Audiometry testing involves measuring hearing levels and can be done as part of health surveillance programs under noise regulations or for safety assessments. Equipment must be calibrated annually and ambient noise must be below 30dB for on-site testing. The employee should avoid loud noises before testing and complete a questionnaire. Hearing levels are tested and any issues identified are reported to management along with recommendations to address noise hazards. Results are used to determine if follow up testing or referrals are needed based on hearing loss categories.

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How to Series Audiometry
Introduction Audiometry can be undertaken as part of a health surveillance
programme under the Control of Noise at Work Regulations or for
fitness for task assessments e.g. safety critical roles
Equipment All equipment must be checked on a daily basis and routinely calibrated
on an annual basis as a minimum. Follow manufacturer’s instructions
for more specific detail.
On-site testing where there is no facilities for an audio booth can be
performed using a mobile audiometer. Care must be taken to ensure
that the ambient noise (background noise) is not higher than 30 dB. In
case of doubt, undertake the audiogram and refer to booth testing if
results show a poor test result.
Calibration
Follow manufacturer’s instructions for both mobile and static
equipment. If in doubt about results or performance of equipment,
results can be tested on yourself if you are familiar with your own
readings.
Cleaning
Follow manufacturer’s instructions
Method Client preparation
The employee should be informed of the proposed testing at least 1
week before testing so that loud noises can be avoided if possible e.g.
concerts at weekends, as this may affect the test results. On the day of
the audiometry the employee should not work in a noise hazard area
prior to testing.
A questionnaire should be completed prior to testing – either an initial
or repeat by the employee.
The OHA should go through the responses to the questionnaire with
the employee to identify any areas of concerns which need further
discussion or explanation with the employee.
Contraindications
Examine both ears with an ophthalmoscope for the presence of wax,
infection or signs of old injury to the ear drum e.g. scarring, perforation,
and note this in the patient records. Clinical judgement will be
required to decide on whether to proceed with testing. It should be
noted that GP’s do not do syringing of the ears as a routine.
Exposure to loud noise in the preceding 48 hours may be a
contraindication to the test as it could produce abnormal temporary
results.
Testing Procedure
• Follow the instructions for testing as outlined in the manufacturers
manual
• Explain clearly to the employee what is to be expected.
• Occasionally there is a problem with claustrophobia in the booth.

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• Always make sure the audiometer is not in sight of the employee
undergoing testing as light indicators give clues to when the sounds
are occurring
• Following audiometry explain the graph and the implications of the
test with the individual in detail
• Decide on category of hearing and follow up appointment with
individual
• Give information on the noise hazard and how to avoid hearing loss
• Ask about hearing protection and observe how it is used, correcting
any poor practice
Common Errors
• Interference noise from the environment, consider retesting in
booth if hearing levels negatively affected by ambient noise
especially if results are in referral category.
• Employee having difficulties with understanding when to press the
button
Outcome If audiometry for noise exposure then a health record should be
completed and passed to Management.
If audiometry for fitness to work in a safety critical role then company
guidelines should be followed for levels of hearing required
Records As with all health surveillance procedures, group results should be
anonymised and reported to the employees/management.
Clinical records should be update
Occupational
Health
implications
The HSE has set out the criteria for deciding if hearing levels need
further investigation. See Guidance documentation below for hearing
categories and referral criteria
Working can continue in noise areas if the individual is aware of
continued risk of losing hearing. More care will need to be taken for
those who have severe noise induced hearing loss and in danger of total
hearing loss
The OHA should explain how noise can damage hearing and that it is
irreversible. Demonstrate the correct use and wearing of personal
protective equipment.
Any individual or groups of individuals presenting with evidence of
noise induced hearing loss should be reported back to management for
a review of the noise control methods.
Consider whether hearing aids can be used whilst working to improve
hearing
Audiometry should be part of a hearing conservation programme
adapted across the company and can include strategies for buying quiet
machinery to subcontracting high noise risk activities etc.
Follow up Follow guidance from the HSE for frequency of repeat hearing checks,
that is, annually for the first two years then 3 yearly if no abnormalities
noted
For safety critical roles consider 3 yearly recall
More frequent testing may be required for those with reduced hearing
or unusual test results

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Further
Information
Noise induced hearing loss is a prescribed industrial disease and
employees should be directed to the local social security offices for
forms to claim. Note that claims cannot be backdated.
Consider the implications of the Equality Act 2010
Surveillance required under the Control of Noise at Work Regulations
2005
See also Controlling Noise at Work, Guidance on the Control of Noise
at Work Regulations available as a free download from the
www.hse.gov.uk
BSI Standards Acoustics- Audiometric Test Methods Part 1 ISO 253-
1:2010