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10 dB Standard Threshold Shift STS Follow-Up Form Employee Name Company Location 1. NOTIFY employee of the 10 dB STS event via Individual Summary Report Graph Report or Employee Notification Letter. Obtain employee signature for documentation and retain documentation in the employee s file. 2. Consider a 30 day retest to be conducted in a period not to exceed 30 days from the date of the test indicating the STS. If no retest is anticipated or a 3...

How to fill out 10 db standard threshold shift (sts) follow-up form

How to fill out 10 db standard threshold shift (sts) follow-up form

1. Step 1: Obtain the 10 db standard threshold shift (STS) follow-up form from the relevant authority or website.
2. Step 2: Fill out personal identification information at the top of the form including name, date of birth, and contact details.
3. Step 3: Indicate the date of the initial audiometric test and any previous related medical history.
4. Step 4: Provide details regarding the current hearing status, including any changes or symptoms experienced since the last evaluation.
5. Step 5: Complete the section on environmental and occupational noise exposure if applicable.
6. Step 6: Sign and date the form to certify that the information provided is accurate.
7. Step 7: Review the completed form for any missing information before submission.
8. Step 8: Submit the form according to the guidelines provided (mail, email, or in person).

Who needs 10 db standard threshold shift (sts) follow-up form?

1. Workers exposed to occupational noise who have experienced a 10 db shift in hearing thresholds.
2. Audiologists and hearing health professionals who assess and manage hearing health in noisy environments.
3. Employers required to monitor the hearing health of employees in compliance with occupational safety regulations.

People Also Ask about

What does STS mean in hearing tests?

A Standard Threshold Shift, or STS, is defined in the occupational noise exposure standard at 29 CFR 1910.95(g)(10)(i) as a change in hearing threshold, relative to the baseline audiogram for that employee, of an average of 10 decibels (dB) or more at 2000, 3000, and 4000 hertz (Hz) in one or both ears.

What is the next step if a standard threshold shift is found?

Paragraph (g)(8)(2) requires that employees be informed in writing within 21 days of the determination that a standard threshold shift (STS) has occurred. Every annual audiogram which, when compared to the baseline audiogram, shows an STS requires employee notification.

What is the next step if a STS is found?

When an STS is identified, the employee must be notified in writing within 21 days. If an STS is present and the average hearing level at 2000, 3000, and 4000 Hz is equal to or greater than 25 dB(HL), then it should be recorded on the OSHA 300 Log.

How to calculate standard threshold shift?

The steps OSHA defines for calculating STS are: Compare the worker's baseline test to the current test. Find the difference in hearing thresholds at 2000, 3000, and 4000 Hz. Compute the average change in these thresholds for each ear separately. STS is present if the average difference is 10 dB or more, in either ear.

What does STS mean on a hearing test?

More detail. (1) What is a Standard Threshold Shift? A Standard Threshold Shift, or STS, is defined by OSHA as a change in hearing threshold, relative to the baseline audiogram for that employee, of an average of 10 decibels (dB) or more at 2000, 3000, and 4000 hertz (Hz) in one or both ears.

How to calculate STS hearing?

The steps OSHA defines for calculating STS are: Compare the worker's baseline test to the current test. Find the difference in hearing thresholds at 2000, 3000, and 4000 Hz. Compute the average change in these thresholds for each ear separately. STS is present if the average difference is 10 dB or more, in either ear.

What is positive STS?

In contrast, the National Institute of Occupational Safety and Health (NIOSH) recommended definition of an STS is “an increase of 15 dB in hearing threshold level (HTL) at 500, 1000, 2000, 3000, 4000, or 6000 Hz in either ear, as determined by two consecutive audiometric tests,” with the second test required to reduce

What is the threshold STS?

When it comes to hearing loss, a Standard Threshold Shift (STS) is a 10 dB(HL) deterioration of the average of thresholds at 2000, 3000, and 4000 Hz when comparing the baseline for each ear to the most recent test. Age correction may be permitted depending on the state where the testing is taking place.

For pdfFiller’s FAQs

What is 10 db standard threshold shift (sts) follow-up form?

The 10 db standard threshold shift (sts) follow-up form is a document used to record and assess changes in an individual's hearing ability, specifically noting any shifts in hearing thresholds of 10 decibels or more.

Who is required to file 10 db standard threshold shift (sts) follow-up form?

Occupational health and safety professionals, as well as employers in industries where noise exposure is prevalent, are required to file the 10 db standard threshold shift (sts) follow-up form for employees who exhibit a significant change in hearing.

How to fill out 10 db standard threshold shift (sts) follow-up form?

To fill out the form, gather audiometric test results, compare previous and current hearing thresholds, and document the noted shifts along with the individual's identification details and any relevant observations or recommendations.

What is the purpose of 10 db standard threshold shift (sts) follow-up form?

The purpose of the form is to monitor hearing health and ensure proper management of employees exposed to hazardous noise levels, facilitating early intervention and compliance with occupational health regulations.

What information must be reported on 10 db standard threshold shift (sts) follow-up form?

The form must report the individual's identification details, audiometric test results, any noted threshold shifts, the date of the tests, and recommendations for further action or follow-up evaluations.