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.
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.
