Audiometric testing can be performed by audiologists, physicians (including ENT specialists), and trained technicians working under professional supervision. The exact qualifications depend on the setting: workplace hearing conservation programs, clinical diagnostics, and school screenings each have different rules about who can run the test and, just as importantly, who can interpret the results.
Workplace Testing Under OSHA Rules
Most people encounter audiometric testing through their job, particularly in noisy industries like manufacturing, construction, and military service. OSHA’s occupational noise standard (29 CFR 1910.95) spells out exactly who can administer these tests. The approved list includes a licensed or certified audiologist, an otolaryngologist (ENT doctor), any other physician, or a technician who meets specific competency requirements.
Technicians are the ones conducting the vast majority of workplace hearing tests. To qualify, a technician must either hold certification from the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or have demonstrated competence in administering audiometric exams, obtaining valid audiograms, and maintaining and calibrating equipment. There is one notable exception: technicians who operate microprocessor-based audiometers (the modern, largely automated kind) are not required to hold certification.
Regardless of certification status, every technician who performs audiometric tests must be “responsible to” an audiologist, otolaryngologist, or physician. That supervising professional does not need to be physically present during testing. Their role is to review audiograms, identify meaningful shifts in hearing, and determine whether a worker needs further evaluation. The technician handles the day-to-day testing; the professional supervisor handles the clinical judgment.
What Occupational Hearing Technicians Can and Cannot Do
A CAOHC-certified Occupational Hearing Conservationist (COHC) is trained to perform a specific, limited set of tasks. They conduct visual inspections of the ear canal to check for obvious blockages like earwax, administer baseline and annual pure-tone air conduction tests, flag problem audiograms for professional review, and ensure equipment is calibrated and functioning properly. They also fit and train workers on hearing protection devices and must notify employees in writing within 21 days of identifying a significant change in hearing.
The boundaries are equally clear. A COHC cannot interpret audiograms, diagnose hearing disorders, conduct bone conduction or speech audiometry testing, independently evaluate the effectiveness of a hearing conservation program, or supervise other personnel. Those tasks require a licensed audiologist or physician. If a technician identifies something abnormal, their job is to refer the employee onward, not to explain what the results mean clinically.
Audiologists: The Primary Diagnostic Professionals
For full diagnostic audiometric testing outside the workplace, audiologists are the go-to professionals. They hold doctoral degrees (typically an AuD, though some hold a PhD or ScD) and are licensed to evaluate, diagnose, treat, and manage hearing loss and balance disorders across all age groups. Their testing goes well beyond the simple pure-tone screening done at work. Audiologists perform speech recognition testing, bone conduction testing, tympanometry, and specialized evaluations for conditions like auditory processing disorder, which only an audiologist is qualified to diagnose.
If you’ve noticed a gradual decline in hearing, such as frequently asking people to repeat themselves or turning the TV louder than others prefer, an audiologist is typically the right starting point. They map out exactly what you can and cannot hear, determine the type and severity of hearing loss, and recommend treatment options including hearing aids or assistive devices.
ENT Doctors and Other Physicians
Otolaryngologists are medical doctors and surgeons who specialize in conditions of the ear, nose, and throat. While they can perform and order audiometric testing, their primary role is diagnosing and treating the underlying medical causes of hearing problems: infections, structural abnormalities, tumors, or conditions requiring surgery. You would typically see an ENT rather than starting with an audiologist if you experience sudden hearing loss (which is a medical emergency), ear pain or drainage, recurring ear infections, or dizziness and vertigo.
In practice, ENTs and audiologists work closely together. An audiologist who finds that hearing aids aren’t providing enough benefit for severe hearing loss will refer you to an ENT to discuss surgical options like cochlear implants. For complex cases, you’ll likely see both.
Other physicians, including primary care doctors, are also legally permitted to perform or order audiometric testing under OSHA standards and in clinical practice, though most refer patients to audiologists for detailed evaluations.
Hearing Instrument Specialists
Hearing instrument specialists (sometimes called hearing aid dispensers) are state-licensed professionals trained to evaluate common types of hearing loss in adults and fit hearing aids. They can conduct basic hearing tests for the purpose of selecting and fitting amplification devices. However, they do not diagnose hearing loss or hearing disorders and are not trained to evaluate or treat tinnitus, hyperacusis, auditory processing disorders, or other complex auditory conditions. If your concern goes beyond needing a hearing aid, an audiologist offers a broader scope of care.
School Hearing Screenings
Children typically receive periodic hearing screenings at school, and the personnel rules vary by state. California, for example, requires school audiometrists to complete a minimum of eight quarter-hours of academic and practical training in audiology, identification audiometry, and hearing assessment from an accredited institution. Public health nurses and credentialed school nurses can qualify through a shorter four quarter-hour approved course instead. These screenings are pass/fail checks designed to catch potential problems early, not diagnostic evaluations. A child who fails a screening gets referred to an audiologist or physician for a full workup.
Automated Testing and Expanding Access
Automated audiometry systems are changing how and where testing happens. The U.S. Department of Defense uses a system that allows technicians to test up to eight people simultaneously in a sound-treated booth, now installed at more than 750 military sites. Newer wireless automated systems reduce the need for dedicated sound booths altogether, requiring less technician time and making mobile or remote hearing services practical.
Validation studies have found strong agreement between automated and traditional manual audiometry, and results from these systems are already being used in routine clinical care, not just research. The technology is particularly promising for expanding access in remote or resource-limited areas where audiologists are scarce. Even so, automated systems still operate under the same supervision framework: a trained person administers the test, and a qualified professional reviews any results that need clinical interpretation.