threshold shift.

Please contact the Occupational Safety and Health Division at 425-2316 to make an appointment to have you hearing protection reevaluated.

If you feel that this hearing loss may be due to your employment with the County, you should notify your supervisor.



_ _
Kathleen Loughlin, M.D.
Occupational Health Program
425-3468

Letter #4
_ _






_ _(date)


To: _ _(employee's supervisor)


_ _(department)

RE: _ _
(employee)

The employee named above has shown a hearing loss called a standard threshold shift on recent hearing tests.

Please ensure that the following steps are taken:

1) The employee must make an appointment with the Occupational Safety and Health Division to have his/her hearing protection reevaluated.

2) If the employee notifies you that she/he feels this hearing loss may be related to County employment, then you must give the employee a claim form within one working day.

3) Your Departmental Safety Liaison will ensure that this standard threshold shift (STS) is entered on the departmental OSHA 200 log as:
_ _ an occupational illness
_ _ an occupational injury

Please call me if you have any questions.


_ _
Kathleen Loughlin, M.D.
Occupational Health Program
425-3468


cc: _ _
Departmental Safety Liaison