Generally, affected employees undergo a work history, a medical history, and a medical examination by a licensed physician; these elements are used to establish a baseline of the employees’ health and then used to monitor their future health as it relates to their potential occupational exposures to hazardous agents.
Medical surveillance examinations for employees covered under this standard must be provided at no cost to the employee and conducted:
Prior to assignment
At least once every 12 months unless the examining physician believes that a longer interval is appropriate given the exposure scenario. However, no interval between examinations shall exceed 24 months.
At termination of employment or reassignment to a non-covered position if the employee has not had an examination within the last six months.
Medical surveillance is the cornerstone of protection of hazardous waste workers. Prior exposure histories and evidence of previous effects from chemical exposures must be considered in recommending any limitations that should be placed on the employee. The physical examination must include an evaluation of the workers ability to wear respiratory protection and other personal protective equipment under the physical conditions of wear and exposure.
There is no compelling evidence to suggest that exhaustive diagnostic tests are indicated unless specific chemical exposures are expected or known. Diagnostic tests should be targeted to the specific exposure in accordance with the accepted principles of medical surveillance. Exercise electrocardiography and chest x-rays should be performed only for specific indications.
The examining physician shall provide a copy of a written opinion to the employer stating any detected medical conditions that would place the employee at increased risk of material impairment of the employee's health from performing the duties of a hazardous waste worker.
This opinion shall include any restrictions or limitations recommended for the employee as to the wearing of personal protective equipment or performance of HAZMAT duties. The employer must provide a copy of this written opinion to the employee. The results of the medical examination and tests shall be made available if requested by the employee.