- The training program includes a pre-learning phase that allows participants to familiarize themselves with foundational concepts before engaging in in-person interactions with the facilitator.
- Following the pre-learning phase, participants will have the opportunity to meet with the facilitator in a physical classroom setting. This direct interaction is crucial for addressing any questions or concerns that may have arisen during the self-study period.
- Additionally, the physical classroom component is designed to facilitate hands-on practical training. This aspect of the program allows participants to apply theoretical knowledge in real-world scenarios, enhancing their understanding and retention of the material. Working under the guidance of an experienced facilitator, learners can practice skills, collaborate with peers, and gain valuable insights that are difficult to achieve through online learning alone.
- Overall, this structured approach—combining pre-learning with direct facilitator contact and practical classroom experiences—ensures a comprehensive and effective learning journey that accommodates various learning styles and maximizes participant engagement.
History Taking for Audiometry Copy- OLD-22
History Taking for Audiometry
Before an audiogram is done a thorough history should be taken from the worker. This will assist in the interpretation of the results. The audiometrist should work in a systematic order to obtain this information. A good audiometric history should always include:
| NB: History Taking: | |
 | Occupational History |
| Medical History |
| Surgical and Trauma History |
| ENT specific History |
| Medication – Chronic and Acute |
| Recreational History |
The occupational history
Medical history
Surgical and trauma history
History specific to the ear nose and throat
Medication
Recreational history
Demographics
It is important to correctly identify the person coming for an audiometric test and to fully understand where the employee comes from, the culture, socio-economic background, and beliefs as this affects how the worker will respond to treatment, care, and management. Demographic data should include:
Name and SurnameAddress and contact details
Gender
Identity number – verify this using statutory documents such as a driver’s license or ID book
The name of the employer / company
The position employed in and department
Other information is important for the overall occupational health assessment but not important at this stage of the examination. The focus is audiometry.
Occupational history
A comprehensive occupational history should be taken starting from the first employment up to the current position and should include informal work done. Ask specific questions to determine exactly what the worker does daily, do not just ask for a job description. For example: If the worker is a “machine operator” ask the worker to explain what the machine does (cut, saw, grind etc.). When taking an occupational history look at past and current employment. Remember the focus is only on audiometry, therefore work history involving noise, hearing and the ears.
| Current employment | |||
| ● | Current occupational exposure to noise (yes/no) | |||
| ● | Length of occupational exposure (how many hours/days) | |||
| ● | Noise level ratings (most workers do not know this) | |||
| ● | Type of HPD used (type/ make, check whether inserted correctly and the NRR / SNR) | |||
| ● | Date of Employment – essential for baseline and pre-employment audiograms | |||
| ● | Date of exit or last shift - essential for exit audiograms | |||
| ● | The reason why the date of employment or exit is important is as follows: | |||
| o | The baseline and pre-employment audiograms must be done within 30 days of employment or exposure in noise zones where the exposure is equal to or greater than 85dB(A). | |||
| o | All exit audiograms must be done as close to the date of exit from the company or noise zones where the exposure was equal to or greater than 85dB(A) and the worker is no longer going to be exposed to this noise. | |||
| Past employment | - start at the very first employment / employer after education. | ||
| ● | Past occupational exposure to noise (yes/no) | |||
| ● | Length of occupational exposure (how many hours/days) | |||
| ● | Level of noise exposure – dB(A) (most workers do not know this) | |||
| ● | Type of HPD used (type/ make, check whether inserted correctly and the NRR / SNR) |
| Tip: | |
| Ask the following question to determine the approximate noise levels. | |
| ● | When you need to communicate on the job is it easy, do you need to raise your voice or shout? |
Calculate and Verify the Noise Free Period
Depending on the type of audiogram required, the worker will need to be out of a noise zone for a specific period of time as specified in SANS 10083:20139, for example:
| The baseline audiogram must be preceded by a period of at least 16 hours during which there has been no exposure to noise levels equal to or greater than 85dB(A). The use of hearing protection does not satisfy this requirement. | ||
| The periodic test shall be preceded by a period of at least 16 hours with no exposure to noise equal to or greater than 85dB(A). The use of hearing protection that meets the requirements of SANS 1451 is deemed to satisfy this requirement. | ||
| The exit test shall be preceded by a period of at least 16 hours with no exposure to noise equal to or greater than 85dB(A). The use of hearing protection that meets the requirements of SANS 1451 is deemed to satisfy this requirement. | ||
| The diagnostic audiogram must be preceded by a period of at least 24 hours during which there has been no exposure to noise levels equal to or greater than 85dB(A). The use of hearing protection does not satisfy this requirement. | ||
| Establish a noise-free period | - use a noise-free checklist or the verification checklist provided on page 139 | |
| ● | Establish when the worker was last exposed to noise equal to or greater than 85dB(A) | ||
| ● | Also include any noise exposure whilst commuting to and from work, noisy taxis etc | ||
| ● | Exclude any noise exposure at home like staying next to the airport or musical events | ||
| ● | Calculate whether the worker has been noise-free for 16 hours before the audiogram | ||
| ● | Establish whether the employee has worn hearing protective devices during the 16 hours before the audiogram. |
