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APPENDIX BEmployee Letter for Notification of STSTO: Employee name and address FROM: EHS Rep. DATE: Current Date SUBJECT:Hearing LossThe results of your recent UM Occupational Health Services physical.

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How to fill out the Sts Notification Letter online

Filling out the Sts Notification Letter is an important step in notifying employees about their hearing health. This guide provides clear instructions on how to complete the form effectively and efficiently online.

Follow the steps to complete the Sts Notification Letter.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the employee's name and address in the designated fields. Ensure that the information is accurate and up-to-date.
  3. Fill in the name and title of the EHS representative in the 'FROM' section. This person is responsible for notifying the employee.
  4. Insert the current date in the appropriate field. This date is essential for record-keeping and for the employee's reference.
  5. In the 'SUBJECT' line, clearly indicate the subject of the letter as 'Hearing Loss' to provide clarity to the employee.
  6. Continue filling out the body of the letter with specific details regarding the Standard Threshold Shift (STS). Provide explanations as needed to ensure the employee understands the significance of the results.
  7. Outline the responsibilities of the employer in regard to hearing conservation methods and personal protective equipment, ensuring that the employee knows what measures are in place to help preserve their hearing.
  8. Specify the topics to be discussed in the upcoming meeting as listed. Clearly enumerate these items to refer to during the discussion.
  9. Include spaces for both the EHS representative and the employee to sign and date the letter, confirming receipt and understanding of the information provided.
  10. After completing all fields, review the document for accuracy and clarity. Save your changes, and then download, print, or share the form as needed.

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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.

A temporary threshold shift which results in a temporary hearing loss is normally caused by exposure to intense and/or loud sounds or noise levels for a shorter or longer time. This could be e.g. an explosion or a concert.

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.

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.

Once an employee's HTL reaches the at least 25 dB over audiometric zero level, an average STS of 10 dB or more will result in a recordable STS. STS = (5 + 5 + 10)/3 = 6.7 dB and HTL = (25 + 30 + 40)/3 = 31.7 dB.

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)

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.

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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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
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
altaFlow
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