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.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the employee's name and address in the designated fields. Ensure that the information is accurate and up-to-date.
- Fill in the name and title of the EHS representative in the 'FROM' section. This person is responsible for notifying the employee.
- Insert the current date in the appropriate field. This date is essential for record-keeping and for the employee's reference.
- In the 'SUBJECT' line, clearly indicate the subject of the letter as 'Hearing Loss' to provide clarity to the employee.
- 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.
- 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.
- Specify the topics to be discussed in the upcoming meeting as listed. Clearly enumerate these items to refer to during the discussion.
- Include spaces for both the EHS representative and the employee to sign and date the letter, confirming receipt and understanding of the information provided.
- 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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Get answers to your most pressing questions about US Legal Forms API.
What is an STS letter?
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.
What causes temporary threshold shift?
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.
Will an employee be notified if a standard threshold shift is identified?
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 STS in regards to hearing?
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 makes a STS recordable?
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.
What does STS mean in hearing test?
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)
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.
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