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Standard Number:1910.95, 1910.95(g)(10)(i), 1910.95 App F, 1904.10(a), 1904.10(b)(3)
February 9, 2024
A. Clarke Darlington, MD, MPH, CPS/A
Peter G. Kachavos, MD, MHCDS
Lara Stahl, MSN, FNP-C, COHN-S, COHC
Premise Health
5500 Maryland Way, #120
Brentwood, Tennessee 37027
Dear Dr. Darlington, Dr. Kachavos, and Ms. Stahl:
Thank you for your letter to the Occupational Safety and Health Administration (OSHA). Your letter was forwarded to OSHA's Directorate of Enforcement Programs for a response. You requested confirmation on whether the current National Health and Nutrition Examination Survey (NHANES) data-derived age-correction tables are acceptable to obtain measurements addressed in the OSHA Occupational Noise Exposure standard (noise standard), 29 CFR § 1910.95, Appendix F. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any questions not delineated within your original correspondence. Your specific question is paraphrased below, followed by OSHA's response.
Background:
Your letter states that OSHA's current age-correction table, Appendix F, discontinues at age 60. It further states that more people are working into their sixties instead of retiring and there is no adequate way to assess presbycusis (age-related hearing loss) in these workers using the current OSHA table and that OSHA's age-correction tables were based on a small sample size and research from 1970's. Your letter advocates for the use of NHANES data-derived age-correction tables stating that they are based on recent data with a much larger sample size and a wider age range sampled when compared to the OSHA age-correction tables. You provided a comparison of the OSHA age-correction tables and the newer NHANES data-derived age-correction tables that show age-related hearing loss continues to occur beyond age 60 1. Your letter states that this can lead to inaccurate medical determinations of hearing loss at no fault of the worker, clinician, or employer. Your letter posits that when complying with OSHA's process for recording, some cases of hearing loss may be recorded on the OSHA log as work-related, when in fact, these cases of hearing loss are caused by presbycusis and are not work-related.
Question: Will OSHA allow the use of the NHANES data-derived age-correction tables (hybrid data) for workers 61-75 years old when determining the cause and work relationship of hearing loss in this older age group?
Response: Paragraph (g)(10)(i) of OSHA's noise standard provides that age correction for the change in hearing level may be made according to the procedure described in Appendix F. 29 CFR § 1910.95(g)(10)(i). OSHA will allow the use of the NHANES age-correction data for the creation and use of age-correction tables other than the ones in Appendix F under certain conditions. For any table based on NHANES data, all the values should be calculated from one dataset to avoid using values from different data sets. For example, the hybrid table listed in your letter's reference is impermissible because it uses values from the OSHA data set while using the NHANES data for anyone over 60.
If an employer chooses to use age-correction tables other than the tables in Appendix F, then the decision to age-correct, and therefore, which table based on NHANES data to use, must be made by a certified audiologist, otolaryngologist, or other physician, and must take into account the employee's noise exposure levels, years of exposure, inclusion in a hearing conservation program, use of hearing protection, and other medical history. OSHA recommends that one set of tables, such as the NHANES data, should be selected and applied equitably for all workers at the onset of their inclusion in a hearing conservation program starting with the baseline audiogram. The employer should maintain a copy of the published reference and tables with the audiometric records.
Regarding recording hearing loss, OSHA's recordkeeping regulation at 29 CFR § 1904.10(a) requires employers to record hearing loss cases when an employee's audiogram reveals that the employee has experienced a work-related standard threshold shift (STS) in one or both ears, and the employee's total hearing level is 25 decibels (dBA) or more above audiometric zero (averaged at 2000, 3000 and 4000 Hz) in the same ear(s) as the STS. In addition, 29 CFR § 1904.10(b)(3) states, "While age-correction is allowed when determining whether an STS has occurred, an age-correction may not be used when determining whether the employee's total hearing level is 25 dBA or more above audiometric zero."
Further, although the noise standard and recordkeeping regulation still allow for this optional age-correction to the STS calculation, the NIOSH Criteria for a Recommended Noise Standard, Occupational Noise Exposure, 1998 revision, changed focus from a hearing conservation standpoint to a hearing loss prevention standpoint. It recommends that age-correction not be applied to an individual's audiogram for STS calculations. See https://www.cdc.gov/niosh/docs/98-126/default.html
As you may be aware, Tennessee is one of 26 states plus Puerto Rico and the Virgin Islands that operates its own occupational safety and health program under a plan approved and monitored by federal OSHA. Employers in Tennessee must comply with state occupational safety and health requirements. As a condition of plan approval, State Plans are required to adopt and enforce occupational safety and health standards that are at least as effective as those promulgated by federal OSHA. A state's interpretation of their standards must also be as least as effective as federal OSHA interpretations. If you would like further information regarding Tennessee's occupational safety and health requirements, you may contact them at:
Department of Labor and Workforce Development
220 French Landing Drive
Nashville, Tennessee 37243
Telephone: (844) 224-5818
https://www.tn.gov/workforce/employees/safety-health/tosha.html
Thank you for your interest in occupational safety and health. I hope you find this information helpful. OSHA's requirements are set by statute, standards, and regulations. Letters of interpretation do not create new or additional requirements but rather explain these requirements and how they apply to particular circumstances. This letter constitutes OSHA's interpretation of the requirements discussed. From time to time, letters are affected when the agency updates a standard, a legal decision impacts a standard, or changes in technology affect the interpretation. To assure that you are using the correct information and guidance, please consult OSHA's website at www.osha.gov.
If you have further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.
Sincerely,
Kimberly A. Stille, Director
Directorate of Enforcement Programs
1 Dobie, R. A., & Wojcik, N. C. (2015). Age correction in monitoring audiometry: method to Update OSHA age-correction tables to include older workers. BMJ open, 5(7), e007561. https://doi.org/10.1136/bmjopen-2014-007561