Confidentiality in Audiometry

At first glance it appears that there is a right old muddle in the noise regs and its associated guidance on running an audiometry programme. In one part it says that where an external service is providing the audiometry, the results should be maintained by the employer, securely and separate to all HR records. But in the another part it says the employer should see anonymous data only.

Some audiometry providers just give you a list of names of those who attended but we do not do that. To be honest, we think that's fairly useless and undermines the whole point of conducting the audiometry in the first place, namely that the employer can use it to verify if their noise control programme is working and also identify any individuals who may be particularly at risk and therefore give additional protection. If all the audiometry data is anonymous then doing this is nigh-on impossible and it greatly reduces the value of the audiometry process.

So, what so we do during the audiometry to address this?

Firstly, in all cases we have carefully designed the audiometry questionnaire so it does not ask for information to be written down unnecessarily. For example, we ask as a 'yes/no' if anyone in the family has a history of hearing loss, but we do not ask who that is on the form. We will verbally ask the attendee who it is and if they know how the hearing loss developed, but we don't write it on anything which anyone else will see. Similarly, if someone has a pre-existing health problem which may affect their hearing we ask if they have it, but don't ask them to write that down as we will discuss it with them - the employer may need to know generically "there is a pre-exiting health problem which is related to the hearing loss", but doesn't need to know what it is in most cases as it has no impact on work.

From there it changes depending on whether we are doing it for someone who is not a specialist in occupational health, such as the HR Manager, Production Manager, Health and Safety Manager, etc., or whether we are doing it for an in-house or external occupational health specialist.

Audiometry for non-specialists

In these cases, the person organising the audiometry is not an occupational health professional, so we've tried to find a balance between respecting confidentiality and providing a good level of information.

On the audiometry questionnaire we give the attendee the option to withhold their consent for the employer to see their result. We presume consent rather than presume no-consent as frankly most attendees don't give a monkey's either way so presuming consent unless it is withheld means the employer gets as much data as possible. From experience less than 5% of people withhold the consent, but where they do we will confirm that they attended in the report and will confirm there are no ongoing issues which the employer should be aware of, which is all the employer needs to know at the end of the day.

There is an exception to this. On very rare occasions we may come across someone who has a potentially serious hearing loss which may be noise related and they withhold consent to give the employer their audiometry result. In such cases we will override that consent if we think the problem is serious enough that the employer needs to take specific action, which ensures the employer is always aware of any people who may have problems. The reason we do this is simple - the employer, and by extension us, has a general duty that an individual cannot be permitted to continue working in such a way as they are knowingly at risk, therefore if we know they are at risk then that general duty to safeguard them has to over-rule the withholding of consent. This could otherwise be described as 'applying common sense'. To be clear though, in HSMC's audiometry programme we conduct in excess of 10,000 audiometry tests a year and in 2011 this situation arose in one single test only, so it's not a common thing.

Audiometry for Occ Health specialists

What's usually happening here is that we are being brought in to churn through larger numbers of hearing tests for an occupational health professional, either an in-house one or an appointed external provider. We have several such contracts where we do the bulk of the tests and filter out the 90% of people with no issues, leaving the specialist free to then concentrate on those who do have an issue which needs managing.

In these cases there is no option to withhold consent. This is simple really - we are conducting the audiometry on behalf of a specified occupational health provider who is appointed by the employer to look after the employees in question and we therefore provide that occupational health person with every result. The confidentiality bit then kicks in between the Occ Health person and the employer, so the employer probably doesn't get to see the detailed results but this is all bundled up in the rest of the Occ Health work the specialist is doing, which is kind of what the employer is paying them for anyway.

General consent to do an audiometry test

One last thing - we do not need the employee's written consent to do the audiometry test in the first place - the Control of Noise at Work Regs. are very clear that the employer has no option but to provide the audiometry programme, and similarly that the employee has no option but to attend the test and co-operate with it. So they have to do it, they can just have a say on what the employer then sees as a result.

So, that's proibably clear as mud!

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