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Program Coverage and Employee Eligibility

Employees exposed at or above the OSHA action level are enrolled in the hearing conservation program critical (required)

Confirm employees exposed to noise at or above the OSHA action level are included in the program under OSHA 29 CFR 1910.95.

Yes No N/A

Baseline audiogram is completed within the required timeframe critical (required)

Verify a baseline audiogram is on file for each covered employee and completed within the required OSHA timeframe.

Yes No N/A

Annual audiogram is current for each covered employee critical (required)

Confirm annual audiometric testing is completed and current for all covered employees.

Yes No N/A

Audiogram tracking log identifies overdue or missing tests

Review the tracking system for overdue baseline, annual, or follow-up audiograms.

Yes No N/A

Baseline Audiogram Documentation

Baseline audiogram date is recorded critical (required)

Document the date the baseline audiogram was completed.

Baseline audiogram is retained in the employee record critical (required)

Confirm the baseline audiogram is available for comparison with subsequent annual tests.

Yes No N/A

Audiometer calibration or test validity documentation is available

Verify supporting documentation shows the audiometric test was performed using valid equipment and procedures.

Yes No N/A

Baseline audiogram includes employee identifier and test location

Confirm the record can be matched to the correct employee and testing site.

Yes No N/A

Annual Audiogram Review

Annual audiogram date is recorded critical (required)

Record the date of the most recent annual audiogram.

Annual audiogram comparison to baseline is documented critical (required)

Confirm the annual result was compared against the baseline audiogram.

Yes No N/A

Any threshold changes are noted and reviewed

Check whether threshold changes were identified and reviewed by the responsible program owner.

Yes No N/A

Next annual audiogram due date is tracked

Document the next scheduled annual audiogram due date.

Standard Threshold Shift (STS) Follow-Up

Potential standard threshold shift (STS) is identified and documented critical (required)

Confirm the record identifies any STS determination under OSHA hearing conservation requirements.

Yes No N/A

Follow-up audiogram is scheduled or completed after STS critical (required)

Verify follow-up testing is scheduled or completed after an STS is identified.

Yes No N/A

Hearing protection is fitted or reinforced after STS critical (required)

Confirm hearing protection is provided, fitted, or reinforced following an STS.

Yes No N/A

Employee retraining on hearing conservation is documented after STS

Verify retraining or counseling on hearing conservation is documented after an STS.

Yes No N/A

Recordkeeping and Compliance Documentation

Audiogram results are retained per recordkeeping requirements critical (required)

Verify audiometric records are retained in accordance with applicable OSHA recordkeeping requirements.

Yes No N/A

Employee notification of results is documented

Confirm employees are notified of audiogram results and any required follow-up.

Yes No N/A

Recordable hearing loss cases are evaluated for OSHA Form 300 reporting

Review whether recordable shifts were evaluated for OSHA injury and illness recordkeeping requirements.

Yes No N/A

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Run: Hearing Conservation Audiogram Tracking

Program Coverage and Employee Eligibility

Baseline Audiogram Documentation

Annual Audiogram Review

Standard Threshold Shift (STS) Follow-Up

Recordkeeping and Compliance Documentation

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