[MCOH-EH] STS hearing conservation question

[Swift, Melanie D., M.D., M.P.H.]

The employer does need to ensure that a physician or other licensed health care professional makes a determination of whether the hearing loss is occupational, in order to determine whether the hearing loss is recordable on the OSHA log. So your IH is correct that the employer does need to provide that determination, but it's not necessary to share the worker's medical history details with IH. The determination of occupational hearing loss is usually made by the professional supervisor of the audiometry program, which per OSHA has to be an audiologist, ENT or other physician. Sounds like in your program your OM physician may be the professional supervisor, which is how we are set up as well.

We include ototoxic medications, trauma, and other medical causes of hearing loss in our audiometry questionnaire, which is helpful at times. As the OM physician serving as our program's professional supervisor, I review that history, combined with the pattern of hearing loss and prior audiograms to determine if the hearing loss is occupational. If your audiometer doesn't have those questions, you should be able to add custom questions.

Just a plug for the CAOHC Professional Supervisor course to be offered this spring in conjunction with the American Occupational Health Conference in Chicago. Any physicians who supervise a hearing conservation course can take advantage of this convenient training course; it's not limited to ACOEM members.

Melanie Swift, MD, MPH
Vice Chair, Division of Public Health, Infectious Diseases and Occupational Medicine
Professor of Medicine, Mayo Clinic College of Medicine and Science
Medical Director, Mayo Clinic Physician Health Center<https://www.mayoclinic.org/departments-centers/preventive-occupational-aerospace-medicine/physician-health-center/referrals>
Associate Medical Director, Occupational Health Service
Vice Chair, Institutional Biosafety Committee
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Lisa Thames Cope
Sent: Tuesday, January 6, 2026 10:03 AM
To: mcoh-eh at mylist.net
Subject: [EXTERNAL] [MCOH-EH] STS hearing conservation question

External Email Notice: This message was sent by someone outside Mayo Clinic.
I am looking for some input regarding STS and  the determination of work related hearing loss.

 We have an HCP in our dept, we conduct the testing, and our OM physician on staff reviews the findings. Because of the multiple variables that may be related to the hearing loss, our Industrial Hygienist wants our dept to get an in-depth medical evaluation for any possible ototoxic medication use or medical illness or condition that may be a cause (which IH feels they should be allowed to have access to all of this information) and then for our dept to make  a definitive determination if the STS is related to work, outside noise, medications or illnesses/medical conditions, which our dept does not feel qualified to determine.

My questions to the group are:
- do you obtain an extensive medical history on every STS and make the determination
- if you don't make the determination regarding if it is or is not r/t work, who or how is it determined ?  Do you refer (employee and or test) out to an audiologist/ or specialist physician for review?

Also, those who use the mobile units, do they evaluate the STS and then make the determination that the STS is r/t work or some other cause.

Any input is greatly appreciated

Thank you

Lisa Cope
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