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SAMPLE SAFETY TRAINING AND
INSTRUCTION PROGRAM
OCCUPATIONAL
NOISE EXPOSURE
OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
DISCLAIMER
This sample safety program is intended solely as a
guide and template for employer reference and
use. This sample program is not intended to be
implemented as is, nor is it intended to comply with
any federal, state, or local regulation or
statute. Rather, the sample program is meant to
assist each employer in developing its own written
safety program based upon its specific needs and
requirements. An employer should review the OSHA
standards for specific requirements applicable to its
operations and make adjustments to this sample
program based upon those requirements.
An
employer will need to modify the sample safety
program by adding information relevant to its
particular jobsites or facilities in order to develop an
effective, comprehensive program. The failure of an
employer to develop its own written safety program
designed for its own operations may result in a
violation of OSHA standards.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
Responsibility: (EMPLOYER NAME) is responsible for administering all facets of
this program and has full authority to make necessary decisions to ensure success of
the program
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
TABLE OF CONTENTS
1. Written Program
6. Training
2. Purpose
7. Code of Safe Practices
3. General
8. Written Assessment
4. Testing and Monitoring
9. Compliance Checklist
5. Employee Notification
10. Job Hazard Analysis
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
1. WRITTEN PROGRAM
This standard practice instruction will be reviewed on annual basis and updated as
changes in company occur, or as changes are noted to 29 CFR 1926.52 which
require revision of this document. Effective implementation of this program requires
support from all levels of management within (EMPLOYER NAME). This written
program will be communicated to all personnel that are affected by it. It encompasses
the total workplace, regardless of the number of workers employed or the number of
work shifts.
2. PURPOSE
It is the intent of this program to provide protection against the effects of noise. When
employees are exposed to excessive levels of workplace noise they will be provided
hearing protection. It will be the policy of all (EMPLOYER NAME) jobsites to prevent,
whenever possible, exposure of employees to noise levels exceeding 90 decibels, “A”
scale (dbA) based on an 8 hour time weighted average (8-hr TWA)
3. GENERAL
3.1 Exposure to noise levels exceeding 90 dBA (8-hrTWA) .
All employees shall wear approved hearing protection at all times in areas with
noise levels that exceed 90 dBA (8-hrTWA). The hearing protection must
reduce the decibel level below 90 dBA (TWA).
Examples of allowable noise levels and durations are included in the following
table:
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
Per Day/Per Hour
Duration Sound Level dBA (8-hrTWA)
8
90
6
92
4
95
3
97
2
100
1½
102
1
105
½
110
1/4 or less
115
(Examples of equipment which may produce noise levels sufficient to trigger
hearing protection requirements include, but are not limited to: welding
machines, jack hammers, compactors, compressors, backhoes, hilti tools, and
the many others.)
3.2 When noise levels exceed these levels, management must first attempt to
reduce noise levels through institution of engineering controls, work practices
and / or administrative controls. If no controls are practical or such controls fail
to reduce sound levels below the levels in the above table, personal protective
equipment, hearing protection must be used at all times during exposure to
sound levels in excess of the values in the table.
3.3 Approved hearing protection equipment consists of noise attenuating
earplugs and muffs. Earplugs shall be fitted individually for all affected
employees according to the manufacturers instructions.
3.4 Employees shall not be exposed to impulsive or impact noises exceeding
140 dBA (TWA) peak sound pressure level.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
4. TESTING AND MONITORING
4.1 Identification of High Noise Areas.
The site manager on each project shall, prior to commencement of on-site
work, ask the client to identify known or likely high-noise areas, and to provide
(EMPLOYER NAME) with the results of any surveys, monitoring, tests and
other information indicating noise levels in such areas. (EMPLOYER NAME)
shall use such information provided by clients to help determine potential noise
problems, however, (EMPLOYER NAME) shall not rely solely on such client for
information in determining the need for noise protection measures.
4.2 Noise Surveys.
At the beginning of any activity that might be expected to generate noise levels
near the values shown in the table above, (EMPLOYER) shall conduct its own
initial site- specific noise level survey, to assess and document prevalent noise
levels. This survey shall be used to confirm the results of any client-provided
information and to identify any other significant noise exposures, and the
results of this survey shall form the basis for determine employee noise
exposure. This equipment must meet the OSHA requirements. Documentation
shall be kept, at minimum, for the life of the project.
5. EMPLOYEE NOTIFICATION
Eight hour time-weighted average noise monitoring results will be posted in a
conspicuous location. Employees will be notified at time of hire and annually
thereafter regarding their right to see and copy exposure monitoring results.
A copy of the OSHA Noise Standard and applicable information and training material
will be kept on-site. Employees will be informed of the availability of these documents
for review.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
6. TRAINING
Employees will be trained in :

The proper use of hearing protection

The hazards associated with noise

The requirements of the OSHA Standard
Learning will be documented, validated and retained for the life of the project, at
minimum.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
7. Code of Safe Practices
OCCUPATIONAL NOISE EXPOSURE
Hearing loss can be prevented if the appropriate preventative measures are taken.
The following Code of Safe Practices are provided to assist employees and
supervisors in the prevention of on the job hearing loss.
1. Noise levels shall be established before employee exposure.
2. Noise exposure shall be measured using the proper procedures.
3. Equipment shall be calibrated properly.
4. Engineering controls shall be developed and implemented.
5. Noise survey information shall be transmitted according to regulatory
requirements.
6. OSHA Regulations shall be available for all employees to review.
7. Employees shall be trained and evaluated annually.
8. Hearing protection shall be provide for all affected employees.
9. Managers and supervisors shall be provided and wear hearing protection.
10. Different sizes and styles of hearing protection shall be available to affected
employees.
11. Employees shall be fitted for proper size and fit of hearing protection.
12. Hearing protection shall be checked and replaced regularly.
13. Employees are responsible for complying with Company and Regulatory
requirements.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
8. WRITTEN ASSESSMENT
1. Excessive noise can cause temporary hearing loss? True or False
2. Hearing protection helps prevent noise induced hearing loss? True or False
3. The best type of hearing protection is?
a. Cotton
b. Ear insert
c. Ear muffs
d. Both b and c
4. A one time loud noise can cause permanent hearing loss? True or False
5. Its best to following the instruction when inserting the earplug? True or False
6. Noise should be controlled at the source? True or False
7. Noise is a wave in the air? True or False
8. Hearing loss is measurable? True or False
9. Which of the following is a critical factor in the analysis of noise exposure?
a. the frequency composition
b. the duration of noise exposure
c. the sound level
d. all of the above
10. The effects of sounds produce what undesirable effects on human?
a. masking of wanted sounds
b. auditory fatigue
c. damage to hearing
d. annoyance
e. all of the above
11. Describe the effects of noise on hearing:
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
12. List the purpose of hearing protection:
13. Discuss the selection, fitting and use of hearing protection
14. Explain the noise hazards of a task
15. Explain how to properly maintain hearing protection
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
9. COMPLIANCE CHECKLIST
YES
1. Noise levels have been established.
2. Noise has been measured using the proper procedures.
3. Equipment has been calibrated.
4. Engineering controls have been developed and implemented.
5. Noise maps have been established.
6. Noise survey information is transmitted according to requirements.
7. OSHA Regulations are available for employee review.
8. Employees are trained annually.
9. All employees have been trained.
10. Hearing protection has been provided.
11. Managers and supervisors are directly involved.
12. Managers and supervisors wear hearing protection.
13. Different sizes and styles of hearing protection are available.
14. Employees are fitted for proper size and fit of hearing protection.
15. Employees are wearing hearing protection.
16. Hearing protection is checked and replaced regularly.
17. Company Disciplinary Policy enforced for non compliance.
SAMPLE SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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NO
OCCUPATIONAL
NOISE EXPOSURE
(EMPLOYER NAME)
10. Job Hazard Analysis
Job No.
(COMPANY NAME)
PRE-JOB HAZARD
ANALYSIS
Activity
Excessive Noise Exposure
Page
Date:
of
JHA No.
Revised:
Site:
Contractor:
Analysis By:
Job Description:
Project Mgr.
Revised By:
Location:
Supt.
Approved By:
Potential Hazards
Potential hearing and communication loss
New:
Recommended Action, Procedure, and/or Equipment
Conduct noise survey to determine 8-hr TWA.
Where possible, noise should be controlled at the source.
Do not enter the space without hearing protection.
Employee/management training.
Provide variation of hearing protection.
Monitor hearing protection proper usage.
Provide visitors and others with hearing protection.
Keep records of noise survey, training and hearing protection usage.
Project Safety Representative
(EMPLOYER NAME)
OCCUPATIONAL
NOISE EXPOSURE
EMPLOYEE ACKNOWLEDGEMENT
By signing below, I acknowledge that I understand and agree to comply with
(EMPLOYER NAME) “Occupational Noise Exposure Safety Program” and Company
Safety Policies and Procedures. I have reviewed a copy of the Program and have
received a verbal orientation identifying the safety requirements associated with the
scope of work contained in this Program.
This statement is to remain in the files of (EMPLOYER NAME).
SIGNATURE
DATE
IMPACT MODEL SAFETY TRAINING AND INSTRUCTION PROGRAM | OCCUPATIONAL NOISE EXPOSURE
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