What Happens During a Workplace Audiometric Test? Step-by-Step Guide

Many Australian workers approach audiometric testing with apprehension. “Will it hurt?” “Can I fail?” “What if something’s wrong?” Understanding the actual process—what happens before, during, and after testing—reduces anxiety and improves participation and result validity. This guide walks through the complete audiometric testing experience, explaining each step in plain language.

This is essential reading for WHS managers preparing workers and for workers who want to know what to expect.

Pre-Test Conditions: The 14-Hour Quiet Period

Before the actual test, there’s a critical preparation step that most workers find surprising: the 14-hour quiet period.

What It Is

Workers must avoid exposure to significant noise for at least 14 hours before the test. This includes occupational noise (from work), recreational noise (music, concerts), and even environmental noise (lawn mowing, power tools).

Why It Matters

When the cochlea (inner ear) is exposed to loud noise, it experiences temporary threshold shift (TTS)—temporary elevated hearing thresholds. If testing occurs while TTS is present, the audiogram appears worse than the worker’s true hearing level. The test would be invalid or misleading.

Example:

• A worker exposed to noise at 8pm (before testing at 9am next morning) has only 13 hours of quiet. TTS may still be present, causing thresholds to appear 10–15 dB worse than baseline
• The same worker with 16 hours of quiet (testing done the afternoon after a full night and morning of quiet) shows true baseline thresholds

The 14-hour quiet period is designed to allow TTS to fully resolve so the test reflects the worker’s permanent hearing, not temporary fatigue.

What “Quiet” Means in Practice

The quiet period means avoiding:

• Occupational noise: Working in a noisy environment (e.g., production floor, construction site)
• Loud music: Concerts, nightclubs, loud headphone use
• Recreational power tools: Lawn mowing, power drilling, chainsaw use
• Loud traffic or machinery: Driving a loud vehicle, near heavy equipment
• Unexpected industrial noise: If you live near an airport or rail line, avoid peak times

Normal conversations, background traffic, and quiet household activities are fine.

How to Instruct Workers

When you notify workers of upcoming testing, include clear guidance:

“Please avoid exposure to loud noise for 14 hours before your scheduled test. This includes work in noisy areas, loud music, power tools, and loud recreational activities. If you’re scheduled for a morning test, avoid noise after 6pm the evening before. A quiet evening at home is ideal.”

Arrival and Registration

When the worker arrives at the testing location (either a mobile van or your site if a booth is set up):

Identification and Scheduling

The tester will check the worker’s identity and confirm the appointment. This ensures records are accurate and the right person is tested.

HPE (Hearing Protection Equipment) History Questionnaire

The tester will ask questions about the worker’s hearing protection history:

• How long have you been in a noise-exposed role?
• Do you consistently use hearing protection? What type (earplugs, earmuffs)?
• Have you ever experienced occupational hearing loss claims or tinnitus?
• Do you have any previous baseline audiograms on file?

This information contextualises the test results and helps identify workers with longer exposure histories.

Previous Baseline Retrieval

If this is not the worker’s first test, the tester will attempt to locate the previous baseline audiogram for comparison. This is crucial—the test’s real value is comparing current hearing to baseline, not assessing absolute thresholds.

If no previous baseline exists (e.g., first test), the current test becomes the baseline for future comparison.

Pre-Test Interview

Before entering the testing booth, the audiometrist conducts a brief clinical interview:

Tinnitus and Ear Health

“Do you have any ringing, buzzing, or hissing sounds in your ears? Any pain, discharge, or recent ear infections?”

Tinnitus is significant because it can indicate cochlear damage (often the first symptom of noise-induced hearing loss). Recent ear infections or ear canal issues can affect test validity.

Recent Illness or Medication

“Are you currently ill or taking any medications?” Some medications (certain antibiotics, aspirin, some blood pressure medications) can affect hearing temporarily.

Work History and Noise Exposure

“How long have you worked in this role? What’s the noise like—constant, intermittent, very loud?”

This helps the tester understand the risk profile and interpret results in context.

Reassurance and Explanation

The tester will explain the test procedure briefly. This is where you hear: “The test doesn’t hurt. You’ll hear tones at different pitches and volumes. When you hear them, you’ll just raise your hand or press a button. There are no right or wrong answers—we’re just finding the quietest sounds you can hear.”

The Test Setup

Entering the Sound-Attenuating Booth

The worker enters a mobile sound-attenuating booth—a small, quiet enclosure that looks like a telephone booth or small cabin. The booth has a door that closes, achieving the specific ambient noise levels required by AS/NZS 1269.4 (usually <70 dB SPL, and much lower at high frequencies).

First-time experience note: Some workers feel claustrophobic in a booth. Testers are experienced with this and can leave the door ajar or test in an alternative configuration if needed (though this may affect compliance).

Headphone Placement

Audiometric headphones (circumaural earphones—large headphones that cover the entire ear) are placed on the worker’s head. These are calibrated to deliver precise sound levels and frequencies.

The fit must be snug to ensure acoustic isolation. The tester will ask: “Are they comfortable? Can you hear me?” and adjust as needed.

Response Indicator

The worker is given a response button or hand-raise gesture to signal when they hear a tone. The tester explains: “When you hear any sound, no matter how quiet, press the button (or raise your hand). Keep pressing as long as you hear it.”

The Pure Tone Audiometry Test

Now the actual hearing test begins:

What the Tones Sound Like

The worker hears pure tones—simple sine waves at specific frequencies. They’re not speech, music, or environmental sounds; they’re just tones that get progressively quieter until they’re inaudible.

Analogy: Imagine a pure musical note played by a tuning fork, gradually getting quieter until you can no longer hear it. That’s the sensation.

Frequency Sweep (250 Hz to 8000 Hz)

The test covers eight frequencies—250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz—spanning the range of human speech and noise exposure:

• 250–1000 Hz (low frequencies): Related to vowel sounds in speech
• 2000–4000 Hz (mid-to-high frequencies): Related to consonants and speech clarity. This is where NIHL typically shows first (especially 4000 Hz)
• 6000–8000 Hz (high frequencies): High-frequency hearing; often affected by age and noise

For each frequency, the test is conducted twice—once on the right ear, once on the left ear.

Air Conduction Testing

First, the test uses standard audiometric headphones (air conduction). Tones travel through the outer and middle ear to reach the inner ear (cochlea). This tests the entire hearing pathway.

The tester uses a bracketing method: starts with an audible tone, then progressively reduces the level until the worker no longer responds. Then increases it slightly until the worker responds again. This narrows down the threshold—the quietest level at which the worker consistently hears the tone.

Typical thresholds (normal hearing): 0–25 dB HL (decibels Hearing Level) at most frequencies.

Bone Conduction Testing

After air conduction, the worker may undergo bone conduction testing. A bone conduction vibrator (a small oscillator) is placed on the mastoid bone (behind the ear). Rather than traveling through the ear canal, the sound vibrations travel directly through the skull bone to the cochlea, bypassing the outer and middle ear.

Bone conduction helps distinguish between two types of hearing loss:

• Conductive hearing loss: Problem in the outer/middle ear (e.g., ear infection, earwax, fluid). Air conduction thresholds are worse than bone conduction
• Sensorineural hearing loss: Problem in the inner ear/cochlea (e.g., NIHL, age-related loss). Air and bone conduction thresholds are similar

For workplace NIHL, bone conduction is usually normal or similarly affected, indicating sensorineural loss.

Note: Bone conduction testing is not always performed in routine workplace testing; it depends on the provider and the initial results. If air conduction is normal, bone conduction is usually skipped.

The Otoscopic Examination

Before or after testing, the tester may perform an otoscopic examination—looking into the ear canal with a small light (otoscope) to check for:

• Earwax impaction (can affect test results)
• Ear canal irritation or infection
• Normal canal anatomy

This is a quick, non-invasive procedure. If significant earwax is found, the tester may note this and suggest ear cleaning, but it doesn’t stop the test.

Post-Test Discussion

Once testing is complete, the tester reviews the preliminary results with the worker:

Audiogram Explanation

The tester will briefly explain the graph (audiogram) and what it shows. You’ll hear something like: “Your hearing is within normal limits across all frequencies” or “There’s a slight dip at 4000 Hz, which is something we’ll monitor.”

Referral Flag Discussion

If results warrant a referral (significant threshold shift, abnormal findings), the tester will explain this and discuss next steps. Important point: The tester will NOT say “you have hearing loss” or “you’re deaf”—they’ll use medical language like “elevated thresholds” or “findings requiring further assessment.”

Worker Concerns

The worker has a chance to ask questions. Common ones:

• “Do these results mean I’m going deaf?” (Usually: “No, we’re just monitoring. No signs of severe loss today.”)
• “What do I do if it gets worse?” (Usually: “We’ll retest in a year; if changes occur, we’ll refer you to a specialist.”)
• “Why is my hearing not perfect?” (Age-related loss, previous noise exposure, individual variation—all normal)

Time Per Test

The entire process typically takes 10–15 minutes per worker:

• Registration and history: 2–3 minutes
• Pre-test interview: 2–3 minutes
• Setup and ear examination: 1–2 minutes
• Actual audiometry: 5–7 minutes (depending on whether bone conduction is tested)
• Discussion: 1–2 minutes

If the worker is nervous or has questions, testing might take 15–20 minutes. If testing is straightforward, it can be as quick as 10 minutes.

Common Worker Concerns and Misconceptions

Concern: “It Doesn’t Hurt, Right?”

True. Audiometric testing is completely painless. No needles, no invasive procedures. The only discomfort is sometimes the snug fit of headphones, which is minor.

Concern: “Can I Fail?”

False. There’s no pass/fail in audiometric testing. Results are categorised as “Normal” or “Refer” (requires further assessment), not “Pass” or “Fail.” Every worker’s results are unique and contextualised to their age and exposure history.

Concern: “Are My Results Private?”

Mostly true. Individual audiograms are confidential health information. The employer receives a summary report (Normal or Refer categories), not individual audiograms, unless the worker consents. The worker always receives their own results.

Concern: “I Have Tinnitus—Does That Mean Something’s Wrong?”

Tinnitus is a flag, not a diagnosis. Tinnitus often accompanies noise-induced hearing loss, but not always. The audiogram will show whether hearing is affected. If tinnitus is present but hearing is normal, this is noted as “tinnitus without measurable hearing loss”—still monitored but not necessarily pathological.

Concern: “What If the Test Shows I’m Deaf?”

Unlikely in a workplace audiometric test. Workplace testing looks for early detection of hearing changes, not severe deafness. If severe loss is detected, the tester will have already noted it during pre-test and the worker would likely have noticed symptoms. Testing aims to catch early changes, not diagnose advanced loss.

Frequently Asked Questions

Q1: What if I can’t hear very quiet sounds? Does that mean I have hearing loss?

Not necessarily. The test establishes your personal thresholds, which vary by age and individual factors. The tester compares your results to an age-adjusted reference. If you’re 60 and have higher thresholds than a 25-year-old, that’s expected and normal.

Q2: Can I fail the 14-hour quiet period and still get tested?

You can, but the test may be less valid. If you have unavoidable noise exposure (e.g., shift work), notify the tester so they can note this in the report. Some providers will allow testing but flag that the result may show temporary threshold shift.

Q3: What if I’m feeling unwell on the day of testing—should I reschedule?

If you have an acute ear infection, pain, or significant illness, yes, reschedule. Minor colds usually don’t affect the test, but ear-related illness should be postponed.

Q4: How accurate is audiometric testing?

Very accurate, if done correctly to AS/NZS 1269.4 standards. Thresholds are typically reproducible to within 3–5 dB across repeat tests. Some natural variation is expected, but major changes are significant.

Q5: Can hearing aids or other medical devices affect the test?

If you wear hearing aids, you’ll be tested both with and without them. The audiogram will show your unaided threshold (your natural hearing) and your aided benefit (the improvement provided by the aids).

Q6: What if I had a loud event the day of testing—can that affect results?

Yes, it can. If you’re exposed to significant noise within 4–6 hours before testing, temporary threshold shift may still be present. Notify the tester so they can note this.

Q7: How long should I avoid discussing my results with other workers?

Your results are your personal health information. You can discuss them with anyone you choose, but the employer shouldn’t broadcast individual results. The employer only receives categorical summaries (Normal/Refer counts), not individual data.

Q8: If I get a “Refer” result, what happens next?

You’ll be referred to an audiologist or ENT specialist for further assessment. Your employer should cover this cost under WHS obligations. The referral assessment determines whether the threshold shift represents a permanent condition requiring intervention or management.