The Value of Professional Supervisors in a Hearing Conservation Program

Offering Hearing Conservation Program (HCP) administration to your model of service provision is an excellent way to help clients run compliant programs while earning a recurring revenue stream. Numerous important factors, however, must be considered carefully to deliver a successful program.

Offering HCP administration can be intimidating, and many occupational service providers need help knowing where to start. Common questions revolve around the audiological review process and the Professional Supervisor (PS) role in the HCP.

Professional Supervisors play a crucial role in the overall effectiveness of any HCP. For example, when a “problem audiogram” is identified, the PS will use their clinical judgment to decide whether any additional examination or information is required before rendering a decision on work-relatedness. In addition, the PS collaborates with other professionals working within the HCP, including occupational hearing conservationists (OHCs), nurses, industrial hygienists, safety professionals, employers and employees.

The Council for Accreditation in Hearing Conservation (CAOHC) provides a certification which authorizes the PS to manage an HCP with their Certified Professional Supervisor of the Audiometric Monitoring Program. During the certification course, Professional Supervisors will gain problem-solving and critical thinking skills through interactive analysis of HCP case studies, discussions and lectures. At the end of the course, after successfully completing the exam, Professional Supervisors will better understand how to review audiograms, determine work-relatedness of hearing loss, implement follow-up actions, revise baselines and manage audiometric databases. Although CAOHC offers various training and certificate programs to professionals working in occupational hearing conservation, only physicians and audiologists can attain certification as a Professional Supervisor, and this CAOHC certification must be renewed every five years.

The Occupational Safety and Health Administration (OSHA) Hearing Conservation Amendment 29 CFR 1910.95 outlines the role of the PS in the following two sections of the Amendment:

Para (g) (3) “A technician who performs audiometric tests must be responsible to an audiologist, otolaryngologist or physician.”

Para (g) (7) (iii) “The audiologist, otolaryngologist or physician shall review problem audiograms and shall determine whether there is a need for further evaluation.”

When looking for a PS to oversee your managed HCPs, they must have up-to-date knowledge of all government regulations, comprehend all program elements and understand how to apply their clinical reasoning in determining work-relatedness in hearing loss.

Roles of a Hearing Conservation Program Professional Supervisor

The American College of Occupational and Environmental Medicine (ACOEM) Guidance Statement clearly defines the roles of a PS:

Supervision of Audiometric Testing

OSHA mandates that testing be completed by a physician or audiologist or by a technician supervised by a physician or audiologist. The PS ensures all audiometric testing environments comply with federal, state and local standards. They design program procedures, manage record-keeping and refer to external healthcare providers when needed. Additionally, a PS identifies sudden shifts in hearing and inconsistent testing responses.

Managing Follow-Up for Workers with Shifts in Hearing

The PS must oversee the follow-up of any Standard Threshold Shift (STS). OSHA outlines that only a physician or an audiologist can determine if an STS is not work-related. Audiometric technicians cannot perform this action. After an STS is classified as work-related, the employee must be notified, re-fitted, and re-trained on hearing protection.

Decisions on Baseline Revision

Baseline audiogram revision is another crucial component of a Professional Supervisor’s role. The PS is the only professional who can choose whether to revise a baseline. Learn more about baseline audiograms in our previously posted article, ‘ It All Begins With a Baseline Audiogram Test.’

Use of Age Correction in a Hearing Conservation Program

Using age correction in calculating an STS is another valuable element of a Professional Supervisor’s job. OSHA has made the use of age correction on audiometric shifts optional and it is ultimately a decision made by the PS whether or not to apply age correction when determining if a shift has occurred.

Determining Work-Relatedness of an STS

One of the more complex aspects of the role of the PS is the determination of the work-relatedness of an STS. When making this determination, numerous factors are considered, along with clinical experience and judgment.

In addition, the type of hearing loss experienced by the worker is reviewed by the PS as part of a comprehensive exposure assessment. Frequencies commonly associated with typical recreational sounds, such as amplified music, firearms, vehicles and machinery, will be considered in the decision-making process.

The PS will also examine records related to hearing protection usage and the employee’s workplace exposure history.

After gathering and analyzing all data, the PS will determine the work-relatedness of an employee’s hearing shift.

Additional Follow-Up for Employees with Hearing Loss

The PS will determine if any external referrals are required for further investigation during the hearing program, regardless of whether or not an STS is identified. This decision happens case-by-case and offers added value to the employees for their hearing health. The worker will be provided with referral decisions and instructions. Each time a PS evaluates a worker with hearing loss, it provides an excellent opportunity to provide education and promote healthy hearing care habits.

Qualification Examinations or Fitness for a Worker’s Duty

A PS may be asked to review an individual worker’s audiogram and determine whether they can function safely. During this time, the professional supervisor will assess the various functions of the worker’s position and determine which are ‘hearing critical.’ They can also investigate if visual aids or louder audio warning signals could resolve any challenges.

Compensation for Workers with an STS

Referring to national, state and local guidelines, the professional supervisor should be aware of hearing compensation guides and how they differ between states, provinces and federal statutes. This task can be complex due to a lack of commonality between states in categorizing the severity of workplace hearing loss.

Finding the Right Professional Supervisor for Your HCPs

A PS provides various important roles, and it’s essential to find the right one to manage your HCPs. CAOHC has an excellent directory which lists certified professional supervisors organized by state. Unfortunately, HCP guidelines can vary significantly from state to state. Therefore, partnering with an experienced PS with a strong understanding of your local region is critical. The CAOHC directory can be viewed at: https://www.caohc.org/training-and-certifications/professional-supervisor/resources-for-the-ps/ps-directory.

The Right Occupational Hearing Screening Solution

We recommend you learn about our easy-to-use, compliant, and cost-effective occupational hearing testing platform – SHOEBOX PureTest. This complete solution ensures consistent results and automated, straightforward employee testing. Centralized fleet management and test configurations make the ideal solution for Occupational Health and Safety Service Providers looking to scale quickly. In addition, our ANSI-compliant audiometer is portable and can be used in any OSHA-compliant environment.

1. https://www.caohc.org/training-and-certifications/professional-supervisor/about/ps-certification-and-training
2. https://www.caohc.org/training-and-certifications/professional-supervisor/about
3. https://www.caohc.org/UserFiles/5ACOEMGuidanceStatementTheRole_of_the_Professional_Supervisor-in-Audiometric-Testing.pdf