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PDFWAC 296-307-70420

Medical surveillance.

Provide medical surveillance to employees.
You must:
(1) Provide medical surveillance for employees to comply with Tables 7 and 8, and the following:
• Make medical surveillance available at:
– Reasonable times and places.
– No cost to employees, including travel associated costs such as mileage, gas or bus fare if the employee is required to travel off site
and
– Wages for additional time spent outside of employees' normal work hours.
• Make sure a licensed physician performs or supervises exams and procedures.
• Give complete information to the examining physician including:
– A copy of this section.
– A description of the employee's duties that relate to hazardous substance exposure.
– The hazardous substance exposure levels anticipated for the employee.
– A description of the personal protective equipment (PPE) the employee could use.
– Information available from previous medical examinations.
– The medical evaluation information required by chapter 296-307 WAC, Part Y-5, Respirators.
• Medical exams must include, at a minimum:
– A medical history.
– A work history (or updated history if on file).
– A special emphasis on:
■ Assessment of symptoms related to handling hazardous substances.
■ Health hazards.
■ Evaluation of fitness for duty (including the ability to wear any personal protective equipment (PPE) or other conditions that may be expected at the workplace).
– Other content as determined by the examining physician.
Note:
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 web site: http://www.osha.gov).
You must:
(2) Obtain the physician's written opinion and give a copy to the employee that includes:
• A statement of whether or not medical conditions were found which would increase the employee's risk for impairment during emergency response work or respirator use.
– Do not include specific findings or diagnoses unrelated to occupational exposures.
• Limitations recommended to the employee's assigned work, if any.
• Exam and test results if the employee requests this information.
• A statement that affirms the employee has been confidentially informed of medical exam results (including medical conditions requiring follow-up).
Table 7
Medical Surveillance for Employee Categories
If the employee is covered by this section 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),
or
• 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.
*Note:
A medical evaluation for respirator use is required by chapter 296-307 WAC, Part Y-5, Respiratory protection, for those employees who have not been cleared for respirator use during medical surveillance activities.
Table 8
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.
– Injury.
– 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.
[Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. WSR 05-01-166, § 296-307-70420, filed 12/21/04, effective 4/2/05.]
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