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Prolonged exposure to hazardous noise can have harmful effects on worker health. Monitor the hearing health status of the noise-exposed workers to identify changes then take action to prevent further damage.
How do we know if noise is affecting the hearing of our workers?
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Under Work Health and Safety Legislation in Australia, a 'persons conducting a business or undertaking' (PCBU) is required provide audiometric testing for a worker required to frequently use Hearing protection Devices (HPDs) as a control measure for noise that exceeds the workplace exposure standard (WES). Where workers are likely to be exposed to noise above the WES, ototoxins and/or vibration, the Safe Work Australia (SWA) Code Of Practice (COP): Managing Noise and Preventing Hearing Loss at Work (listed in Appendix B) (2018), and AS/NZS 1269.4 Occupational noise management - Auditory assessment, also recommend that audiometric testing be made available.
Before introducing an audiometric testing program to your workplace, a duty holder must consult with workers and their health & safety representatives regarding the program objectives i.e. to assess and evaluate the effectiveness of control measures in place to protect worker hearing.
An audiometric testing program checks the hearing thresholds of workers and tracks them over time. The objective is to detect changes or shifts in hearing that may signal the beginning stages of noise-induced hearing loss (NIHL). Identifying the signs and symptoms early enough, allows duty holders to intervene before the symptoms get worse. Therefore, part of the audiometric testing program is to ensure that effective follow-up actions are taken.
Audiometric monitoring programs depend on checking hearing thresholds in a consistent, standardised manner, using trained and competent personnel. The test room should be quiet enough to minimise distractions for valid thresholds to be obtained. A baseline hearing check (reference audiometry) must be provided within three months of the worker commencing work where HPDs are required. This reference test is then compared to future, routine hearing checks. SWA COP (2018) state regular follow-up tests (monitoring audiometry) must be carried out at least every two years or more frequently if exposure to noise in the workplace is equal to, or greater than 100 dB (A). These results help to identify problems, such as hearing threshold shifts.
Audiometric test programs can be offered in a variety of ways, including in-house testing, mobile service providers, or at a health clinic. All testing should be performed by a competent person, appropriately trained and experienced in using procedures and equipment that comply with AS/NZS 1269.4. Audiogram test results that display a significant threshold shift require review by an appropriate medically or audiologically qualified professional, to help determine follow-up actions. If a permanent hearing loss occurs, a professional can help determine whether it is related to noise on the job.
Copies of audiometric assessment results informing workers of their hearing health status, should be provided to workers preferably after testing. The meaning and implications of test results should be clearly and simply communicated. When applicable, audiometric data base analysis can identify trends in the workplace and detect signs of occupational hearing loss in similar exposure groups (SEGs), before large threshold shifts occur for individuals. This analysis can therefore assist the workplace in application of an appropriate intervention plan to correct shortcomings evident in the hearing conservation program (or noise management program). Refer to AS/NZS 1269.4 "Occupational noise management - Auditory Assessment" for more specific details.
Key Takeaways
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- Audiometric testing must be provided to workers who are assigned HPDs to protect against hearing loss within three months of the worker commencing work.
- In addition, situations where workers are also exposed to noise, ototoxic substances, and/or vibration, audiometric testing is also recommended.
- Routine hearing checks can help detect early symptoms of over-exposure to hazardous noise.
- Effective follow-up for workers with hearing shifts can help prevent permanent noise-induced hearing loss.
- Quality audiometric testing programs rely on consistent procedures, standardized practices, and competent personnel.
- Careful review of hearing test results can help determine what follow-up actions are needed and if workplace noise is a factor.
- The audiometric database is a snapshot of the hearing health of the noise-exposed workforce and can be used to identify trends and develop intervention plans.
Purposes of Audiometric Testing
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- Audiometric testing plays an important component in any hearing conservation program (or Noise Management Program).
- When workers are required to be in hazardous noise, they should be checked routinely.
- The purpose of the hearing check is to identify small changes in hearing which may be a symptom of being over-exposed to noise.
- Workers who show no changes in hearing, despite working in hazardous noise, are assumed to be well-protected. However, those who show hearing threshold shifts, need an intervention plan.
- Hearing testing can also be done in order to qualify (or disqualify) a worker from a particular job, if that job has written criteria for hearing. For example, in order to be licensed, an airplane pilot or commercial driver must have good enough hearing to meet the requirements.
- Hearing evaluations can also be performed to determine the cause of the hearing loss for purposes of determining if a hearing loss is work-related.
Getting Started With Audiometric Testing
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Step 1. Identify who is required to have a hearing test
A worker who is required to frequently use HPDs as a control measure for noise that exceeds the WES of LAeq,8h of 85 dB(A) or LC, peak of 140 dB(C) must be included in an audiometric testing program. SWA COP (2018) also recommends that regular follow up audiometric testing be conducted in situations where workers are exposed to any known ototoxic substances (listed in Appendix B of the SWA COP 2018), that display airborne exposures greater than 50% of the TWA-WES (without regard to respiratory protection worn) regardless of the noise level, and when workers are exposed to ototoxic substances and/or hand-arm vibration at any level of noise with an LAeq,8h greater than 80 dB(A) or LC, peak 135 dB(C). This includes workers who are noise-exposed every day as well as those who are exposed only one day per year.
To ensure all workers are included in the program, review all noise exposure data in noise assessments/surveys/reports, identify ototoxic substance use in the workplace, and understand where exposure to vibration is prevalent, as this information can assist in identify which areas, job tasks, and/or workers are affected.
A duty holder may also choose to expand the program to include other workers; however, it is helpful to specify who is required and who is optional before the testing cycle starts.
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Step 2. Choose how to deliver the testing program
Knowing how many workers will need to be tested will help to determine the best method for delivering the hearing tests. Many factors, such as quality, worker time away from the job, flexibility, space, personnel, access to records, and total cost of the program, are all typically considered. The goal is to establish a robust long-term program that is stable and continuous. Keep in mind that the cost of poor quality can be high, not only in dollars, but also in wasted time and effort, worker health, productivity, and morale, and duty holder liability.
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Step 3. Schedule and conduct the testing
Scheduling the tests is somewhat dependent on the method chosen for delivering them. For example, the testing can be spread throughout the year or done within the same week or month, with periodicity being dependent on degree of exposure. Some considerations for scheduling are the time or season of the year, the start and end times of the work shifts, and the availability of workers to be away from job tasks.
Opportunities to interact with workers is also a given when conducting audiometric testing. Consider including hearing protector quantitative fit testing during the audiometric testing program to help improve your HCP (or Noise Management program). The benefits of hearing protector fit testing are being realised by duty holders and workers alike, and fit testing has become a recommended best practice in hearing loss prevention globally.
Hearing protector fit testing is the measurement of the amount of noise reduction, or attenuation, a hearing protector provides while it is being worn by a specific individual. This real-world measurement is referred to as a 'Personal Attenuation Rating' or PAR. The purpose of hearing protector fit testing is to verify that the attenuation is adequate for the individual and to help validate hearing protectors that can be used successfully in their work environments.
Benefits of implementing hearing protector fit testing on site include:
- Ability to identify at-risk workers who may not be obtaining adequate attenuation
- Provision for one on one training and motivation of workers
- Ability to validate the appropriate size and model of HPD for each worker
- Ability to document and record adequate attenuation achieved by each worker
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Step 4. Threshold shifts
AS/NZS 1269.4 stipulates that when comparing audiometric results from baseline (reference) test with follow up (monitoring) tests (as per section 9.3), and if a temporary threshold shift is prevalent, a retest should be requested on another day, after 16 hours in quite conditions. If the retest confirms the threshold shift, the worker should be referred to an appropriately qualified professional for further assessment and review.
Occurrence of significant temporary or permanent threshold shifts or tinnitus in your audiometric results can indicate that the hearing conservation program (or noise management program) may be failing, and review of control measures to determine if more effective measures can be implemented, should ensue.
Actions to affect this could include:- Reviewing job tasks of affected worker/s to ascertain if any changes to work practices may have increased exposure to noise and/or ototoxic substances.
- If necessary, re-determine exposure to noise and/or ototoxic substances.
- Verify if personal protection equipment provided for ototoxic substances is adequate and properly used, and if HPDs are adequate for the level of noise exposure of affected worker/s.
- Examine HPDs of affected worker/s to ensure they are well maintained and in good condition.
- Instruct worker/s to fit HPD as they would in the field, and check once fitted that the seal isn’t broken.
- Check if worker/s uses HPD correctly and consistently during job task.
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Step 5. Updating Baseline (reference) Audiograms and Completing any Follow-up Actions Needed
When a significant threshold shift has occurred, or 10 years have passed since the initial baseline (reference) audiogram, the baseline audiogram must be updated. Changes, such as medically assessed significant permanent threshold shift, requires the baseline (reference) audiogram to once again be updated. Any subsequent follow up (monitoring) audiograms will need to be compared with the most recent baseline (reference) audiogram.
There are many types of follow-up actions that may be necessary based on the audiometric test results and the medical history information given by the worker. Some types of follow-up are required and others are optional. It is typically helpful to work with an audiologist or medical professional to outline follow-up and intervention needs. Some examples of follow-up actions are: retesting and retraining workers who have experienced a significant threshold shift/s, retesting a worker who had an incomplete or invalid test, referring workers with signs of medical conditions to a medical professional or audiologist, fit-testing of hearing protection, investigating workplace hazards, and determining work-related hearing loss.
Requirements for audiometric testing are detailed in AS/NZS 1269.4 Occupational noise management - Auditory Assessment. The following is a brief summary of the requirements; the regulation itself should be consulted for actual language and/or use. Note that State Regulations or Codes of Practice may have additional requirements.
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Who must have an audiometric test? Who can perform the test?
Who must have an audiometric test?
- Workers who are required to use HPDs as a control measure for noise that exceeds the WES of LAeq,8h of 85 dB(A) or LC,peak of 140 dB(C) must be included in an audiometric testing program
- Workers who are exposed to any known ototoxic substances (listed in Appendix B of the SWA COP), that display airborne exposures greater than 50% of the TWA-WES (without regard to respiratory protection worn) regardless of the noise level
- Workers who are exposed to ototoxic substances and/or hand-arm vibration at any level of noise with an LAeq,8h greater than 80 dB(A) or LC,peak 135 dB(C)
Who can perform the audiometric test?
All testing should be performed by a competent person, appropriately trained and experienced in using procedures and equipment that comply with AS/NZS 1269.4.
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What are key requirements of the testing program?
- Audiometric testing must be available at no cost to the employees.
- Audiometers must meet specified equipment and calibration requirements.
- Testing of equipment should be conducted as specified in AS/NZS1269.4
- Relevant audiometric test procedures are described in Section 8 of AS/NZS1269.4
- Pure tone air-conducted thresholds are obtained for a minimum of the following frequencies: 500, 1000, 1500, 2000, 3000, 4000, 6000 and 8000 Hz. Each ear is tested separately.
- Baseline (reference audiometry) tests, must be preceded by 16 hours away from workplace noise.
- Regular follow up (monitoring audiometry) tests must be carried out at least every two years or more frequently if exposure to noise in the workplace is equal to, or greater than 100 dB (A).
- Retests: Where regular follow up (monitoring audiometry) tests display threshold shifts after comparison to baseline results, a further audiometric test on another day, after 16 hours in quite conditions is required.
- If threshold shift is confirmed, worker should be referred to an appropriate medically or audiologically qualified professional for medical opinion.
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When are audiometric tests conducted?
Baseline (reference audiometry)
Should be scheduled during pre-employment medicals or as soon as possible within three months of the worker commencing work. Testing must be performed immediately after a period of not less than 16 hours of quiet.Regular follow ups (monitoring audiometry)
The SWA COP state regular follow-up tests must be carried out at least every two years or more frequently if exposure to noise in the workplace is equal to, or greater than 100 dB (A). AS/NZS 1269.4 Occupational noise management - Auditory Assessment, recommends testing be carried out within 12 months after the of initial baseline. Testing shall be scheduled well into or at the end of the work shift and compared with baseline results to reveal if any temporary thresholds shifts are due to inadequacies in HPD use. -
Where are the tests conducted?
Audiometric test can be conducted in-house by site, by mobile service providers, or at a health clinics. The background noise where the hearing test is conducted must meet specific noise levels as outlined in AS/NZS1269.4
Beyond the Basics
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Testing Considerations
- Testing is performed by competent person - competent as described in AS/NZS 1269.4 Appendix E.
- Minimise distracting background noise in the test room by applying lower maximum octave band limits, similar to a clinical environment,
- Consider use of insert earphones to minimise background noise, improve hygiene, and reduce masking needs,
- Do not allow the use of hearing protection as a substitute for the 16-hour noise-free interval before the baseline test,
- Schedule regular follow up (monitoring audiometry) audiograms during the work shift to better identify changes in hearing thresholds due to on-the-job noise exposure
- Offer an “exit audiogram” for workers who are leaving the HCP or terminating employment
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Intervention Strategies
- Expand the intervention protocol by enhancing worker education
- Verify hearing protection attenuation through hearing protection fit-testing,
- Investigate and implement better noise control options
- Re assess exposure to noise, ototoxic substances and/or vibration above the WES in the workplace
Have You Considered?
Answers to common questions
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What triggers mandatory hearing tests?
Workers who are required to use HPDs as a control measure for noise that exceeds the WES of LAeq,8h of 85 dB(A) or LC,peak of 140 dB(C)
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When does the baseline audiogram have to be done?
A baseline audiogram should be scheduled during pre-employment medicals or as soon as possible within three months of the worker commencing work. Testing must be performed immediately after a period of not less than 16 hours of quiet.
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How often are hearing tests done?
Regular follow-up (monitoring audiometry) tests must be carried out at least every two years or more frequently if exposure to noise in the workplace is equal to, or greater than 100 dB (A).
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Can the worker work in noise before the baseline test?
No. The baseline test (reference audiometry) should be carried out prior to exposure to noisy areas. A period 16 hours quiet time prior to testing is required.
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Can the worker work in noise before the regular follow up (monitoring audiometry)?
Yes. Testing shall be scheduled well into or at the end of the work shift
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Can the worker be sent to a local clinic to complete the hearing test?
Yes, assuming that the clinic is competent and there is no cost to the worker by doing so.
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I have a worker with a hearing aid. Can a test be done?
Yes, however the hearing test must be done without the hearing aid. If necessary, the worker could be tested by an audiologist or medical professional.
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I have a worker who has severe tinnitus. Can I still test hearing?
Yes, however sometimes tinnitus (ringing in the ears) can make it more difficult to obtain valid thresholds. If the results are inconsistent, the worker may be having trouble distinguishing the test tone from the ringing in his ears. One option is to refer the worker to an appropriate medically or audiologically qualified professional, to obtain a valid test.
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My workers don’t speak English. How can they be tested?
One option is to use an interpreter to explain the purpose of the test and instructions. Some audiometers have an additional feature to instruct the worker through the earphones, in the preferred language.
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Is it required to look in the ears with an otoscope before the test?
An Otoscopy examination is a visual ear examination using an otoscope to check for any abnormal features in the external auditory canal of the ear.
Resources for Audiometric Testing
Noise, SafeWork Australia
See “Codes and Guides” tab links to: Model Code of Practice: MANAGING NOISE AND PREVENTING HEARING LOSS AT WORK: October 2018 .
This page also includes links to State and Territory Regulators for specific local requirements
The Australian Standard AS/NZS 1269 series, Occupational noise management (1 – 4), provides technical requirements and guidance on all facets of occupational noise management.
Audiometric testing and assessment of audiograms should be carried out by competent persons in accordance with the procedures in AS/NZS 1269.4:2005 - Occupational noise management - Auditory assessment.
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IMPORTANT NOTE: This information is based on selected current national requirements. Other country or local requirements may be different. Always consult User Instructions and follow local laws and regulations. This website contains an overview of general information and should not be relied upon to make specific decisions. Reading this information does not certify proficiency in safety and health. Information is current as of the date of publication, and requirements can change in the future. This information should not be relied upon in isolation, as the content is often accompanied by additional and/or clarifying information. All applicable laws and regulations must be followed.
