You’ve had a hearing test at work and been referred — yet your GP or Audiologist says your hearing is “fine.” Who’s right?
Both are right!
This apparent contradiction between occupational health and a GP or audiologist gets to the heart of why the HSE’s 3rd Edition of the Hearing Surveillance Guidance (2021) made an important change: in most cases, GPs should not be used for occupational hearing referrals. We covered this in an earlier blog
GP vs. OHP – What’s the Difference?
A GP (General Practitioner) is, by definition, a generalist. Their role is to manage your overall health and decide whether you might need medical intervention, such as a hearing aid or earwax removal.
An Occupational Health Physician (OHP), however, focuses on whether your work is harming your health — for example, whether your job’s noise exposure is damaging your hearing.
Put simply:
GP/Audiologist: “Does this person need help hearing better?”
OHP: “Is this person’s hearing being damaged by their job?”
Prevention vs. Reaction
Occupational health is preventative — it looks for early warning signs before permanent damage occurs. GPs and Audiologists, by contrast, are typically reactive, intervening once hearing loss is clinically significant.
That’s why you may be referred after a workplace screening even though your GP/hearing care specialist would consider your hearing “normal.” The goal is early detection — stopping damage before it progresses.
Spotting Noise-Induced Hearing Loss
Unfortunately, Noise-Induced Hearing Loss (NIHL) is notoriously hard to diagnose and the HSE failed to provide criteria to identify it (unlike in the case of poor hearing, where there is a defined set of hearing levels). Which makes NIHL difficult to spot. Helpfully, the Society of Occupational Medicine and the UK Hearing Conservation Association have provided supplementary guidance to help — mainly around identification of a “notch” around 4 kHz in your hearing thresholds. This information is used to identify NIHL in the individual and thereby signpost any systemic issues in the workplace which might be causing elevated noise levels or other reasons for NIHL.
And detection of NIHL doesn’t just protect you as an individual — it helps identify wider workplace risks like poor use of hearing protection or excessive noise exposure.
Which again means that the point of surveillance and screening is to take action as soon as possible.
The Bottom Line of Occupational Health
If your occupational health team tells you there are early signs of damage, take it seriously. Whether you’re 20 or 64, preventing avoidable hearing loss today means protecting your quality of life tomorrow.
When both your GP and Occupational Health seem to disagree, remember: in a well-run surveillance programme, they’re both right — your hearing is still good, and that’s exactly why it’s the right time to act.
Conclusion: To GP or not GP?
Because they are both right – in their own ways – this apparent conflict between GP’s/Audiologist and OHP’s explains why the CORRECT referral pathway after hearing surveillance is for analysis by an OHP and NOT a GP or Audiologist. The OHP can then make the correct assessment in the context of occupational health and direct any onward referral.
About Hearing Wizard, by Health Wizard
Hearing Wizard Surveillance Audiometry assesses all surveillance hearing tests according to both the HSE guidance and the SOM/UKHCA supplementary guidance. Our OHPs are on hand to manage any referrals – or we can refer into your OHP pathway, so that workers get the best access to the appropriate care pathway.