Chapter Outline
Chapter Outline
| Records | Reports |
| Submission to relevant authority | Referrals to specialist |
Educational Aims
After studying this chapter, you should be able to:
Discuss the details required on an audiogramDiscuss the various records for safe keeping required in audiometry
Produce reports that adhere to national standards
Discuss records and reports required for compensation purposes
Key Terms / Abbreviations
| Abbreviation | Explanation |
| ≤ | These symbols means equal to or less than |
| ≥ | This symbol means equal to or greater than |
| CC | Compensation Commissioner |
| COIDA | Compensation of Occupational Injuries and Disease Act No. 130 of 1993 (including Instruction 171) |
| DA | Diagnostic Audiogram |
| dB | Decibel |
| DMRE | Department of Mineral Resources and Energy |
| DOL | Department of Employment and Labour |
| ENT | Ear Nose and Throat specialist |
| HCP | Hearing Conservation Program |
| HPD | Hearing Protective Device |
| HTL | Hearing Threshold Levels |
| Hz | Frequency |
| MHS Act | Mine Health and Safety Act, 1996 Act 29 of 1996) |
| NIHL | Noise Induced Hearing Loss |
| NIHL regulations | Noise Induced Hearing Loss Regulations (Government Notice number 307 of 7 March 2003) under section 43 of the Occupational Health and Safety Act 1993 (Act 85 of 1993) |
| OHNP | Occupational Health Nurse Practitioner (Nurse) |
| OHP | Occupational Health Practitioner (Nurse or Doctor) |
| OHS Act | The Occupational Health and Safety Act, No 85 of 1993 |
| OMP | Occupational Medicine Practitioner (Doctor) |
| PD | Permanent Disability |
| PLH | Percentage Loss of Hearing |
| PLHS | Percentage Loss of Hearing Shift |
| PTAC | Pure Tone Air Conduction |
| SANS 10083:2013 | South African National Standard 10083: 2013. The measurement and assessment of occupational noise for hearing conservation purposes |
| STS | Standard Threshold Shift |
| TTS | Temporary Threshold Shift |
| Term | Definition |
| Air conduction Testing | In air-conduction testing, a pure tone is presented via an earphone. The signal travels through the air in the outer ear to the middle ear and then to the cochlea in the inner ear. Air conduction thresholds are usually marked with an O for the right side and an X for the left side. |
| At Risk Employees / Safety Critical Employees | Means employees exposed to noise level above or equal to the occupational exposure limit. |
| Audiogram | A graph that shows the softest sounds a person can hear at different frequencies. A chart or graph or table indicating the hearing threshold levels as a function of frequency (namely 0.5, 1, 2, 3, 4, 6 and 8kHz as determined by means of a monoaural, pure –tone, air conduction threshold test (NIHLR March 2003). |
| Audiologist | A graduate in audiology registered with the HPCSA in South Africa (SANS 10083:2013). |
| Audiometer | An audiometer is a machine used for evaluating hearing acuity. An audiometer is a subjective device that is used to evaluate the hearing threshold levels of a person. A competent person uses an audiometer together with special audiometric testing techniques to determine the hearing threshold levels to identify as well as quantify the degree of hearing loss of a person. The audiometer produces tones of different frequencies which are presented at different levels to the workers ears (one side at a time). An audiometer is a subjective testing device, as a response from the worker is needed. The instrument for the determining of hearing threshold levels in South Africa must comply with the requirements in IEC 60645-1 (SANS 10083:2013). |
| Audiometric Zero | The milestone baseline. |
| Audiometrist / Technician | A person with a certificate of competence in audiometry that is registered with the Department of Employment and Labour as such and which is administrated by SASOHN (SANS 10083:2013). |
| Audiometry | The testing and measurement of hearing acuity for variations in sound intensity and pitch and tone. |
| Baseline Audiogram | The baseline audiogram is the reference audiogram (1st audiogram ever performed) on a worker when exposed to noise equal to or above 85dB(A) for the first time. This the audiogram against which all future audiograms are compared in order to determine the extent to which an employee's hearing deteriorates if exposed to noise equal to or above 85dBA at work. |
| Bilateral | Both ears - in the context of this course hearing or hearing loss in both ears. |
| Compensation Commissioner | The Compensation Commissioner (CC) is appointed under section 2(1)(a) of the Compensation for Occupational Injuries and Diseases Act, 1993 (Act 130 of 1993); one of the responsibilities of the CC is to determine the validity of a claim, determine the degree of disability and payment of compensation to the claimant. |
| Demographics | Demographic data refers to socio-economic information expressed statistically, also including employment, education, income, marriage rates, birth and death rates and more factors. Demographic analysis is the study of a population based on factors such as age, race, and gender. |
| Diagnostic audiometry | Measurement of hearing threshold levels and other parameters to determine the nature (for example, conductive, sensory, neural, or mixed) and degree of hearing impairment. It is performed by an audiologist regeared with the Health Professions Council of South Africa. |
| Employment | Is a working relationship between two parties, usually based on contract where work is paid for and services are provided. |
| Exit Audiogram | An exit audiogram is performed at the termination of an employee’s service, contract or on the conclusion of exposure to noise equal to or greater than 85dB(A) in a workplace. |
| Exposure | The state of having no protection from something harmful. Exposure refers to when an employee is subjected to a hazard in the course of employment through any route of entry (inhalation, ingestion, skin contact or absorption, etc.), and includes potential, accidental or possible, exposure. |
| Frequency | Frequency is the speed of the vibration and this determines the pitch of the sound (highness or lowness of the sound). Frequency is measured in decibels (dB). |
| Hazard | A hazard is any source of potential damage, harm, or adverse health effects on someone. |
| Hearing Threshold Levels | Hearing thresholds are defined as the lowest level sound that can be heard 50% of the time. |
| Hertz | This is the pitch of frequency of the sound and represented as Hz. It is the number of vibrations in cycles per second.⁵ |
| Hierarchy of Control | The hierarchy of control is a system for controlling risks in the workplace. It is a step-by-step approach to eliminating or reducing risks and it ranks risk controls from the highest level of protection and reliability through to the lowest and least reliable protection. |
| Initial | An entry audiogram is a single complete audiogram which is conducted on a new employee starting at a company or site for the first time who has been exposed to previous to noise equal to or above 85dB(A) or who presents with an invalid baseline audiogram or is an employee is moved from one department to another and noise exposure increases. |
| Medical Surveillance | Medical surveillance is a planned program to monitor the health of workers and is permissible in terms of legislation and justifiable in terms of medical evidence, conditions of employment and the inherent requirements of the job. |
| Milestone Baseline | Means the initial audiometric value determined at the first STS testing. |
| Monitoring Audiogram | Monitoring audiograms are performed on employees who are exposed to noise levels equal to or greater than 85dB(A) in the mining industry. The objective of monitoring audiograms is to focus on the prevention of permanent hearing loss and to assess the effectiveness of the Hearing Protection Devices (HPD). The test is performed immediately after exposure to noise to detect a temporary threshold shift when the worker presents for audiometry during medical surveillance. |
| Noise Induced Hearing Loss | Noise-induced hearing loss begins at the higher frequencies (3000 to 6000Hz) and develops gradually as a result of chronic exposure to sound levels equal to or above 85dB(A) (continuous exposure to loud noise over an extended period of time, such as noise generated in an engineering workshop). Although the loss is typically symmetric, noise from firearms or sirens may produce an asymmetric loss. NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion often leading to acoustic trauma. Recreational activities can also cause NIHL such as target shooting and hunting, listening to MP3 players at high volume through earbuds or headphones, playing in a band, and attending loud concerts. NIHL is 100% preventable. |
| Normal hearing | Hearing threshold levels between 0 – 25dB in all frequencies. |
| Occupational Audiometry | A screening test which measures the hearing of workers exposed to noise at work. Audiometry in the workplace assesses the effect of workplace noise on the individual with the purpose of early diagnosis and management of hearing loss due to workplace noise exposure. |
| Otoscope / auriscope | An otoscope or auriscope is a medical device which is used to look into the ears. |
| Ototoxic Drugs | Oto means ear and toxic means poisonous. Certain medications can damage the ear, resulting in hearing loss, ringing in the ear, or balance disorders. These drugs are considered ototoxic. There are more than 200 known ototoxic medications (prescription and over the counter) on the market today. |
| Percentage Loss of Hearing | Percentage Loss of Hearing (PLH) is a reference value for the hearing status of an individual against which loss can be measured however PLH does not necessarily indicate hearing loss. Instruction 171 introduced a measure of impairment termed percentage loss of hearing (PLH) which is calculated by using a series of tables based on a summation of hearing loss in each ear at the following frequencies: 500, 1000, 2000, 3000 and 4000Hz (COIDA, 2001). The PLH forms the principal criterion for assessing hearing status for compensation claims. |
| Periodic Audiogram | The Periodic Audiogram is performed either on an annual basis or every 6 months depending on the noise level the worker is exposed to. |
| Pure Tone Audiometry | Pure tone audiometry or pure-tone audiometry is a hearing test used to identify the hearing threshold levels of an individual, to determination the degree, type and configuration of hearing loss and thus providing a basis for diagnosis and management. It performed by presenting a pure tone (sound) to the ear through an earphone and measuring the lowest intensity in decibels (dB) at which this tone is perceived. |
| Risk | Risk is the chance or probability that a person will be harmed or experience an adverse health effect if exposed to a hazard. |
| Standard Threshold Shift | Means an average change in hearing of 10dB or more at the frequencies of 2000Hz. 3000Hz and 4000Hz in one or both ears, as compared to the employee's milestone baseline audiogram. |
| STS Reportable Level | Means the STS that is reported in terms of milestone monitoring if the average change in hearing from 'audiometric zero'. Note i.e., milestone baseline STS, is 25dB hearing loss or greater at the same frequencies in the same ear. |
| Temporary Threshold Shift | A threshold shift is defined as a reduction in a person’s ability to hear. A Temporary Threshold Shift normally occurs after exposure to loud sound and is described as fatigue of the hair cells. |
| Unilateral | One sided – in the context of this course one sided hearing or hearing loss. |