The physician should consult the Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities and the Medical Management Guidelines for Acute Chemical Exposure (search OSHA website: http://www.osha.gov).
Medical Surveillance for Employee Categories
If the employee is covered by this chapter and is:
Then you must:
• Exposed for at least 30 days a year to health hazards or hazardous substances at or above the permissible exposure limit or published exposure levels (even when respirators are used),
• Required to wear a respirator for at least 30 days a year.*
• Offer standard medical surveillance as specified in Table 8.*
• A hazardous materials (HAZMAT) team member
• A hazardous materials specialist
• Provide standard medical surveillance as specified in Table 8.
• An emergency responder who shows immediate or delayed signs or symptoms possibly resulting from exposure to hazardous substances during an incident.
• Provide incident-specific medical surveillance as specified in Table 8.
• Not an emergency responder and:
- May be injured
- Shows immediate or delayed signs or symptoms possibly resulting from exposure to hazardous substances
- May have been exposed to hazardous substances at concentrations above the permissible exposure limits (PELs) or the published exposure levels without appropriate PPE.
• Offer incident-specific medical surveillance as specified in Table 8.
A medical evaluation for respirator use is required by chapter 296-842 WAC, Respirators, for those employees who have not been cleared for respirator use during medical surveillance activities.
Frequency of Exams and Consultations
If the employee is covered by:
Then medical surveillance must include:
• Standard medical surveillance
• Exams and consultations:
- Before assignment.
Note: If the employee is a hazardous materials (HAZMAT) team member or a hazardous materials specialist, the employee must receive a baseline physical examination.
- At least once every 12 months after their initial assignment unless the physician believes a shorter, or longer interval (but no more than 24 months) is appropriate.
- Whenever employees are reassigned to an area where they will no longer be covered by medical surveillance and they have not been examined within the past 6 months.
- As soon as possible after an employee reports:
♦ Signs or symptoms of possible overexposure to hazardous substances or health hazards
♦ Exposure above the permissible exposure limits or published exposure levels
- At the termination of their employment unless they were examined within the past 6 months.
• Incident-specific medical surveillance
• Medical consultations and exams:
- As soon as possible following the incident or development of signs or symptoms.
- At additional times, if the physician determines follow-up is medically necessary.