Audiometry

Or 'hearing tests' as normal people call it.

One of the outcomes of a noise assessment may well be a need to provide your minions with a hearing test and despite it being kind of a tail-end-Charlie bit of the Noise Regs it is a whole other complex area. Again, like noise assessments I do not provide audiometry services but have spent many many years doing so, (indeed more years than I care to think about) meaning I can hopefully provide some tips and pointers on what to do and what to look for in a consultant.

'Health surveillance' - this doesn't sound like some overbearing 1984 Orwellian surveillance nightmare at all does it? Perhaps not the best choice of wording by the Safety Gods who decide these things. Health surveillance is basically 'hearing tests', or 'audiometry' and Regulation 9 of the Noise Regs says that you needs to have a programme of health surveillance for anyone who remains at risk of noise while at work. IE anyone who is still exposed to over 85dB(A) or 137dB(C), ignoring the reductions offered by the hearing protection

Why do audiometry?

Shhh, say it quietly, but the human ear is not all that brilliant and is particularly rubbish at detecting small reductions in hearing ability over time. Health surveillance is therefore the back-stop to all the other controls and provides a means of identifying any ongoing reductions in hearing ability, usually long before the person themselves become aware of it. It acts as a double-check that the reductions measures in place are working and allows changes to be made if people are showing signs of still being at risk.

It also allows people for whom noise is more of a risk than other to be identified who can then maybe have additional protective measures. For example, a small drop of hearing in a woman in her 20s would probably mean she still has excellent bat-like hearing, while a small drop in hearing ability of someone who already has problems could be the difference between being able to hear normal conversation or not. Clearly that second person is more at risk than the former as the impact on them is much greater and the health surveillance can help identify them. Don't forget, it is true in health and safety in general that you DO NOT assume everyone is the same and treat them equally, some people may be more at risk in some situations than others and you need to account for this at work, and this applies just the same to noise risks.

What is Audiometry?

It's basically a three part process:

  1. Reviewing a health questionnaire with the individual concerned. This looks at their health with respect to hearing to look for any factors which may have an impact on their hearing ability and how at-risk they may be.
  2. A peek down their ears with an otoscope - the little pointy torch thing. This is to visually check the outer ear is OK, how blocked the ear canal is and importantly, how healthy the ear drum looks.
  3. Then the 'hear noise press button' part where there is a series of beeps or noises and the attendee indicates when they can hear them.
Audiogram - good result

At the end, the result is classified according to criteria set out by the HSE and the result should be discussed with the attendee.

And that's your lot. The audiometry can be carried out in a mobile clinic which has one of those mini TARDIS-like booth things in it, or in an on-site medical room with a booth, or even just at a desk if the room itself is very quiet. Some companies choose to do it in-house, either via an occupational health nurse or by getting an in-house employee trained, or they choose to use an external service provider who comes and does it for them.

In-house or external?

Booth

This is a choice to be made by each business as it sees fit. For smaller businesses, using an external provider can be most efficient as they don't need to invest in the equipment and training to get someone qualified to do it in-house. For larger businesses they may have an in-house occupational health department but also choose to use an external provider due to the large numbers of people involved. For example, in my time providing audiometry we had clients who had couple of thousand employees. For us, we could churn through them all in four to six weeks depending on shifts, while to do them in-house would have taken a couple of members of their occupational health department pretty much all year. They chose to use an external provider to churn through the large number of people which identified the hundred or so individuals who were most at risk and the occupational health department could then concentrate their efforts most effectively on those people. 

Some audiometer-selling retailers encourage companies to do it themselves but then they would, it means more companies buying audiometers and more sales for them. And more training courses sold. You can send an employee on a basic course and have them press the buttons on the audiometer software to get a result but I would argue that although cheap, this is very very poor value of money and actually a poor service for the employees receiving the tests. Someone with more experience will be able to look more thoughtfully and meaningfully at the results and provide more suitable advice to both the employees and employer. It probably costs a little more but is far better value and come a claim for noise induced hearing loss, which is better? Either having someone in-house who doesn't fully understand the subject but can get-by, or being able to rely on results which were generated by professionals who know the subject, can explain the results and importantly can also stand by their results? My advice, unless you have an Occy Health person in-house, get someone in.