OSHA Required Medical Tests: Audiometric and Respiratory

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Audiometric and respiratory testing may be required for employment under OSHA 29 CFR

Occupational Safety and Health Administration (OSHA) and Mine Safety and Health Administration (MSHA) require pre-employment and annual medical testing for workers in various industries, including oil and gas, trucking, manufacturing, and more to ensure safe and healthy working conditions.

When it comes to employment, there are many different types of exams and testing that may be required under OSHA rules. The most common physical exams include:

• work fitness assessment
• fitness-for-duty exam
• pre-employment physicals

Beyond exams, there are important occupational health tests that may be required for employment under OSHA 29 CFR, which include:

• audiometric testing and
• pulmonary function testing or respiratory testing

What is Audiometric Testing?

Audiometric testing is a test of a person’s ability to hear sounds and assists in monitoring an employee’s hearing over time and is OSHA required if the work environment provided by the employer meets certain guidelines.

An audiometric testing follow-up program should indicate whether the employer’s hearing conservation program is preventing hearing loss and needs to be managed by a licensed or certified audiologist, otolaryngologist, or other physician. Both professionals and trained technicians may conduct audiometric testing.

There are two types of audiograms required in the hearing conservation program, which include, baseline and annual audiograms.

Baseline audiograms

The employer must retain the original baseline audiogram for the length of the employee’s employment. The professional may decide to revise the baseline audiogram if the employee’s hearing improves. This will ensure that the baseline reflects actual hearing thresholds to the extent possible.

Annual audiograms

Annual audiograms must be provided within 1 year of the baseline. It is important to test workers’ hearing annually to identify deterioration in their hearing ability as early as possible. This enables employers to initiate protective follow-up measures before hearing loss progresses.

Employers must compare annual audiograms to baseline audiograms to determine whether the audiogram is valid and whether the employee has lost hearing ability or experienced a standard threshold shift (STS). An STS is an average shift in either ear of 10 dB or more at 2,000, 3,000, and 4,000 hertz.

What are employer OSHA requirements?

Under the OSH law, employers are required to maintain a safe workplace for all employees. Failure to do so can lead to serious fines and penalties.

Employers must:

1. make audiometric testing available to all employees exposed to an action level of 85dB (decibels) or above, measured as an 8-hr time weighted average (TWA).
2. maintain a Hearing Conservation Program to include monitoring, testing, follow-up, training and recordkeeping (regardless of the number of employees).document and keep noise exposure measurement records for 2 years and maintain records of audiometric test results for the duration of the affected employee’s employment.
   • Audiometric test records must include:
     • the employee’s name
     • job classification,
     • date
     • examiner’s name
     • date of the last acoustic or exhaustive calibration
     • measurements of the background sound pressure levels in audiometric test rooms, and
     • the employee’s most recent noise exposure measurement.

We provide baseline, periodic, and exit audiograms, as well as any follow-up testing and training at the employer’s request. Testing will be performed by trained technicians and the program will be overseen by an Audiologist or Physician.

What is Pulmonary Function Testing (PFT) or Respiratory Testing?

A pulmonary function test or respiratory test is OSHA-mandated to determine if an employee can safely and effectively wear a respirator to protect the health of the employee against breathing airborne contaminants.

Before your employees use a respirator or are fit-tested, they must be medically evaluated and cleared by a licensed healthcare professional using a “Respirator Medical Evaluation Questionnaire.”

Employers must select a physician or other licensed healthcare professional (PLHCP), such as a registered nurse or physician’s assistant, to perform the medical evaluation and evaluate your health, specific job description, respirator type, and workplace conditions.

Some conditions that could prevent you from using a respirator include:

• heart conditions
• lung disease, and
• psychological conditions, such as claustrophobia

An employees responses to the medical questionnaire are confidential and may not be shared with your employer.

When required by the PLHCP, additional follow-up testing may include a medical exam, additional questionnaire, PFT, EKG, chest x-ray, blood draw and urine sample.

What is Spirometry Testing?

Some occupational and personal exposures can accelerate this loss of function over time. Beyond the respirator medical evaluation, a spirometry breathing test shows how well you can move air in and out of your lungs. Periodic spirometry testing can be used to detect such accelerated losses.

Under OSHA 29 CFR PFT, spirometry testing is required in conjunction with the respirator fit test under certain circumstances to measure respiratory function.

Spirometry testing may be performed on workers who perform jobs that may cause exposure to possible lung hazards, are physically demanding, or require wearing a respirator. Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing and is required for some workers by OSHA standards.

Before conducting spirometry testing, technician should interview the worker, review medical records, and possibly consult with the PLHCP to identify health conditions that may prevent the worker from safely performing maximal efforts in a spirometry test.

All respiratory testing will be performed by a PLHCP and/or trained technician and will provide you and your employer with a written recommendation (with no confidential information) that includes:

• If you are medically able to wear the respirator and any medical limitations for using one;
• If any follow-up medical evaluations are needed; and
• A statement that the doctor or licensed healthcare professional has provided you with a copy of their written recommendation.

You must be re-evaluated when:

• Reported medical signs or symptoms, such as a heart condition, lung disease, or claustrophobia;
• A physician or licensed healthcare professional, supervisor, or the respirator program administrator informs your employer that you need to be re-evaluated;
• The respiratory protection program indicates a need for you to be re-evaluated; or
• A change occurs in workplace conditions that increases the burden on you while using the respirator.

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Occupational Medicine Services

Employer OSHA and Occupational Medicine testing

We are able to assist with your OSHA and Occupational Medicine needs, no matter your company size.

Individual and combined services are available:

• Audiograms, respiratory and hazwoper physicals
• DOT and non-DOT drug and alcohol consortiums
• Drug and alcohol testing programs
• Exposure testing and medical surveillance
• Mobile Health Clinic available for on-site services
• OSHA compliant physicals and exams
• Pre-hire screenings
• Pre-employment and DOT physicals
• School bus driver physical exams
• Vaccinations and flu shots
• Workplace injury treatment and management

The goal of our best-in-class medical examiners is to keep workers safe and healthy on the job, creating long term health and wellness, allowing you to continue the production that keeps your business running.