FAQ

Yes. The Data Management Portal supports import of historical audiometric data from legacy audiometric systems — not limited to SHOEBOX-generated data. DMP PLUS includes historical audiogram import including baselines. SHOEBOX Customer Success provides data import professional services to facilitate migration, including baseline verification and data mapping from common legacy formats. The fidelity of imported data depends on the format and completeness of records from the originating system.

The portal stores the complete record set required by 29 CFR 1910.95(m)(2)(ii) and (m)(3)(ii): employee name and job classification, audiogram date, examiner identity, date of most recent calibration, employee’s most recent noise exposure assessment, and ambient room noise measurements from each test session. Records are retained for the duration of employment and remain accessible regardless of changes to the organization’s equipment or service provider — the data is in the portal, not on the device. Access is available on demand without submitting a records request to an external vendor. SHOEBOX: The SHOEBOX Data Management Portal provides this record access directly to program administrators, replacing the vendor-mediated records request process that outsourced models typically require.

OSHA requires that all employee audiometric test records be retained for the duration of that employee’s employment (29 CFR 1910.95(m)(3)(ii)). This requirement applies regardless of whether the employee leaves voluntarily, is terminated, or retires. Noise exposure measurement records carry a shorter retention period: 2 years from the date of measurement (29 CFR 1910.95(m)(3)(i)). Three operational implications follow. First, records must be accessible — not just stored. OSHA requires that audiometric records be made available to employees, former employees, designated representatives, and OSHA upon request (29 CFR 1910.95(m)(4)). Records that cannot be produced promptly on request do not meet this requirement regardless of where they are stored. Second, if a business closes or is acquired, audiometric records must be transferred to the successor employer, or if there is none, employees and NIOSH must be notified before disposal (29 CFR 1910.95(m)(5)). Third, the audiometric record is not just a test result — it must include the employee’s name and job classification, the test date, the examiner’s name, the date of the most recent acoustic calibration, the employee’s most recent noise exposure assessment, and the background sound pressure levels in the test room at the time of testing (29 CFR 1910.95(m)(2)(ii)). SHOEBOX: The SHOEBOX Data Management Portal stores the complete required record set — audiogram results, examiner identity, calibration dates, and ambient noise measurements — with automatic backup from the iPad. Records are accessible on demand without submitting a request to an external vendor, and they remain in the portal regardless of changes to the organization’s equipment or service provider.

Historical record quality varies significantly by source. Paper audiograms from clinic visits, CSV exports from legacy audiometric software, and data from previous service provider platforms all require different handling. The first priority is establishing accurate baselines in the new system: many transition complications arise from importing incorrect or outdated baselines, which causes STS determinations to be made against the wrong reference point. SHOEBOX Customer Success provides data import services to facilitate migration, including baseline verification and mapping from common legacy formats. Before importing, it is worth reviewing whether the historical baselines on file are actually the best baselines for each employee — in some cases, a fresh baseline under controlled conditions is preferable to importing a suspect historical record.

Employers must retain all employee audiometric test records for the duration of that employee’s employment (29 CFR 1910.95(m)(3)(ii)). Noise exposure measurement records must be retained for 2 years (29 CFR 1910.95(m)(3)(i)). Audiometric records must include: employee name and job classification, test date, examiner’s name, date of the most recent acoustic or exhaustive calibration, the employee’s most recent noise exposure assessment, and the background sound pressure levels in the test room at the time of testing. Records must be available to employees, former employees, and OSHA upon request (29 CFR 1910.95(m)(4)). SHOEBOX: SHOEBOX’s cloud-based Data Management Portal stores the complete required record set — including audiogram data, examiner identity, calibration dates, and ambient noise measurements — with automatic backup from the iPad. Records are accessible at any time without requesting exports from a service provider.

The portal’s automatic triage system evaluates each completed audiogram against configurable rules and routes it to an appropriate action state without manual review. Configurable triage rules include: voiding significantly incomplete audiograms (less than 50% of configured frequencies recorded); flagging audiograms with an identified STS for audiology review; routing problem audiograms for clinical evaluation; and marking audiograms that require retesting based on validity or shift criteria. The triage system replaces the manual step of reviewing each audiogram result individually to determine what action is needed — the portal sorts, flags, and routes, and the EHS manager sees a prioritized action list rather than a raw result pile. SHOEBOX: The triage system is part of the SHOEBOX Data Management Portal and is available to all portal users. Triage rules are configured by the program administrator, allowing each organization to match routing logic to its internal workflow.

The base Data Management tier provides cloud-based storage, automatic backup from iPads, centralized employee and audiogram search and filtering, electronic data export, employee data import, and project-based organization. It also performs automatic threshold shift identification and consolidates data from all devices in the program. Data Management PLUS adds: multi-level organizational grouping (company, region, site, project), historical audiogram import including baselines, administrator-controlled access permissions, baseline management tools, threshold shift monitoring against OSHA and MSHA standards, individual patient summary reports, OSHA compliance reporting, and the Due-for-Testing scheduling report. Programs with complex organizational structures, multi-site operations, or data migration from legacy systems typically require PLUS. SHOEBOX: Both tiers are part of the SHOEBOX Data Management Portal. SHOEBOX Customer Success helps determine which tier fits the program’s operational requirements during onboarding.

Multi-state programs face a specific compliance consideration: audiogram review is a clinical function, and audiologists are licensed by state. An organization with employees in multiple states should ensure that its Audiology Reviewers are licensed in the states where reviewed employees are located. SHOEBOX Audiological Services maintains a network of state-licensed reviewers that can cover multi-state programs without requiring the employer to source reviewers state by state. The Data Management Portal supports project-based organization that allows multi-site programs to manage employee data, testing schedules, and reporting by location.

OSHA 29 CFR 1910.95(g)(3) requires that any technician who performs audiometric tests be responsible to an audiologist, otolaryngologist, or physician. This creates two distinct roles: the Professional Supervisor and the Audiology Reviewer. Both are mandated; they can be fulfilled by the same individual or by different people, depending on the organization. The Professional Supervisor has program-level responsibility: ensuring that testing environments, procedures, and recordkeeping meet standards, and that technicians are appropriately trained. The Audiology Reviewer has patient-level responsibility: evaluating individual audiograms for clinical significance, confirming or ruling out STSs, and identifying problem audiograms requiring further evaluation. SHOEBOX: SHOEBOX Audiological Services provides access to both roles: CAOHC-certified Professional Supervisors for program oversight and a network of state-licensed Audiology Reviewers for individual audiogram review. This allows organizations to run a compliant in-house program without maintaining these roles on staff.

The OSHA 300 Log (Form 300) records all work-related injuries and illnesses, including hearing loss. A hearing loss case is recordable when two conditions are both met: the employee has experienced an STS (average 10 dB or more at 2,000/3,000/4,000 Hz in the same ear), AND the employee’s total hearing level in that ear — averaged at the same frequencies — is 25 dB or more above audiometric zero (29 CFR 1904.10(a)). Both conditions must be present in the same ear. If the STS occurs in one ear but the hearing level threshold is met only in the other, the case is not recordable. Employers may use age correction when evaluating the STS component, but age correction cannot be applied when evaluating whether the 25 dB threshold is met. SHOEBOX: SHOEBOX PureTest automatically calculates STS at the time of testing, and the Data Management Portal flags audiograms that may meet recordability criteria — giving EHS managers early visibility into potential 300 Log entries before the 7-calendar-day recording deadline.

These are the two most commonly confused values in hearing conservation. The action level — 85 dBA as an 8-hour TWA — triggers the requirement to implement a full hearing conservation program: monitoring, audiometric testing, HPD provision, training, and recordkeeping (29 CFR 1910.95(c)(1)). The permissible exposure limit (PEL) — 90 dBA as an 8-hour TWA — is the threshold at which feasible engineering and administrative controls must be implemented to reduce exposure (29 CFR 1910.95, Table G-16). Three distinctions matter in practice: (1) the action level triggers the Hearing Conservation Program; the PEL triggers noise control obligations; (2) exceeding the PEL does not exempt the employer from Hearing Conservation Program requirements — both apply; (3) NIOSH recommends a more protective 85 dBA REL using a 3 dB exchange rate, compared to OSHA’s 5 dB exchange rate. Content that cites NIOSH guidance must clarify that NIOSH recommends rather than requires.

The OSHA 300 Log records all work-related injuries and illnesses, including occupational hearing loss. A hearing loss case is recordable when two conditions are met in the same ear: the employee has experienced a standard threshold shift (an average change of 10 dB or more at 2,000, 3,000, and 4,000 Hz relative to baseline), and the employee’s total hearing level in that ear — averaged at those same three frequencies — is 25 dB or more above audiometric zero (29 CFR 1904.10(a)). Both conditions must be present simultaneously in the same ear. If the STS occurs in one ear but the 25 dB hearing level threshold is met only in the other, the case is not recordable. Three distinctions matter in practice. First, the recordability determination is separate from the STS determination under 1910.95 — a confirmed STS does not automatically produce a recordable case. Second, age correction may be applied when evaluating the STS component of recordability, but it cannot be applied when evaluating whether the 25 dB hearing level threshold is met. Third, if a retest within 30 days does not confirm the STS, the case does not need to be recorded. If the retest confirms it — or no retest is conducted — the employer must enter the case on the OSHA 300 Log within 7 calendar days of that determination (29 CFR 1904.10; 29 CFR 1904.29(b)(3)). SHOEBOX: SHOEBOX PureTest automatically calculates STS against the established baseline upon test completion. The Data Management Portal flags confirmed shifts and tracks retest scheduling, giving the EHS manager a clear record of when the STS determination was made — the reference point for the 7-day recording clock.

Under 29 CFR 1910.95(g)(3), audiometric tests may be performed by a licensed or certified audiologist, an otolaryngologist or other physician, or a technician certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC), or one who has satisfactorily demonstrated competence in administering audiometric examinations. An important exception: technicians operating microprocessor audiometers are not required to hold CAOHC certification. In all cases, the technician must be responsible to an audiologist, otolaryngologist, or physician. This professional responsibility requirement applies regardless of equipment type. SHOEBOX: SHOEBOX PureTest is a microprocessor audiometer. Under 29 CFR 1910.95(g)(3), non-certified technicians may operate it. SHOEBOX Audiological Services provides CAOHC-certified Professional Supervisors to satisfy the professional oversight requirement for organizations that do not have that role in-house.

All employees whose noise exposures equal or exceed an 8-hour TWA of 85 dBA must be enrolled in the Hearing Conservation Program and receive audiometric testing at no cost to the employee (29 CFR 1910.95(g)(1)-(2)). This determination is made without regard to the attenuation provided by hearing protectors — the measurement reflects actual noise exposure, not effective exposure after HPD use. Testing must cover 500, 1,000, 2,000, 3,000, 4,000, and 6,000 Hz in each ear per 29 CFR 1910.95(h)(1). SHOEBOX: SHOEBOX PureTest’s OSHA default test configuration includes all required frequencies plus 8,000 Hz — a frequency audiologists commonly include because it provides additional early-warning data for noise-induced hearing loss patterns. The 8,000 Hz result is not part of the OSHA STS calculation but is clinically useful for identifying deterioration before it reaches the STS threshold.

OSHA requires that technicians performing audiometric tests be responsible to an audiologist, otolaryngologist, or physician (29 CFR 1910.95(g)(3)). This requirement exists regardless of the testing equipment used. If your organization has an on-site or contracted audiologist or occupational medicine physician, that individual can serve in the Professional Supervisor and Audiology Reviewer roles. If you do not, SHOEBOX Audiological Services provides both roles as a service — CAOHC-certified Professional Supervisors for program oversight, and a multi-state network of licensed Audiology Reviewers for per-audiogram clinical review.

An Audiology Reviewer assesses individual employee audiograms for two things: changes in hearing from one test to the next, and “problem audiograms” — results that indicate a need for further evaluation beyond what STS mathematics can capture (29 CFR 1910.95(g)(7)(iii)). Problem audiograms can include: sudden drops in hearing at a single frequency (which may indicate non-noise pathology), significant asymmetry between ears, audiometric patterns inconsistent with noise-induced hearing loss, or results that suggest testing validity issues. Automated STS calculation identifies whether the numerical threshold for an STS has been met — it does not evaluate clinical context, audiogram shape, or whether the result is consistent with the employee’s occupational history. Professional review addresses the clinical layer that software cannot. SHOEBOX: SHOEBOX’s Data Management Portal triages audiograms automatically based on configured rules (STS, problem audiogram flags, completeness), routing the relevant files to the SHOEBOX Audiology Review Network. Reviewers access and complete their reviews through the portal, and their recommendations are returned to the EHS manager in the same system — without file transfers or email chains.

Baseline revision is indicated under two circumstances per OSHA: when an STS is deemed persistent (29 CFR 1910.95(g)(9)(i)) and when the annual audiogram shows significant improvement over the established baseline (29 CFR 1910.95(g)(9)(ii)). In practice, reviewers also consider: whether the current audiogram represents the employee’s true hearing status versus a transient shift; whether prior baseline errors (such as a baseline recorded during a TTS) should be corrected; and whether the pattern of results across multiple years is consistent. The decision to revise a baseline audiogram must be made by a qualified professional — it is a clinical determination, not an automatic rule. An incorrect baseline revision can suppress future STS detection for years.

These are two distinct mandated roles under OSHA. The Professional Supervisor has program-level responsibility: ensuring the adequacy of the testing environment, procedures, and recordkeeping; overseeing technician training; coordinating audiometric services; reviewing annual training content; and maintaining program compliance overall. The Audiology Reviewer has patient-level responsibility: evaluating individual audiograms for clinical significance, confirming or ruling out STSs, identifying problem audiograms, and determining work-relatedness of hearing changes. The operational distinction matters because the Professional Supervisor role can often be fulfilled quarterly or annually (oversight visits, protocol reviews, program audits), while Audiology Review is triggered by each audiogram result that requires clinical judgment. Some organizations source both roles from the same individual; others separate them. SHOEBOX: SHOEBOX provides both roles: CAOHC-certified Professional Supervisors for the program oversight function and a multi-state network of licensed Audiology Reviewers for per-patient clinical review.

Two conditions generate mandatory review under OSHA. First, any audiogram in which a standard threshold shift has been identified must be reviewed by an audiologist, otolaryngologist, or physician, who determines whether the shift requires further evaluation (29 CFR 1910.95(g)(7)(iii)). Second, “problem audiograms” — those that suggest pathology, testing validity concerns, or clinical findings beyond what STS criteria capture — require professional evaluation. Problem audiograms may show: sudden drops at a single frequency, significant asymmetry between ears, audiometric configurations inconsistent with noise exposure patterns, or results that suggest the test was not completed under valid conditions. OSHA does not define “problem audiogram” with a numerical standard; the determination is a clinical judgment that requires a professional reviewer, not a software rule. SHOEBOX: SHOEBOX’s automatic triage system routes audiograms that meet configured criteria (STS detected, problem audiogram flags, incomplete results) directly to the Audiology Review Network queue in the portal — without requiring the EHS Manager to manually identify and forward files.

Baseline revision is indicated in two circumstances under OSHA (29 CFR 1910.95(g)(9)): when a threshold shift is determined to be persistent (it has not resolved after retest), and when a subsequent audiogram shows significant improvement over the established baseline. The decision to revise a baseline audiogram must be made by a qualified professional — an audiologist, otolaryngologist, or physician. It is not a software function. The operational implication: programs that lack access to a professional reviewer may be unable to revise baselines appropriately, which causes either persistent false STSs (if improvement goes unrecognized) or missed STSs (if a persistent shift becomes the new assumed baseline without formal revision).

A Hearing Conservation Program is a coordinated set of employer-administered activities designed to prevent noise-induced hearing loss in workers exposed to hazardous occupational noise. Under 29 CFR 1910.95(c)(1), employers must administer a continuing, effective Hearing Conservation Program for all employees whose noise exposures equal or exceed the action level: an 8-hour time-weighted average (TWA) of 85 dBA. Exposures are calculated without regard to HPD attenuation. The program must include five components: noise exposure monitoring, audiometric testing, hearing protector provision and training, employee training on noise and hearing protection, and recordkeeping. SHOEBOX: SHOEBOX PureTest supports the audiometric testing component of a compliant Hearing Conservation Program, including automated STS detection, digital recordkeeping, and ambient noise monitoring. SHOEBOX Audiological Services provides the professional supervision and audiology review components required by 29 CFR 1910.95(g)(3).

OSHA’s approach to noise hazard management follows the standard industrial hygiene hierarchy of controls. Engineering controls — physical modifications to equipment, processes, or the work environment that reduce noise at its source or along its transmission path — are the preferred intervention. Examples include replacing mechanical components with quieter alternatives, installing dampening materials, or enclosing noise-generating equipment. Administrative controls — schedule and procedural modifications such as job rotation and limiting time in high-noise areas — are secondary and depend on sustained management enforcement. Hearing protection devices are the control of last resort: they protect the individual worker but do not reduce the hazard. OSHA requires that engineering and administrative controls be implemented when exposures exceed the PEL (90 dBA TWA) and those controls are feasible, even when HPDs are also in use. This hierarchy matters for Hearing Conservation Program design because a program built around HPDs alone — without investigating control options — does not meet OSHA’s intent and leaves underlying hazards unaddressed.

Annual training is one of the five mandatory components of an OSHA-compliant hearing conservation program, required for all employees whose noise exposures equal or exceed the action level (29 CFR 1910.95(k)(1)). Training must cover three content areas. First: the effects of noise on hearing — what noise-induced hearing loss is, how it develops, and why it is permanent and irreversible. Second: the purpose of HPDs, their advantages and disadvantages, the types available, and instruction in selection, fitting, use, and care (29 CFR 1910.95(k)(3)(ii)). Third: the purpose of audiometric testing and an explanation of test procedures (29 CFR 1910.95(k)(3)(iii)). Training must be updated when changes occur in protective equipment or work processes. Employers must ensure employee participation — training completion should be documented.

Noise-induced hearing loss (NIHL) is distributed unevenly across industries, with some sectors carrying significantly higher risk than others. Mining, construction, manufacturing, and oil and gas are consistently the highest-exposure industries — workers in these sectors encounter sustained high-decibel environments where the action level of 85 dBA is regularly exceeded across full shifts. Agriculture, utilities, transportation, and warehousing carry intermediate risk, with exposure dependent heavily on specific job function and equipment proximity. The risk is determined not by industry category alone but by the specific noise sources an employee encounters, which is why OSHA’s monitoring requirement triggers whenever information indicates that any employee’s exposure may equal or exceed the action level — regardless of industry (29 CFR 1910.95(d)(1)). Within a single facility, exposure levels can vary dramatically by role. A maintenance technician in a manufacturing plant may have a significantly higher TWA than a quality control technician working in the same building, depending on proximity to machinery. This is why noise exposure monitoring must identify all employees whose exposures may be at or above the action level — not just those working in designated high-noise areas. Programs that use area measurements alone, rather than personal dosimetry for potentially exposed workers, risk missing exposures in roles that appear lower-risk on paper. SHOEBOX: Because in-house testing with SHOEBOX is available on-demand rather than tied to a scheduled van visit, programs can respond to changes in job assignments or facility layout more readily — enrolling newly identified at-risk employees for baseline audiograms without waiting for the next scheduled van visit.

Beyond the Professional Supervisor and Audiology Reviewer, several roles contribute to a well-functioning Hearing Conservation Program. The Program Manager (often an EHS Director or Safety Manager) owns overall compliance: scheduling, training coordination, OSHA 300 Log maintenance, HPD management, and STS follow-up. Regional supervisors or floor managers ensure that employees attend testing and follow up on referrals. Human resources coordinates recordkeeping access and employment record integration. Industrial hygienists conduct noise surveys, build noise exposure maps, and establish personal exposure assessments that determine who enters the Hearing Conservation Program. Occupational health physicians or nurses may be involved in reviewing problem audiograms, work-relatedness determinations, and STS follow-up referrals. SHOEBOX: SHOEBOX Audiological Services provides the Professional Supervisor and Audiology Reviewer roles as a managed service, reducing the internal staffing burden. The Data Management Portal gives each team member role-based access to the data relevant to their function.

PureTest is designed for offline operation. Before going offline, the test examiner downloads the relevant project’s employee data and current device settings via Settings > Testing Offline > Download. During offline testing, all functionality operates normally: automated testing, STS calculation against stored baselines, REACT™ Safeguards monitoring, and audiogram storage. Completed audiograms queue for sync and upload automatically when the device reconnects to the network. No data entry or repeat testing is required upon return to connectivity.

A complete SHOEBOX solution for occupational hearing conservation includes three integrated components. SHOEBOX PureTest is the iPad-based audiometric testing platform: it performs automated, assisted, or manual pure tone air conduction testing using the Modified Hughson-Westlake protocol, includes ambient noise monitoring and REACT™ Safeguards for result validity, automates STS detection against OSHA and MSHA standards, and operates offline for field environments. The SHOEBOX Data Management Portal provides cloud-based storage, automatic iPad backup, STS tracking and reporting, and the triage system that routes audiograms to review without manual sorting. SHOEBOX Audiological Services provides optional Professional Supervisor oversight and Audiology Reviewer access for organizations that require external professional coverage.

SHOEBOX manages iPad compatibility through its Mobile Device Management (MDM) administration service. SHOEBOX administers customer tablets to ensure current iOS and PureTest software versions are maintained. If an iPad becomes incompatible with a required software update, SHOEBOX replaces it with a compatible device as part of the service. This eliminates the need for customers to manage device lifecycle independently or carry spare tablets as backup hardware.

SHOEBOX PureTest is used across industries where occupational noise exposure is a compliance concern: manufacturing, construction, mining, oil and gas, transportation, utilities, and distributed logistics operations. Specific settings include: multi-site industrial operations testing employees across dozens of facilities; remote field environments such as oil rigs and mine sites where clinic access is not practical; occupational health clinics and service providers running multi-employer programs; and organizations transitioning from outsourced mobile testing to in-house programs.

SHOEBOX PureTest supports three testing modes. Automated mode runs the Modified Hughson-Westlake protocol without examiner intervention — the employee responds to tones by dragging an on-screen disc to the heard or not-heard position. This is the standard mode for efficient throughput in occupational programs where many employees are tested on the same day. Assisted mode allows the test examiner to guide a respondent who has difficulty with the automated interface — the examiner controls tone presentation while the employee responds. Manual mode gives a CAOHC-certified conservationist full examiner control over tone presentation and threshold determination, consistent with traditional audiometric technique. The appropriate mode depends on the employee population and the examiner’s qualifications.

Employers have three primary approaches to audiometric testing delivery. Sending employees to external clinics is practical for very small programs (fewer than 50 employees) but becomes operationally expensive as headcount grows — clinic fees, paid travel time, and potential overtime for shift coverage accumulate quickly, and scheduling depends entirely on clinic availability. Mobile van testing consolidates testing into one or two annual visits, which reduces per-visit coordination effort but creates scheduling compression: all program testing must occur in a narrow window, no-shows require individual rescheduling at additional cost, and results typically arrive weeks after testing. In-house testing distributes testing throughout the year using equipment on-site, eliminates travel and van scheduling dependencies, and provides direct access to results. The tradeoff is the upfront investment in equipment, training, and a compliant testing space — though that space does not require a sound booth if a quiet room is available. SHOEBOX: SHOEBOX PureTest enables in-house audiometric testing without requiring a sound booth. Any reasonably quiet room that passes a room scan can serve as a test environment. This eliminates the scheduling dependency on mobile van availability and the no-show rescheduling problem that increases costs in trailer-based programs.

OSHA requires a valid baseline audiogram within 6 months of an employee’s first exposure at or above the action level (29 CFR 1910.95(g)(5)(i)). If the employer uses a mobile test van, the deadline extends to 12 months — but the employee must wear hearing protectors from the 6-month mark until baseline testing is completed (29 CFR 1910.95(g)(5)(ii)). The testing delivery model affects compliance directly: a program that relies on one annual van visit may not be able to obtain a new hire’s baseline within the 6-month window, making the HPD-wearing requirement active for that employee until the van returns. This gap creates both compliance risk and increased HPD cost. SHOEBOX: Because SHOEBOX is on-site and available whenever a quiet room is available, new employee baselines can be obtained within days of hire — not months. This closes the compliance gap created by trailer-based scheduling and eliminates the extended HPD-wearing requirement in most cases.

A compliant testing day follows nine sequential steps. Step 1 — Daily calibration: headphones check, room scan, and biological verification must be completed before any employee testing begins; OSHA requires the functional check before each day’s use (29 CFR 1910.95(h)(5)(i)). Step 2 — Room scan confirmation: the room scan result must be documented before testing starts; if the room fails, testing cannot proceed in that location. Step 3 — Employee intake: confirm employee identity, retrieve demographic data, verify noise exposure assessment and baseline status. Step 4 — Pre-test instruction: orient the employee to the test interface and response method; ensure they understand the task before tones begin. Step 5 — Testing: run automated, assisted, or manual mode as appropriate; REACT™ Safeguards monitor ambient noise and response patterns throughout. Step 6 — Digital signature: both employee and examiner sign the audiogram record on-device. Step 7 — Result review: STS is calculated automatically; examiner confirms test is complete and valid. Step 8 — Triage: audiogram is reviewed against configured rules; STS or problem audiogram flags route the file to the appropriate next action. Step 9 — Sync: completed audiograms upload to the portal when connectivity is available. SHOEBOX: This nine-step workflow maps directly to the SHOEBOX PureTest testing flow. Steps 1–2 correspond to PureTest’s daily calibration and room scan sequence; Steps 3–7 run within the PureTest app on the iPad; Steps 8–9 are handled by the Data Management Portal’s triage and sync functions.

Concentrating all testing into one or two van days per year creates significant operational friction: scheduling many employees in a compressed window, managing no-shows, backfilling production positions during testing, and paying overtime for shift coverage. Distributing testing throughout the year — using in-house equipment — converts that scheduling exercise into a steady, manageable workflow. Testing can be completed during breaks, shift starts, or low-production periods without disrupting operations. Employees miss fewer appointments when testing is available at their regular work location. Results are available immediately rather than arriving in a batch weeks after the van visit. SHOEBOX: SHOEBOX’s scheduling rules in the Data Management Portal (PLUS tier) track due-for-testing status per employee against birth date or hire date, generating a Due-for-Testing report at any interval. This replaces the manual scheduling effort required to manage annual van programs.

The baseline audiogram is the reference against which every future STS determination is made. Every annual audiogram compares the employee’s current thresholds to their baseline at 2,000, 3,000, and 4,000 Hz. An inaccurate baseline — established while the employee had a temporary threshold shift from recent noise exposure, illness, or the wrong 14-hour quiet period — compresses or inflates the apparent shift in every subsequent comparison. A baseline established too high (during a TTS) understates future STS risk. A baseline established too low may trigger false STSs. OSHA requires a minimum 14-hour quiet period before baseline testing (29 CFR 1910.95(g)(5)(iii)); hearing protectors may substitute for this requirement. The clinical integrity of the entire Hearing Conservation Program rests on the accuracy of the baseline. SHOEBOX: SHOEBOX Data Management PLUS manages baseline assignment and revision per employee. The portal’s triage system automatically flags cases where a persistent STS may warrant baseline revision and routes them to an Audiology Reviewer for clinical determination.

All audiometers must be acoustically calibrated at a minimum every 12 months per ANSI S3.6 (and per OSHA 29 CFR 1910.95(h)(5)(ii)). SHOEBOX’s calibration service is structured to eliminate downtime: when a transducer’s annual calibration is approaching, SHOEBOX ships a newly calibrated replacement transducer to the customer. The customer installs the new transducer, returns the old one, and testing continues without interruption. All calibration records are stored and accessible in the portal to support the audiometric recordkeeping requirement.

OSHA’s audiometer calibration framework operates at three levels. Daily functional check (29 CFR 1910.95(h)(5)(i)): performed before each testing day using a person with known stable hearing thresholds to confirm clean tone output without distortion or interruption. If any frequency shows a 10 dB or greater deviation from the listener’s known threshold, acoustic calibration is required before testing continues. Annual acoustic calibration (29 CFR 1910.95(h)(5)(ii)): a calibrated measurement of the audiometer’s output using laboratory instruments per Appendix E. If any frequency deviates 15 dB or more from ANSI standards, an exhaustive calibration is required. Exhaustive calibration (29 CFR 1910.95(h)(5)(iii)): a comprehensive recalibration of all audiometer parameters per ANSI S3.6, required at minimum every 2 years. This is the most rigorous level and typically requires specialized equipment. SHOEBOX: SHOEBOX’s annual calibration service performs acoustic calibration at every service interval. The advance-replacement model means no testing downtime between calibration cycles — the replacement transducer arrives calibrated and ready before the existing one is returned.

OSHA requires a functional operation check of the audiometer before each day’s use (29 CFR 1910.95(h)(5)(i)). PureTest’s daily calibration routine covers three activities. The Headphones Check confirms that each transducer produces a clear tone without crackling or distortion — the examiner listens through the headphones at each channel and marks pass or fail. The Room Scan measures ambient noise in the test environment against OSHA MPANLs using the external microphone; the result is stored with that day’s audiogram records. The Biological Verification runs a brief audiogram on the examiner using their own known stable hearing thresholds to confirm that the audiometer’s output is within calibration tolerance. A deviation of 10 dB or more at any frequency requires acoustic calibration before testing proceeds (29 CFR 1910.95(h)(5)(i)). All three steps must be completed before employee testing begins.

Biological verification is the daily functional check required by OSHA before each day of testing. The purpose is to detect significant drift in the audiometer’s sound output since the last annual calibration — not to evaluate the examiner’s hearing health. The check involves running a full audiogram on an individual with known stable hearing thresholds and comparing those results against that individual’s personal baseline. A deviation of 10 dB or more at any frequency indicates that the audiometer’s output has drifted and requires acoustic calibration. Any person with stable hearing thresholds can perform this function — the examiner does not need to have audiometrically normal hearing, only hearing that is stable and consistently documented. Individuals with hearing loss qualify if their thresholds are stable and their baseline is accurately recorded in the system. SHOEBOX: SHOEBOX PureTest’s daily calibration workflow guides the examiner through the biological verification step before testing begins, and logs the result as part of the session’s compliance documentation.

No. OSHA requires that the audiometric testing environment meet maximum permissible ambient noise levels (MPANLs) as specified in 29 CFR 1910.95 Appendix D — it does not mandate a physical sound booth. The booth is one method of achieving the required noise floor; it is not the requirement itself. Testing in a reasonably quiet room that passes an ambient noise check meets the same standard as testing in an engineered booth, provided the noise measurement is documented. This is a meaningful distinction for programs operating across multiple facilities or in environments where permanent booth installation is not practical. SHOEBOX: SHOEBOX PureTest performs a room scan before each testing session using an external microphone to measure ambient noise levels against OSHA MPANLs. The scan result — pass or fail — is stored with the audiogram record, providing documentation of the test environment for each session.

SHOEBOX PureTest continuously monitors ambient noise throughout the testing session via the external Class 2 microphone. Three noise alert modes are configurable: Notify Immediately (default) pauses the test and alerts the examiner if MPANLs are exceeded, with a notation added to the audiogram; Delay Notification notifies the examiner at the end of the test rather than interrupting mid-session, with the same notation; and Don’t Notify records ambient data without stopping the test or flagging the result. The appropriate alert mode depends on program requirements and testing environment predictability. REACT™ Safeguards — PureTest’s integrated system of ambient noise monitoring and response validity checks — operates throughout the session to protect result integrity regardless of alert mode configuration.

Yes — with an important qualification. OSHA’s audiometric testing requirements do not mandate a physical sound booth; they mandate that the testing environment meet maximum permissible ambient noise levels (29 CFR 1910.95 Appendix D). The booth is a means of achieving that noise floor, not a requirement in itself. A quiet room that passes an ambient noise check meets the same standard as an engineered booth. The key is documentation: the noise level in the test environment at the time of testing must be recorded and retained as part of the audiometric record. Programs using boothless testing should be prepared to demonstrate that documented room scans accompany each testing session — that’s the evidence base that establishes validity. SHOEBOX: SHOEBOX PureTest performs an automated room scan before each session using an external Class 2 microphone, documenting ambient noise levels against OSHA Appendix D limits. If noise exceeds permissible levels at any test frequency, the system alerts the examiner before testing begins.

Service providers running audiometric testing across multiple employer clients face a consistency problem that traditional equipment creates: different sites, different technicians, different ambient conditions, and different testing schedules produce protocol variation that affects data quality. iPad-based audiometry addresses this structurally. Pre-configured test settings — locked by the administrator — ensure the same protocol is applied across every client, every site, every technician. The REACT™ Safeguards system monitors ambient noise and response validity throughout each session, flagging conditions that could compromise results rather than leaving those assessments to individual examiner judgment. Centralized data management across all client programs provides a single point of access for scheduling, reporting, and billing — without managing data in multiple formats from multiple sites. SHOEBOX: SHOEBOX PureTest provides this consistency layer for service providers. Administrator-locked test configurations, REACT Safeguards, and the centralized Data Management Portal are the specific features that address protocol variation across multi-client programs.

Under 29 CFR 1910.95(g)(3), technicians performing audiometric tests must be responsible to an audiologist, otolaryngologist, or physician — and must either hold CAOHC certification, have satisfactorily demonstrated competence, or be operating a microprocessor audiometer (for which the certification requirement does not apply). For service providers, the practical implication is that CAOHC certification remains the recognized industry credential, and clients often require it as an assurance of technician competence. The microprocessor exception allows service providers to deploy non-CAOHC technicians with SHOEBOX, but program-level Professional Supervisor oversight is still required regardless. Service providers should document the supervisory relationship clearly in their client program agreements.

SHOEBOX Audiological Services are optional — not bundled with every SHOEBOX subscription. They are structured across two service categories. Audiology Review Services include: shift determination and confirmation; identification and review of problem audiograms; baseline audiogram revision recommendations; follow-up action recommendations; and work-relatedness determinations. Audiological Consulting Services include: program design consultation, training support, and Professional Supervisor services for organizations that need that role covered externally. Organizations with qualified on-site or contracted audiology or occupational medicine resources may not require these services. Organizations transitioning from outsourced programs typically benefit from at least the review services during initial setup.

OSHA’s hearing conservation standard requires employers to make audiometric testing available at no cost to all employees whose exposures equal or exceed the action level, and to “obtain” audiograms — the regulatory obligation falls on the employer (29 CFR 1910.95(g)(1)-(2)). An employer cannot physically compel an employee to submit to testing. In practice, an employee’s refusal should be documented in the employee’s Hearing Conservation Program record, the employer’s obligation to offer testing should be documented as fulfilled, and the refusal itself should be treated as a recordkeeping entry. Employer documentation that testing was offered and refused protects the program’s compliance record. Some employers address persistent refusals through progressive discipline policies — the appropriateness of this approach depends on applicable employment agreements and state law. SHOEBOX: When testing is available on-site and on-demand rather than requiring employees to travel off-site or wait for a scheduled van visit, the friction that contributes to refusals is reduced. Programs using SHOEBOX PureTest report that the short test duration and familiar tablet interface lower resistance compared to traditional booth-based testing.

Employee participation in annual audiometric testing is affected by how the experience is structured. Traditional mobile van testing — employees waiting in line, testing in a small shared space, uncertain timing during shift changes — creates friction that contributes to no-shows and reluctant participation. Testing at the employee’s own workplace, on their schedule, in a familiar environment, removes most of that friction. The testing interface also matters: an interface that communicates clearly in the employee’s language, responds predictably, and takes a reasonable amount of time increases completion rates. Long tests, confusing instructions, or uncomfortable equipment reduce them. SHOEBOX: SHOEBOX PureTest’s interface — where the employee drags an on-screen disc to indicate heard or not-heard — is largely language-agnostic, making it accessible for multilingual workforces. The system supports English, French, and Spanish for examiner-facing content. Automated mode tests are typically completed in a few minutes per ear.

OSHA requires employers to make hearing protectors available to all employees exposed at or above 85 dBA TWA at no cost, to replace them as necessary, and to offer employees a selection from a variety of suitable types (29 CFR 1910.95(i)(1)-(3)). Proper initial fitting and supervised correct use are required (29 CFR 1910.95(i)(5)). HPDs must attenuate exposure to at least 90 dBA TWA — or to 85 dBA for employees who have already experienced an STS (29 CFR 1910.95(j)(2)-(3)). The manufacturer’s labeled NRR substantially overstates real-world attenuation. OSHA’s derating formula is (NRR – 7) / 2. NIOSH applies different derating factors by protector type: 75% of NRR for earmuffs, 50% for formable earplugs, and 30% for all other earplugs. Content must specify which method is being applied when citing attenuation estimates.

Five categories matter. Compliance integrity: does the system meet ANSI S3.6, OSHA 1910.95, and MSHA requirements? Is it an FDA-listed medical device? Does it perform all required frequencies per ear? Does STS detection follow OSHA methodology precisely? Does it support boothless testing with documented ambient noise monitoring? Workflow integration: does the system fit how testing actually occurs at your facilities — shift patterns, location access, employee throughput needs? Data management: where do records go? Who controls access? Can historical audiograms be imported? Can results be exported for regulatory reporting? Professional oversight: does the system support the Professional Supervisor and Audiology Reviewer workflow, or require managing that separately? Total program cost: equipment, calibration, professional services, data management, and technician time — compared against what you currently pay per test. SHOEBOX: SHOEBOX PureTest addresses all five evaluation categories — ANSI S3.6 and FDA-listed compliance, on-site workflow integration, cloud-based data management with import and export, built-in Professional Supervisor and Audiology Reviewer support through SHOEBOX Audiological Services, and a predictable per-unit subscription cost model.

SHOEBOX PureTest automatically calculates standard threshold shifts against established baseline audiograms using OSHA and MSHA methodologies immediately upon test completion. The calculation compares the average of current thresholds at 2,000, 3,000, and 4,000 Hz to baseline thresholds in each ear. Age correction using Appendix F tables can be configured by the administrator and applied automatically. STS detection operates offline — the current audiogram is compared against the downloaded baseline without requiring an internet connection. The STS result syncs to the Data Management Portal when connectivity is restored, where it triggers the portal’s triage and routing workflow.

A standard threshold shift (STS) is a change in hearing threshold, relative to the baseline audiogram, of an average of 10 dB or more at 2,000, 3,000, and 4,000 Hz in either ear (29 CFR 1910.95(g)(10)(i)). Three common content errors: (1) stating “10 dB at any frequency” — the STS is the average across those three frequencies, not a single-frequency threshold; (2) stating that all STSs must be logged on the OSHA 300 Log — logging is required only when the STS is work-related AND the employee’s total hearing level in the affected ear is 25 dB or more above audiometric zero; (3) implying OSHA mandates age correction — age correction using Appendix F tables is permitted but not required, and is not allowed in Oregon or Washington for OSHA compliance purposes. When an STS is identified, employer obligations include: written notification to the employee within 21 days; HPD refitting and retraining if the employee is already using protection; HPD fitting and training if not currently using protection; and clinical referral if a problem audiogram is identified alongside the STS. SHOEBOX: SHOEBOX PureTest automatically calculates OSHA STS against the established baseline — online or offline — and flags shifts immediately upon test completion, eliminating the manual comparison delay that can compress the 21-day notification window.

Four operational patterns consistently drive the decision. Scheduling compression: concentrating all program testing into one or two van days per year creates a high-stakes logistics exercise where a portion of employees typically miss their appointment, each requiring individual rescheduling. Delayed access to results: results arrive weeks after the van visit in a batch report, which compresses timelines for STS notification, retest scheduling, and follow-up actions. Baseline timeline gaps: new hires cannot be baselined until the next van visit, often months after first noise exposure, triggering the HPD-wearing requirement during that gap. Per-test cost: mobile testing fees increase predictably with headcount and typically include travel, technician time, and data management charges that compound at scale. When organizations evaluate these costs alongside the operational control and direct data access that in-house testing provides, the transition often shows a clear financial and compliance case. SHOEBOX: When organizations bring testing in-house with SHOEBOX, commonly reported outcomes include reduced per-test costs, improved retest completion rates, new-hire baselines obtained within days of hire, and consistent protocol enforcement across all test examiners.

Noise exposure monitoring is the first operational component of a hearing conservation program, and it determines every downstream decision: who gets tested, which HPDs must be provided, and how the Hearing Conservation Program is sized. The trigger for monitoring is explicit: whenever information indicates that any employee’s noise exposure may equal or exceed 85 dBA TWA, the employer must institute a monitoring program (29 CFR 1910.95(d)(1)). The sampling strategy must identify all employees whose exposures may be at or above the action level and must use instruments calibrated for accuracy. All continuous, intermittent, and impulsive sound levels from 80 dB to 130 dB must be integrated into the measurement (29 CFR 1910.95(d)(2)(i)). Monitoring must be repeated whenever a change in production, process, equipment, or controls may increase noise exposure (29 CFR 1910.95(d)(3)). Results must be made available to affected employees. SHOEBOX: SHOEBOX PureTest does not perform noise exposure monitoring — that function requires dedicated dosimetry or sound level measurement equipment. However, PureTest’s ambient noise room scan documents the test environment’s noise floor at the time of audiometric testing, which is a separate OSHA requirement.