Mandatory components of audiometric testing
For the non-specialist, audiometric testing for screening at work can seem like a confusing minefield of jargon and nonsense. This is a simple breakdown, covering what is the mandatory minimum, and what extras we include as standard in our testing.
When we say an audiometric test is ‘compliant’, what do we mean?
This means that the audiometric test has to meet the requirements of two standards:
BS EN ISO 8253-1:2010 - British Standard for Pure Tone Audiometry
The standards set out by the HSE in L108 - Controlling Noise at Work
If testing does not meet both of these then problems are likely to arise in the future, both from an enforcement stance but also from an insurance perspective if trying to defend a claim.
It is important that any audiometric testing at work meets at least all the mandatory elements as a minimum. Skipping one, e.g. no otoscopic examination or no on-site daily verification test of the equipment means all test results are immediately suspect.
|Component of an audiometric test||Mandatory for compliant testing||Included in our testing|
|Provide schedule of appointments for the testing||✔︎|
|Person administering the tests must have undergone some relevant training and be qualified||✔︎||✔︎|
|Audiometer and headset must be within annual calibration||✔︎||✔︎|
|Measure the noise levels in the testing area (booth) to prove it was suitable - for a visiting service, this means measure and record it for every job.||✔︎||✔︎|
|Verification check of audiometer to identify faults or interference - by a technician who knows what to listen for and who can identify faults, must be done in-situ before testing||✔︎||✔︎|
|Pre-test health history questionnaire completed and reviewed by trained technician||✔︎||✔︎|
|Otoscopic visual examination of ears to check their physical health and suitability for testing||✔︎||✔︎|
|Attendees remove hats, glasses, hearing aids, etc.||✔︎||✔︎|
|Technician puts headphones on (attendees must not put the headphones on themselves - the testing standards are very specific on this)||✔︎||✔︎|
|Trial at 1kHz to confirm the attendee understands the instructions and responds properly||✔︎||✔︎|
|Test the 1, 2, 3, 4 and 6 kHz frequencies||✔︎||✔︎|
|Test the 500hz and 8kHz bracketing frequencies for superior data and diagnosis||✔︎|
|Technician monitors external noise and will pause, stop or restart the audiometric test as needed.||✔︎||✔︎|
|Technician will not just accept the computer's result but will retest frequencies which look out of place or which are inconsistent||✔︎|
|Technician looks at how they achieved the result (were they sure or hesitant, etc) as well as the result itself when considering the outcome||✔︎|
|Test includes comparison to older results to check for unusual rates of deterioration.||✔︎||✔︎|
|Technician liaises with client to keep them up to date on no-shows, etc as the session goes on - makes sure the client doesn't only discover no-shows until it is too late||✔︎|
|Results must include age and gender of attendees||✔︎||✔︎|
|Results categorised in accordance with HSE's specification in L108||✔︎||✔︎|
|Referrals made as needed to attendee's GP / specialist||✔︎||✔︎|
|Full report provided to the client including ALL results||✔︎|
|Technician recommends which results employer should monitor as a potential work impact and which can be left to the attendee as the referral is primarily for their own health||✔︎|
|Notify client when future audiometric tests are coming due to minimise the ongoing management||✔︎|
What information do you need to defend claims?
When a company looks to defend a claim for noise induced hearing loss, there are some specific elements of the audiometric test which are needed for the insurance company, and therefore courts, to treat the tests as reliable and valid.
Make sure the noise levels in the testing environment are known and recorded. You have to know this, and be able to prove it, to know that all the subsequent audiometric tests were valid.
Ensure the audiometer is not just within calibration, but was tested by the Technician on the day, in-situ, and this is recorded. This means checking every frequency, before each day of testing, in the location where the attendees will have their examination.
Ensure the testing included a visual inspection of the ear - the use of an otoscope to look down it. If that is not done then the whole result is frankly useless as there is no idea of how healthy or clear the ear was.