The primary goal of any hearing loss prevention program must be to reduce, and
eventually to eliminate, hearing loss due to workplace exposures. While management may
have the best intentions of implementing this goal and a company's hearing loss prevention
program may have the appearance of being complete and complying with OSHA's requirements,
the program may not achieve this goal. A thorough evaluation of the effectiveness of all
of the program's components is necessary to determine the extent to which the hearing loss
prevention program is really working.
Management and program implementors should conduct periodic program evaluations to
assess compliance with federal and state regulations and to make sure hearing is being
conserved. There are two basic approaches to follow in program evaluation: (1) assess the
completeness and quality of the program's components, and (2) evaluate the audiometric
data. The first approach can be implemented using checklists, such as those found in
Appendices A and B. Appendix A can be used to assess compliance with each provision of
OSHA's noise standard, and Appendix B is useful for identifying gaps in the program which
could limit the program's effectiveness. Checklists such as these can serve as important
tools in the evaluation process.
The second approach is to evaluate the results of audiometric tests, both for
individuals and for groups of exposed employees. Each individual's current test should be
compared to the baseline test to see if an OSHA standard threshold shift or NIOSH
significant threshold shift(3) has occurred.
Previous audiograms for that individual should be inspected also and compared to each
other and to the current test results to identify hearing loss progressions that may not
have reached the severity of the OSHA standard threshold shift.
Audiometric data for groups of noise-exposed employees should also be evaluated using
criteria other than the OSHA standard threshold shift. This usually involves statistical
procedures to assess variability in population hearing levels, and usually requires
computerized audiometric data. A well protected exposed population will show the same
hearing levels as a non-exposed population, when matched for age and other factors.
Different manifestations of variability can provide information on the extent to which
workers are losing their hearing, and can assist in pointing out the trouble spots in the
hearing loss prevention program. For further information on audiometric database analysis,
readers should consult the suggested readings at the end of this section.
In addition, a working group of the American National Standards Institute has drafted
guidelines for analyzing audiometric data to evaluate hearing loss prevention program
effectiveness-ANSI S12.13, Draft Standard for Evaluating the Effectiveness of Hearing
Conservation Programs. The procedures of this standard are most useful in determining
that the audiometric data are consistent and lack much variability; that the database has
integrity. If year-to-year audiograms show changes that are due to poor audiometry and not
to changes in hearing, it will be impossible to use the audiometric data to determine
whether or not the hearing loss prevention program is successful.
The reader is also referred to the chapter on Emerging Trends and Technologies for a
discussion of the use of attitude surveys to assess the effectiveness of hearing loss
prevention intervention strategies.
Management needs to dedicate sufficient resources for a comprehensive program
evaluation to the program implementor responsible for the hearing loss prevention program.
Management should see that this individual is adequately trained to conduct hearing loss
prevention programs and to analyze data. Management must ensure that periodic evaluations
of the program actually take place.
Managers need to be committed to act on the outcome of the program evaluation. They
must be willing to acknowledge and solve the problems which may require the dedication of
both financial resources and personnel. They must also be willing to institute and carry
out disciplinary measures for noncompliance. Another important responsibility of
management is to be attentive to the comments and reactions of exposed employees and to
make use of their feedback during the program evaluation.
Program Implementor Responsibilities
Program implementors must be willing to commit the time and resources needed to conduct
a thorough evaluation. They need to be able to perform the mechanics of audiometric
database analysis, or they must be willing to engage the assistance of an outside
contractor or consultant. They should look for early threshold shifts, such as the
NIOSH significant threshold shift, and not wait until the shift becomes as severe as an
OSHA standard threshold shift.
Those who perform the program evaluation must be willing to ask questions, seek out
elusive information, and interact with all members of the hearing loss prevention program
team. For example, they may need to call for audiometric retests, make sure that
recommendations for treatment or evaluation have been followed, and to assure that
necessary changes in hearing protection have been implemented. They must communicate their
findings to management and to the affected employees.
As with many other components of the hearing loss prevention program, the primary
responsibility of employees is to provide feedback to the program implementor and to
management. For effective program evaluation to take place employees need to communicate
their hearing loss prevention problems, and explain why they are unwilling or unable to
wear their hearing protectors. They need to make their needs known to higher management if
they are unable to obtain replacement hearing protectors. Employees should notify the
technician or audiologist if they have a problem understanding the instructions for taking
the audiometric test, and they should report any medical problem that affects their
hearing. Finally, they need to draw attention to changes in the noise levels produced by
their equipment, or any malfunctioning noise control devices. Evaluation of the program,
just like the conduct of the program, requires a team effort.
ANSI  Draft Standard for the Evaluation of Hearing Conservation Program
Effectiveness. New York, NY American National Standards Institute. ANSI S12.13
Melnick W . Evaluation of industrial hearing conservation programs: A review and
analysis. American Industrial Hygiene Assoc. Journal, 45:459B467
Royster LH, Royster JD  Getting started in audiometric database analysis.
Seminars in Hearing 9: 325B337..
Royster JD, Royster LH . Audiometric database analysis. In: Berger EH, Ward WD,
Morrill JC, Royster LH, eds.  Noise and Hearing Conservation Manual. 4th
ed. Akron, OH: American Industrial Hygiene Assoc., Chapter 9.
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