Asbestos medical surveillance

This training must include topics specified by the OSHA rules. If an employee is exposed at or above the action level for a period of 30 days or more in a calendar year, medical surveillance is required according to the OSHA construction industry asbestos standard. 

Employees exposed to asbestos concentrations in excess of the action level shall be medically examined and the records kept for at least 30 years after the date of the last entry. The affected employees must be kept under medical surveillance by an Employment Medical Adviser or appointed doctor. The medical surveillance shall include a medical examination incorporating a specific examination of the chest which should have occurred not more than two years before the beginning of the exposure and thereafter at intervals not exceeding two years. Certificates of examination shall be kept for four years and a copy shall be given to the employee. 

Appendix H to 1926.1101—Substance technical information for asbestos. Non-mandatory. 49 Appendix I to 1926.1101—Medical Surveillance Guidelines For Asbestos, Non-Mandatory. 50 Appendix J to 1926.1101—Smoking cessation program information for asbestos—non-mandatory. 52... 

The employer is required to institute a medical surveillance program for all employees who are or will be exposed to asbestos at or above the permissible exposure limit (0.1 fiber per cubic centimeter of air). All examinations and procedures must be performed by or under the supervision of a licensed physician, at a reasonable time and place, and at no cost to the employee. 

For plumbers and roofers who use lead in their work, medical surveillance by a doctor will be required if exposure is significarrt and the surveillance will include blood lead tests. Similarly workers who come into contact with asbestos will require medical surveillance as described later in this chapter. 

Therefore, compliance with Regulations 8 (licence), 9 (notification), 15(1) (emergency arrangements), 18(1)(a) (designated areas) and 22 (health records and medical surveillance) is not required in such circumstances. Those other Regulations which apply to all work with asbestos must be observed. 

In addition to the early PELs, OSHA published expanded standards for fourteen substances in 1974. Included were asbestos and several carcinogens, such as benzidine, beta-naphthylamine and ethylenimine. These standards define requirements for workplace monitoring, training, labeling, medical surveillance, respiratory protection, and recordkeeping. Expanded standards have since been published for several additional chemicals, including benzene, ethylene oxide and formaldehyde. The standard for asbestos has been updated to address the carcinogenicity of that compound. 

All chlor-alkali producers should have a surveillance and monitoring program. Given the long latency period of asbestos-related diseases, employers should retain monitoring and medical records for longer than normal periods. The tabulation below shows the normal lag after the first exposure for death rates to become mathematically significant and the number of years required for death rates to reach their peaks. 

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