The Audiologist's Role in Occupational Hearing Conservation and Hearing Loss Prevention Programs

Introduction

It is the position of the American Speech-Language-Hearing Association (ASHA) that audiologists play a critical and direct role in the development, implementation, and maintenance of occupational and nonoccupational hearing conservation programs. This statement expresses ASHA's position regarding audiologists' participation in hearing conservation, both occupational and nonoccupational. Occupational hearing conservation is defined as the prevention of significant, permanent hearing loss resulting from on-the-job exposure to ototoxic or ototraumatic agents (of which noise is the most common) in workers (employees and military personnel). Nonoccupational hearing conservation refers to the prevention of significant, permanent hearing loss resulting from off-the-job exposure to ototraumatic agents (most commonly noise) in persons of all ages.

Audiologists are knowledgeable about normal and abnormal anatomy and physiology of the auditory and vestibular systems and their response to ototraumatic agents (most commonly noise). Their educational and clinical background prepares audiologists to assume a variety of roles with expertise related to the prevention of significant, permanent hearing loss resulting from on- and off-the-job exposure to ototraumatic agents (most commonly noise).

This statement has been formulated to offer guidance to audiologists, related professionals, and consumers of occupational and nonoccupational hearing conservation services in the following areas:

• Preparation of the audiologist to provide hearing conservation services;

• Role of the audiologist on the interdisciplinary team in hearing conservation;

• Components of service delivery in hearing conservation; and

• Professional ethics related to service delivery in hearing conservation.

The audiologist intending to work in hearing conservation should acquire expertise in the following areas:

• Auditory effects of noise on humans, including noise exposure metrics (e.g., daily average exposures normalized to 8 hours such as Occupational Safety and Health Administration [OSHA] TWA and L_A8hn, spectral measures such as octave-band sound pressure levels, addition of sound levels from multiple noise sources, and annoyance-related measures such as day-night average sound levels), as well as damage risk criteria for habitual exposures and for single-exposure acoustic trauma;

• The effects of noise on communication and job performance, including use of metrics such as the Speech Interference Level or the Speech Intelligibility Index for predicting the masking of speech by noise;

• Community noise annoyance criteria;

• Nonauditory effects of noise on health;

• Federal, state, and local noise regulations;

• Development, organization, and administration of Occupational Hearing Conservation Programs via an interdisciplinary team approach including the effective integration of contracted services when needed to supplement the employer's resources;

• Program audits and evaluations of effectiveness;

• Workers' Compensation regulations and trends, and methods of claim evaluation;

• Physical characteristics of personal hearing protection devices (HPDs), methods for selecting HPDs appropriate for workplace demands and wearer's needs, techniques for fitting and user training, realistic field performance estimates, and methods for field evaluations of attenuation;

• Criteria of CAOHC (Council for Accreditation in Occupational Hearing Conservation) for certification of Occupational Hearing Conservationists (OHCs), and other recommendations for training and supervising OHCs and other technicians;

• Educational and motivational concepts and techniques for employees and management;

• Noise measurement instrumentation, techniques for conducting noise surveys, and evaluation of the resulting noise exposure data;

• Principles of noise control;

• Forensic audiology;

• Business and human resources management;

• Information management techniques and applications;

• Marketing of audiology services; and

• Business report writing.