For those professionals working in occupational health and safety settings, one of their most complicated tasks has traditionally been the recording of work-related injuries and illnesses as required by the Occupational Safety and Health Administration (OSHA). OSHA's recordkeeping requirements, in place since 1971, were designed to help employers recognize workplace hazards and correct these hazardous conditions by tracking work-related injuries and illnesses and their causes. In addition, OSHA uses the reported data to help direct their training and enforcement priorities. Needless to say, companies take their OSHA recordkeeping obligations very seriously, often stringently reviewing potentially recordable cases and even rewarding their management personnel (through recognitions, raises and eligibility for promotion) for maintaining low rates of recorded injuries and illnesses.
OSHA's requirements for recording/reporting hearing loss are particularly complex and controversial. In the mid-1980s, OSHA specified vaguely that 'occupational hearing loss' must be recorded on the OSHA 'log,' categorized as an 'injury' for cases of acoustic trauma, and as an 'illness' for gradual-onset noise-induced losses (BLS, 1986). Methods for determining the amount of hearing change which triggers recording, and the determination of work-relatedness, have been topics of confusion and disagreement over the past 15 years.
In their most recent attempt to alleviate this uncertainty, OSHA addressed hearing loss 'recordability' as part of a long-awaited general recordkeeping rule, 'Occupational Injury and Illness Recordkeeping and Reporting Requirements' (29 CFR Part 1904), published January 19, 2001 in the Federal Register (OSHA 2001a). This release was issued on the last day of the Clinton administration and immediately underwent review by the Bush administration pursuant to a directive issued by White House Chief of Staff Andrew Card. On June 29, 2001, Secretary of Labor Elaine Chao announced that the recordkeeping rule would largely go into effect as scheduled on January 1, 2002, with two notable exceptions: the requirements for recording musculoskeletal disorders, and the requirements for hearing loss (OSHA, 2001b). These two provisions will be subject to further review and OSHA proposed a new effective date of January 1, 2003. Written comments were invited, with a due date of September 4, 2001 (OSHA, 2001c).
Following is a summary of hearing loss recordability issues and OSHA's latest Call for Comments. If the proposed one-year delay takes effect, OSHA-jurisdiction employers have been instructed to follow existing guidelines for recording work-related hearing losses during the 2002 calendar year.
Existing Federal Interpretations:
Because the existing recordkeeping rule (BLS, 1986) provides little specific information on hearing loss, OSHA's Federal Directorate of Compliance Programs issued a memorandum in June 1991 instructing regional offices to cite employers for failure to record occupational hearing losses defined as follows: an average shift in hearing of 25 dB or more at 2000, 3000, and 4000 Hz in either ear, if an exposure in the work environment either caused, aggravated, or contributed to the case (OSHA, 1991a). In August 1991, OSHA clarified that the shift must be calculated by comparing the current hearing test to the original baseline audiogram for that employee and that age-adjustments may be used (OSHA, 1991b). This policy has become OSHA's federal standard of interpretation for the past 10 years, and is in effect today. In September 1999, the Mine Safety and Health Administration (MSHA) issued a new noise rule, 30 CFR Part 62 (MSHA, 1999). MSHA followed suit with OSHA's existing policy and defined 'Reportable Hearing Loss' as an average 25 dB change for the worse at 2000, 3000, and 4000 Hz (age-adjustments allowed).
Existing State OSHA Interpretations:
Because state-run OSHA programs are allowed to enforce their own interpretations, if they are more stringent than those of federal OSHA, some state policies have differed from the federal interpretation. Five states have reported policies in effect that require companies within their jurisdictions to record work-related Standard Threshold Shift (STS), defined as an average 10 dB shift at 2000, 3000, 4000 Hz compared to baseline (age-adjustments allowed): California, Michigan, North Carolina, South Carolina, and Tennessee (Megerson, 1995; CAOHC, 2000).
New Rule Issued January 2001:
On February 2, 1996, OSHA published a notice of proposed rulemaking regarding general recording and reporting requirements (OSHA, 1996). Special guidance was provided for recording specific types of injuries and illnesses, including hearing loss (Mandatory Appendix B). Under this 1996 proposal, OSHA indicated that a work-related average shift of 15 dB or more at 2000, 3000 and 4000 Hz in either ear should be recordable (age-adjustments allowed).
OSHA received more comments on the proposed criterion for hearing loss than were received for any other type of injury or illness (other than musculoskeletal disorders).
Written comments regarding Mandatory Appendix B were submitted by 443 individuals, companies and organizations. 95 of these comments included responses specific to occupational hearing loss (Megerson, 1997). Of the written comments received by OSHA, only 19% were in favor of OSHA's 15 dB proposal. There was a wide split on the preferred alternatives. Notably, 71% of industry and industry trade associations suggested OSHA adopt a more lenient approach of requiring recording of 20 or 25 dB average shifts in hearing. In contrast, 100% of employee unions/associations and 100% of professional associations (including the American Industrial Hygiene Association, the American Speech-Language-Hearing Association, the American Academy of Otolaryngology-Head and Neck Surgery, and the Council for Accreditation in Occupational Hearing Conservation) supported a more stringent criterion of recording work-related average 10 dB shifts, or STS (Coalition, 1996).
Nearly five years following the call for comments, OSHA's new recordkeeping rule was issued January 19, 2001 with an effective date of January 1, 2002. Hearing loss was specifically addressed in 1904 under subsection 10 'Recording criteria for cases involving occupational hearing loss.' Below is a summary of both requirements published in subsection 10 and explanations provided by OSHA in supporting documents.
HIGHLIGHTS of January, 2001 - Recording Criteria:
- Recording criterion: E
Latest Delay and Request for Comments:
When announcing the proposed delay of the final rule for hearing loss in the July 3, 2001 Federal Register, OSHA explained that the Agency selected STS as the appropriate criterion based heavily on evidence submitted by the Coalition of Professional Organizations. The Coalition submitted evidence that STS is a serious health problem and 'represents a non-minor injury or illness of the type Congress identified as appropriate for recordkeeping purposes'.
Following publication of the final rule in January 2001, OSHA received submissions from several industry groups, such as the National Association of Manufacturers and the American Iron and Steel Institute. Those groups (and others) were critical of OSHA's position that an STS represents a significant health condition. They argued that STS is a precursor event, or warning flag, but not an indicator of material hearing impairment alone. Based on those submissions, OSHA is reviewing the hearing loss recordkeeping requirements and requesting comment on the following issues:
- What is the appropriate criterion for recording cases of occupational hearing loss? (change of 10, 15, 20, 25 dB? Or perhaps a sliding scale for change based on initial hearing levels?)
- What is the variability of audiometric testing equipment and how should this variability be taken into account, if at all?
- What is the appropriate benchmark against which to measure hearing loss? (baseline, audiometric zero, etc.?)
- Should the rule treat subsequent hearing loss in the same employee as a newly recordable case?
Role of the Audiologist:
Regardless of which criterion is eventually adopted by OSHA, case review is an important aspect of managing recordability of occupational hearing loss. Each 'potentially recordable shift' which meets the criterion, and any other suspected work-related hearing loss, should receive careful review by an audiologist (or physician) knowledgeable in the effects of noise and hearing conservation programs. Audiologists providing hearing conservation services should understand the issues associated with hearing loss recordability, as well as hearing conservation program regulations and matters of workers' compensation (all distinct and separate rules with different purposes and requirements).
Specifically, recordability of hearing loss in no way impacts a company's obligations under current Hearing Conservation Program regulations (OSHA 1910.95, MSHA Part 62, etc.) nor their liabilities under state Workers' Compensation laws. Importantly, recordkeeping practices certainly should not detract from the company's primary goal: hearing loss prevention.
For detailed information on the final recordkeeping rule and for a copy of OSHA forms and explanations, visit OSHA's website at: www.osha-slc.gov/recordkeeping/index.html.
For a complete copy of OSHA's announcement of delay and request for comments, access the Federal Register at: www.access.gpo.gov/su_docs/aces/aces140.html. Please note, you will need to go to 'Federal Register' and do a search with such qualifiers as 'issue date: July 3, 2001' and 'topic: Recordkeeping'.
BLS (1986). Recordkeeping Guidelines for Occupational Illnesses and Injuries (OMB NO. 1220-0029), Bureau of Labor Statistics, U.S. Department of Labor, Washington, D.C.
CAOHC (2000). Oregon OSHA Changes Position on Recordability of Occupational Hearing Loss, CAOHC Update, Council for Accreditation in Occupational Hearing Conservation, Volume 11, Issue 4.
Coalition to Preserve OSHA and NIOSH and Protect Workers' Hearing (1996). Comments in Response to OSHA's Notice of Proposed Rule, Occupational Injury and Illness Recording and Reporting Requirements, comments submitted to OSHA Docket No. R-02, Washington, D.C.
Megerson, S. C. (1995). Noise in Washington over Hearing Loss Recordability, CAOHC Update, Council for Accreditation in Occupational Hearing Conservation, Volume 6, Issue 1.
Megerson, S. C. (1997). Occupational Hearing Loss and OSHA Recordability: An Update, Annual Conference of the American Industrial Hygiene Association, Dallas, Texas.
MSHA (1999). Health Standards for Occupational Noise Exposure; Final Rule, Mine Safety and Health Administration, 30 CFR Part 62, Federal Register, Vol. 64, pages 49548-49637.
OSHA (1991a). Memorandum to OSHA regional administrators from Patricia Clark and Stephen Newell regarding recording of hearing loss and cumulative trauma disorders, Occupational Safety and Health Administration, June 4, 1991.
OSHA (1991b). Memorandum to OSHA regional administrators from Leo Carey and Patricia Clark regarding recording of hearing loss on OSHA Form 200, Occupational Safety and Health Administration, August 27, 1991.
OSHA (1996). 29 CFR Parts 1904 and 1952, Occupational Injury and Illness Recording and Reporting Requirements; Proposed Rule, Occupational Safety and Health Administration, Federal Register, Vol. 61, Number 23, pages 4030-4067.
OSHA (2001a), Occupational Injury and Illness Recordkeeping and Reporting Requirements, Occupational Safety and Health Administration, Federal Register, Vol. 66, Number 13.
OSHA (2001b). OSHA Rule on Recordkeeping for Workplace Injuries to Go into Effect as Scheduled, Occupational Safety and Health Administration, National News Release USDL: 01-201, June 29, 2001.
OSHA (2001c), Occupational Injury and Illness Recording and Reporting Requirements: proposed delay of effective date; request for comments, Occupational Safety and Health Administration, Docket No. R-02A, Federal Register, Vol. 66, Number 128, pages 35113-35115.