What this is
What is an audiometric test record?
What is an audiometric test record?
It documents the results of one hearing test: the conditions the test was run under, the thresholds measured in each ear, and the comparison against the worker's baseline. It exists so a shift in hearing can be detected while it is still small enough to act on.
Who carries out the test and completes the record?
A technician certified to perform audiometry, using calibrated equipment, in a booth meeting the ambient noise limits the test depends on. The record belongs to occupational health rather than the safety function, because the result is clinical information even though its trigger is an exposure programme.
How does this differ from a threshold shift review?
This record is the test itself: the thresholds, by frequency, for each ear, on this occasion. The review is a separate, later record that only exists when this one detects a shift, and its job is to decide whether the shift is real, work-related, and what follows.
Scope
When is an audiometric test record required?
This record is the periodic hearing test itself, sitting early in a chain that only works if each record hands off cleanly to the next. Using it to do the work of the record that follows produces a test with no judgement attached, and a judgement with no test to point back to.
Use this template when
- A baseline audiogram is due for a worker newly entering hearing conservation monitoring
- An annual audiogram is due for a worker already above the noise action level
- A retest is needed to confirm or rule out a shift found on a previous test
- An exit or transfer audiogram is required as a worker leaves noise-exposed work
- A test is being repeated because the prior attempt was invalidated by occlusion, a failed quiet period, or unacceptable booth noise
Do not use it for
- Standard Threshold Shift Review, where the shift this record detects gets investigated and judged, not recorded a second time here
- Hearing Protection Fit Check, which verifies what attenuation a worker's protection actually delivers, independent of any test result
- Noise Survey, which measures the area or task exposure that determines who is enrolled in testing at all
- Qualitative Exposure Assessment / Similar Exposure Group register, which decides who is due a test and on what interval
- Any record of the corrective action arising from a shift, which belongs with the review and its linked action
Compliance mapping
Which OSHA 1910.95(g) requirements does this satisfy?
OSHA 1910.95(g) is specific about the audiometric programme in a way most hearing conservation duties are not: it sets timing, test conditions and evaluation steps in named subparagraphs, so this record can be checked against the standard almost field by field.
| Clause | Requirement | Where it lands |
|---|---|---|
| OSHA 1910.95(g)(1) | Employer shall establish and maintain an audiometric testing programme for employees exposed at or above the action level | Header |
| OSHA 1910.95(g)(3) | Audiometric tests shall be pure tone, air conduction, threshold tests, with test rooms meeting specified ambient noise limits | Test conditions |
| OSHA 1910.95(g)(5)(i) | Baseline audiogram preceded by at least 14 hours without workplace noise exposure, or hearing protectors worn for that period | Test conditions |
| OSHA 1910.95(g)(5)(ii) | Annual audiogram obtained for comparison against the baseline | Results |
| OSHA 1910.95(g)(6) | Each audiogram evaluated to determine whether a standard threshold shift has occurred, with age correction permitted | Results |
| OSHA 1910.95(g)(8) | Follow-up procedures triggered where a standard threshold shift is found | Actions |
| OSHA 1910.95(g)(9) | Provisions for retesting to confirm a shift and for revising the baseline where appropriate | Actions |
| OSHA 1910.95(m) | Recordkeeping requirements for audiometric test records, retained for the duration of employment | Header |
What it does not cover
- Standard Threshold Shift Review, which is triggered once this record shows a confirmed shift and makes the work-relatedness and follow-up decision.
- Hearing Protection Fit Check, which verifies the attenuation a worker's protection actually delivers, not anything this test result implies about need.
- Noise Survey, which maps exposure across the site and is the upstream source of who is enrolled in testing at all.
- Similar Exposure Group register / Qualitative Exposure Assessment, which groups workers by exposure and sets the testing interval.
- A recordable occupational illness log entry, made once this record and the linked threshold shift review together establish that a confirmed, work-related shift meets the recording criteria.
Global
Audiometric Test Record requirements by country
The duty to test hearing is prescriptive in the United States and framed as part of a broader health surveillance duty elsewhere; the difference is how much the test conditions are regulated versus left to competent practice.
OSHA 1910.95(g)
Names the test method, the timing of baseline and annual tests, and the ambient noise limits the test room must meet.
An inspector can check this record against a named subparagraph, so a missing quiet-period confirmation or an uncalibrated booth is a specific, citable gap.
Control of Noise at Work Regulations 2005, health surveillance provisions
Requires health surveillance including audiometric testing above the upper exposure action value, without prescribing the test method itself.
Defensibility rests on following recognised guidance and being able to show it, rather than citing a regulatory clause.
ISO 1999, estimation of noise-induced hearing loss
The statistical model relating noise exposure and age to expected hearing threshold, used to judge whether a shift looks like noise or ageing.
It underpins the age correction tables this record's age correction field draws on.
How to complete it
How to complete an audiometric test record, step by step
The form prompts for the conditions and the numbers. Whether the record is trustworthy depends on whether those conditions were actually enforced and the comparison made against the right thing.
The field records a number of hours; it does not verify the worker actually avoided noise for that period, or wore protection if they didn't. Accepting the worker's word without checking the roster or protection log records a claim, not a controlled condition.
A baseline can be revised under the standard's own provisions, and comparing against a superseded one misstates the shift in either direction. Confirming which baseline is current, not which is on file, is a deliberate check.
Age correction changes whether a threshold change counts as a standard threshold shift. Applying it inconsistently between tests for the same worker manufactures apparent shifts, or hides real ones.
Marking shift detected without raising and linking a threshold shift review leaves the finding with nobody accountable for it. The review ID field exists so a shift cannot be recorded and quietly left.
What auditors find
Most common audiometric test record findings
Because the standard is prescriptive about method, findings tend to be procedural: the test was run, but a condition making the result trustworthy was skipped or not verified.
| Finding | Clause | What fixes it |
|---|---|---|
| Quiet period recorded as satisfied with no verification of what the worker actually did beforehand. | OSHA 1910.95(g)(5)(i) | Cross-check against the shift roster or protection log, or require it in writing from the worker. |
| Booth background noise not measured or not within the standard's limits before the session. | OSHA 1910.95(g)(3) | Measure and log booth ambient noise on a defined schedule, and block testing when out of tolerance. |
| Test compared against no baseline, or against a baseline later superseded. | OSHA 1910.95(g)(5)(i) | Confirm the current baseline before comparison, and flag any test where none exists. |
| Shift detected but no threshold shift review raised or linked. | OSHA 1910.95(g)(8) | Block record completion on a detected shift until a review ID is entered. |
| Age correction applied on one test and not the next for the same worker, with no stated reason. | OSHA 1910.95(g)(6) | Fix the age correction policy for the worker and apply it consistently. |
| Worker not informed of results, or informed without the finding explained in plain language. | OSHA 1910.95(g) | Require both fields signed off before the record closes, not just the technician's signature. |
Case in point
Case in point: the shift that was a Monday morning, not a Monday problem
A meat processing site ran its annual audiograms on Monday mornings to catch everyone before the working week began. One worker's test showed a clear shift at 4 kHz in the left ear, and the technician flagged it and moved on, as the schedule required. Nobody asked what the worker had done over the weekend.
The threshold shift review that followed found the worker had spent Saturday at a shooting range without hearing protection, a fact that came out only when occupational health finally asked directly. The quiet-period field had been marked satisfied because the worker had not been at work since Friday, which technically met the 14-hour rule while missing the point entirely: the exposure in the intervening period was the problem, not the workplace.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
4 sections
- Reference
- HLT-027
- Archetype
- Record
- Record ID
- AUD2-2026-000
- Scoring
- Threshold shift
- Direction
- High is bad
- Singleton
- No
- Basis
- OSHA 1910.95(g)
- Links
- Links Worker, SEG
- Tags
- Health, Noise
- Sections
- 4
- Fields
- 39
- Follow up fields
- 0
- Repeating sections
- 0
- Links out
- 3
Header
15 fieldsRecord ID*
Auto sequence. Format AUD-2026-000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time*
Completed By*
Site*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Worker*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Record Confidentiality
Clinical detail stays with occupational health. Management receives a fitness outcome and any restrictions, never a diagnosis. Restrict access to this template accordingly.
Clinical Detail Held Separately*
- Yes3 pts
- No0 pts
Access Restricted To Occupational Health*
- Yes3 pts
- Partly1 pt
- No0 pts
Worker Consent Obtained*
Consent to share the fitness outcome with the employer. Withdrawal is the worker's right.
- Yes3 pts
- No0 pts
Test Type*
Baseline, annual, retest after shift, or exit.
- Full restore4 pts
- Partial restore2 pts
- File level restore1 pt
Tester Qualified*
- Yes3 pts
- No0 pts
Equipment Calibrated*
- Yes3 pts
- No0 pts
Test conditions
6 fieldsQuiet Period Before Test Hours*
Fourteen hours away from noise is standard. Testing at the end of a shift produces a temporary shift and a false result.
Booth Background Noise Acceptable*
- Yes3 pts
- No0 pts
Otoscopic Check Done*
- Yes3 pts
- No1 pt
Wax Occlusion Present
- No3 pts
- Yes, test deferred1 pt
History Questionnaire Completed*
- Yes3 pts
- No0 pts
Non Occupational Exposures Recorded
- Yes3 pts
- No1 pt
Results
8 fieldsLeft Ear Thresholds Recorded*
- Yes3 pts
- No0 pts
Right Ear Thresholds Recorded*
- Yes3 pts
- No0 pts
Audiogram Attached
Compared With Baseline*
- Yes3 pts
- No baseline exists0 pts
Age Correction Applied
- Yes3 pts
- No1 pt
Shift Detected*
- No shift3 pts
- Shift detected0 pts
Category*
Acceptable, mild warning, referral level, or rapid loss requiring immediate action.
Notch At 4 kHz
The classic signature of noise induced loss.
- No3 pts
- Yes0 pts
Actions
10 fieldsRetest Required*
Threshold Shift Review ID
Links to HLT-028 Review ID
Referral Made
Worker Informed Of Results*
- Yes3 pts
- Partly1 pt
- No0 pts
Results Explained In Plain Language*
- Yes3 pts
- Partly1 pt
- No0 pts
Next Test Due*
Occupational Health*
Signature*
Worker*
Second Signature*
HLT-027 · record IDs look like AUD2-2026-000 · Links Worker, SEG
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The test itself is controlled and well-defined. What fails around it is scheduling the right worker for the right test at the right interval, and making sure a detected shift reaches the review that must act on it.
Schedules baseline, annual and exit tests against the exposure register, and blocks closure when a detected shift has no linked review.
Feeds noise survey and exposure data into who is due testing and when, so the programme tracks the actual hazard rather than a fixed list.
Turns a confirmed shift's protector-use finding into a retraining requirement, so a behavioural cause gets a behavioural fix.
Watches for a shift marked detected with no review raised, and surfaces it before the next test cycle passes it by.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Audiometric Test Record definitions and key terms
- Standard threshold shift (STS)
- A change in hearing threshold, relative to baseline, averaging 10 dB or more at 2000, 3000 and 4000 Hz in either ear, with age correction optionally applied.
- Baseline audiogram
- The reference test a worker's later results are compared against, established before or shortly after enrolment in noise exposure and revisable under defined conditions.
- Action level
- The exposure threshold, an 8-hour time-weighted average of 85 dBA under OSHA, above which hearing conservation programme requirements including audiometric testing apply.
- Age correction
- An adjustment to a threshold shift calculation that accounts for expected hearing loss due to ageing alone, drawn from standardised tables.
- Otoscopic examination
- A visual check of the ear canal before testing, used to identify wax occlusion or other obstruction that would produce an artificially poor result.
FAQ
Frequently asked questions about audiometric test record
Why does the quiet period matter if the test itself is accurate?+
Noise exposure in the hours before testing temporarily raises the threshold. An accurate test taken in the wrong state produces an accurate reading of the wrong thing: a temporary shift, not the worker's underlying hearing.
Should age correction always be applied?+
Not automatically. It changes whether a shift crosses the standard threshold, so applying it should be a stated policy applied consistently across a worker's tests, not a case-by-case choice.
What happens when a shift is detected?+
The record should link to a threshold shift review, where the shift is confirmed by retest, investigated for cause, and followed up. This record's job ends at detection; it does not decide what the shift means.
Does wax in the ear canal actually change the result?+
Yes. Occlusion attenuates sound reaching the eardrum and produces a threshold that looks worse than the worker's real hearing, which is why the otoscopic and occlusion checks come before the result is treated as valid.
Who is qualified to run the test?+
A certified audiometric technician, using calibrated equipment. Both are conditions the record should confirm rather than assume, since an uncalibrated audiometer invalidates everything it produces that day.
How soon after the test should the worker be told the result?+
As soon as practicable, in language they can act on rather than a raw number. A worker not told what a shift means cannot make the behavioural changes, such as consistent protector use, the finding is meant to prompt.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Used together in Hearing Conservation
Similar Exposure Group Register
Groups workers who share the same tasks, agents and exposure patterns
Qualitative Exposure Assessment
Rates likely exposure using professional judgement, task knowledge and existing data, before any sampling
Standard Threshold Shift Review
Reviews a detected hearing shift to decide whether it is work related and what to do
Hearing Protection Fit Check
Checks that a worker's hearing protection actually fits and gives the attenuation assumed
Noise Survey
Maps noise levels across an area to identify where protection and controls are needed
Hazard Communication Training
Covers chemical labels, safety data sheets and what the hazard symbols mean
More in Hearing Conservation
Standard Threshold Shift Review
Reviews a detected hearing shift to decide whether it is work related and what to do
Hearing Protection Fit Check
Checks that a worker's hearing protection actually fits and gives the attenuation assumed
Noise Survey
Maps noise levels across an area to identify where protection and controls are needed
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- OSHA 29 CFR 1910.95(g) — Audiometric testing program
- OSHA 29 CFR 1910.95, Appendix F — Calculation and application of age correction
- ANSI S3.1 — Maximum permissible ambient noise levels for audiometric test rooms
- NIOSH Criteria for a Recommended Standard: Occupational Noise Exposure
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.