The debate over recordable job-related hearing loss rages on, and OSHA will soon have to decide: Where do you draw the line in an area that is so gray?

OSHA's revised rule addressing the recording and reporting of occupational injuries and illnesses (29 CFR parts 1904 and 1952) will largely take effect as scheduled on January 1, 2002. However, the agency sought comment on two proposed modifications to the rule's recordkeeping requirements, one of which involves the recording of job-related hearing loss.

The criteria for recording work-related hearing loss will not be implemented for one year pending further investigation into the level of hearing loss that should be recorded as a "significant" health condition. OSHA had received comments indicating that the medical community and state workers' compensation systems do not support the new rule's hearing loss standard.

10dB or 25dB?

At the heart of the issue is the standard threshold shift (STS) in employees' hearing - a change in an employee's hearing threshold relative to a baseline audiogram. The new rules require employers to record changes of 10 decibels (dB) or more at 2000, 3000 and 4000 hertz in one or both ears - quite a difference from the existing rule, which calls for an STS of 25dB or more to be recorded.

The recording of occupational hearing loss has long been a problem in that, unlike most other occupational injuries or illnesses such as falls and fractures, hearing loss does not typically require time away from work for recuperation. OSHA believes there are probably thousands of cases of hearing loss that occur each year as a result of job-related noise exposure, but since they generally don't result in days away from work, they are not captured in Bureau of Labor statistics.

In short, it's very difficult to tell where, how and when an STS occurs.

OSHA set the new, stricter recordable hearing loss provision of 10dB in part to make the threshold shift consistent with the already existing hearing conservation amendment (HCA). Additionally, OSHA received numerous comments during the rulemaking stages in favor of changing from 25dB to 10dB, according to an OSHA official. The rule changes are also expected to improve national hearing loss statistics due to a new column added to the OSHA 300 Log that will require employers, for the first time, to separately list data specific to occupational hearing loss.

Not a problem

The new provision, however, has been held up because not everyone thinks a 10dB STS is a serious health problem. Following publication of the final rule in January 2001, some organizations, such as the American Iron and Steel Institute, asserted that an STS is merely a "precursor event" indicating the need for follow-up actions. AISI also noted that the American Medical Association (AMA) states that a person has suffered material impairment when testing reveals a 25dB average hearing loss from audiometric zero at 500, 1000, 2000 and 3000 hertz.

Those opposed to the new rules for recording job-related hearing loss generally feel the 10dB shift is too sensitive, does not reflect enough hearing loss to be considered a serious injury and is going to capture too many cases, says an OSHA official. Their argument also claims that audiometric test results are not always reliable and can result in a lot of "false-positives."

Another concern is determining whether noise-induced hearing loss comes from the workplace or from off-the-job environments, such as concerts, airports and personal music headsets. Why should companies pay for hearing loss suffered elsewhere?

Delaying the provision

As a result of such concerns, along with a lawsuit filed by the National Association of Manufacturers (NAM) against OSHA that challenges the recordkeeping rule, OSHA is reconsidering the 10dB criterion for recording hearing loss and is proposing to delay the effective date of Section 1904.10 until January 1, 2003. It is also proposing to remove the "hearing loss" column from the version of the log to be used during calendar year 2002.

Quentin Riegel, deputy general counsel for NAM, says the lawsuit was filed because the recordkeeping rule requires the recording of injuries that may not be work-related, or may not even be actual injuries or illnesses. "The 10dB threshold for recording is too low and should not be recorded as an occupational injury on the OSHA log," says Riegel. "It might be a warning sign, but it's not an indication of an actual injury of sufficient magnitude to warrant recording."

NAM's stance, along with the Can Manufacturers Institute and others, is that a 25dB shift should continue to be used as the trigger for recordability based on guidance from the AMA.

Putting up a fight

In favor of the new rule to lower the threshold shift level to 10dB is the American Industrial Hygiene Association (AIHA), which helped form a coalition to oppose the stay of the recordkeeping rule. The Coalition to Protect Workers' Hearing, consisting of AIHA and six other organizations such as the American Speech-Language-Hearing Association and the National Hearing Conservation Association, wants OSHA to implement all provisions of the final rule on January 1, 2002.

"AIHA supports the 10dB recordability criteria," says Steve Hacker, chair of the AIHA Noise Committee and industrial hygiene team lead at Solutia, Inc. "The stricter provision was put in to raise the level of awareness of hearing loss as a problem so that better control methods could be put in place."

"25dB STS is a severe hearing loss, and that's a lot of hearing to lose before it goes on the log," insists Lee Hager, vice chair of AIHA's Noise Committee and executive vice president of JAA Inc., a provider of noise control and hearing loss prevention services. "In reality, it's unlikely that most people in U.S industry will actually get to 25dB age-corrected hearing loss," he says. "They could lose a significant amount of hearing without triggering the 25dB recordability requirement."

Hager likens someone who experiences considerable hearing loss without reaching the 25dB level to someone who loses a finger but is told, "It's no big deal. You've got nine others." "Losing 10dB of hearing is a serious thing," he contends.

Raising awareness or undue alarm?

NAM believes that the 10dB level will lead to OSHA logs that contain more numbers and recording than is justified, and that manufacturers will be forced to devote resources to something that doesn't really need fixing. "Those resources could be better used in other areas of safety," says Riegel. "We want to make sure the recordkeeping system doesn't arbitrarily skew the numbers so that preventative measures and resources are misallocated. An injury that's recorded should be serious enough to be recorded."

Hager feels that industry doesn't want the scope of this issue to become widely known. "As it is now, you can sort of hide hearing loss in with a number of other things. You don't have to think about recording it until it gets to 25dB shift, which rarely occurs," he says.

"Changing recordability criteria to a more stringent 10dB shift and giving it a unique location on Form 300 will bring this issue to the fore," adds Hager, "and it's not something that industry is going to be real comfortable with."

SIDEBAR: Have you heard?

From 1994-1999, the number of cases involving days away from work due to job-related deafness or hearing loss or impairment totaled 1,134. That's 189 cases each year. About 30 percent of these involved workers ages 25-34.

Source: Bureau of Labor Statistics