[MCOH-EH] STS hearing conservation question

[Jolene Mitchell]

Regarding hearing conservation determination of causation, the audiologist
or physician who is the supervising physician for the program is
responsible for making the determination of causation.

In the event that you have a standard threshold shift, it is strongly
advised to repeat the audiogram within 30 days to verify that the STS is
valid. This is not required, but optional under OSHA law.

Additionally the supervising physician can adjust The report for age. There
are two calculations for this again. This is an option, but not required.

To make a fully defensible determination of causation, it is advisable to
do a past medical history review as well as auto toxic medication’s.

I had one case where an individual was hospitalized and given very high
doses of gentamycin, subsequently the following year he suffered
significant hearing loss.

Upon reviewing all historical audiograms due to his prolonged employment
and his demonstrated evidence of compliance of PPE, the degree of loss was
more likely than not related to the gentamicin and not related to his
occupational exposure.

This does get more complicated with the 3M hearing protection issues, but
as an Occupational Medicine physician, this is a normal expectation of
services.

I hope this was helpful,

Jolene Mitchell, DO Mitchell.jolene7020 at gmail.com C: 502-510-7221


On Wed, Jan 7, 2026 at 12:32 PM Lisa Thames Cope <lmc25 at cornell.edu> wrote:

> 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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