Actual-model hearing-protector fitting checklist
Use with the employer’s responsible person and actual workplace information.
Use with the employer's fitting instructor and the manufacturer's instructions for the exact protector supplied. Practice in a suitable quiet location. This checklist does not supply model-specific insertion steps, prove attenuation, replace the employer's attenuation evaluation, or certify compliance. Do not treat checked boxes as proof that a formal fit test occurred.
| Record | Details |
|---|---|
| Employee / assignment | |
| Date / instructor name or role | |
| Protector manufacturer / model / size | |
| Task / noise environment for which employer selected it | |
| Manufacturer instructions used / location | |
| Other equipment worn during the fitting practice | |
| Suitable alternative needed / requested |
For each item, mark reviewed, needs action, or not applicable and record why. Use model-specific instructions to decide applicable checks.
| Practice item | Status / notes |
|---|---|
| Employer confirmed that selected protection is suitable for the assignment. | |
| Employee can identify when and where wear is required. | |
| Device inspected according to its instructions; damaged equipment replaced. | |
| Instructor demonstrated fitting steps for this exact model. | |
| Employee practiced fitting and removal using those instructions. | |
| Instructor checked initial fit and corrected observed errors. | |
| Manufacturer's fit or seal checks demonstrated, where provided. | |
| Fit checked with task equipment; eyewear, headwear, or other items interfering with protection addressed. | |
| Slipping, discomfort, or inability to achieve correct fit reported and resolved. | |
| Care, storage, reuse limits, and replacement instructions reviewed for this model. | |
| Employee located replacement supplies and identified help contact. | |
| Employer's process for supervising correct use explained. |
Follow-up
| Issue | Responsible person | Action / due date | Resolution date |
|---|---|---|---|
If formal individual fit testing is part of the employer's program, record its separate record location here: ____________________. Do not enter a result unless the test was actually performed.
Source basis: 29 CFR 1910.95(i)(1), (3)-(5), and (j). OSHA requires proper initial fitting, training in supplied protectors, supervision of correct use, and employer evaluation of attenuation. This checklist is a practical aid and does not claim that every listed documentation field or a particular fit-testing method is mandated by that section.