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Occupational Hearing Testing Best Practices: Tips and Tricks for Test Examiners

Hearing Conservation

Boothless audiometric testing continues to find a place in many workplace hearing conservation programs. We’ve collected a list of some of the most common tips and tricks for examiners using SHOEBOX to test their employees.

Best Practices for Audiometric Testing with SHOEBOX Puretest

  • When performing a hearing test with your Puretest Audiometer, it is important to use the iPad stand. Do not lay the device flat on the table or hold it in your hands. This is a common mistake test examiners make, and it causes noise monitoring interference. (Check out this video on using the iPad stand effectively here.)
  • Make sure that the iPad’s case doesn’t cover the microphone holes.
  • Keep your SHOEBOX unit together as a kit. The headphones can’t be swapped with another without uploading the appropriate calibration files.
    When doing a headphone check, be sure to move the cords around. This is an excellent way to find out if the headphones are correctly connected to the iPad or if there is any breakage in the wiring. (For more information on checking your transducers click here.)
  • When testing, we recommend that you perform biological verification in Assisted Mode. We’ve heard that some of our customers think they are testing their hearing when doing their biological verification, and therefore they attempt to get a good score. These tests are performed as a comparative measure to ensure your audiometer is operating without mechanical errors or defects. (For more information on biological verification, click here.)
  • Testing with SHOEBOX is a very different experience than the usual test in a soundproof hearing booth. With SHOEBOX, you drive the speed of the test instead of waiting to hear a tone like you would in a booth.
  • It’s important to pay attention to the response wizard’s suggestions for retesting frequencies. If you press the ‘Accept Threshold’ button when there’s excessive noise or an inconsistent response warning, this may result in having an incomplete test. Instead, you should push the blue ‘Retest Frequency’ button. If these issues happen more than a couple of times, you should switch to Assisted Mode. Ensuring that you are retesting those thresholds properly will prevent invalid results and avoid wasted time retesting the employee. (Click here for more information on addressing notifications during your SHOEBOX tests.)
  • We recommend that your employees tap the blue button multiple times while being tested. If someone has hearing loss or suffers from a condition like tinnitus, they may find it difficult to hear the tone if they press and hold down the button. This is especially important to communicate if someone appears to be struggling during the test.
  • If individuals being tested have significant hearing loss, feel uncomfortable using an iPad, or do not understand how to get through the test on their own, we recommend taking over with Assisted Mode. This will help you get through the hearing assessment faster; it’s easier on the person you’re testing, making the experience better for everyone.
  • When conducting a hearing assessment using Assisted Mode, ensure the person is facing away from the tester and blinded to both the tester and the iPad. (For more information on testing in Assisted Mode, click here, or view a video)
  • It’s a good idea to let the person know that up to 50 percent of the time, they will not hear a sound and that this is a normal part of an audiometric test.
  • Once the test is complete, you should review your results, looking for seven ‘ Xs and seven ‘Os. When using PureTest, look for any red exclamation marks at the end of the test; these are indicators that there were issues with the test and it is incomplete. You’ll want to test the person again while they are still with you rather than having them return after an audiological review. Instead, you’ll want to see the green checkmarks. (For more information on the interpretation of your SHOEBOX results, click here.)
  • Completing any needed retests is critical to maintaining a compliant program and decreasing the number of standard threshold shifts (STS) you will encounter.
  • Certain people shouldn’t be tested with SHOEBOX, including people with draining ears, ear implants, with profound hearing loss, or people who don’t have an outer ear canal. These people should instead visit a hearing clinic.
  • It’s perfectly fine to test the hearing of a person who wears hearing aids. They would take off their hearing aids before they proceed with the test.

SHOEBOX Testing Environment and Room Selection

Room selection is another crucial element of workplace hearing testing. A testing room should be selected several days before the scheduled go-live date for testing. Recommendations may require planning and research and often require other departments’ involvement.

You will want to find a room with a solid table with at least two chairs. It’s vital that the room is private and quiet and should be located in an area with a low possibility of interruption during testing. In order to adhere to OSHA guidelines, the room must be quieter than 40dB at the lower frequencies (500Hz and 1000Hz). Remember, the sound produced by air vents and white noise can cause a room to be too noisy to test in.

(For more information on how to find an OSHA Compliant testing room, click here.)

Once an adequate room is selected, you will need to run a room scan using your SHOEBOX App and external microphone to ensure the room is appropriate for testing. If the roomscan fails, consider some of the common causes of ambient room noise:
500Hz – 1000Hz: Check for white noise or issues related to ventilation system noise
2000Hz and above: Check for external noise, such as people talking outside the room or noisy equipment.

(For more information on how to perform a room scan with SHOEBOX, click here.)

Noisy Room Troubleshooting

White Noise or Ventilation System

  • Put the iPad on a table and ensure that it is at least a couple of feet away from the air vents. Try scanning again in a different part of the room.
  • Ensure that the iPad is not beside a refrigerator, freezer, or printer. Turn off any devices that are making a humming sound.
  • Fluorescent lights can sometimes give off a slight humming sound. If this happens, you may need to turn off the light or find a different room for testing.

External Room Noise

  • Commonly, machines running outside of the testing room can cause a room scan to fail. If this happens, you will need to scan when the offending device is turned off or find a different room.
  • Loud talking outside of the test room is another common reason for a failed room scan. Place a sign outside the room asking for quiet or find a new room if the noise continues. Placing a “Quiet – Hearing Testing in Process” sign on the test room door can be helpful here.

(Click here to read our full Testing Environment and Room Selection guide.)

Suggestions for Solving Noisy Rooms

  • Ventilation System – Recommend Discussing with the Site HVAC Technician
  • Check to see if a damper has been installed in the room’s supply duct and if so, check it down to reduce the airflow and, therefore, any noise. If there is no damper installed, consider installing one for use during testing.
  • Confirm the diffuser (HVAC vent) design CRM (cubic feet per minute) and ensure that it has correct airflow. Extreme noise can happen when more air is coming through the diffuser than it is designed to handle.
  • Check to see if the fan noise can be insulated at the air handler.
  • Try using air duct silencers or mufflers; they can reduce air noise coming through the HVAC ductwork and air ventilation systems without any restrictions.
  • When all else fails, consider turning off any offending ventilation for the duration of the testing.
  • Various external room panels available for purchase can also help limit external noise.

(For more information on room selection for SHOEBOX testing, click here.)


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