NIOSHTIC-2 Publications Search

Health hazard evaluation report: HETA-2003-0273; 2003-0280; 2003-0287-2974, Kaiser-Permanente, Santa Teresa, Redwood City, and Santa Clara, California.

Tubbs-RL; Kardous-CA
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2003-0273-0280-0287-2974, 2005 Jun; :1-29
In May and June 2003, the National Institute for Occupational Safety and Health (NIOSH) received three separate requests from the Service Employees International Union (SEIU) Local 250 officials to conduct health hazard evaluations in the Health Information Management (HIM) offices of Kaiser Permanente hospitals in the South Bay region of California. The requests involved medical transcriptionists who use a telephone dictation system to transcribe medical records dictated by hospital physicians. The transcriptionists were concerned about excessive noise from the telephone headset. Before NIOSH received the union's request, a California Occupational Safety and Health Administration (Cal-OSHA) industrial hygienist began an investigation at Kaiser Permanente in April 2003. Shortly thereafter, Cal-OSHA contacted the Federal OSHA Salt Lake Technical Center about a procedure for measuring headset noise they had published in the OSHA Technical Manual. Cal-OSHA also contacted NIOSH to discuss the technical difficulties associated with the investigation. These discussions eventually led to the request from the union on behalf of the employees. During the week of January 27, 2004, NIOSH and OSHA investigators visited the Kaiser Permanente hospitals and measured the noise levels through the transcriptionists' headsets with an acoustic mannequin and the ambient noise levels in their offices. Employees in each of the three HIM departments were interviewed by a NIOSH investigator to document their concerns about the dictation system and any symptoms they felt were the result of their work. In the fall of 2004, a telephone dictation system similar to the ones used at Kaiser Permanente was evaluated in the NIOSH Acoustics Laboratory in Cincinnati, Ohio, using actual medical dictations. These dictations were chosen by the transcriptionists as problematic. The noise levels and quality of the recordings were evaluated at three volume settings to determine the risk for excess noise exposure and the clarity of the dictations. The NIOSH investigators determined that a potential for excessive noise exposure exists with the dictation equipment used by the medical transcriptionists at Kaiser Permanente. Excessive noise is delivered through the headsets when the manual volume control on the telephone dictation system is left in the maximum position. If the volume control is placed in the middle position or lower, the noise exposures through the headsets are at a safe level for an 8-hour work shift. Recommendations are offered to the employees and management at Kaiser Permanente to maintain the noise levels from the headsets at a safe level and to improve the clarity of medical dictations.
Region-9; Hazard-Confirmed; Noise; Noise-control; Noise-levels; Hearing-conservation; Medical-facilities; Health-care-facilities; Author Keywords: General medical and surgical hospitals; medical transcriptionists; medical records; dictation; hearing loss; noise; telephone headsets; room noise; hearing conservation program
Publication Date
Document Type
Field Studies; Hazard Evaluation and Technical Assistance
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
HETA-2003-0273-2974; HETA-2003-0280-2974; 2003-0287-2974
NIOSH Division
SIC Code
Source Name
National Institute for Occupational Safety and Health
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division