Noise and Hearing Conservation Functional Checklist

PAC:
Facility / Location:
Date of Assessment:
Assessment Team Composition:

Compliance (Mark 1 in the relevant column)

NO Checklist Evidences Remark
Yes No N/A
1. Planning
1.1 Hearing conservation programme (HCP) management i. HCP procedure.
HCP programmes have been established according to OSH (Noise Exposure) Regulations 2019 & ICOP Noise 2019 ii. HCA identification / appointment.
that include appointment of Hearing Conservation Administrator (HCA) who is responsible of administering & supervising iii. HSE Plan that include element of HCP.
hearing conservation programme.
1.2 Identification of excessive noise Filled annual checklist of identification of excessive
Identification of excessive noise has been conducted annually or if there is a change in the machinery, equipment, noiseas per Appendix 1 of ICOP Noise 2019.
process, work, control measures or operation at the workplace which may exposure workers to excessive noise.

1.3 Noise Risk Assessment Valid Noise Risk Assessment report.

Noise Risk Assessment has been conducted upon positive findings from identification of excessive noise by engaging
with a DOSH registered Noise Risk Assessor & reviewed once every 5 years,
1.4 Assessment of Noise Control Noise Control Assesment Report or Remedial action plan
An assessment whether it is practicable to reduce excessive noise by way of engineering control or administrative from Noise Risk Assessment findings.
control based on recommendation from Noise Risk Assessment report has been conducted.
1.5 Implementation of Noise Control Closure of remedial action plan from Noise Risk
Recommendations from Noise Risk Assessment report have been carried out Assessment findings with supporting evidence.
1.6 Inspection & maintenance of noise engineering controls Maintenance plan & record of noise engineering control.
A system has been established to ensure regular inspection & maintenance of vibration mountings, impact absorbers,
gaskets, seals, silencers, barriers, absorptive materials & other equipment used to control noise.
1.7 Personal Hearing Protector (PHP) i. PHP purchase record (DOSH-SIRIM Certification)
- Approved PHPs have been provided to exposed workers and is suitable, efficient & able to attenuate workers' ii. HCP / PPE procedure outlining PHP selection,
exposure below the Noise Exposure Limit (NEL). inspection & maintenance requirement
- The PHP provided is properly inspected, maintained & made available at all time.

1.8 Information & Training i. Noise & HCA attendance record

Annual Noise & Hearing Conservation Awareness (HCA) training has been conducted for workers exposed to excessive ii. Training module
noise covering the elements as specified in OSH (Noise Exposure) Regulations 2019 & ICOP Noise 2019.
1.9 Audiometric Testing i. Tracking of annual audiometric testing completion
Annual audiometric testing & analysis (compare with baseline audiogram) has been conducted for workers who are ii. Audiometric testing record / analysis report
exposed to excessive noise above than the NEL at the approved Audiometric Testing Centre (ATC)
2. Execution & Monitoring
2.1 Issuance & Wearing of Personal Hearing Protector (PHP) i PHP issuance record (site sampling)
- Record of PHP issuance is available ii. Actual PHP worn for a specified task as per Noise Risk
- Workers wear PHP based on the requirement as specified in the risk assessment & PTW Assessment / JHA / PTW / PPE matrix (site sampling)
2.2 Hearing Protection Zone (Noise Warning Sign) Noise warning signs meeting the regulatory requirement
Noise warning sign 'marked' with the words "HEARING PROTECTION ZONE" at areas where workers are exposed to (site sampling)
excessive noise above than the NEL is available.

Percentage Compliance
#DIV/0!
= Total Complied(Y) / Total Questionnaires(Y+N)

References:

1 OSH (Noise Exposure) Regulations 2019

2 Industry Code of Practice for Management of Occupational Noise Exposure & Hearing Conservation 2019
3 Self-assessment checklist on Noise Integrated & Comprehensive Enforcement (NICE) by DOSH
4 Self-assessment checklist on Noise Control & Preventive Programme (NCAPP) / NIHL Enforcement (NFORCE) by
DOSH

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