Module 5: Legislation: Hearing Loss and Compensation Lecture - Fine Tuning Our Practical Approach To The New Hearing Conservation Legislation (Continued)

BASELINE:

Establishment of a proper baseline is critical. The procedure for establishing the baseline is:

• Required by 16 November 2003 or within 30 days of employment.
• Subject must be for 16 hours in a noise free environment - no PPE (and no taxi noise!!) prior to testing.
• The better of 2 screening audiograms is taken (they are not to differ >10 dB at 0.5, 1, 2, 3, 4 kHz).
• If difference > 10dB, audiologist must perform the baseline.
• Audiograms must be obtained at the same sitting.
• The baseline is the basis for future NIHL, and is the valid baseline for life.
• If no baseline done by Nov 2003 the baseline PLH will be considered 1.1% .

Periodic Screening:

Employees must be screened periodically:

• This must be carried out annually,
• after 16 hours noise-free (PPE allowed),
• PLH calculation:
  • If PLH >10% from baseline - Repeat
  • If still >10% from baseline - Refer to OHMP
  • Then for diagnostic, ENT (if > 30 % from baseline) and then to the Compensation Commissioner.
• Deterioration of PLH in workers with PLH <10% from baseline:
  • Compare 3, 4, 6 kHz - (>15 dB difference)
  • or >15 dB increase at 4kHz only
  • or Schilling (good for general pathology, not NIHL necessarily)
  • or PLH criteria (but what is arbitrary and what scientific?)

Exit audiometry:

• If you leave noise zone permanently,
• 16 hours noise free (no PPE allowed),
• calculate PLH,
• enter baseline, "pre-employment" (if applicable), exit and PLH onto exit certificate.

Diagnostic Audiometry:

• 24 hours noise free (no PPE);
• Pure tone and bone;
• 2 audiograms - different sittings; same day;
• If more than 10dB difference between audiograms (X3) - try in 6 months again.
• If PLH 10-30% from baseline - OHMP.
• If PLH >30% from Baseline - ENT.
• > 10% from baseline - compensation.
• Percentage disability = ½ x PLH.