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  • Standard Threshold Shift Notification Letter

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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.

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How to fill out the Standard Threshold Shift Notification Letter online

Filling out the Standard Threshold Shift Notification Letter is a vital process to ensure the health and safety of employees in environments with potential hearing risks. This guide provides a clear, step-by-step approach to assist you in completing the form accurately and efficiently online.

Follow the steps to complete the form seamlessly.

  1. Click ‘Get Form’ button to obtain the form and open it in the required editor.
  2. Input the employee's name in the designated field labeled 'Employee Name'. Ensure the spelling is correct for accurate documentation.
  3. Enter the name of the company in the field marked 'Company'. This helps to associate the form with the correct organizational context.
  4. Fill in the 'Location' field with the appropriate details pertaining to where the employee works. This information is essential for proper record-keeping.
  5. Notify the employee of the 10 dB STS event. Choose to use either an Individual Summary Report or Employee Notification Letter, ensuring documentation is obtained through the employee's signature.
  6. Determine whether a retest is needed within the next 30 days, as specified, and document this decision clearly.
  7. Depending on the noise exposure levels, notify the employee of any mandatory hearing protection required. Note this in the appropriate section.
  8. If hearing protection was not previously used, assign appropriate hearing protection and verify that it meets the necessary Noise Reduction Rating.
  9. If hearing protection was used prior to the STS event, record the type of hearing protection in the designated area, ensuring its adequacy based on recent noise level surveys.
  10. Request that the employee demonstrate the appropriate use and care of their hearing protection device to validate understanding.
  11. Counsel the employee regarding the hazards of noise exposure and the importance of using hearing protection during potentially damaging circumstances.
  12. Gather the employee's signature along with the date, ensuring that all information is complete before finalizing the document.
  13. Once all sections are filled out, save your changes, and choose to download, print, or share the completed form as required.

Take the next step in ensuring workplace safety by completing the necessary forms online today.

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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.

The employee will also be informed of what will be done as a consequence (e.g. provide repeat testing within 30 days). A Standard Threshold Shift letter (see Form #2) is an appropriate method of documenting this information to the employee. A copy of the STS letter will also be forwarded to the employee's supervisor.

Threshold shifts of up to ~50 dB immediately after a single noise exposure may recover completely, while more extensive immediate hearing losses are likely to result in permanent losses of hearing sensitivity (e.g. 3, 4).

A permanent threshold shift can be caused by exposure to noise. Another common cause is age. We all lose our hearing as we age and hearing loss is a natural consequence of getting older. A permanent threshold shift may also occur as a result of disease, infection or drugs.

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.

The opposite of a temporary threshold shift is a permanent threshold shift. A permanent threshold shift is when the ability to hear is reduced permanently, which causes a permanent hearing loss. A professional hearing test can measure the level of the threshold shift and the results can be seen on an audiogram.

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. 1904.10(b)(2)

The opposite of a temporary threshold shift is a permanent threshold shift. A permanent threshold shift is when the ability to hear is reduced permanently, which causes a permanent hearing loss. A professional hearing test can measure the level of the threshold shift and the results can be seen on an audiogram.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232